Escherichia coli meningitis during bacteremia in the Ibrahima-Diop-Mar infectious diseases clinic, Dakar Fann National Hospital Center (Senegal)

OBJECTIVES: The aim of this study was to describe epidemiological, clinical, and bacteriological aspects of Escherichia coli bacteremia and meningitis in the Ibrahima-Diop-Mar infectious diseases clinic, Dakar Fann National Hospital Center (Senegal). MATERIALS AND METHODS: Data was collected from the bacteriology laboratory and hospitalization files. RESULTS: 57 cases of E. coli bacteremia were reported. Among them, 10 were associated with meningitis. AIDS was diagnosed in 74% of the cases. The global lethality rate was 47% but this rate was higher in cases of associated meningitis (80 vs 37%) and in AIDS patients (50 vs 27%). Ceftriaxone, aztreonam, gentamicin, and ciprofloxacin were active on more than 95% of strains but cotrimoxazole was active on only 49% of the strains. Resistance to cotrimoxazole was higher among E. coli strains isolated from AIDS patients (62 vs 13%). CONCLUSION: The low susceptibility to cotrimoxazole might increase the incidence of E. coli infections among patients with AIDS. It is therefore important to find an alternative to cotrimoxazole chemoprophylaxis.     

Epidemiological, clinical, etiological features of neuromeningeal diseases at the Fann Hospital Infectious Diseases Clinic, Dakar (Senegal)

OBJECTIVES: This retrospective study was carried out to determine the prevalence of cerebromeningeal diseases at the Fann Teaching Hospital Infectious Diseases Clinic, in Dakar, and to describe their epidemiological, clinical, and etiological features. PATIENTS AND METHODS: Data was collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003. RESULTS: Four hundred seventy cases were identified (11.4% of total admissions) with a M/F sex ratio of 1.38 and a mean age of 33 years. Eighty-nine patients were infected by HIV and clinical presentations included fever (78%), meningeal syndrome (57.4%), coma (64.9%), convulsions (19%), focal neurological deficits (15.5%), and cranial nerves dysfunction (7.2%). Etiologies presented as cerebral malaria (85 cases), purulent meningitis (51 cases), neuromeningeal cryptococcosis (37 cases), tuberculous meningitis (11 cases), intracranial abscess (10 cases), toxoplasma encephalitis (4 cases), cerebrovascular attack (11 cases), and cerebromeningeal hemorrhages (3 cases). In as many as 248 cases (52.8%) no etiology could be found. The case fatality rate was 44.5% overall (209 deaths) and 68.5% among HIV-infected patients. Neurological sequels were found in 22 survivors (8.8%), consisting in focal neurological deficit (12 cases), deafness (5 cases), diplopia (2 cases), dementia (2 cases), postmeningitic encephalitis (1 case). CONCLUSION: These results show the need to improve our technical capacities in our diagnostic laboratories, the prevention of opportunistic infections in the course of HIV/AIDS infection, and the involvement of various specialists in the management of cerebromeningeal diseases.     

Nontyphoidal Salmonella bacteremia cases in AIDS patients in a Dakar University Hospital (Senegal)

OBJECTIVES: This study had for aim to describe epidemiological, clinical and bacteriological aspects of nontyphoidal Salmonella bacteremia in patients with AIDS in the Dakar University Hospital Infectious Diseases Clinic. METHOD: This study was made on data recorded between 1January1996 and 31December2005. The strains were identified according to biochemical (API 20E, BioMérieux) and antigenic features. Their susceptibility to antibiotic drugs was tested by antibiogram. Screening for strains secreting of an extended-spectrum betalactamase was performed. RESULTS: Sixty-two cases of nontyphoidal Salmonella bacteremia were recorded in AIDS patients as follows: Salmonellaenteritidis bacteremia (32 cases), Salmonellatyphimurium bacteremia (11 cases), and Salmonella spp bacteremia (11 cases). The strains were susceptible to ciprofloxacin, ceftriaxone, aztreonam, amoxicillin plus clavulanic acid in at least 92% of the cases. Only 79% of them were susceptible to cotrimoxazole. The lethality rate was 55%. DISCUSSION: This lethality rate of nontyphoidal Salmonella bacteremia is high in AIDS patients. Therefore, the priority should be put on prevention and, in patients with AIDS, on food hygiene measures, antiretroviral treatment and efficient chemoprophylaxis. This should prove efficient to reduce incidence of nontyphoidal Salmonella bacteremia.     

医院HIS系统与国家传染病、死因网络直报系统联接的试点探索

目的 通过试点探索医院HIS系统建设如何提高传染病和死因网络报告的效率和质量的方法、问题和解决之道. 方法 技术方面,通过Web Server技术建立与国家数据库联接,将局域网HIS系统的数据审核后直接送入国家数据库;管理方面,调整医院诊疗程序,配合医院内部的制度建设,以保障报告效率. 结果 医院HIS系统与国家直报系统成功实现了联接,并提高了报告质量与效率. 结论 实现HIS系统与国家直报系统联接,需要在硬件技术与管理两个方面着手方能确保高效准确.     

苍南县乡镇卫生院传染病管理现状及需求调查

乡镇卫生院是农村卫生服务网络的重要组成部分,作为广大农村地区传染病防治的第一道防线,在农村传染病防治工作中起着举足轻重的作用。本文旨在通过对苍南县基层传染病管理现状及需求的调查了解,全面系统掌握目前苍南县传染病防治基     

妇产科专科医院医院感染现患率调查分析

目的 了解妇产科专科医院医院感染发病特点,为修订医院感染控制措施提供依据.方法 由专职人员、临床监控医师和信息员组成调查组,对2009年9月23日560例住院患者进行现患率调查.结果 实查率98.25%;医院感染率1.43%;医院感染率最高科室为新生儿重症监护病房6.90%;感染部位以胃肠道居首,占37.50%;抗菌药物使用率56.07%;治疗性使用抗菌药物前病原学送检率为94.03%.结论 医院感染现患率调查简单、可靠,基本反映专科医院医院感染现状;需加强对重点科室医院感染和规范使用抗菌药物的管理.     

2010年高邮市人民医院传染病报告资料分析

[目的]了解高邮市人民医院法定传染病报告情况和流行特征,为今后医院传染病防治工作提供依据。[方法]对2010年高邮市人民医院报告的法定传染病疫情报告资料采用描述性流行病学方法进行分析。[结果]2010年报告乙、丙类传染病13种共719例,其中乙类传染病10种544例,丙类3种175例,无甲类传染病报告。719例中,手足口病占23.37%,肺结核占20.72%,病毒性肝炎占19.47%,梅毒占17.94%,细菌性痢疾占10.57%;1月发病占10.85%,3月占10.15%;男性占61.61%,女性占38.25%;0～5岁占24.90%,40～49岁占15.72%;工人占19.75%,农民占36.30%。[结论]手足口病、肺结核、病毒性肝炎是传染病控制重点。     

Cardiovascular events in the course of tetanus: a prospective study on 30 cases in the infectious diseases clinic, in the Fann teaching hospital, Dakar

OBJECTIVES: This prospective study had for aim to determine the frequency and characteristics of cardiovascular events in the course of tetanus. PATIENTS AND METHODS: From September to December 2002, we studied all patients over 4 years of age presenting with tetanus without any documented underlying disease. RESULTS: Thirty cases were included (mean age 36+/-20 years; sex-ratio 2.3). Seventy-three per cent had a mild-gravity tetanus (stage II of Mollaret) upon admission. One hundred and seventeen ECG were recorded and 93.3% of the patients had more than one abnormality: arrhythmia (24 cases), prolonged QT interval (23 cases), ventricular hypertrophia (17 cases), and atrial hypertrophia (4 cases) especially left (3 cases), failure of AV conduction (3 cases), ST segment depression (3 cases), left and right axis deviation (3 cases), baseline undulation (3 cases) and repolarization disturbances (1 case). All patients had a normal Doppler echocardiographic examination. The mean hospitalization stay was 11.6+/-1.4 days and complications were noted in 60%; sinus tachycardia in apyrexia (5 cases), instable BP (5 cases), excessive sweatiness in apyrexia (1 case), and access of bradycardia with sudden cardiac arrest (2 cases). 8 patients died (26.7%). Six patients with cardiac autonomic dysfunction died, the case fatality rate being statistically higher in this group (P=0.007). A prolonged QT interval, sinus tachycardia and left ventricular hypertrophia were statistically more frequent at the acute phase of the illness. CONCLUSION: The case fatality rate of tetanus is still high, due among others to autonomic dysfunctions.     

2000～2009年山东某省级医院法定传染病疫情资料分析

[目的]探索大型综合性医院的传染病疫情管理方式,提高传染病疫情管理质量。[方法]在综合性医院建立疫情监督网络,对传染病疫情进行监督管理。对山东某省级医院2000-2009年传染病上报情况进行统计分析。[结果]疫情监督网络建立前的2000-2004年共上报传染病报告卡8 071张,合格的6 531张,合格率为80.92%;完整率为84.91%;准确率为82.44%。疫情监督网络建立后的2005-2009年共上报传染病报告卡18 571张,合格的18 463张,合格率为99.42%;完整率为99.78%;准确率为99.84%。差异均有统计学意义（P〈0.01）。不同科室传染病报告卡上报合格率由网络建立前的80.92%上升到99.42%,无迟报、漏报现象。[结论]疫情监督网络的建立,提高了医院传染病疫情管理质量。     

Current aspects of extra-uterine pregnancy in Libreville (Gabon): an account of 153 cases

The impact of extra-uterine pregnancy is still increasing in the world. At the same time, its treatment is being improved in developed countries. The purpose of this study is to assess the current aspects of extra-uterine pregnancy in Libreville (Gabon) and to suggest actions which may improve its vital prognosis in the African context. The present study is only prospective and focuses on 153 extra-uterine cases of pregnancy recorded from February 1, 1997 to July 31, 2000. The average frequency was 2.32%. This frequency has been steadily increasing and went from 2% in 1997 to 2.32 % in 2000. The average age of the patients was 29. Extra-uterine pregnancy was diagnosed until the patients were 17. It concerned all parities. The average age was 8 weeks of pregnancy. Three para-clinical investigations allowed the confirmation of the diagnosis: ultrasound scan, coelioscopy, beta GCH plasma dosage. Laparotomy was the main therapeutic solution. No maternal death was recorded. The education of women capable of procreating on the necessity of early consultations, the supplying of hospitals with means which allow para-clinical investigations and the motivation of medical staff seem to be the main solutions to decrease the mortality rate due to extra-uterine pregnancy in Africa.     

综合性医院门诊236例传染病分析

目的了解综合性医院传染病发病及流行的特点,探讨减少医院门诊交叉感染的措施. 方法对我院近两年接诊的236 例传染病病因和特点进行调查分析. 结果 236 例传染病中细菌性菌痢占第1位,其次为流行性脑膜炎、艾滋病、脊髓灰质炎、麻疹和疑似克雅病. 结论必须重视综合医院门诊传染病的规范化管理,强化医护人员传染病的隔离防护意识,加强医院感染监测,加强消毒隔离,才能确实控制和降低医院感染.     

Review of Rare Diseases Resources: National Organization for Rare Disorders (NORD) Rare Disease Database,NIH Genetic and Rare Diseases Information Center,and Orphanet

This column profiles three important online resources for rare disorder information. The National Organization for Rare Disorders (NORD) Rare Disease Database set the standard for thorough, detailed monographs on rare diseases starting in the 1990s. The NORD Database is complemented by the National Institutes of Health (NIH) Genetic and Rare Diseases Information Center online and the European resource, Orphanet, both of which provide much broader coverage, if less in depth than NORD’s. Reading level for all three information sources is high, and there are occasional issues with currency. However, consumer health librarians should find these organizations’ web-based databases to be reliable sources of information on health conditions that can be perplexing for both patient and health care providers alike.     

Empyema caused by Staphylococcus aureus in children: the experience of the Albert Royer Children's Hospital at Fann University Hospital, Dakar

We report a retrospective study of 58 cases of empyema caused by Staphylococcus aureus at the Albert Royer Children's Hospital at the Fann University Hospital, between January 1st 1992 and December 31st 1995. Staphylococcus aureus is the principal bacterium responsible for pleural effusions in children (54%), way ahead of Streptococcus pneumoniae (19%). Most of the children affected (86%) are less than 30 months old. Theses infections are often serious due to the resistance of the bacterium to the usual antibiotics, the lack of solid research data and mechanical complications associated with the effusion. Treatment is based on the use of an appropriate bactericidal antibiotic treatment and pleural drainage.     

仙桃市1998—2007年传染病流行趋势分析

传染病流行趋势分析是对传染病发生流行的三间分布的描述,即人间、时间和地区分布等特征进行的分析。为了解和掌握法定传染病流行因素与流行特点,为制定有效的防制措施提供依据,对仙桃市1998—2007年10年间法定传染病发病、死亡情况统计分析如下。     

Characterization of virulence factors in the newly described Salmonella enterica serotype Keurmassar emerging in Senegal (sub-Saharan Africa)

From 2000 to 2001, nine strains of Salmonella enterica belonging to the new serotype Keurmassar have been isolated from human and poultry samples at the Senegalese National Salmonella and Shigella Reference Laboratory at the Pasteur Institute, in Dakar. All strains carried virulence factors including Salmonella Pathogenicity Islands (SPI)-1, -2, -3 and -5 encoded genes. Strains did not harbour virulence plasmid. Ribotyping analysis revealed a single clone identical to Salmonella Decatur isolated in Zimbabwe. These data suggest that strains are closely related, and may have been spread clonally. In this new serotype, insertion sequence IS200 is not present.     

2001-2005年乌鲁木齐市肠道传染病流行动态分析

为了解乌鲁木齐市肠道传染病的流行趋势和发病特点，为政府制定预防控制措施提供科学依据，现将2001—2005年肠道传染病疫情动态分析如下。