DR. BURURIA JOHN MUTUIRI

Prevalence and sensitivity' trend of Enterobacteriaceae isolated from septic wound were determined through' a prospective cross sectional study, One hundred and fifteen specimen isolated from in-patients in the Department of Orthopaedic were studied and antibiotic sensitivity testing performed using the Kirby and Bauer disc diffusion technique The prevalence of organism isolated was Proteus sPP (33.9%), Esherichia coli (13.2%), Klebsiella spp (7.9%), Alcaligenes (1.7%), Citrobacter freundii (O.9%) and serratia spp (0.9%) and Acinetobacter baumanii (0.9%). The sensitivity rate of ceftriaxone, ceftazidirne and ciprofloxacin was above 70% in all cases Co-amoxiclav, gentamicin, cefuroxime, minocycline and piperacillin showed moderate to high activity Kles iella spp isolates portrayed high resistance against several drugs. The sensitivity patterns showed that empirical prescribing should be discouraged since the organism appear to be developing resistance against commonly used antibiotics.

Eighty six Klebsiella isolates from Kenyatta National Hospital and the Centre for Microbiology, Kenya Medical Research Institute, Nairobi were screened for resistance to commonly prescribed antimicrobial agents and for their plasmid content. Plasmids were transferred into Esherichia coli K-12 and resulting transconjugants screened for resistance to the antimicrobial agents used on Klebsiella donors and for their plasmid content. Plasmids from the Klebsiella isolates were also transformed into Eschericia coli and transformants analyzed for resistance and plasmid content. Endonuclease restriction mapping was done to characterize the plasmids from Klebsiella isolates and their Eschericia coli transformants. Resistance was found to be plasmid borne and transmissible.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A retrospective descriptive study was carried out from June to November 2004 in a retail pharmacy situated at the School of Pharmacy, University of Nairobi within the Kenyatta National Hospital complex. The objective was to evaluate prescribing habits and to determine the frequency of prescribing of commonly used drug classes in a hospital. The average number of drugs per prescription was 2.20  1.16. The prevalence of prescribing was 28.6% anti-infective drugs, 21.1% musculoskeletal agents, 16.6% respiratory system drugs, 8.1% cardiovascular system drugs, 7.2% central nervous system drugs, 7.1% gastrointestinal system drugs, 4.3% minerals and vitamins, 2.1% ear, nose and throat drugs, 1.1% endocrine drugs, 2% skin preparations, 0.9% anticancer drugs and 0.74% eye preparations. The prescribing habits evaluated were compared to the legal requirements in Kenya and to recommended international practice. The information gathered may serve as a basis for rational use of drugs.