African Journals Online
Journal of the Nigerian Association of Infection Control

Volume 1 Number 1, 1998
Abstracts

The Role of Antiseptic in Infection Control.

Before the introduction of antibiotics, antiseptics were the only method of infection control. The emergence of organisms that are resistant to antibiotics has called for the increased use of
relevant antiseptics in some cases. Antiseptics, like antibiotics, need to be tested in order to determine their antimicrobial activity against a range of organisms. The suspension test, an in vitro method, has proved that many resistant bacteria, such as methicillin- resistant Staphylococcus aureus and vancomycin- resistant Enterococcus faecalis, are killed within 5 minutes by antiseptics such as Dettol and Beta dine. The more relevant surface and skin
tests proved the good activity of some antiseptics, such as Dettol, against Staphylococcus aureus and other organisms such as Candida albicans. Virucidal tests have also shown that Dettol, Hibitane and Betadine were all effective against the human immunodeficiency virus after 1 minute and that Dettol, Savlon and Dettol Hospital Concentrate killed Herpes simplex virus Type - 1 after 5 minutes. It is possible that an increased use of antiseptics, both in the
environment and on the skin, may help to limit the transmission of some infectious disease, and may help to alleviate the problem of antibiotic resistance.


A Review of Nosocomial Infection at the Lagos university Teaching Hospital: Problems and Strategies for Improvement.

The infection control program of the Lagos Universityteaching hospital was started in 1974 with an Infection Control team reporting to an Infection Control Committee. There is currently no functioning Infection Control Committee. An analysis of data of a hospital- wide surveillance obtained between November 1993 - November 1996 is presented, highlighting the problems associated with maintaining an effective infection control Programme in a developing economy and discussing possible solutions. The monthly prevalence ranged between 0.11 - 8.1% for nosocomial infections with a 14:1 ratio of gram- negative organism. Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli
were the most common pathogens accounting for 75% of all organisms isolated. The prevalence of Staphylococcus aureus was only 4.8% of all isolates and that of hospital - acquired Plasmodium falciparum was 6.2%. urinary tract infections were the most
common nosocomial infections and were often catheter related. These were followed by wound infections of which 55.2%were surgical site infections. Nosocomial respiratory tract and bloodstream infections appear uncommon. Lack of an Infection Control Committee, lack
of an effective antibiotic policy, poor funding, inadequate and ageing infrastructure including poor water supply and a lack of awareness of the cost benefits of an efficient Programme have been identified as some of the problems mitigating against an effective infection control Programme in the hospital.

Key words: Nosocomial, Surveillance, Problems.

Experience with Hospital- Acquired Infections in Pediatric Wards of the Lagos University Teaching Hospital.

From January 1994 to December 1995, patients in the out -born (NNU) neonatal wards, lying in wards (C2/C3), general pediatrics wards (D2/D3) and the pediatric surgical ward (E4) of the Lagos University Hospital were prospectively monitored for nosocomial infections (NI) using the surveillance techniques of the Centers for Disease Control National Nosocomial
Infections Surveillance system. Of a total of 4,981 admissions, 589 patients had 739
NI, representing an overall NI patients rate of 14.8%. Paediatrics surgical patients had the highest overall NI patient rate (45.8%), ward D1 came second with 33.4%, followed by NNU (15.1%), then D2/D3 (5%) and lastly C2/C3 (1%). Mortality in patients without NI was 5.5%. Sixty- six patients (1.3%) who acquired NI subsequently died during hospitalization. However, only 40 of these deaths were causally associated with NI. Predominant NI sites included the surgical site (28.7%), bloodstream (24.1%), eye (12.2%), cutaneous (11.8%) and urinary tract (11.4%). When the NI was causally- related to death, bloodstream infection
(79.1%) predominated. The most frequently encountered nosocomial pathogens were Klebsiella pneumoniae (22%), Staphylococcus aureus (16.7%) and Pseudomonas
aeruginosa (11.9%). Intensification of infection control measures in peadiatrics wards of this hospital should be accorded priority consideration.

Potency Studies of live- Attenuated Viral Vaccines Administered in Lagos Metropolis, Nigeria.

We critically carried out a potency study in 1992 and 1997 on measles and poliovirus vaccines administered at five different vaccination centers in the metropolitan Lagos, Nigeria. using WHO guidelines on titration of live- viral vaccines, our results revealed that only 6 (16.7%) of 36 measles vaccine (MV) vials and 11 (24.4%) of the 45 trivalent oral
poliovirus vaccine (TOPV) vials titrated met the WHO recommended human dose. We observed that 14 (38.9%) of the total 45 polio vaccine vials titrated from different vaccination centers for both 1992 and 1997 were found to be expired or about 2 - 3 weeks to their
expiry dates. Moreover, while noting the potency of the reference vaccine obtained from the national cold store to be adequate, it may not be improper to observe that the vaccines were also about 4 weeks to their expiry dates. It then suffice to say by our findings that, the inadequacies observed in our vaccines cold chains, poor vaccine handling, lack of
laboratory back - up services and the administration of these sub - potent and/or, impotent expired vaccines, will be a big clog in the wheel of Nigeria towards meeting the WHO deadline of disease eradication Programme particularly, the vaccine preventable ones like measles and polio, by the year 2000. We suggested however, that education of health
officers and/or, vaccinators on vaccine handling, subjection of imported vaccines to a thorough laboratory tests, discontinued distribution and non - administration of laboratory - certified expired vaccine to children are some but important remedies to the scourge of vaccine failure in Nigeria.

Key words: Potency, Viral Vaccine, Measles, Polio.