Hospital In Southwestern Nigeria Research Articles

Characteristics of Breast Cancer Patients Who Refused Conventional Treatment in a Teaching Hospital in Southwestern Nigeria

Background Patients’ adherence to treatment recommendations is in the form of a spectrum: complete adherence or total rejection of the offered standard treatments. The aim of this study was to describe the characteristics of breast cancer patients who refused standard treatments in order to engender a focused intervention. Methods This was a retrospective study of breast cancer patients from 2017-2022. Data generated were analyzed using SPSS version 23.0. The results were presented using descriptive statistics. Inferential statistics for subgroup analysis was by chi-square test or risk difference with confidence intervals Results Among 343 patients, 86 (25% (95% CI 21-30) did not initiate conventional oncologic treatment. All were females and their age range was 33–83 years (mean, 49.9±12.0 years). The majority of the women were married (73%), educated (79%), low-income earners (69%), rural dwellers (63%) with advanced disease (81%). None of the patients had government insurance. The mean duration of symptoms was 11.9±9.7 months. Among 71patients with vital information, 50 (70% (95%CI 58-71) were confirmed dead in the last 3 years. The probability of death within 3 years was 38% (95%CI 8.0-68%) and was higher among those diagnosed as late-stage disease. Conclusions A large number of patients still fail to accept conventional treatments after breast cancer diagnosis. Understanding the patients’ characteristics may be necessary to recognize situations where active education and support can help patients accept standard treatment thereby prolonging survival.

Molecular detection of ExoU and ExoS virulence genes among clinical isolates of P. aeruginosa recovered from patients attending a private tertiary hospital in southwestern Nigeria

Molecular detection of ExoU and ExoS virulence genes among clinical isolates of P. aeruginosa recovered from patients attending a private tertiary hospital in southwestern Nigeria

Quality of life and spiritual needs of patients diagnosed with cancer in a tertiary hospital in southwestern Nigeria

ObjectiveIn Africa, cancer is considered a death sentence. Its impact can be debilitating for the patient and those who care for them. This study therefore assessed the spiritual needs and Quality of life of Cancer patients in a tertiary hospital in Nigeria. MethodsThis study utilized a cross-sectional descriptive design. We systematically recruited 302 cancer patients who visited the cancer registry and outpatient departments. A standardized and validated Spiritual needs questionnaire (SpNQ) and WHO Quality of Life (WHOQL) were used to collect data. Data was analyzed with SPSS version 23 with a significance level set at p < 0.05. ResultsThe preponderance cancer among respondents was breast cancer 146 (48.4%) followed by prostate cancer 41 (13.6%). Most of the respondents admitted having “strong” spiritual needs. Categorization of the spiritual need score was below average in 20% of the respondents which indicated those with low spiritual needs and the majority 241 (79.8%) of the patients had high spiritual needs. Most respondents had poor quality of life in all four domains. The spiritual care needs of respondents were significantly associated with the quality of life of the respondents particularly in the psychological domain (p = 0.040) and social domain (p = 0.005). ConclusionThis study revealed high spiritual needs and poor quality of life among cancer patients. Healthcare practitioners should provide for the spiritual needs of cancer patients to enhance their quality of life.

Evaluation of Ascitic Fluid Cytology in a Tertiary Hospital in South-Western Nigeria: A 7-year Retrospective Study

Background: Ascites is the pathological accumulation of fluid within the peritoneal cavity of varied etiology. Various abnormalities can be detected through cytological analysis of ascitic fluid. Ascitic fluid cytology (AFC) is a rapid and cost-effective means of evaluating ascites to establish its nature and cause. Aim: To evaluate ascitic fluid cytological findings over a seven-year period and to correlate the cytological features with the clinical profile of the patients. Materials and Methods: This was an observational retrospective study conducted in a healthcare facility in south-western Nigeria. The reports of AFC tests performed from January 1, 2016 to December 31, 2022 were retrieved to obtain the following information for analysis: Age, Gender, Tribe, Year of the test, Provisional diagnosis, and Cytological diagnosis. Results: The data of a total number of 121 patients were analyzed; 61 males (50.4%) and 60 females (49.6%) with a mean (±SD) age of 51.51 ± 15.22. Decompensated cirrhosis was the commonest clinical diagnosis 65 (53.7%) followed by hepatocellular carcinoma 11 (9.1%). Ascitic fluid cytological findings showed 45 (37.2%) were positive for malignant cells; 46 (38.0%) were negative for malignant cells; 13 (10.7%) were suspicious for malignancy; 9 (7.4%) were acellular smears; and 8 (6.6%) were inflammatory smears. The ascitic fluid of only 4 out of 11 patients with hepatocellular carcinoma tested positive for malignant cells, giving a sensitivity of 36.4%. Conclusion: AFC remains very useful in the diagnostic work-up of patients with ascites but should not be completely relied upon in confirming a malignancy, other additional diagnostic investigations should be deployed.

Occurrence and seroprevalence of infectious viral, bacterial, and protozoal diseases among patients attending the Ore General Hospital in southwestern Nigeria

Infectious diseases caused by viruses, bacteria, protozoans, and fungi continue to pose significant challenges globally, with transmission routes including person-to-person contact, animal vectors, and environmental exposure. Despite global efforts to control these diseases, limited studies and resource constraints in Ore, Nigeria, have led to increasing prevalence, highlighting the need for targeted public health interventions. This study aimed to determine the distribution of infectious diseases among patients attending General Hospital Ore, Odigbo, Nigeria. Serum samples from consenting patients were assayed for the presence of malaria parasites, human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), Salmonella infection, Helicobacter pylori infection, high vaginal swab (HVS) results, and urinary tract infections (UTIs). The subjects included 1900 males (38.8%) and 3000 females (61.2%). The overall prevalence rates were as follows: HIV (40%), malaria (35%), typhoid (37.5%), HBsAg (20%), H. pylori (6.3%), HVS (45%), and UTIs (10%). The high rates of infectious diseases observed in this study, compared to rates reported elsewhere, suggest the need to strengthen public health measures and infection prevention strategies in the area. In addition, routine screening for these diseases and early passive or active immunization for vaccine-preventable diseases are essential to further reduce the burden of these infections.

Molecular detection of OXA-48 and NDM-1 carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria

There have been increasing reports of Klebsiella pneumoniae resistant to β-lactam antibiotics. This study aimed to determine the prevalence of some selected carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria. The study was conducted over two months (February-March 2024). A total of 50 clinical isolates of Klebsiella pneumoniae from different clinical specimens were obtained from the Medical Microbiology Department, Babcock University Teaching Hospital (BUTH). The clinical isolates were then characterized using standard microbiological procedures and were tested for susceptibility to meropenem and other classes of antibiotics according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Polymerase Chain Reaction (PCR) detection for OXA-48 and NDM-1 carbapenemase genes was performed on the 50 clinical isolates. PCR analysis showed that 9 (18%) clinical isolates were positive for the OXA-48 gene, 22 (44%) were positive for the NDM-1 gene, 4 (8%) possessed both the OXA-48 and NDM-1 genes, and 23 (46%) possessed neither the OXA-48 nor NDM-1 genes. Antibiotic Susceptibility Testing (AST) revealed that all the clinical isolates were resistant to meropenem. In conclusion, this study demonstrates the presence of OXA-48 and NDM-1 genes in clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria, highlighting the role of ESBL (extended-spectrum beta-lactamase) as a major resistance mechanism alongside other mechanisms. Population-based surveillance programs should be implemented to monitor the prevalence and epidemiology of Klebsiella pneumoniae infections at the community level, facilitating early detection of outbreaks and identification of emerging antimicrobial resistance patterns.Core TipThis study highlights the significant prevalence of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae clinical isolates in a private tertiary hospital in Southwestern Nigeria, with 44% and 18% of isolates harboring these genes, respectively. Notably, 46% of isolates were resistant to carbapenems despite lacking these genes, suggesting alternative resistance mechanisms. The findings underscore the urgent need for enhanced surveillance, infection control measures, and antibiotic stewardship programs to combat the spread of multidrug-resistant Klebsiella pneumoniae in healthcare settings.

Helicobacter pylori Infection among Symptomatic Adults in a Tertiary Hospital in Southwestern Nigeria: A Retrospective Study

Aim: To determine the prevalence of Helicobacter pylori (H. pylori) infection among symptomatic adults in a tertiary hospital in a peri-urban setting in Southwestern Nigeria. Methodology: It was a retrospective, cross-sectional study conducted in the Medical Microbiology Laboratory, Department of Medical Microbiology and Parasitology, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigeria, between January 2022 and June 2024. The study involved a review of the medical microbiology laboratory records to evaluate the H. pylori stool antigen results of samples obtained from adults with gastrointestinal symptoms suggestive of H. pylori infection. Results: A total of 1061 adults were included in the study with females accounting for 56.2% of the participants. The age range of the participants was 18 – 95 years with a mean age of 34.59 + 15.51. The prevalence rate of H. pylori infection was 32.4% (344/1061). The infection was higher in females (50.6%) than in males (49.4%) and it was statistically significant (P = 0.011). However, a higher proportion (36.6%) of males had the infection than females (29.2%). The age group 21 – 30 years accounted for 23.3% of the H. pylori-positive participants while 37.6% of participants in the age group 41 -50 years were H. pylori-positive, however it was not statistically significant. Conclusion: H. pylori infection is prevalent among symptomatic adults in this locality. Hence, screening for H. pylori is recommended for detection, prompt treatment and eradication of H. pylori infection to prevent long-term complications.

Epidemiology of geriatric orthopaedic injuries in a tertiary hospital in southwestern Nigeria

Life expectancy in sub-Saharan Africa (SSA) has increased owing to economic growth and improvements in medical care. An increased representation of older people among orthopaedic trauma victims is a significant consequence of population ageing, as shown in previous studies, including few in SSA. This retrospective review in Nigeria aims to corroborate previous studies and highlight the emergence of geriatric orthopaedic trauma (GOT) as a public health concern in SSA. Among 241 orthopaedic trauma in-patients aged ≥ 60, the mortality rate was 3.7%. They made up 21.2% of adult orthopaedic trauma admissions. The incidence of GOT increased steadily over the five-year study period with a spike during COVID-19 lockdown. Males constituted 51%. Mean age was 72.5 years (range, 60–105 years). Mean distance to the hospital was 35.8 km and 50.6% lived farther than 10 km. The main causes of injury were falls (50.6%) and traffic crashes (48.1%). Fractures were the predominant (91.7%) injuries. Univariate analyses revealed significant differences along age and gender stratifications. Longer distance to the hospital significantly delayed presentation. The study supports previous studies and shows that GOT is evolving as a public health concern in SSA. The 2030 Sustainable Development agenda is apt to stem the trend.

Health Promotion Practices among Pregnant Women Attending Antenatal Clinics at a Tertiary Hospital in Nigeria.

A cross-sectional study conducted in a semi-urban tertiary healthcare hospital in South western Nigeria to assess health promotion practices and associated sociodemographic factors among pregnant women attending antenatal clinics. A total of 220 pregnant women were studied. Results showed that 95.0% of the participants had good health promotion practices with physical activities having the lowest while spiritual values had the highest score. Moreover, age, religion, education, and occupation were significantly associated with health promotion practices among the pregnant women.

Factors Influencing the Adoption of Technology in Pharmaceutical Service Delivery in Tertiary Hospitals in Southwestern Nigeria

The aim of this paper is to identify those factors determining the adoption of technology in pharmaceutical service delivery in selected tertiary hospitals in Southwestern Nigeria. The study was a cross-sectional survey of 132 pharmacists who were randomly selected from a pool of 186 pharmacists in eight of the sixteen tertiary hospitals in Southwestern Nigeria. Primary data were collected using a pre-tested structured questionnaire with items on a 5-point Likert scale of importance and weighting scores of 1-5. The data were analysed with the aid of SPSS statistical package version 21 using descriptive statistics including relative significance indexes (RSI) as well as ANOVA inferential statistics at p&lt;0.05. The results show that the respondents’ knowledge (RSI = 0.96), skill in the application of technology (RSI = 0.94), quality of output of the technology (RSI = 0.91) and relative advantage over current technology (RSI = 0.91), were the key adoption influencing factors (F = 14.062, p&lt;0.05). The chapter concludes that the main factors determining the adoption of technology in pharmaceutical service delivery in tertiary hospitals were pharmacists’ knowledge of technology and skill in the application the technology, among others.

Extent of use of digital technologies for records and information management in selected hospitals in Southwestern Nigeria

This cross-sectional survey aimed to identify the extent of the use of digital technologies in dental hospitals for records and information management. Questionnaire were administered to dental practitioners across six purposely selected dental Hospitals in Southwestern Nigeria. Amongst the 210 copies of questionnaire administered, 162 were completed, retrieved, and fit for the analysis, which resulted in a response rate of 77.1%. The extent of use of digital technologies for information management in the selected hospitals was measured by the period of purchase; number owned; frequency of use; current state of the technology; and the level of automation at the selected hospitals. Based on the period of purchase, most of the respondents (82.1%) have been using digital technologies for below 5 years. As regards the number of digital technologies owned; analysis showed that most (91.3%) of the hospitals have less than or equal to three digital technologies in use for information management. The frequency of use shows that majority (45.7% and 21.6% respectively) of the respondents never and rarely uses digital technologies for information management. However, a further investigation into the current state of the technologies owned showed that most of the respondents (65.4%) of the respondents have non-functional technologies. Furthermore, a 0% value was recorded on the question about the present level of automation of the selected hospitals. This showed that none of the hospitals have fully automated their information management processes. Finally, 80.2% of the respondents agreed that information management processes in their hospitals are totally paper-based.

Prevalence and Determinants of Sickness Absenteeism among Healthcare Workers in a Tertiary Hospital in Southwestern Nigeria

Introduction: Sickness absenteeism is a global problem that affects almost all forms of workers, especially healthcare workers. This study assessed the prevalence and determinants of sickness absenteeism among healthcare workers in a tertiary hospital in Southwest, Nigeria. Methods: An institutional-based, cross-sectional study was conducted among 360 healthcare workers in a Tertiary Hospital in Southwest, Nigeria from October to December 2022. A pre-tested interviewer-administered, semi-structured questionnaire was used to elicit information from the respondents who were selected using a stratified sampling technique. Bivariate analysis and binary logistic regression analysis were performed to identify the predictors of sickness absenteeism using SPSS version 25.0. The significance of associations was determined at p-value &lt; 0.05. Results: The mean age ± SD of the respondents was 34 ± 7.15 years. The prevalence of sickness absenteeism among the health workers was 21.0%, while the causes of sickness absenteeism were malaria (51%), body pain (18%), and diarrhea (5%). Family obligation (AOR: 2.1, 95% CI: (1.20, 3.53), P=0.009) and the job type (AOR: 2.7, 95% CI: (1.05, 6.83), P=0.038) were the only predictors of sickness absenteeism. Conclusion: About one-fifth of the respondents had one spell of sickness keeping them away from work due to illnesses such as malaria, diarrhea, and body pain. Preventive interventions should be instituted by stakeholders based on the identified factors to reduce the prevalence of sickness absenteeism among these populations.

Hospitalization and mortality outcomes among adult persons living with HIV in a tertiary hospital in South-western Nigeria: A cross-sectional study.

HIV infection continues to be a major public health issue, with significant morbidity and mortality especially in resource poor areas. Infection with HIV results in an increased risk of opportunistic infections and other complications, which may lead to hospital admission and death. Morbidity and mortality patterns among hospitalized persons living with HIV (PLHIV) have been well documented in high income countries, but there is paucity of such data in Nigeria. We investigated the reasons for hospitalization and predictors of death among adult PLHIV at the Federal Medical Center (FMC) Abeokuta, Nigeria. This was a hospital based cross-sectional study carried out over a 15-month period between January 2018 and March 2019. All consenting hospitalized adult PLHIV who met the inclusion criteria were enrolled into the study. Causes of hospitalization and death were obtained and analyzed. Over the study period, 193 hospitalizations of PLHIV were studied. Although a number of clinical syndromes were documented, Sepsis and Tuberculosis were the commonest causes of hospitalization and mortality. Mortality rate was 37(19.2%) for outcomes on day 30, with anaemia [OR 3.00 (95% C.I: 1.04-8.67)], poor adherence with Cotrimoxazole [OR 4.07 (95% C.I: 1.79-9.28)], poor adherence with cART [OR 13.40 (95% C.I: 3.92-45.44)], and a longer duration of fever [OR 3.34 (95% C.I: 1.10-9.99)] being predictors of mortality. Part of the study's limitation was resource-constraint of some of the indigent patient which affected their ability to access some diagnostic investigations and get optimal care thereby impacting on their outcome. Despite the upscaling of cART, opportunistic infections and sepsis remain common causes of hospitalization and death in adult PLHIV. More attention should therefore be placed on early diagnosis, prevention of immunosuppression and sepsis through timely administration and adherence to cART and other prophylactic measures.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

Distribution patterns of airborne bacteria and fungi in a teaching, public and private hospital in southwestern Nigeria

Distribution patterns of airborne bacteria and fungi in a teaching, public and private hospital in southwestern Nigeria

Impacted Mandibular Third Molar Prevalence and Patterns in a Nigerian Teaching Hospital: A 5-Year Retrospective Study

Mandibular third molars are the most commonly impacted teeth. The prevalence and pattern of impacted mandibular third molars in patients presenting to the Obafemi Awolowo University Teaching Hospitals Complex, a tertiary hospital in south-western Nigeria, are largely unknown. This retrospective study examined 469 patient records, extracting socio-demographic and clinical information for analysis. It also determined the prevalence and pattern of impacted mandibular third molars from January 2015 to December 2019. The positioning of impacted teeth was assessed via periapical radiographs utilizing Winter’s classification. Data were subjected to analysis with IBM SPSS version 20, utilizing frequencies, percentages, and likelihood ratios, with statistical significance set at p &lt; 0.05. The prevalence of impacted mandibular third molars within the study cohort was 2.51%, with a higher incidence observed in the 21–29 age group (p &lt; 0.001). Mesioangular impaction was the most prevalent, with pericoronitis being the primary reason for extraction, and periodontal pockets being the most common associated pathology.

A correlation of 8-hour and 12-hour with 24-hour urinary protein among pregnant women with preeclampsia in a teaching hospital in South-Western Nigeria

Background and Objective: Proteinuria is one of the cardinal features of preeclampsia, which is a common and potentially severe complication of pregnancy. This study sought to determine how the quantitative measurement of urine protein from 8-hour and 12- hour samples correlate with that of a 24-hour sample in diagnosing preeclampsia.&#x0D; Materials and Methods: 52 eligible pregnant women with preeclampsia were recruited between April 2017 and April 2018. For each patient, having emptied the bladder at 0 hour, urine was collected into three different containers (containers 1, 2, 3) at 8th hour, 12th hour and 24th hour ensuring that the bladder was emptied into each container at hours 8, 12 and 24. Volumes of 8 hours urine (volume in container 1), 12 hours urine (total volume in containers 1 and 2), and 24 hours urine (total volumes in containers 1, 2 and 3) were measured and 5 ml aliquot respectively obtained from each sample for colorimetric analysis of urinary protein. Data was analyzed using the EPI Info software&#x0D; Results: A total of 52 patients completed the study. The mean gestational age was 33+ 2.82weeks. The mean 8-hour, 12-hour and 24-hour urinary protein values were 2.1+1.53, 2.3+1.52 and 3.1+1.89 respectively. There were significant correlations between the protein values of 8-and 12-hour urine samples with those of 24-hour urine samples&#x0D; Conclusion: 8-hour and 12-hour values of urine protein correlated positively with values in 24-hour samples and may be useful for initial assessment of cases of preeclampsia for prompt interventions.

Current Trend in the Epidemiology of Thermal Burn Injury at a Tertiary Hospital in South Western Nigeria.

Worldwide, thermal burn is the leading etiological type of burn injury accounting for 86% of burn injuries requiring admissions. Flame, Scald, and contact burn are the leading causes of thermal burn. Changes in the sociodemographic characteristics of societies have led to alterations in the epidemiology of burn. An understanding of such changes in the epidemiology of burn is essential in formulating and executing adequate burn prevention programs. We sought to establish the current trend in the etiology, gender distribution, age, occurrence of inhalation injury, burn surface area, burn depth, and mortality rate of thermal burns at Ibadan. This was a retrospective study carried out between January 2013 and December 2022. Thermal burns constitute 92% of burn injuries. The male-to-female ratio was 1.4:1. There were 265 (45%) patients in the pediatric age group and 323 adults (55% of the patients). The proportion of flame, scald, and contact burns were 378 (58%), 203 (32%), and 14 (2%), respectively. Flame burns resulting from liquified petroleum gas (LPG) explosion show a rising trend, with a decline in flame burns from kerosene (P < .001). One hundred and ninety (32%) patients had inhalation injury. The overall mortality was 19% (N = 114). Kerosene flame, 38% (17 of 45 patients), and LPG, 32% (41 of 130 patients), were the most lethal causes of flame injuries (P < .043). The study shows the increasing contribution of LPG to the etiology of thermal burn injuries. Burn prevention programs should target safe use of LPG stoves and cylinders.

Histopathological Outcome of Colonoscopic Biopsies in a Tertiary Hospital in Southwestern Nigeria: A 7-Year Retrospective Study.

Colonoscopy with histopathological analysis of mucosal biopsy samples remains the gold standard procedure for diagnosing lower gastrointestinal disorders. This study aimed to determine the pattern of histopathological findings of mucosal biopsies obtained at colonoscopy over a 7-year period and to correlate the histological findings with the clinical profile of the patients. This was a retrospective study conducted in a healthcare facility in southwestern Nigeria. The Histology reports from January 1, 2016, to December 31, 2022, were retrieved from the histopathology department of the institution to obtain the following information for analysis: age, gender, year of the test, presenting complaint, provisional clinical diagnosis, colonoscopy diagnosis, and histological diagnosis. The data of a total number of 81 patients were analyzed; 51 males (63.0%) and 30 females (37.0%) with a male-to-female ratio of 1.7-1. The age range of the patients was 30-86 years with a mean (±standard deviations) age of 59.87 ± 14.44. The most common indication for colonoscopy was hematochezia (23 (28.4%)) followed by change in bowel habit (16 [19.8%]), constipation (11 [13.6%]), and tenesmus (10 [12.3%]). Large bowel masses suggestive of cancers were the most common colonoscopy finding in the study subjects (36 [44.4%]). Colorectal cancer was the most common histologic abnormality in the study subjects (26 [32.1%]) followed by chronic nonspecific colitis (8 [9.9%]), polyps (7 [8.6%]), adenomas (5 [6.2%]) and acute on chronic colitis (5 [6.2%]). Twenty-two (27.2%) patients had normal histologic findings. Patients aged between 45 and 64 years had the highest prevalence of colorectal cancer (13 [50.0%]). Colorectal cancer was the most common histopathological finding in this study and the patients were mostly within the middle-age group. Early screening colonoscopy is therefore recommended and histopathological analysis of the mucosal specimens obtained is essential for early detection of premalignant lesions.

High Genetic Diversity of Carbapenem-Resistant Acinetobacter baumannii Isolates Recovered in Nigerian Hospitals in 2016 to 2020.

Acinetobacter baumannii causes difficult-to-treat infections mostly among immunocompromised patients. Clinically relevant A. baumannii lineages and their carbapenem resistance mechanisms are sparsely described in Nigeria. This study aimed to characterize the diversity and genetic mechanisms of carbapenem resistance among A. baumannii strains isolated from hospitals in southwestern Nigeria. We sequenced the genomes of all A. baumannii isolates submitted to Nigeria's antimicrobial resistance surveillance reference laboratory between 2016 and 2020 on an Illumina platform and performed in silico genomic characterization. Selected strains were sequenced using the Oxford Nanopore technology to characterize the genetic context of carbapenem resistance genes. The 86 A. baumannii isolates were phylogenetically diverse and belonged to 35 distinct Oxford sequence types (oxfSTs), 16 of which were novel, and 28 Institut Pasteur STs (pasSTs). Thirty-eight (44.2%) isolates belonged to none of the known international clones (ICs). Over 50% of the isolates were phenotypically resistant to 10 of 12 tested antimicrobials. The majority (n = 54) of the isolates were carbapenem resistant, particularly the IC7 (pasST25; 100%) and IC9 (pasST85; >91.7%) strains. blaOXA-23 (34.9%) and blaNDM-1 (27.9%) were the most common carbapenem resistance genes detected. All blaOXA-23 genes were carried on Tn2006 or Tn2006-like transposons. Our findings suggest that a 10-kb Tn125 composite transposon is the primary means of blaNDM-1 dissemination. Our findings highlight an increase in blaNDM-1 prevalence and the widespread transposon-facilitated dissemination of carbapenemase genes in diverse A. baumannii lineages in southwestern Nigeria. We make the case for improving surveillance of these pathogens in Nigeria and other understudied settings. IMPORTANCE Acinetobacter baumannii bacteria are increasingly clinically relevant due to their propensity to harbor genes conferring resistance to multiple antimicrobials, as well as their ability to persist and disseminate in hospital environments and cause difficult-to-treat nosocomial infections. Little is known about the molecular epidemiology and antimicrobial resistance profiles of these organisms in Nigeria, largely due to limited capacity for their isolation, identification, and antimicrobial susceptibility testing. Our study characterized the diversity and antimicrobial resistance profiles of clinical A. baumannii in southwestern Nigeria using whole-genome sequencing. We also identified the key genetic elements facilitating the dissemination of carbapenem resistance genes within this species. This study provides key insights into the clinical burden and population dynamics of A. baumannii in hospitals in Nigeria and highlights the importance of routine whole-genome sequencing-based surveillance of this and other previously understudied pathogens in Nigeria and other similar settings.