[Upper urinary tract infections in adults: about 261 episodes]

Upper urinary tract infections are frequent. Escherichia coli is the main pathogen identified from community acquired infections. We aim to study epidemiologic, clinical and bacterial features of this infection. We identified 261 episodes that occurred in241 patients. They were 213 females and 48 males aged of 48, 75 years. Enterobacteriaceae were the main pathogens isolated in 93,5%: E. coli in 73,3% and Klebsiella pneumoniae in 15,3%. E.coli sensitivity was of 30% for amoxicillin, 98% for cefotaxim, 96% for gentamicin, 90% for ciprofloxaine and 56% for co-trimoxazole. Anterior antibiotic use was associated with low E. coli sensitivity mainly with fluoroquinolones [96 vs 77%] and co-trimoxazole [62 vs 43%]. This enhances the role of antibiotic pressure on the resistance emergence. The reasonable use of antibiotics is necessary to limit resistance extent

[Brain abscess in medical environment, a current problem]

Brain abscesses are severe infections with lethal outcome in the case of delay in diagnosis and treatment. The authors report their experience about 30 patients with pyogenic brain abscesses treated between 1989 and 2000. The goal of the study is to analyse epidemiological, clinical and therapeutic aspects of this disease. The sex ratio [M:W] was 2,3 and the mean age was 34 years. Predisposing factors were sepsis of adjacent organs [53%] and bacteremia [30%]. The clinical manifestations were: fever [83%], headaches [90%] and focal neurologic signs [57%]. CT-scan findings were single lesions in 80% of cases. CT-scan showed a deep ring-enhancing lesion with surrounding edema in 77% of cases. Bacteriological agents in 13 cases [43%] were: 4 Staphylococcus aureus, 2 Neisseria meningitidis and 7 negative Gram bacilli. Medical treatment alone was in 77% of cases seven patients benefited from medical and neurosurgical approaches. Death occurred in 10% of cases