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Background: Today, bacterial resistance is a public health challenge throughout the world, and infections caused by resistant bacteria are associated with increased morbidity, mortality and health care costs. The objective of this descriptive study is to determine the prevalence and distribution of multi-drug resistant (MDR) clinical bacteria isolates at the National Hospital of Zinder, Niger Republic in 2021. Methodology: We conducted a descriptive cross-sectional study of in- and out-patients from whose clinical samples' bacteria were isolated at the bacteriology unit of the laboratory. Bacteria were isolated from the clinical samples following standard aerobic cultures and identified using conventional biochemical test schemes. Antibiotic susceptibility testing (AST) was performed by the agar disk diffusion technique, and categorization of the isolates into sensitive, intermediate or resistant was done according to the recommendations of the Antibiogram Committee of the French Society of Microbiology (CA-SFM) 2020 version 1.2. MDR was defined as resistance to at least one antibiotic in three or more categories, while selected MDR bacteria such as ESBL was identified using double disk synergy test, and MRSA by cefoxitin disk diffusion test. Results: Seventy-seven (6.7%) bacterial species were isolated from 1153 clinical samples processed at the bacteriology unit of the hospital laboratory between June and December 2021, of which 65.0% (50/77) were members of the order Enterobacteriales. Escherichia coli represented 40.3% (40/77) of the isolated bacteria, Staphylococcus aureus 13.0% (10/77) and Pseudomonas aeruginosa 11.7% (9/77). The overall prevalence of MDR was 44.2% (34/77), including 61.8% (21/34) ESBL-producing Enterobacteriales (ESBL-E), 26.5% (9/34) multi-resistant P. aeruginosa and 11.7% (4/34) MRSA, with 67.6% (23/34) of the MDR isolates from outpatients. Resistance rates of the Enterobacteriales to ciprofloxacin, gentamicin, amikacin and imipenem were 62.0%, 52.0%, 38.0% and 8.0% respectively. Resistance rates of P. aeruginosa were 100.0%, 88.9%, 77.8%, 33.3%, 22.2%, and 22.2% respectively to ceftazidime, ticarcillin, imipenem, ciprofloxacin, levofloxacin, and amikacin. Resistance rates of S. aureus were 100.0%, 50.0%, 40.0%, 10.0%, 0% and 0% to penicillin G,erythromycin, cefoxitin, tetracycline, fusidic acid, and chloramphenicol respectively. ESBL-E were 47.6%,85.7% and 0% resistant to amikacin, ciprofloxacin and imipenem, and MRSA resistance rates were 75.0%, 75.0%, 50.0% and 0% to erythromycin, tetracycline, gentamicin, and chloramphenicol respectively. Conclusion: This study reports high prevalence of MDR bacteria, mainly ESBL-E, with concerning high resistance to carbapenem. Rational use of antibiotics and implementation of surveillance system for MDR bacteria must be implemented in order to limit the emergence and spread of MDR bacteria in Niger Republic.
Subject(s)
Humans , Outpatient Clinics, Hospital , Genes, MDR , Bacteria , Inpatient Care Units , NigerABSTRACT
Background: Risk assessment is the means of identifying and evaluating potential errors or problems that may occur in testing process. The aim of this study was to perform risk assessment of antimicrobial susceptibility testing (AST) process in clinical microbiology laboratories of Niamey, Niger Republic. Methodology: We conducted a descriptive cross-sectional study from October 1 to December 31, 2019, to evaluate AST performance in seven clinical microbiology laboratories at Niamey, the capital city of Niger republic. The evaluation focused on the determination of the criticality index (CI) of each critical point (frequency of occurrence of anomalies, severity of the process anomaly, and detectability of the anomaly during the process) in the AST process and the performance of the AST through an observation sheet using two reference strains; Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213. Results: The criticality index (CI) was greater than 6 for most of the critical points related to material, medium, equipment, method and labour for the AST process in all the laboratories. A range of 18-100% errors on the inhibition zone diameters of the reference strains were observed. Major and/or minor categorization (Sensitive S, Intermediate I and Resistance R) discrepancies were found at all the laboratories for either one or both reference strains. The antibiotics most affected by the S/I/R discrepancies were trimethoprim (100%), vancomycin (100%), amoxicillin (80%) and amoxicillin + clavulanic acid (70%). Conclusion: This study showed a deficiency in the control of critical control points that impacts the performance of the AST reported by the laboratories in Niger. Corrective actions are needed to improve the performance of AST in clinical microbiology laboratories in Niger
Subject(s)
Humans , Quality Control , Microbial Sensitivity Tests , Medical Laboratory Science , Microbiology , Critical Illness , NigerABSTRACT
Background: In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.Methods: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.Results: Authors collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e. a frequency of 51.92%. Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%) The surgical treatment was conservative in 92.60%. The total hysterectomy was performed in 7.40. Lethality was 1.4%.Conclusions: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In this context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment are necessary for less invasive surgery.
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Background: The objective of this study was to highlight obstetrical complications that occurred among adolescent girls who delivered at the ward and to identify factors associated with the occurrence of such complications.Methods: This was a prospective study of descriptive and analytical type extending over a period of one year from September 1, 2016 to August 31, 2017 carried out at the maternity ward of Ignace Deen National Hospital at Conakry Teaching Hospital (CHU). It covered a continuous series of 1034 deliveries among adolescent girls.Results: The frequency of childbirth among adolescent girls was 16.7%. The main complications identified were dystocia, severe preeclampsia, eclampsia, retroplacental hematoma, placenta previa, uterine rupture, severe anemia, postpartum hemorrhage and puerperal endometritis. These complications occurred among adolescent girls aged 18 to 19, christian, skin and pelvic bones secondary school or university students. Factors associated with such complications were the marital status (p=0.010), the gestational age (p=0.012), the number of prenatal consultations (p=0.001), the place of prenatal consultation (p=0.001), the reason for admission (p=0.000) and the mode of admission (p=0.000).Conclusions: Childbirth among adolescent girls is frequent in this context; complications are numerous but they are preventable in the vast majority of cases.
ABSTRACT
Le but de l'etude etait d'estimer la prevalence des infections a Neisseria gonorrhoeae et d'evaluer la sensibilite aux antibiotiques des souches; en vue d'une revision eventuelle du traitement par approche syndromique des ecoulements genitaux au Niger. De juillet a decembre 2007; un depistage systematique a ete effectue chez des professionnelles du sexe (PS) dans 5 localites; et des patients consultant pour IST a Niamey. Parallelement a l'examen microscopique apres coloration de Gram; les prelevements endocervicaux ou uretraux ont ete mis en culture sur gelose chocolat Polyvitex (bioMerieux); avec/sans inhibiteurs VCN; en atmosphere humide; sous 5-10CO2; pendant 1 a 2 jours. Les colonies suspectes sont identifiees sur galerie API NH (bioMerieux) et les antibiogrammes realises. Le gonocoque n'a ete isole que chez 0;68(5/739) des PS. Aucune souche n'a ete obtenue chez les 20 patientes IST; contre 2 chez les 9 cas d'uretrite masculine. Chacune des souches est resistante a au moins un des antibiotiques recommande par l'OMS dans l'approche syndromique. Cinq produisent une penicillinase et 2 une beta-lactamase a spectre elargi. Avec cette relative rarete des isolats et l'existence de resistance a au moins un des antibiotiques preconises; seule une surveillance microbiologique de routine permettra une collecte suffisante de souches pour avoir des donnees fiables necessaires a une revision de protocole
Subject(s)
Antibiotic Prophylaxis , Neisseria gonorrhoeae , Niger , Penicillin ResistanceABSTRACT
Dans ce travail; 2350 demandes de confirmation serologique des suspicions cliniques d'infection a VIH a Niamey sont examinees. 430 malades suspects sont seropositifs; soit une prevalence globale de 18;29 pour cent. Il n'y a pas de difference significative par rapport au sexe. Dans plus de 76 pour cent des cas; ces seropositifs avaient entre 16 et 45 ans. Le profil VIH-1 predomine avec une frequence de 67;21 pour cent; viennent ensuite le double profil VIH-1 + VIH-2 avec 21;63 pour cent et le profil VIH-2 avec 11;16 pour cent. Les quatre premiers motifs cliniques de suspicion sont la diarrhee chronique; l'amaigrissement important; la fievre au long cours et les infections pulmonaires
Subject(s)
AIDS Serodiagnosis , HIV Infections/diagnosis , HIV SeropositivityABSTRACT
Un bilan de la recherche de neisseria gonorrhoeae dans 6.608 prelevements genitaux effectues de 1985 a 1992; a Niamey est presente. Ce germe a ete isole 624 fois; soit une prevalence globale de 9;44 pour cent. Quant aux antibiogrammes; pour les 17 antibiotiques retenus; l'on constate de grandes variations dans la frequence de leur utilisation. Cela n'a pas permis de tirer des conclusions generalisables sur les taux d'efficacite de chacun de ces produits sur le gonocoque. Celui-ci semble cependant plus frequemment sensible au chloramphenicol; aux cyclines et a l'oleandomycine