Introduction: Entero bacteria are mainly found in the gut of man and animals. The frequent acquisition of antibiotic resistance mechanisms explains why they are the bacteria most often implicated in human infectious p...Introduction: Entero bacteria are mainly found in the gut of man and animals. The frequent acquisition of antibiotic resistance mechanisms explains why they are the bacteria most often implicated in human infectious pathology. It is estimated to be involved in 50% of sepsis, 60% of enteritis, 70% of urinary tract infection case. Objective: To determine the prevalence of enterobacterial infections diagnosed at Fann Infectious Diseases Clinic, and describe their epidemiological, clinical, therapeutic and evolutionary aspects. Patients and Methods: This is a retrospective and descriptive study, on patients hospitalized from January 2013 to December 2014, at Fann Infectious Diseases Clinic, with bacteriological confirmation of an enterobacteria infection. Results: A total of 129 cases were collected during the study period. The average age was 41 years, and female were predominant (60%) with a sex ratio of 0.67. Comorbidity was found in 88.4% of the cases, most of which were HIV infection. The most common clinical signs were infectious syndrome (53.49%) and general impairment (40.31%). The main gateway was urinary (55.8%). Samples were monomicrobial in 76.7% of cases. Klebsiella and Escherichia were the most common and 68.7% of the subjects had probabilistic treatment. Most enterobacterial strains were resistant to third generation cephalosporins (C3G), aminoglycosides to ciprofloxacin and cotrimoxazole. Aside from 4% of them, all were sensitive to imipenem. Conclusion: The advent of antibiotics has brought hope in the treatment of enterobacterial infections. However, an increase in their resistance to the usual antibiotics has been noted in recent years. As a result, the fight against antibiotic resistance must be a priority.展开更多
Introduction: Diabetic ketoacidosis (DKA) is the most common metabolic complication of diabetes. Although historically reported in children, it is increasingly observed in adults. Short-term outcomes and prognosis var...Introduction: Diabetic ketoacidosis (DKA) is the most common metabolic complication of diabetes. Although historically reported in children, it is increasingly observed in adults. Short-term outcomes and prognosis vary widely across healthcare settings. Therefore, we aimed to determine the prevalence, diagnostic characteristics, and outcomes of newly diagnosed diabetic ketoacidosis in a hospital setting in Dakar. Methodology: We conducted a descriptive and analytical cross-sectional study from January 1, 2020, to January 31, 2021, in the Endocrinology-Metabolism Department of the Pikine National Hospital Center. All diabetic patients hospitalized for newly diagnosed diabetic ketoacidosis during this period were included. Results: A total of 54 patients were enrolled in the study. The prevalence of newly diagnosed DKA in the facility was 17.1%. The mean age was 38.54 years, with a male predominance and a sex ratio of 1.16. Thirty-five patients had a family history of diabetes. Upon admission, 14.9% of patients had altered consciousness, and 92.4% exhibited cardinal symptoms, with an average duration of 14.2 days. Kussmaul breathing and gastrointestinal symptoms were observed in 13% and 33% of cases, respectively. The mean capillary blood glucose level at admission was 3.43 g/L. Infection was identified as the precipitating factor in half of the cases, while no triggering factor was found in the remaining cases. The mean BMI was 25.27 kg/m², and the average glycated hemoglobin (HbA1c) level was 12.2%. We recorded the diabetes classification for all patients. Nine had type 1 diabetes, twelve had type 1b diabetes, thirty-one had type 2 diabetes, and two had diabetes secondary to corticosteroid therapy. All patients received continuous intravenous insulin therapy via a syringe pump. The mean time to ketosis resolution was 34.6 hours. The average total dose of regular insulin administered was 442.3 IU. The mean duration of hospitalization was 7.6 days. One patient died, and fifty-one were discharged while continuing insulin therapy, with an average dose of 53 IU. Conclusion: The prevalence of newly diagnosed DKA remains high. With proper management, the prognosis is generally favorable. Diabetes classification is crucial, as it determines subsequent treatment strategies.展开更多
文摘Introduction: Entero bacteria are mainly found in the gut of man and animals. The frequent acquisition of antibiotic resistance mechanisms explains why they are the bacteria most often implicated in human infectious pathology. It is estimated to be involved in 50% of sepsis, 60% of enteritis, 70% of urinary tract infection case. Objective: To determine the prevalence of enterobacterial infections diagnosed at Fann Infectious Diseases Clinic, and describe their epidemiological, clinical, therapeutic and evolutionary aspects. Patients and Methods: This is a retrospective and descriptive study, on patients hospitalized from January 2013 to December 2014, at Fann Infectious Diseases Clinic, with bacteriological confirmation of an enterobacteria infection. Results: A total of 129 cases were collected during the study period. The average age was 41 years, and female were predominant (60%) with a sex ratio of 0.67. Comorbidity was found in 88.4% of the cases, most of which were HIV infection. The most common clinical signs were infectious syndrome (53.49%) and general impairment (40.31%). The main gateway was urinary (55.8%). Samples were monomicrobial in 76.7% of cases. Klebsiella and Escherichia were the most common and 68.7% of the subjects had probabilistic treatment. Most enterobacterial strains were resistant to third generation cephalosporins (C3G), aminoglycosides to ciprofloxacin and cotrimoxazole. Aside from 4% of them, all were sensitive to imipenem. Conclusion: The advent of antibiotics has brought hope in the treatment of enterobacterial infections. However, an increase in their resistance to the usual antibiotics has been noted in recent years. As a result, the fight against antibiotic resistance must be a priority.
文摘Introduction: Diabetic ketoacidosis (DKA) is the most common metabolic complication of diabetes. Although historically reported in children, it is increasingly observed in adults. Short-term outcomes and prognosis vary widely across healthcare settings. Therefore, we aimed to determine the prevalence, diagnostic characteristics, and outcomes of newly diagnosed diabetic ketoacidosis in a hospital setting in Dakar. Methodology: We conducted a descriptive and analytical cross-sectional study from January 1, 2020, to January 31, 2021, in the Endocrinology-Metabolism Department of the Pikine National Hospital Center. All diabetic patients hospitalized for newly diagnosed diabetic ketoacidosis during this period were included. Results: A total of 54 patients were enrolled in the study. The prevalence of newly diagnosed DKA in the facility was 17.1%. The mean age was 38.54 years, with a male predominance and a sex ratio of 1.16. Thirty-five patients had a family history of diabetes. Upon admission, 14.9% of patients had altered consciousness, and 92.4% exhibited cardinal symptoms, with an average duration of 14.2 days. Kussmaul breathing and gastrointestinal symptoms were observed in 13% and 33% of cases, respectively. The mean capillary blood glucose level at admission was 3.43 g/L. Infection was identified as the precipitating factor in half of the cases, while no triggering factor was found in the remaining cases. The mean BMI was 25.27 kg/m², and the average glycated hemoglobin (HbA1c) level was 12.2%. We recorded the diabetes classification for all patients. Nine had type 1 diabetes, twelve had type 1b diabetes, thirty-one had type 2 diabetes, and two had diabetes secondary to corticosteroid therapy. All patients received continuous intravenous insulin therapy via a syringe pump. The mean time to ketosis resolution was 34.6 hours. The average total dose of regular insulin administered was 442.3 IU. The mean duration of hospitalization was 7.6 days. One patient died, and fifty-one were discharged while continuing insulin therapy, with an average dose of 53 IU. Conclusion: The prevalence of newly diagnosed DKA remains high. With proper management, the prognosis is generally favorable. Diabetes classification is crucial, as it determines subsequent treatment strategies.
