Pattern of Uropathogens and Antibiotics Susceptibility in a Tertiary Hospital in North-Western Nigeria

Background: A uropathogen is a microorganism capable of causing urogenital tract infection (UGI). The most common uropathogens are Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Klebsiella pneumonia. They lead to UGI in patients with urinary tract obstruction, indwelling catheter/stent, elderly and patients with immunosuppression. There is increasing resistance to commonly used antibiotics due to empirical misuse of antibiotics The objective of this study is to document pattern of uropathogen and their antibiotics susceptibility in our hospital. Materials and methods: This is a retrospective study of consecutive urological patients with features of urinary tract infection (UTI) in our hospital from June 2017 to June 2018. Data was collected using a semi-structured proforma and analysed using SPSS version 20.0 for windows. Results were reported in percentages and mean ± standard deviation. Results: There were 126

andro-test and Semen Self-Exam: their importance in prevention and in the diagnostic process

The andro-test is the only semen analysis which describes the health condition of the male genital tract and the only one qualified for diagnostic purposes. The physiological values defined are used to evaluate the relative risk mainly of having a urogenital tract infection. This study assesses the importance of the andro-test and of the Semen Self-Exam in the preventive checkup of men and in the andrological diagnostic process. It is proven that in almost 9 out of 10 cases (87,68%), if at least one of the semen parameters is outside the physiological values, a microbe is detected in the semen sample in exam. Inversely, it is also proven that in 98,76% of the samples where a microbe was detected, at least one of the parameters of the andro-test was outside the physiological values.

P4779High facility preference for rivaroxaban in atrial fibrillation increases risk of major bleeding compared to facility preference for apixaban

Background No randomized trial has compared efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF). Previous real-world comparisons could be biased by patient characteristics of importance for treatment selection, but instrumental variables could potentially account for measured and unmeasured confounders. Purpose To compare efficacy and safety of rivaroxaban and apixaban using facility preference for type of NOAC as instrumental variable. Methods AF patients started on apixaban or rivaroxaban were identified using nationwide registries. We categorized patients according to facility preference for type of NOAC, measured as percentage of the prior 20 AF patients started on rivaroxaban in the same facility. Occurrence of stroke/thromboembolism (TE), major bleeding, myocardial infarction and all-cause mortality during two years of follow-up were investigated using adjusted Cox regressions. To further examine general frailty according to facility preferences we also investigated occurrence of cancer, urogenital tract infection, dehydration and fracture. Results We analyzed 6264 AF patients initiated on rivaroxaban or apixaban. Compared with patients treated in facilities that used rivaroxaban in 0–20% of cases, the adjusted hazard ratio for bleeding was 1.05 when treated in a facility with 25–40% use; 1.40 with 45–60% use; 1.50 with 65–80% use; and 1.81 for 85–100% use (Ptrend=0.002). Higher facility level use of rivaroxaban was not associated with increased risk of stroke/TE (Ptrend=0.06), myocardial infarction (Ptrend=0.87) or all-cause mortality (Ptrend=0.91), and there was no association between facility preference for rivaroxaban and risk of cancer (Ptrend=0.83), urogenital tract infection (Ptrend=0.49), dehydration (Ptrend=0.91) or fracture (Ptrend=0.47). Characteristics by facility preference Percent of previous AF patients from facility started on rivaroxaban P for trend 0–20% 25–40% 45–60% 65–80% 85–100% No. of patients 1406 1421 1551 930 956 Received rivaroxaban, (%) 279, (19.8) 499, (35.1) 711, (45.8) 632, (68.0) 774, (81.0) <0.001 Standard dose, (%) 1216, (86.5) 1232, (86.7%) 1366, (88.1%) 793, (85.3%) 824, (86.2%) 0.62 Median age, (interquartile range) 70, (63.3–74) 69, (63–74) 70, (64–74) 70, (64–75) 70, (63–75) 0.11 Below median income, (%) 740, (52.6) 699, (49.2) 764, (49.3) 458, (49.3) 471, (49.3) 0.31 Prior stroke, (%) 99, (7.0) 115, (8.1) 134, (8.6) 69, (7.4) 74, (7.7) 0.56 Prior bleeding, (%) 136, (9.7) 141, (9.9) 163, (10.5) 91, (9.8) 97, (10.1) 0.51 Antiplatelet therapy, (%) 445, (31.7) 465, (32.7) 491, (31.7) 303, (32.6) 317, (33.2) 0.49 Rate of events according to instrument Conclusion High facility preference for rivaroxaban increases risk of major bleeding compared to facility preference for apixaban. Acknowledgement/Funding This study was funded by an unrestricted grant from the Capital Region of Denmark, Foundation for Health Research.

Omental actinomycosis imitating a foreign body infection

Actinomycosis is a rare chronic disease caused by a group of anaerobic Gram-positive bacteria that colonize the mouth, colon, and urogenital tract. Infection involving the cervicofacial area is the most common clinical presentation, followed by that of the pelvic and thoracic areas. The preoperative diagnosis of abdominal actinomycosis is difficult because the condition can be easily confused with malignancy, tuberculosis, or other inflammatory diseases. We report a case of omental actinomycosis mimicking a foreign body. Actinomycosis is diagnosed based on the histopathologic demonstration of sulfur granules in a tissue or organ that was surgically removed. Following confirmative diagnosis by surgical intervention, the patient was treated with oral doxycycline 100 mg twice daily for 6 months. A follow-up abdominopelvic computed tomography after 16 months showed no evidence of inflammation. Moreover, the patient no longer had disease-associated symptoms and exhibited normal laboratory findings.