Childhood pyogenic septic arthritis as seen in a teaching hospital South East Nigeria

Background: Childhood pyogenic septic arthritis and its associated musculoskeletal morbidity is an important health concern in developing countries. Its pattern of presentation that varies from and within subregions has implications on the early recognition, treatment, and outcome. The aim of this study was to determine the pattern and outcome of childhood septic arthritis in our environment. Materials and Methods: This was a retrospective study of all the children seen with pyogenic septic arthritis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015. Results: Childhood septic arthritis accounted for 44 (83%) of the 53 patients seen with pyogenic septic arthritis. Female to male ratio was 1:1.75 and the mean age was 5.7 ± 0.73 years. Eight patients (18.2%) had polyarticular involvements. The right shoulder was significantly more involved than the left and the left hip more than right. Overall, there was a preponderance of onset of symptoms in the dry season. Children from the rural areas accounted for 85.7% of those with the onset of symptom in rainy season. Delayed presentation >6 days (in 68.2% of patients) was related to age (P < 0.042), and health seeking behavior (P < 0.036). Staphylococcus aureus was the commonest causative organism. Seventy-seven percent (77%) underwent open arthrotomy. Anemia, septic shock, and joint stiffness were three top complications observed. Mortality rate was 2.3%, and cause of death was overwhelming sepsis. Conclusion: In our setting, pyogenic septic arthritis is predominantly a childhood health problem and children under 5 years of age are the most vulnerable. Delayed presentation, an important factor in morbidity and mortality associated with septic arthritis was common among the patients, calls for a public enlightenment program on the importance of early presentation

Invasive Staphylococcus Aureus Infections in Diabetes Mellitus : Review

Staphylococcus aureus; the most virulent of the many staphylococcal species; has remained a major cause of morbidity and mortality despite the availability of numerous effective anti-staphylococcal antibiotics. S. aureus causes disease through both toxin-mediated and non-toxin-mediated mechanisms. This organism is responsible for both healthcare-associated and community-based infections ranging from relatively minor skin and soft tissue infections to severe life-threatening systemic infections. Patients with diabetes mellitus are at increased risk of invasive S aureus infections. This article focuses on the spectrum of invasive S aureus infections and discusses the clinical features; investigations and management of these infections in patients with diabetes mellitus

Antibiotiques locaux : retraits et restrictions dans les infections cutanees

Plusieurs antibiotiques sont commercialises pour certaines infections cutanees Plusieurs antibiotiques sont commercialises pour certaines infections cutanees superficielles.Leur balance benefices-risques n'est pas toujours favorable. Le plus souvent; la priorite est a donner a l'eau et au savo. En France; la reevaluation des antibiotiques locaux continu. Certains de ces medicaments etant aussi commercialises au Burkina Faso; La Lettre du CEDIM fait l'echo des retraits et restrictions d'indications

Infections post-operatoires de plaies a Staphylococcus Xylosus dans les services chirurgicaux du Centre National Hospitalier et Universitaire de Cotonou: aspects bacteriologiques

Les Staphylocoques a coagulase negative representent 14 pour cent des germes isoles des plaies operatoires et 44 pour cent de ceux isoles des prelevements de l'environnement hospitalier. Parmi eux l'espece Staphylococcus xylosus rarement impliquee dans les infections humaines a ete isolee 7 fois dans les plaies operatoires. Elle marque une resistance de 30 a 74 pour cent vis-a-vis des antibiotiques testes. Le lysotype 28/275/459 est le plus frequent. Staphylococcus xylosus a determine des heteoinfections et des autoinfections

La meningite a Staphylocoques (staphylococcus aureus) au service des maladies infectieuses du CHU de Dakar

La meningite purulente est une urgente infectieuse d'evolution imprevisible. Le staphylocoque (staphylococcus aureus) est responsable des cas sporadiques. Au service des maladies infectieuses du CHU de Dakar ; 42 cas ont ete colliges en 9 ans soit 2;71 pour cent des meningites. Les grands enfants et les adultes sont majoritaires. La porte d'entree est cutanee dans 2/3 des cas. Le Chloramphenicol est souvent efficace et l'association trimethoprime-sulfamethoxazole souvent active in vitro. Un retard a l'hospitalisation; un coma initial ou d'installation rapide et un terrain debilite sont des facteurs de mauvais pronostic. La mortalite est de 54;76 pour cent sur cette serie. Le traitement precoce des foyers cutanes. O.R.L. et ophtalmologiques doit etre systematique

Control of spread of Methicillin Resistant Staphylococcus aureus (MRSA) in Burns Units

Results of four years' studies from a number of hospitals in Kenya have shown that nosocomial infections in burns units are due to Methicillin Resistant Staphylococcus aureus (MRSA). Through chromosomal DNA and plasmid DNA; the stain is highly resistant to sulphonamide ointment and other antibiotics. 90 per cent of patients admitted in burns units get colonized or infected with MRSA. The strain prolongs the duration of patients in hospitals. The burns degenerate to second and third degree burns; thereby necessitating skin grafting. The environment has been found to be contaminated with this strain with some staff members having chronic throat infections. Minocycline was found to be effective in treating the infected staff members. Cleaning this environment with Sodium dichloroisocyanurate (precepts)/Sodium hypochlorite (JIK) reduced drastically the mechanical transmission of bacteria in the units. The duration of stay of the patient was reduced. This shows that MRSA which is spread in government and private hospitals can cheaply be controlled by the proper use of disinfectants; antiseptics; and use of effective antibiotics when necessary

Aspects cliniques; therapeutiques et evolutifs de la staphylococcie pleuro-pulmonaire du nourrisson au C.H.U. de Lome-Tokoin (Togo)

Les auteurs ont mene une etude retrospective de 112 cas de staphylococcie pleuro-pulmonaire (SPP) du nourrisson; observes en 10 ans (janvier 1981 a decembre 1990) dans le service de pediatrie du CHU de Lome-Tokoin. La SSP du nourrisson a represente 60;2 pour cent des SPP et 1;3 pour cent des infections pulmonaires de l'enfant avec un sex-ratio de 1;04. Malnutrition proteino-energique; anemie nutritionnelle; drepanocytose; cardiopathie congenitale et rougeole en ont ete les principaux facteurs favorisants; ainsi que l'harmatan (janvier a mars). Le diagnostic; evoque devant les troubles respiratoires et digestifs sur fond infectieux; est confirme par la radiographie pulmonaire; l'hemoculture et la culture du liquide pleural. Oxacilline; Gentamicine; Macrolides et Mhenicoles ont ete couramment utilises; associes ou non a un drainage pleural et a la reanimation; selon les cas. L'ampleur de cette affection dont la letalite est tres elevee (35;7 pour cent); peut etre reduite par un depistage precoce et un traitement adequat des infections ORL et cutanees