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- Southern African Journal of Epidemiology and Infection
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- Volume 26, Issue 2, 2011
Southern African Journal of Epidemiology and Infection - Volume 26, Issue 2, 2011
Volume 26, Issue 2, 2011
Source: Southern African Journal of Epidemiology and Infection 26, pp 47 –49 (2011)More Less
The beginning of the second millennium heralded molecular-based technologies as potent diagnostic tools for the diagnosis of infectious diseases. In the field of tuberculosis (TB), exciting new nucleic acid amplification techniques have been developed, as well as new ways of detecting amplified products (amplicons).
National surveillance of private sector respiratory tract pathogens in South Africa, 2010 : surveillance dataSource: Southern African Journal of Epidemiology and Infection 26, pp 51 –53 (2011)More Less
Antibiotics are prescribed more frequently for community-acquired respiratory tract infections than any other infection. However, antibiotic resistance is an increasing problem worldwide. When selecting an antimicrobial agent for empirical therapy, it is important to know the susceptibility patterns of the bacteria that frequently cause these infections in a particular geographical region.
Author A. WhitelawSource: Southern African Journal of Epidemiology and Infection 26, pp 55 –59 (2011)More Less
The tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics pose huge challenges to health services in South Africa. People with HIV infection are at significantly higher risk of both TB infection and progression to active disease. There is, thus, a need to implement adequate infection control policies and processes to reduce transmission of TB from patient to patient, from healthcare worker to patient, and from patient to healthcare worker. The purpose of this article is to review what is known about the risks of TB transmission particularly in the setting of HIV co-infection, and to describe possible infection control interventions.
Source: Southern African Journal of Epidemiology and Infection 26, pp 60 –64 (2011)More Less
This overview describes the relationship between Staphylococcus aureus and its human host, as a part of the normal colonising flora and as an aggressive pathogen. The history of antimicrobial usage and the development of resistance in this organism are related to new challenges, including the epidemiology of resistant strains, the emergence of community-acquired methicillin-resistant strains and the emergence of decreased susceptibility to the glycopeptides. Finally, considerations when treating infection caused by S. aureus are summarised and treatment guidance is provided.
Source: Southern African Journal of Epidemiology and Infection 26, pp 66 –70 (2011)More Less
A 34-year-old pilot flying for an exploration company in arid Chad was reported as being ''very ill with malaria.'' He was jaundiced in spite of having been given a quinine drip three times a day. The drip was administered by a heroic local doctor who leopard-crawled into the exploration camp under threat of rebel fire three times a day. The patient had not taken malaria prophylaxis and no laboratory confirmation of the diagnosis had been made. The camp was a seven-hour arduous drive from N'djamena and the pilot was too ill to fly himself out.
When the pilot finally made it to Johannesburg, there was no laboratory evidence of malaria whatsoever, but he had a markedly elevated hepatitis A IgM. He admitted to not having been vaccinated against hepatitis A prior to his departure.
A comparative in vitro microbiological evaluation of generic meropenem compounds against the innovator compound : original researchSource: Southern African Journal of Epidemiology and Infection 26, pp 73 –77 (2011)More Less
Background: Meropenem is a broad-spectrum carbapenem widely used in the treatment of critically ill patients. A generic meropenem product has recently become available in South Africa and we aimed to compare the generic product with the innovator product using established in vitro microbiological testing methods.
Method: Comparative minimum inhibitory concentrations (MICs) were determined for 115 clinically relevant isolates using the broth microdilution reference method. Comparative analysis of MIC was done using categorical and essential agreement. A subset of isolates was evaluated using minimum bactericidal concentration (MBC) testing.
Results: The overall essential agreement exceeded the international standard of > 90%. A single major error and six minor errors were detected in 230 comparative MICs. For the 55 Enterobacteriaceae isolates tested, the MIC50 and MIC90 were 0.03 μg/ml and 0.06 μg/ml respectively, with no difference between extended-spectrum β-lactamase producers (ESBL) and non-ESBL isolates. Bactericidal activity was demonstrated for both generic and innovator products in all isolates tested. For eight of the 11 isolates, the MBC was only twice the MIC.
Conclusion: Reference method MIC and MBC testing of a large sample of clinically relevant microorganisms against meropenem has demonstrated comparable in vitro activity between the innovator and generic products. Low MICs and bactericidal activity at concentrations close to the MIC indicate that meropenem remains a useful agent in the treatment of infections caused by ESBL-producing Enterobacteriaceae.
Assessment of existing practices in the operating theatre in the Khartoum North Teaching Hospital, Sudan : original researchSource: Southern African Journal of Epidemiology and Infection 26, pp 79 –82 (2011)More Less
This study, assessing existing practices in the operating theatre regarding hand washing, disinfection and sterilisation, was conducted at Khartoum North Teaching Hospital. As far as we know, this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51% of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition, planning and organising training courses in infection control should be seen as a priority.
Source: Southern African Journal of Epidemiology and Infection 26, pp 83 –87 (2011)More Less
The aims of this study were to identify the demographic characteristics of injury victims and the types of injury cases seen and admitted for treatment in Khorixas District Hospital, Namibia. A descriptive retrospective survey of all injuries attended to and admitted in the hospital from January 2001 to December 2004 was done using document review of patients' medical records. A total of 331 injury cases (6.8% of all admissions) were admitted. The age group 20-29 years was the most commonly affected, with 18% injured. Injury was common among the males (76%). The unemployed constituted 36% of all the injuries, followed by children/infants (19%). Over two-thirds (68%) of the injuries were unintentional. Cuts and stabs were the most common (24%) type of injury among the injury cases admitted. Motor vehicle accidents accounted for 21% of all injuries admitted. Over a third (36%) of all the injuries were alcohol related. Farmers (11%) constitute the most affected group among the employed. Type of injury and occupation were significantly associated (χ2=107.879, p<0.001). Mass propagation of anti-violence education is needed to reduce the high rate of intentional injuries among the injuries such as cuts/stabs, assaults, human bite and gunshot injuries.
Pansinusitis in an HIV-infected patient due to Scedosporium apiospermum (Pseudallescheria boydii complex) : case reportSource: Southern African Journal of Epidemiology and Infection 26, pp 88 –89 (2011)More Less
Pseudallescheria boydii is a very rare cause of sinusitis but an increasingly recognised infection among HIV-infected patients. Its correct identification is vital as voriconazole, which has good in vitro activity against the fungus, has important interactions with antiretroviral drugs. We report the successful treatment of Scedosporium apiospermum pansinusitis, in an HIV-infected woman, which required alteration of antiretroviral therapy.
Cytomegalovirus pneumonia occuring soon after initiation of highly active antiretroviral therapy in an infant : case reportSource: Southern African Journal of Epidemiology and Infection 26, pp 90 –91 (2011)More Less
A two-month-old HIV-infected infant was ventilated for very severe Pneumocystis jiroveci pneumonia. After successful extubation, he was started on antiretroviral therapy. He developed a proven cytomegalovirus infection, localising as pneumonia. This required repeated ventilation. He was extubated after six weeks and completed 32 days of ganciclovir.