ABSTRACT
BACKGROUND: An eight (8) months prospective study was carried out to control an outbreak of nosocomial pneumonia due to a Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus, in the paediatrics' unit at the Zou/Collines Departmental Hospital (CHDZ/C), (Benin). METHODS: Between 1(st) September 2004 and 30(th) May 2005 an investigation was conducted that involved the screening of all patients suspected to have nosocomial pneumonia, hospital environment sampling and the follow-up of cases until the end of hospital admission period. Isolates were identified, tested for antimicrobial susceptibility and analysed for PVL production. The study period was divided into Period I, corresponding to the outbreak period and Period II, after the complete renovation of the Unit along with hand washing promotion. RESULTS: A total of 453 patients were admitted during the period of the study; (235 during Period I and 218 during Period II) in the malnourished children sector. Twenty eight (28) cases of pneumonia due to S. aureus were discovered and PVL-producing S. aureus constituted 61% (17/28) of identified cases. The mortality rate among the PVL- producing strains was 15/17 (88%) while it was 1/11 (9%) among non PVL-producing strains. Enhanced hygiene measures helped to terminate the outbreak. CONCLUSIONS: This study showed that PVL was strongly linked to nosocomial pneumonia. PVL-producing S aureus can be controlled in the hospital by a combination of the promotion of preventive measures, decontamination of the environment and the early use of the correct antibiotic at the appropriate dose and for an adequate duration.
Subject(s)
Bacterial Toxins/biosynthesis , Cross Infection/microbiology , Cross Infection/mortality , Exotoxins/biosynthesis , Leukocidins/biosynthesis , Pneumonia, Staphylococcal/microbiology , Pneumonia, Staphylococcal/mortality , Staphylococcus aureus/metabolism , Benin/epidemiology , Child , Child Nutrition Disorders/complications , Cross Infection/prevention & control , Drug Resistance, Bacterial , Equipment Contamination/prevention & control , Female , Hand/microbiology , Hospitals , Humans , Male , Microbial Sensitivity Tests , Pneumonia, Staphylococcal/prevention & control , Prospective Studies , Staphylococcus aureus/isolation & purificationABSTRACT
OBJECTIVE: Promotion of environmental hygiene and sanitation in school districts contributes to community health. The purpose of the present study using physicochemical and biological parameters was to show the impact of these hygiene and sanitation measures on the health of schoolchildren in Collines Departement of Benin. MATERIALS AND METHODS: This prospective study was carried out in three selected primary schools from 28 September to 30 December 2007. A group of 210 children (100 boys and 110 girls) was obtained by careful identification of schoolchildren who benefited from the program and simple random selection. Physicochemical and bacteriologic analysis of water distributed in schools, assessment of the clinical condition of schoolchildren and screening of their hands for pathogenic bacteria allowed us to evaluate the level of hygiene in schools. Existing sanitary equipment was evaluated by on-site visual inspection. RESULTS: Hand screening identified the presence of pathogenic microorganisms on the hands of 74% of schoolchildren. Diarrhea was observed in 30% of pupils, osteomyelitis in 15% and tooth dystrophy in 25%. Water quality analysis showed fluorine and nitrate concentrations of 3.5 mg/L and 15 mg/L respectively and demonstrated contamination by fecal bacteria, especially during storage. CONCLUSION: The present study revealed a high level of pathogenic organisms on hands and confirmed their presence in water. Training teaching staff about educating and monitoring pupils regarding sanitary standards and protocols is needed to improve the level of competency and of compliance with hygiene measures.
