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Objective: To determine the pattern of orthopaedic wound infection and the influence of environmental factors on the distribution of the etiologic bacterial agents., Design: A prospective observational study., Setting: Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria., Subjects: Sixty patients with orthopaedic wound infections and orthopaedic ward environment., Results: Thirty- nine males (mean age 33.31+2SD) and 21 females (mean age 27.47 + 2SD) with orthopaedic wounds. Three hundred and ten bacteria (190 from patients and 120 from ward environment) were isolated. The pattern of bacterial isolates from patients' wounds was different from that of the airborne bacterial isolates irrespective of the length of stay on the ward. There was a significant difference in the distribution and resistance pattern of bacterial isolates from the patient's wounds and ward environment., Conclusion: There is a high incidence of antibiotic resistance of bacterial isolates from samples cultured from patients compared with isolates from ward environment at this centre. The extensive use of pre-operative prophylactic and post-surgical antibiotics in various combinations at this centre needs to be re-examined to reduce the preponderance of antibiotic resistance.

Background: The acquired immunodeficiency syndrome (AIDS) is of major public health concern worldwide more so in sub-Saharan Africa where there is an upsurge in the incidence of the disease. Reports from developed countries have shown that a close link exists between the human immunodeficiency virus (HIV) and pulmonary tuberculosis. No such study has ever been carried out in Ile-Ife, Nigeria., Objective: The study was designed to determine the prevalence of HIV infection among randomly selected tuberculosis patients seen in a Nigerian chest clinic using third generation ELISA kits that detect HIV-1 and HIV-2 strains., Results: Of the 79 subjects with confirmed active tuberculosis, 12.7% tested positive for HIV antibodies compared with 2.0% of subjects without tuberculosis designated as the control group--a value that is statistically significant (p < 0.05). Farmers, artisans and students contributed a large proportion of the seropositive sera. Although the seroprevalence rate of 12.7% is low compared with the rates from eastern and southern African countries, this value was threefold higher than 5.2% value reported in metropolitan Lagos--suggesting concern about the spread of HIV in a semi-urban centre such as Ile-Ife., Conclusion: This study suggests that a close link exists between active tuberculosis and HIV infection in Ile-Ife, Nigeria which underscores the urgent need to monitor tuberculosis patients as the increase in the rate of new cases may indicate the spread of HIV infection. The study also recommends that an aggressive public awareness programme be undertaken to enlighten communities about the risk of TB/HIV infection.

The pattern and frequency of bacterial isolates cultured from 687 clinical specimens from four University teaching hospitals in South Western Nigeria were determined. A total of 707 bacterial isolates were cultured from 18 different clinical sources giving an average of 1.03 bacteria per sample identified in this collection. Of these, gram negative rods constituted 78.1% and the rest were staphylococci. The most common organism isolated in urine samples was E. coli (32.1%) whilst S. aureus (28.9%) was the most frequently isolated organism from wounds. An interesting observation was the significant occurrence of Aeromonas hydrophilia and Klebsiella pneumoniae in urine samples.

Clinical laboratory records and case files of 1,038 cases of urinary tract infections (UTI) were examined for the spectrum of bacterial and candida isolates for age and sex distribution of the UTI cases and antibiotic susceptibility pattern of isolates. The results show that 867 (83.5%) of the cases were aged 21 years and above, of which 81.3% in that age group were females. While only 20.7% of the cases were males, 74.0% of those in that category were also 21 years and older. Eleven organisms were isolated, with E. coli, Klebsiella spp and Staphylococcus aureus respectively representing 36.1%, 22.8% and 15.4% of the total bacterial isolates. The prevalence of S. aureus isolates in cases of UTI in this centre suggests the increasing role of these microorganisms in the aetiology of urinary tract infections in Nigeria.

The incidence of postsurgical clean wound infection in 101 consecutive operations was 1.98%. Staphylococci were the predominant bacteria cultured from the anterior nares of the patients and attending surgical personnel--and were found to colonize the wounds. The nasal carriage rates of Staphylococcus aureus amongst the patients and surgical staff were 12.1% and 17.% respectively. Group III and non-typeable (NT) S. aureus strains accounted for about 65% of S. aureus isolates cultured from the anterior nares. A low incidence of nasal carriage of S. aureus isolates correlated with low incidence of wound sepsis. The operating room air seemed considerably contaminated but this did not reflect in high incidence of postsurgical wound sepsis. Our results suggest patients microflora and operating room air were the major sources of intra-operative bacterial colonization of wound at this centre.

Of the nine hundred and twenty patients clinically diagnosed of having septicaemia at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between 1980-1987, 233 (25.3%) had blood samples positive by culture. Thirteen different bacterial species were identified from positive blood cultures of which six predominated: Staphylococcus aureus (30.5%), Coliforms (17.6%), Klebsiella spp. (14.2%), Pseudomonas aeruginosa (9.2%), Escherichia coli (7.9%) and Salmonella typhi (5.9%). The in vitro antibiotic, disc sensitivity pattern of the isolates showed they were relatively resistant to ampicillin and penicillin G but comparatively sensitive to antibiotics commonly used in the treatment of infections caused by these organisms. Septicaemia cases were recorded in all age groups but incidence in females was slightly but not significantly higher than in males (p less than 0.05). The study reveals the predominance of S. aureus strains in case of septicaemia in Nigeria.