Particularités de l'infection néonatale bactérienne précoce en milieu hospitalier du CHU Gabriel Touré de Bamako / Particularities of early neonatal bacterial infection in the hospital environment of the CHU Gabriel Touré in Bamako

Introduction : L'infection néonatale bactérienne précoce (INBP) est une préoccupation majeure en néonatologie. Au Mali, aucune étude n'avait abordé cet aspect d'où l'initiation du présent travail afin d'étudier le profil épidémio-clinique, biologique et bactériologique de l'INBP. Matériel et méthodes :Il s'est agi d'une étude longitudinale descriptive qui s'est déroulée du 27 juin au 03 septembre 2016 ayant concerné les nouveau-nés d'âge ≤ à 72 heures hospitalisés pour INBP confirmée à l'hémoculture dans le service de néonatologie du département de pédiatrie du Centre Hospitalier et Universitaire (CHU) Gabriel Touré de Bamako. Les paramètres étudiés étaient les caractéristiques sociodémographiques et obstétricales des mères, les caractéristiques cliniques, biologiques et bactériologiques des nouveau-nés infectés précocement. Résultats : Sur les 324 hémocultures réalisées, 52 étaient positives soit une fréquence d'INBP de 11,04 %. Le sex-ratio était de 1,3 avec 73,1% de petit poids de naissance. A l'admission, 90,4 % des nouveau-nés avait moins de 24 H de vie et 86, 5%étaient des naissances hors du CHU Gabriel Touré. Les principaux signes cliniques étaient l'hyperthermie ou l'hypothermie et la détresse respiratoire. Les principales bactéries isolées à l'hémoculture étaient Staphylococcus aureus (55,8%), Klebsiella pneumoniae (13,5 %) et Escherichia coli (07,7 %). La sensibilité à la biantibiothérapie de première intention (ceftriaxone + gentamicine)était faible (63,6%) et celle de l'amikacine était meilleure (100 %). La moitié des nouveau-nés infectés précocement est décédée et 19,2% d'exéat sans accord médical a été enregistrée. Conclusion: L'infection néonatale bactérienne précoce est une cause majeure de morbi-mortalité néonatale. Dans notre contexte, l'amikacine pourrait être une meilleure alternative thérapeutique

Introduction: Early neonatal bacterial infection (ENBI) is a major concern in neonatology. In Mali, no study had addressed this aspect, hence the initiation of this work to study the epidemiological-clinical, biological and bacteriological profile of ENBI. Materials and methods: This were a descriptive longitudinal study that took place from june 27 to september 3, 2016 involving newborns aged ≤ 72 hours hospitalized for ENBI confirmed by blood culture in the neonatology service of the pediatrics department of the Center Hospitalier et Universitaire (CHU) Gabriel Toure in Bamako. The parameters studied were the socio-demographic and obstetrical characteristics of the mothers, the clinical, biological and bacteriological characteristics of newborns infected early. Results: Of the 324 blood cultures performed, 52 were positive, i.e. an ENBI frequency of 11.04%. The sex ratio was 1.3 with 73.1% low birth weight. On admission, 90.4% of newborns had less than 24 hours of life and 86.5% were births outside the CHU Gabriel Toure. The main clinical signs were hyperthermia or hypothermia and respiratory distress. The main bacteria isolated in blood culture were Staphylococcus aureus (55.8%), Klebsiella pneumoniae (13.5%) and Escherichia coli (07.7%). Sensitivity to first-line biantibiotic therapy (ceftriaxone + gentamicin) was low (63.6%) and that of amikacin was better (100%). Half of the newborns infected early died and 19.2% of exeat without medical agreement was recorded. Conclusion: Early neonatal bacterial infection is a major cause of neonatal morbidity and mortality. In our context, amikacin could be a better therapeutic alternative

Characterization of antibiotic resistance and species diversity of staphylococci isolated from apparently healthy farm animals

Background: Staphylococcus species are adaptable commensals usually involved in a diverse multiplicity of ailments in animals and humans. This study surveyed the occurrence, antibiotic-resistance profile and putative resistant genetic elements of staphylococci isolates from apparently healthy farm animals Methodology: Nasal and rectal samples were collected from a total of 400 cows and pigs in Benin City between May and December 2017. Staphylococci were isolated following aerobic cultures of samples using standard microbiological methods. Susceptibility profiles of the isolates to eighteen selected antimicrobials were determined using the Kirby-Bauer disk diffusion test. Species of staphylococci were established and antibiotic resistance genes detected by the polymerase chain reaction using species-specific and antibiotic-resistant primers respectively Result: A total of 139 staphylococci isolates were phenotypically and genotypically identified from the food-producing animals; 87 (62.6%) from pigs and 52 (37.4%) from cows. The most frequent Staphylococcus species were Staphylococcus haemolyticus 38 (27.3%), Staphylococcus aureus 27 (19.4%) and Staphylococcus capitis 21 (15.1%). Antibiotic resistance profile showed 120 (86.3%) isolates to be resistant to penicillin G, 100 (71.9%) to nalidixic acid and 99 (71.2%) to minocycline. The prevalence of antibiotic resistance genes assessed were mecA 78 (56.1%), mphC 23 (16.6%), and ermA 20 (14.4%). Conclusion: Our finding indicates that food animals are potential reservoirs of antibiotic resistant staphylococci which pose a significant threat to food security and public health

Antibiotics resistance profile of staphylococci isolated from urogenital infections and toxins production of staphylococcus aureus strains

Aim: The aim of this study was to investigate the antibiotic resistance of staphylococci and seek toxin production by Staphylococcus aureus strains isolated from urogenital infections. Material and Methods: The staphylococci strains were isolated from urogenital samples collected from hospitalized patients or not. The antibiotic susceptibility was performed by the diffusion method and the search of production of toxin by S. aureus was done by radial immunoprecipitation technique. Results: Out of the 1904 samples analyzed, 80 staphylococci strains were isolated. The major (70%) part of the positive samples were coagulase-negative staphylococci composed of S. saprophyticus (50.0%), S. epidermidis (16.25%), S. xylosus (2.5%), and S. haemolyticus (1.25%). S. aureus was the unique coagulase positive strains. It was observed a multi-resistance of the isolated strains to beta-lactams, aminoglycosides, tetracycline, and co-trimazole. All the S. haemolyticus and S. xylosus strains were resistant to methicillin. Nitrofurantoin was the most active molecule in all kind of strains. There was no methicillin-resistant S. aureus producing Panton-Valentine Leukocidin (PVL) detected but all the S. aureus producing PVL were community methicillin-sensitive S. aureus. Most of the tested strains produced ETB (83.33%) and ETA (45.33%). Conclusion: The presence of multidrug resistance staphylococci strains producing toxins indicate an existence of potential reservoir of virulent antibiotics resistance stains in the community

Candidaemia or candidasis: controversy of staphylococcus sexually transmitted infection?

Herbal medications are becoming increasingly popular but a most-extraordinary claim by traditional/herbal medical practitioners relates to a Gram-positive bacterium; Staphylococcus check for this species in other resources ; which has been depicted as a deadly sexually transmitted disease that manifest in the form of worms and other symptoms; with contributory roles including infertility; sexual dysfunction and impotency. They further boasted that they are the only ones that possessed the remedy (herbal) for the Staphylococcus sexually transmitted scourge. In the absence of distinguishing phenotypic taxonomic tools; Staphylococcus and Candida check for this species in other resources spp. may be confused for each other. However; Staphylococcus is a bacterium and not an infection; therefore; there must be more to the traditional medical practitioners' boasts in ability to cure an infection that was not an infection in the first place. In conclusion; the common sense is that candiaemia or candidiasis is most likely the misdiagnosed sexually transmitted Staphylococcus disease; which is of significant human clinical health issue

Pleuresie chez l'enfant au centre national hospitalier et universitaire de Cotonou : aspects epidemiologiques; cliniques; paracliniques et therapeutiques

But : déterminer les caractéristiques épidémiologiques, cliniques, paracliniques et thérapeutiques des pleurésies chez les enfants au Centre National Hospitalier et Universitaire (CNHU) de Cotonou.Méthode : Il s'agit d'une étude rétrospective descriptive et analytique faite de janvier 2004 à décembre 2008 dans le service de Pédiatrie du CNHU de Cotonou. Elle a porté sur tous les enfants âgés de plus de 1 mois à 15 ans hospitalisés pour épanchement pleural et ayant une radiographie thoracique à l'admission. Les outils statistiques utilisés étaient l'Epi Info et le test du X² de Pearson.Résultats : L'incidence des pleurésies dans le service de Pédiatrie du CNHU était en augmentation 2004 à 2008. Les enfants de moins de 5 ans étaient les plus touchés avec comme motif fréquent des difficultés respiratoires. Les signes associés étaient dominés par la fièvre, des atteintes respiratoires et des troubles digestifs. Le diagnostic de pleurésie était évoqué à l'admission chez 56,3%. Le germe le plus retrouvé était le Staphylococcus aureus. Le traitement était souvent fait d'une antibiothérapie,d'un drainage pleural et d'une transfusion sanguine. La mortalité était de 5,6%.Conclusion : La prise des pleurésies de l'enfant au CNHU de Cotonou reste perfectible en matière de diagnostic étiologique

Characterization of Staphylococcus Species Isolated from Raw Milk and Milk Products (lben and jben) in North Morocco

Background: To investigate the incidence and antibiotic resistance of staphylococcal strains isolated from milk and milk products and to trace the ecological origin of the Staphylococcus aureus isolated. Methodology: Eighty-one samples of raw milk; lben (whey) and jben (cheese) were analyzed for the presence of staphylococcal strains. Isolates were identified by Gram stains; tests for coagulase; the API staph system and the WalkAwayr 40/96; which also determines the antimicrobial susceptibility profiles. The S. aureus strains were biotyped; and variable regions of the coagulase gene were amplified using the polymerase chain reaction. Results: The identification results showed a predominance of coagulase-negative staphylococci (54). Coagulase-positive staphylococci that were identified were divided into 3 groups comprising S. aureus (40); Staphylococcus intermedius (2) and Staphylococcus hyicus (4). Among the S. aureus that was isolated; biotype C was the predominant biotype. Among 40 coagulase gene PCR-amplification products; 37 produced a single band; while 3 isolates produced two bands. The antimicrobial susceptibility-profile of the staphylococcal strains revealed a high incidence of S. aureus to penicillin G. In addition; Staphylococcus lentus presented considerable resistance to the oxacillin; erythromycin and lincomycin. Conclusions: The presence of staphylococci in raw milk; lben and jben in areas of northern Morocco poses a health hazard; so it is necessary for the public health inspectors to properly examine the conditions during production; storage and commercialization of all products made with unpasteurized milk. Key Words: milk products; Staphylococcus; coagulase-gene typing; biotyping; antimicrobial susceptibility

Empyema and parapneumonic effusions in children: an update

Childhood empyema is an important complication of bacterial pneumonia. The incidence of empyema is increasing worldwide. Streptococcus pneumoniae and Staphylococcus aureus are the most common aetiologies in high and low-income countries respectively. The diagnosis is based on clinical; radiographic and pleural fluid examination. Tuberculosis (TB) is an important cause of a pleural effusion in high TB prevalence areas. There is controversy about the optimal treatment for empyema in children. Sepsis should be controlled with antibiotics and drainage of the pleural cavity. Intrapleural fibrinolysis and Video Assisted Thorascopic Surgery (VATS) are modern interventions widely used in high-income countries but mostly unavailable in the developed world. There are however few properly conducted studies that would support one therapeutic approach over the other. Despite this; the clinical outcome of paediatric empyema is usually good regardless of therapeutic approach. This review summarises aetiology; pathogenesis and clinical presentation of childhood empyema and discusses the various treatment modalities with an emphasis on clinical practice in developing countries

Epidemiology and Bacterial Colonization of Burn Injuries in Blantyre

Forty-nine patients from the Burns Unit at the QECH had swabs taken from various sites in order to determine the bacterial profile and antibiotic susceptibilities in burn wounds colonized by bacteria. The mean age was 16 years (range 1-70 years); 27 (55 ) of the study population were female and 22 (45) were male. Twenty-four (49) patients were epileptic. Open fire (41) was the most common cause of burn injuries among epileptics while hot water burns (29) were commonest among non-epileptics. Burn injury and percentage total burn surface area (TBSA) injuries decreased with age; and the upper and lower limbs; trunk; head and neck were the most commonly affected sites. Staphylococcus aureus was the commonest isolate (23); followed by Proteus mirabilis (22.7); Streptococci spp (15.9); Pseudomonas aeruginosa (4.5) and 3.4 for Escherichia coli; Salmonella and Klebsiella spp. There was a significant trend of bacterial growth with increasing CI 1.58-10.99]). Broad-spectrum antibiotics are required as first-line therapy for burns-related sepsis but there is need for surveillance of antibiotic susceptibility to help determine appropriate therapy

Epidemiology of Antimicrobial Resistance in pathogens Isolated in Mulago Hospital in 1998 and 2000

This study analysed the antimicrobial resistance distribution of Staphylococcus; Enterobacteria; Haemophillus and Pseudomonas isolated from the common service departments in Mulago Hospital; over periods of 1998 and 2000. The Standard Errors (se) of two proportions (resistance) and 95Confidence Interval (CI) for the difference between two proportions were used as statistical tests for determining whether there were changes being experienced over the study period. The analysed agents such as Methicillin; Etythromycine and Ceftazidime did not change in resistance point prevalence mechanisms that do not modify or attack them. While Augumentin; Sodium Cefuroxime; Chloramphenicol; Ciprofoxacin; Gentamicin; Tetracycline and Nitrofurantoin showed icnreased resistance prevalence (P0.05 possibly because of being overused or modified by many resistance mechanisms; high rates of resistance were seen in Enterobacteria (67); Staphylococcus (62) and haemophilus (50). Antipseudomonal agents did not show change in resistance prevalence (P0.05). Departmental/ward distribution of resistant isolates did not also change; except in Emergency and Outpatient departments since bacterial ecology tends to keep constant unless contronted by high level of infection control practice

Resistance aux antibiotiques de 1368 souches de staphylocoque pathogene isolees a Brazzaville

En quatre ans; 1368 souches de staphylocoque pathogene ont ete isolees des malades de ville par le Laboratoire National de Sante Publique. Ces souches resistent a toutes les beta-lactamases excepte les cephalosporines de troisieme generation. 41;7 pour cent d'entre elles sont productrices de beta-lactamases plasmidiques. La Kanamycine est le moins actif de tous les Aminosides. 20 pour cent des souches testees presentent une resistance a plusieurs antibiotiques de cette famille. Les macrolides sont les meilleurs produits inhibiteurs et la Pristinamycine est le premier de tous