prevalence of nosocomial infections and antibiotics susceptibility profile of bacteria isolates in

234 Pages·2010·1.3 MB·English

PREVALENCE OF NOSOCOMIAL INFECTIONS AND
ANTIBIOTICS SUSCEPTIBILITY PROFILE OF BACTERIA
ISOLATES IN SOME HOSPITALS IN ILORIN, NIGERIA

BY

RAZAQ FUNSHO ATATA
B.Sc (Microbiology), BUK; M.Sc (Microbiology), ILORIN.
Ph.D/Pharm.Sc/24906/2000-2001.

AUGUST, 2008
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PREVALENCE OF NOSOCOMIAL INFECTIONS AND
ANTIBIOTICS SUSCEPTIBILITY PROFILE OF BACTERIA
ISOLATES IN SOME HOSPITALS IN ILORIN, NIGERIA

BY

RAZAQ FUNSHO ATATA
B.Sc. (Microbiology), BUK; M.Sc. (Microbiology), ILORIN
Ph.D/Pharm.Sc/24906/2000-2001

A THESIS SUBMITTED TO THE POSTGRADUATE SCHOOL, AHMADU BELLO
UNIVERSITY, ZARIA, IN PARTIAL FULFILMENT OF THE REQUIRMENT FOR
THE AWARD OF DOCTOR OF PHILOSOPHY IN PHARMACEUTICAL
MICROBIOLOGY.

DEPARTMENT OF PHARMACEUTICS AND PHARMACEUTICAL
MICROBIOLOGY, FACULTY OF PHARMACEUTICAL SCIENCES, AHMADU
BELLO UNIVERSITY, ZARIA, NIGERIA

AUGUST, 2008

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DECLARATION

I hereby declare that the work reported in this thesis was carried out by me under the
supervision of Prof. Y.K.E. Ibrahim and Prof. P.F. Olurinola in the Department of
Pharmaceutics and Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences,
Ahmadu Bello University Zaria.
The work of other investigators referred to were appropriately acknowledged. I declare
that no part of this dissertation has been submitted elsewhere for the purpose of a degree.

R.F. Atata
Department of Pharmaceutics and Pharmaceutical Microbiology,
Faculty of Pharmaceutical Sciences,
Ahmadu Bello University, Zaria, Nigeria

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CERTIFICATION
This thesis entitled: PREVALENCE OF NOSOCOMIAL INFECTIONS AND
ANTIBIOTICS SUSCEPTIBILITY PROFILE OF BACTERIAL ISOLATES IN SOME
HOSPITALS IN ILORIN, NIGERIA by RAZAQ FUNSHO ATATA meets the
regulations governing the award of the degree of Doctor of Philosophy (Pharmaceutical
Microbiology), Ahmadu Bello University, Zaria, Nigeria and approved for its
contributions to knowledge and literary presentation.

______________________________
_____________
External Examiner Date
Prof. J.O.Akerele
B.Pharm, M.Sc Pharm Micro, PhD (UNIBEN)
Faculty of Pharm Sciences,
University of Benin, Benin City, Nigeria.

______________________________ _____________
Internal Examiner Date
Prof. Y.K.E. Ibrahim
B. Sc. Pharm. (ABU), M. Sc Pharmaceutics (ABU), Dr. Sc. hum (Heidelberg)
Department of Pharmaceutics and Pharmaceutical Microbiology
Ahmadu Bello University, Nigeria

_______________________________ ___________
Internal Examiner Date
Prof. P.F. Olurinola
B. Sc Pharm. (ABU), PhD (Bradford), FPSN
Department of Pharmaceutics and Pharmaceutical Microbiology
Ahmadu Bello University, Zaria, Nigeria

___________________________________ _____________
Head of Department, Date
Dr. (Mrs). T. S. Allagah
B.Sc Pharm Sc(ABU), M.Sc Pharm (London), PhD (ABU).
Department of Pharmaceutics and Pharm Microbiology,
Faculty of Pharmaceutical Sciences,
Ahmadu Bello University, Zaria-nigeria.

___________________________ _____________
Dean Postgraduate School Date
Prof. S.A. Nkom
B.Sc, M. Sc, PhD Sociology
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COPYRIGHT STATEMENT

Copyright © 2008 RAZAQ FUNSHO ATATA
All right reserved. This copy of the thesis has been supplied on condition that anyone who
consults it recognizes that its copyright rest with its author and that no portion of this
thesis may be used or published without the written permission of the author.

R.F. ATATA
Department Of Pharmaceutics and Pharmaceutical Microbiology
Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria

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DEDICATION

This work is dedicated to my late father, Mallam Abdul-Kareem Ishola Atata, who though
did not have western education, struggled hard against all odds and gave me the best of
education available, but could not live long enough to reap the fruit of his labour. And
also to Prof. Shuaib Oba Abdulraheem (Former Vice Chancellor, University of Ilorin) who
gave me the courage to take career in Microbiology at my undergraduate level and made
me see the prospect in the programme which I had once thought was not good enough for
me and contemplated withdrawal. He said to me “Excel in the course and see the reward of
excellence” today, I am happy being a Pharmaceutical Microbiologist.
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ACKNOWLEDGEMENT

I thank Almighty Allah for giving me life, strength and wisdom to undergo the programme
and for His Guide and Guard throughout my life.
My sincere gratitude goes to my supervisor, Prof. YKE Ibrahim who did not only stand as
my supervisor, but also as my father as he was always ready to bail me out any time,
especially when I am in financial crisis. May Allah continue to endow him with wisdom,
and may his children prosper and greater than he is. May Allah continue to shower His
blessing on him both in this world and in the here after.
My thanks also go to my second supervisor Prof. P.F. Olurinola, for his untiring advice
and constant guidance, May God in His infinite mercy continue to shower His blessings on
him and his entire family. I also appreciate Dr. Akanbi II, A.A. who stood for me as a
consultant to over see my work within the University of Ilorin Teaching hospital and with
patients. My gratitude also goes to Dr. Adigun, I.A., Dr. Yusuf, I.F. Dr. Abdul, I.F. and
Mrs. Oshodi (Senior Nursing Officer Theater) who gave me free access to the theater in all
their surgical operations with their patients during this research work. My unquantifiable
gratitude also goes to Prof. Hassan Saliu who acted as God sent at the most critical period
of this work, by given necessary moral and financial support when it becomes necessary.
May Allah be with him and his entire family. I must not forget to thank Prof. S.A
Abdulkareem and Prof. I.O. Oloyede (DVC Amin) who created way out of my financial
problem at a stage during this work.
My gratitude also goes to all staff of Medical microbiology Lab. Of UITH, particularly
Mr. Afolabi, Mrs. Gbenle, and Pastor. I can not forget the assistance of infection control
dept. most especially Mrs. Naa-Allah, Mrs. Akeju and entire members of infection control
team of UITH.A big thank you also to all staff of genetic engineering and biotechnology
Lab.of Nigerian Institute for Medical Research (NIMR-Lagos), especially, Dr Mrs. Smith,
Mr. Omonigbeyin, Mrs. Googluck, Mrs. Fowora Nike, Mr. Moses. My appreciation also
goes to Mallam Alfanla Mansur who always give me words of encouragement any time I
get despaired and take good care of my family any time am a away in the course of this
programme, Brother Baqi Jimoh for his encouragement and unquantifiable assistance.
May Allah be with you all. I thank all staff of Microbiology, Plant Biology and Zoology
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dept. of Unilorin, especially Dr. A. sani, Dr. GP Oyeyiola, Prof. AB Olayemi, Dr. OT
Mustapha, Prof. Morakinyo, Prof. Etejere, Dr. Amadi and Prof. Omotosho. For their moral
support. I must specially thank my friends especially Dr. M.S. Ajao, Barrister Kayode
Adams, Muritala Omotosho for their unimaginable moral and financial support.
Finally, I thank my mother for her constant prayers for my success throughout this
programme may Allah give her a long life in abundant of health to enjoy the fruits of her
labour. My wife Mrs. Wasilat Aduke. Atata, my children, Miss Bashirat Atata, Raheemat
Atata, Taiye and Kehinde (Boys) Atata, Taiye and Kehinde (Girls) Atata, for their
supports, patience, endurance and some unintentional pains they must have received as a
result this programme, I pray that Allah will give us long life and good health to reap the
fruits of our labour. To my brothers and sisters, Alh. Afusat Ayilara, Momy Biola Katibi,
Kehinde Atata, Idowu and Fatai Atata, I say thank you so much for your supports. Jamila
Abdulhameed I appreciate your supportive roles, May Allah see you through your
programme too.
I thank every other person who has contributed to the success of this programme who I
could not mention for limited space. May Allah be with you.

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TABLE OF CONTENTS
Title page - - - - - - - - i-ii
Declaration - - - - - - - - iii
Certification - - - - - - - - iv
Copyright statement - - - - - - - v
Dedication - - - - - - - - vi
Acknowledgement - - - - - - - - vii-viii
Table of contents - - - - - - - - ix-xiii
List of table - - - - - - - - xiiv-xvii
List of fugues - - - - - - - - xviii
List of Plates - - - - - - - - xix
Definition of terms - - - - - - - - xx
Abstract - - - - - - - - xxi-xxiii
CHAPTER ONE
1.0 Introduction - - - - - - - - 1
1.1 General Introduction - - - - - - - 1-2
1.2 History of nosocomial infections - - - - - 2-5
1.3 Factors influencing the development of nosocomial infections - 5-6
1.3.1 Microbial agents - - - - - - - 5-6
1.3.2 Patients’ susceptibility - - - - - - 6-7
1.3.3 Environmental factors - - - - - - 7-8
1.3.4 Bacterial resistance - - - - - - - 8-9
1.4 Statement of research problem - - - - - 9
1.5 Justification - - - - - - - 9-10
1.6 objective of the study - - - - - - 10
1.6.1 Objective approach - - - - - - - 8
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1.6.2 modalities - - - - - - - 11-12
1.7 Expected outcome of the study - - - - - 12-13

CHAPTER TWO
2.0 Literature review - - - - - - - 14
2.1 Nosocomial pathogens - - - - - - 14-15
2.2 types of nosocomial sites infections - - - - - 15
2.2.1 Surgical site of nosocomial infection - - - - 16-18
2.2.2 Urinary tract nosocomial infection - - - - - 19-26
2.3 Antibiotics and Nosocomial infection - - - - 26-28
2.4 Hospital bacterial and antibiotics resistance - - - - 28-30
2.5 Antibiotic resistance in specific bacteria - - - - 30
2.5.1 Enterobacteriaceae - - - - - - - 30-31
2.5.2 Pseudomonas aeruginosa - - - - - - 31-32
2.5.3 Staphylococcus aureus - - - - - - 32-33
2.5.4 Coagulase negative staphylococcus - - - - - 33-34
2.5.5 Enterococcus - - - - - - - 34-35
2.6 Commonly prescribed antibiotics and their mode of action & spectrum - 35
2.6.1 Penicillins - - - - - - - - 35-37
2.6.2 Cephalosporins - - - - - - - - 38-41
2.6.3 Monobactam - - - - - - - - 41
2.6.3.1 Aztreonam - - - - - - - - 41-42
2.6.4.2 Carbapeneum - - - - - - - - 42-43
2.6.5 β-lactamase inhibitors - - - - - - - 44
(a) Clavulanic acid - - - - - - - 44
(b) Sulbactam - - - - - - - - 44-45
2.6.6 Aminoglycosides - - - - - - - 45-48
2.6.7 Quinolones - - - - - - - - 48-50
2.6.8 Tetracyclines - - - - - - - - 50-51
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