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Background Healthcare-associated infection (HAI) is a major challenge for patient safety worldwide, and is further complicated by antimicrobial resistance (AMR) due to excessive antimicrobial use in both humans and animals. Existing infection prevention and control (IPC) networks must be strengthened and adapted to better address the global challenges presented by emerging AMR. Methods In June 2017, 42 international experts convened in Geneva, Switzerland, to discuss two key areas for strengthening the global IPC network: 1) broadening collaboration in IPC; and 2) how to bring the fields IPC and AMR control together. Results The US Centers for Disease Prevention and Control, the European Centre for Disease Prevention and Control, and the World Health Organization (WHO) convened together with international experts to discuss collaboration and networks, demonstrating the participating organizations’ commitment to close collaboration in IPC. The challenge of emerging AMR can only be addressed by strengthening this collaboration across international organisations and between public health and academia. The WHO SAVE LIVES: Clean Your Hands initiative is an example of a successful collaboration between multiple global stakeholders including academia and international public health organisations; it can be used as a model. IPC-strategies are included within the four pillars to combat AMR: surveillance, IPC, antimicrobial and diagnostic stewardship, research and development. The prevention of transmission of multidrug-resistant microorganisms is a patient safety issue, and must be strengthened in the fight against AMR. Conclusions The working group determined that international organisations should take the lead in creating new networks, which will in turn attract academia and other stakeholders to join. At the same time, they should invest in bringing existing IPC and AMR networks under one umbrella. Transmission of multidrug-resistant microorganisms in hospitals and in the community threatens the success of antimicrobial stewardship programmes, and thus, research and development in IPC should be addressed as an enhanced global priority.

Akara results from frying of fermented batter which after frying gives a dome –like shape, it has a brown crust and burnt material at the edges. Information on the existence of a mechanical device with capability for frying akara and carrying out turning operations appears to be very scarce. An empirical analysis of the traditional akara frying process was carried out in order to solve the above problem. The effect of different batter concentration (11g/ml, 13g/ml and 17g/ml) and spoon diameter-depth ratio (3.4.4.0,4.2) on the physical characteristics, frying time and frying rate of akara was investigated. The physical characteristics which include crust thickness, level of shrinkage, oil consumption, akara weight, density, surface area and extent of burnt material formation. Data obtained were subjected to statistical analysis using Excel and SPSS. The results showed that crust thickness, level of shrinkage, oil consumption, and burnt material increased with increase in concentration, frying time, weight, density and surface area also increased with increase in concentration. The result also indicates that crust thickness, level of shrinkage, oil consumption, weight, density, surface area, burnt material, frying time, decreases with increase in spoon diameter-depth ratio. Statistical analysis of variance (ANOVA) showed that all the processing variation and their interaction had significant effects on the physical characteristics of akara at 1% of significance. The model yielded coefficients that enabled the akara physical characteristics to be predicted with high coefficient of determination.

Background The high burden of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) is partially due to excessive antimicrobial use both in human and animal medicine worldwide. How can technology help to overcome challenges in infection prevention and control (IPC) and to prevent HAI and emerging AMR? Methods In June 2017, 42 international experts convened in Geneva, Switzerland to discuss four potential domains of technology in IPC and AMR: 1) role and potential contribution of microbiome research; 2) whole genome sequencing; 3) effectiveness and benefit of antimicrobial environmental surfaces; and 4) future research in hand hygiene. Results Research on the microbiome could expand understanding of antimicrobial use and also the role of probiotics or even faecal transplantation for therapeutic purposes. Whole genome sequencing will provide new insights in modes of transmission of infectious diseases. Although it is a powerful tool for public health epidemiology, some challenges with interpretation and costs still need to be addressed. The effectiveness and cost-effectiveness of antimicrobially coated or treated environmental high-touch surfaces requires further research before they can be recommended for routine use. Hand hygiene implementation can be advanced, where technological enhancement of surveillance, technique and compliance are coupled with reminders for healthcare professionals. Conclusions The four domains of technological innovation contribute to the prevention of HAI and AMR at different levels. Microbiome research may offer innovative concepts for future prevention, whole genome sequencing could detect new modes of transmission and become an additional tool for effective public health epidemiology, antimicrobial surfaces might help to decrease the environment as source of transmission but continue to raise more questions than answers, and technological innovation may have a role in improving surveillance approaches and supporting best practice in hand hygiene.

Surgical site infection (SSI) rates in low- and middle-income countries (LMICs) range from 8 to 30% of procedures, making them the most frequent healthcare-acquired infection (HAI) with substantial morbidity, mortality, and economic impacts. Presented here is an approach to surgical site infection prevention based on surveillance and focused on five critical areas identified by international experts. These five areas include 1. Collecting valid, high-quality data; 2. Linking HAIs to economic incapacity, underscoring the need to prioritize infection prevention activities; 3. Implementing SSI surveillance within infection prevention and control (IPC) programs to enact structural changes, develop procedural skills, and alter healthcare worker behaviors; 4. Prioritizing IPC training for healthcare workers in LMICs to conduct broad-based surveillance and to develop and implement locally applicable IPC programs; and 5. Developing a highly accurate and objective international system for defining SSIs, which can be translated globally in a straightforward manner. Finally, we present a clear, unambiguous framework for successful SSI guideline implementation that supports developing sustainable IPC programs in LMICs. This entails 1. Identifying index operations for targeted surveillance; 2. Identifying IPC “champions” and empowering healthcare workers; 3. Using multimodal improvement measures; 4. Positioning hand hygiene programs as the basis for IPC initiatives; 5. Use of telecommunication devices for surveillance and healthcare outcome follow-ups. Additionally, special considerations for pediatric SSIs, antimicrobial resistance development, and antibiotic stewardship programs are addressed. © 2020

This study investigated the effects of physico-chemical properties of Yellow oleander (Thevetia peruviana) on quality of biodiesel. The seeds were processed and extraction of oil was carried out using solvent extraction method. Biodiesel was produced from the extracted oil using trans esterification process. Physical and chemical properties of Thevetia peruviana biodiesel were determined using the ASTM standard test procedures. Results showed that the biodiesel contained little sulphur (3.0 mg/kg) and exhibited a high cetane number of 55 that exceeded the standard limit of 47 and 51 prescribed for EN 14214 and EN 590 respectively, which is a good indication of fuel’s ignition and combustion quality. Kinematic viscosity of the biodiesel at 40°C was 4.81 mm2/s, which was within the range specified by EN 14214. The density at 15°C was found to be 0.89g/cm3which was well within the range specified by EN 14214. 0.16 mg/g of acid level was obtained for the bio-diesel, which conformed to the standard set by Calorific value of the biodiesel produced from Yellow oleander seed oil was obtained as40.42 kJ/g which indicated good fuel properties such as density, ignition quality, viscosity, cetane number, heating value and flash point. Carbon residue of the biodiesel was 0.14 mass %. Quality of the biodiesel produced conform to biodiesel and petroleum diesel standards of EN14214 and EN590 respectively.

Fish is a vital high quality protein necessary for growth and development. It is affected by biological and chemical substances that pollute the body of water and affects its growth during production. This often leads to the use of different antibiotic growth promoters which have residual effects on consumers of fish while sometimes continual or sub-optimal use leads to development of antibiotics resistant pathogens. This growing concern for antibiotic growth promoters in animal nutrition has elicited the need to search for phytobiotic growth promoting agents. Bitter leaf (Vernonia amygdalina) has been of use as antioxidant and growth promoter in man and some animals. The study examined the growth enhancing potential of Vernonia amygdalina leaf powder in Catfish (Clarias gariepinus) production. Two hundred and forty juvenile catfish were allotted to six treatment groups identified as A, B, C, D, E and F consisting of two replicates with twenty fishes per replicate in a Completely Randomized Design (CRD). Treatment A serve as the control, B was administered 1.5ml of known antibiotics (Florphenicol) and served as positive control while treatments C, D, E and F were administered 10, 20, 30, and 40g/15litres of water respectively for 3hours after which the water was changed. The fishes were fed 3% of their biomass twice daily 800-900 h and 1500-1600h with Durante feed containing 42% crude protein for the 8 weeks experimental period. Twenty fishes were selected per treatment and blood samples were collected by caudal vessels puncture into bijou bottles containing ethylene diamine tetracetic acid (EDTA) as anticoagulant. The result indicated that feed intake, condition factor, mean final weight, protein efficiency ratio and weight gain were significantly higher (p0.05), though it numerically increase with the treatments. Red blood cell (RBC) and haemoglobin (Hb) concentration were significantly higher (p

Background: The daily use of Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis reduces morbidity and mortality among patients infected with human immunodeficiency virus (HIV) but its impact on increasing antimicrobial resistance rates has been of public health concern, globally. This study investigated the effect of daily TMP-SMX prophylaxis on feacal carriage rates of resistant isolates of Escherichia coli in HIV-infected adult patients in Lagos.Methods: A total of 550 HIV-infected patients with CD4-cell counts of less than 350 cells/mm3 who were eligible for TMP-SMX prophylaxis and attending Lagos University Teaching Hospital, Lagos, Nigeria, were recruited for this study. Stool/rectal swab samples were aseptically collected from the patients and processed using standard methods for culture and sensitivity.Results: There was a baseline Trimethoprim-Sulfamethoxazole resistance rate of 54% which increased to 77.9% in first 3 months, rising to 96.1% by 6 months and all isolates were resistant by the 9th month. There was also evidence of cross-resistance to other antibiotics with significance in association with TMP-SMX resistance (p

Cryptosporidium is said to cause diarrhoea in HIV / AIDS patients. The study was done to determine the prevalence of cryptosporidiosis in Lagos. Stool samples were collected from 193 HIV positive and 200 HIV negative (control) patients presenting with diarrhoea at LUTH. The patient or a close relative filled a questionnaire covering demographic and other relevant information. Fresh stool specimens were processed using direct stool smear and formol-ether concentration methods. Permanently stained slides were prepared by Kinyoun acid-fast stain. Cryptosporidium was found in 36 (18.7%) of HIV positive patients and none in the control. More males than females were affected, 26 (24.8%) of 105 males as against 10 (11.8%) of 87 females. Isolation rates were highest in patients with CD4+ lymphocyte counts of 201-250 cells/ml, falling to zero in patients with CD4+ counts above 351cells/ml. Cryptosporidium is a relatively common cause of diarrhoea in HIV/AIDS patients. Keywords: Cryptosporidium, Prevalence, HIV/AIDS.NQJHM Vol. 16 (2) 2006: pp. 49-52

Blood culture was performed on 204 children (aged 1 day – 12 years) who presented at the University College Hospital (UCH) Ibadan, Nigeria, with fever. Eighty-four (41.3%) out of 204 blood cultures were positive. Staphylococcus aureus was the commonest bacterial agent isolated and accounted for (50%) of all the isolates. Klebsiella spp and Salmonella spp each accounted for 21.4% and 10.7% respectively. Other bacterial agents isolated included Escherichia coli, Enterobacter spp. Citrobacter spp. Pseudomonas aeruginosa, Streptococcus Pneumoniae and Serratia spp. Two of the children died in spite of early use of appropriate antibiotics as determined by antibiotic susceptibility testing. Phenotypic and molecualr investigation showed extended-spectrum β-lactamase (ESBL) producing K. pneumoniae to be implicated in the death of the children. Several other K. pneumoniae isolates recovered from blood samples expressed ESBLs and the isolates were shown by pulsed field gel electrophoresis of chromosomal DNA to be genetically unrelated. KEY WORDS: Klebsiella pneumoniae, septicaemic, ESBL. Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 79-84

Acinetobacter spp are well recognized as causes of nosocomial infections particularly in patients with immature or defective body defence system. Information concerning these organisms are lacking in this environment. For this reason the pattern of infection and the antimicrobial susceptibility profiles of these organisms isolated over a one-year period were studied. A total of 58 (3%) of the 2001 isolates from all clinical specimens received in the laboratory during the year were Acinetobacter spp. The 58 Acinetobacter spp constituted 5.5% of all 1051 NLF-GNB isolated, and caused 4.6% of all the 1261 nosocomial infections. Thirty-seven (63%) and 17 (30%) of the Acinetobacter isolates were from wound infections and UTI respectively. All the infections were nosocomially acquired and were associated with compromised host immunity, defective body defence, surgery or urinary catheterization; with Acinetobacter baumannii being the predominant species. There was an apparent male predominance over females by a ratio of 1. 9:1 in the infections, predominance over females by a ratio of One hundred percent and 96.6% of the isolates were susceptible to cefoperazone-sulbactam and travofloxacin respectively. Forty-five (77.6%) were susceptible to cefotaxime, 49 (84.5%) to ticarcillin-calvulanic acid and 41 (70.7%) to ciprofloxacin. Generally the Acinetobacter spp showed multiple resistance to the range of antibiotics tested. All the isolates produced beta-lactamase. Keywords: Acinetobacter, Epidermiology, Antimicrobial susceptibility. Résumé Les Acinetobacters spp sont bien reconnus commes les causes de infections nosocomiaux en particulier chez les patients avec le système de la defense du corps defectif ou immaturé. On manqué des informations adéquates concernant ces organisms dans cet environnement. A cause de cette raison, le modèle de l'infection et les profiles de la susceptibilité antimicrobien de ces organisms isolès au cours de la période d'une année ont été étudiés. Le nombre total de 58 soit 3% de 2001 isolès de tous les specimens cliniques recu dans le laboratoire Durant cette année étaient Acinetobacters spp. Tous les cas de 58 Acinetobacters spp avaient constitué 5,5% de tous les 1051 NLF-GNB isolès et ont cause 4,6% de tous 1261 cas des infections nosocomiales. Trente sept soit 63% et 17 soit 30% de cas des isolés Acinetobacters résultent des infections des blessures et de UTI respectivement. Toutes les infections sont acquises à travers la nosocomiale et elles avaient des rapports avec la faiblesse de l'immaturité de l'hóte, la defense du corps défectueux, la chirurgie ou la catechization urinaire, avec Acinetobacter baumannil qui était l'espèce le plus predominant. On avait note la predominance de male par rapport aux femmes dans la proportion 1:9:1 dans l'infection à partir de l'âge de 45 et au dessus en particulier. Cent pour cent et 96.6% des isolés étaient susceptibles au cefoperazone-sulbacta, et travofloxacine respectivement. Quarante cinq soit 84.5% au ampicilline-sulbacta, 34 soit 58.6% au ceftazidine, 38 soit 65.6% a l'acide ticareilline-clavulanie et 41 soit 70,7% au ciproflozacine. Dans l'ensemble, l'Acinetobacter spp. A indiqué une résistance multiple au champs des épreuves antibiotiques. Tous les isolés avaient produit betalactamase. West African Journal of Medicine Vol.21(3) 2002: 226-229

Twenty five isolates of B. cepacia, representing 1.4% of all isolates, were obtained at the Microbiology Laboratory of a University Teaching Hospital in Lagos between January 1996 and December 1997. Identification of isolates was done using analytical profile index systems (Biomerieux, France) and sensitivity testing was by disc diffusion methods as recommended by the National Committee for Clinical Laboratory standards Majority of these isolates (24 out of 25) were cultured from in-patients, with most isolates from specimens which came in from the paediatric wards. Eighteen (72%) of the 25 isolates were obtained from blood, 4 (16%) were from urine and the remaining isolates were from wound d swab (1) and sputum (1). Five (27.8%) of the blood isolates were obtained from neonates with symptoms and signs of septicaema, 8 (44.4%) from neonates without features of septicaemia while diagnosis of septicaemia was uncertain in the remaining 5 blood isolates also from neonates. Factors that appeared to predispose to infection included intravenous fluid administration, catheterisation and surgery. Twelve (48%) of the 25 isolates were found to produce beta-lactamase by starch paper technique. B. Cepacia showed reduced sensitivity to commonly used antibiotics like gentamicin (0%) and co-trirnoxazole (0%). Majority of the isolates were sensitive to nalidixic acid (64%), cefriaxone (56.5%) and ceftazidime (73.9%). B. Cepacia probably causes nosocomial infections in this environment. It may therefore be necessary to routinely carry out in-vitro antibiotic sensitivity testing testing for this organism in view of its resistance to commonly used antibiotic agents, so that appropriate therapy can be instituted. (J. of the Nigerian Association of Infection Control, 2000, 3(1): 10-15)

In the Nigerian market are many brands of disinfectants with varying efficacy against bacteria, fungi and viruses. Recently Virkon brand of potassium monoperoxysulphate (Antec, UK) was introduced. The Kelsey -Sykes test was carried out to determine the efficacy of Virkon against standard bacterial strains and hospital-acquired clinical bacterial isolates (Pseudomonas aeruginosa, Methicillin- resistant Staphylococcus aureus, Candida spp., High-level gentamicin resistant Enterocoocus faecalis, Multiply-resistant Escherichia, Coli, and Klebsiella pneumoniae.)At the contact time of 5min, 10min, 15min, 20min, The effect of organic matter and 7-day storage on pre-diluted disinfectant was also determined. Virkon prevented the growth of all the organisms tested even after storage for 7-days. It' activity was not affected by organic matter. Virkon is very effective against Candida Spp; gram-positive and gram-negative bacteria. (J. of the Nigerian Association of Infection Control, 2000, 3(1): 34-35)

Introduction: Ebola virus (EBOV) has been shown to persist in some body fluids of Ebola Virus Disease (EVD) survivors with implication for future transmission particularly in Nigeria where EVD was experienced for the first time in 2014. Thus, this paper was aimed at providing information on the duration of persistence of EBOV in Nigeria. Materials and Methods: Ten consenting EVD survivors were enrolled. Baseline specimens; urine and semen (males), urine and high vaginal swab (HVS) (females) were obtained within one month after discharge from the Ebola Treatment Centre (ETC) and subsequently every fortnight. Samples were analyzed using quantitative Real-Star Filovirus Screen RT-PCR kit 1.0 at the National Reference Laboratory in Lagos.Results: Ten EVD survivors comprising 4 (40%) males and 6 (60%) females with age ranges of 28 to >33 years (mean age: 33.0 ± 6.9 years) were evaluated. EBOV RNA was not detected in the urine of all the participants and HVS from the females. However, EBOV RNA was detected in the semen of all 4 (100%) male participants at baseline, and at 2 months after discharge from the ETC. Two men were still positive for EBOV RNA 4 months after discharge from the ETC despite persistent negative vireamia. Conclusions: Our data confirm that a negative viremia in the convalescent period is not predictive of the absence of the virus in semen. Despite an early clearance of the virus from the urine and HVS, there was persistence of EBOV RNA in semen of male survivors 4 months after recovery.

Background\ud Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation.\ud \ud Methods\ud In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR.\ud \ud Results\ud Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research.\ud \ud Conclusions\ud Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective.