Introduction: Infections represent a real public health problem aggravating the morbidity and mortality of hospitalized patients. Methods: This was a retrospective study with descriptive purposes over a period of 05 y...Introduction: Infections represent a real public health problem aggravating the morbidity and mortality of hospitalized patients. Methods: This was a retrospective study with descriptive purposes over a period of 05 years, in the Pneumology Department of the University Hospital of Cocody. Results: The average age in our population was 42 years. We observed a male predo- minance of 64.5%, with a sex ratio of 1.8. Medical history was dominated by HIV infection (23.5%), followed by tuberculosis (15.6%). Concerning lifestyle, smoking was found in 38% of cases. Symptoms progressed chronically in 80% of cases. An infectious syndrome was found in 75% of cases. Microbial culture was positive in 42% of cases. Pseudomonas aeruginosa and Klebsiella pneumoniae were encountered in 26.4% of cases each, followed by Echerichia coli in 10.4% of cases. Klebsiella pneumoniae in the first three years topped the list, but gradually. Pseudomonas aeruginosa maintained its leadership over the last three years. Pseudomonas aeruginosa isolates expressed a resistance rate of 9.8% to ceftazidime and 8.1% to imipenem;to aztreonam (36%), ticarcillin (33.3%) and levofloxacin. These strains were susceptible to fosfomycin (100%), mero- penem (96.6%) and amikacin (96%). For isolated strains of Entero- bacteria- ceae, resistance was observed about ticarcillin (83.3%) and amoxicillin clavula- nic acid (71.2%). Streptococcaceae showed resistance to tetracycline (69.2%) and erythromycin (50%). Over the years there has been an increase in re- sistance to amoxicillin-clavulanic acid ceftriaxone. The death rate was 14%. Conclusion: The bacterial profile of infections is dominated by germs respon- sible for nosocomial infection with significant mortality.展开更多
Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January t...Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January to August2012 inthe emergency department, neurology and intensive care unit. It included patients admitted for cerebral hemorrhage confirmed by CT-scan. A statistical analysis by logistic regression was carried out to evaluate the correlation between infection and death. Result: Among total of 261 patients for stroke, 82 admitted for cerebral hemorrhage (31.4%). The mean age was 55 ± 11 years (range 26 to 83 years). The sex ratio men/women was 1.7. Hypertension was the most important risk factor to 80.5%. The average intake in neurology time was 28 ± 13 hours. The average time for completion of the CT-scan was 2.4 ± 2 days. Thirty-eight (46.3%) patients had a fever linked to an infectious cause from the third day of hospitalization. The most frequent infectious complications were sepsis (n = 16%;42%), pulmonary infection (n = 14%;37%) and urinary tract infection (n = 8%;21%). Specific mortality of infection was 31.7% (n = 26). The multivariate analysis showed a positive correlation between the occurrence of infection and mortality (p = 0.002), specifically between sepsis and mortality (p = 0.0004), and an association between the time of admission late in neurology and the occurrence of infectious complications (p = 0.0001). Conclusion: Infection is one of the dreaded complications of cerebral hemorrhage. It is often associated with delayed care in specialized areas, and is thereby a preventable cause of death.展开更多
Background: Lower respiratory tract infections (LRTI) are among the leading causes of morbidity and mortality. A severe form of atypical pneumonia, Q fever, has been found in Northern Tanzania. Assessment of the quali...Background: Lower respiratory tract infections (LRTI) are among the leading causes of morbidity and mortality. A severe form of atypical pneumonia, Q fever, has been found in Northern Tanzania. Assessment of the quality of health care for lower respiratory tract infection from the clinicians’ performance has rarely been performed. Methods: A cross sectional descriptive study using the qualitative and quantitative approaches for assessing clinicians and patient files from 11 health facilities of Kilimanjaro region. The facilities were of 4 different levels of public health care delivery and 1 private independent hospital. Results: Medications for LRTI were highly variable in 346 files and from attempts of treatment reported in 53 clinician’s interviews. No file showed attempts for assessing the severity of Pneumonia. Only 6 (11.1%) clinicians could mention causes of atypical pneumonia. Only 7 clinicians (13.0%) were aware of Q-fever and could mention the cause. The quality of clinical records for monitoring the progress was not the same in all levels of care and the difference in availability was statistically significant as level of mental state χ2 (4) = 139.4;P展开更多
Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social ...Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social costs. Study aim: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of infectious spondylodiscitis in the elderly in a rheumatological setting in Togo. Patients and methods: This was a multicenter, cross-sectional study conducted on the records of patients aged at least 65 years, suffering from infectious spondylodiscitis and hospitalized in four rheumatology units from their respective opening dates till December 31, 2020. Data collection lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was radioclinical and laboratory-based. Results: 83 (49 women, 34 men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the clinical course was 12 months. Spondylodiscitis was of tuberculous etiology (89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%) segments. The location was multifocal in 12.05% of cases. It was associated with pulmonary involvement in 22.64% of cases. A neurological complication was identified in 48.19%. The main risk factors identified were promiscuity (48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%) and sickle cell disease (6.03%). The clinical course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization, tuberculosis being the most frequent etiology. Multifocal location, deterioration of general condition, gibbosity and neurological complications are exclusive to the elderly subject.展开更多
文摘Introduction: Infections represent a real public health problem aggravating the morbidity and mortality of hospitalized patients. Methods: This was a retrospective study with descriptive purposes over a period of 05 years, in the Pneumology Department of the University Hospital of Cocody. Results: The average age in our population was 42 years. We observed a male predo- minance of 64.5%, with a sex ratio of 1.8. Medical history was dominated by HIV infection (23.5%), followed by tuberculosis (15.6%). Concerning lifestyle, smoking was found in 38% of cases. Symptoms progressed chronically in 80% of cases. An infectious syndrome was found in 75% of cases. Microbial culture was positive in 42% of cases. Pseudomonas aeruginosa and Klebsiella pneumoniae were encountered in 26.4% of cases each, followed by Echerichia coli in 10.4% of cases. Klebsiella pneumoniae in the first three years topped the list, but gradually. Pseudomonas aeruginosa maintained its leadership over the last three years. Pseudomonas aeruginosa isolates expressed a resistance rate of 9.8% to ceftazidime and 8.1% to imipenem;to aztreonam (36%), ticarcillin (33.3%) and levofloxacin. These strains were susceptible to fosfomycin (100%), mero- penem (96.6%) and amikacin (96%). For isolated strains of Entero- bacteria- ceae, resistance was observed about ticarcillin (83.3%) and amoxicillin clavula- nic acid (71.2%). Streptococcaceae showed resistance to tetracycline (69.2%) and erythromycin (50%). Over the years there has been an increase in re- sistance to amoxicillin-clavulanic acid ceftriaxone. The death rate was 14%. Conclusion: The bacterial profile of infections is dominated by germs respon- sible for nosocomial infection with significant mortality.
文摘Objective: To evaluate the impact of urinary tract and pulmonary infection on mortality after cerebral hemorrhage. Method: We conducted at the University Hospital of Brazzaville, a cross-sectional study from January to August2012 inthe emergency department, neurology and intensive care unit. It included patients admitted for cerebral hemorrhage confirmed by CT-scan. A statistical analysis by logistic regression was carried out to evaluate the correlation between infection and death. Result: Among total of 261 patients for stroke, 82 admitted for cerebral hemorrhage (31.4%). The mean age was 55 ± 11 years (range 26 to 83 years). The sex ratio men/women was 1.7. Hypertension was the most important risk factor to 80.5%. The average intake in neurology time was 28 ± 13 hours. The average time for completion of the CT-scan was 2.4 ± 2 days. Thirty-eight (46.3%) patients had a fever linked to an infectious cause from the third day of hospitalization. The most frequent infectious complications were sepsis (n = 16%;42%), pulmonary infection (n = 14%;37%) and urinary tract infection (n = 8%;21%). Specific mortality of infection was 31.7% (n = 26). The multivariate analysis showed a positive correlation between the occurrence of infection and mortality (p = 0.002), specifically between sepsis and mortality (p = 0.0004), and an association between the time of admission late in neurology and the occurrence of infectious complications (p = 0.0001). Conclusion: Infection is one of the dreaded complications of cerebral hemorrhage. It is often associated with delayed care in specialized areas, and is thereby a preventable cause of death.
文摘Background: Lower respiratory tract infections (LRTI) are among the leading causes of morbidity and mortality. A severe form of atypical pneumonia, Q fever, has been found in Northern Tanzania. Assessment of the quality of health care for lower respiratory tract infection from the clinicians’ performance has rarely been performed. Methods: A cross sectional descriptive study using the qualitative and quantitative approaches for assessing clinicians and patient files from 11 health facilities of Kilimanjaro region. The facilities were of 4 different levels of public health care delivery and 1 private independent hospital. Results: Medications for LRTI were highly variable in 346 files and from attempts of treatment reported in 53 clinician’s interviews. No file showed attempts for assessing the severity of Pneumonia. Only 6 (11.1%) clinicians could mention causes of atypical pneumonia. Only 7 clinicians (13.0%) were aware of Q-fever and could mention the cause. The quality of clinical records for monitoring the progress was not the same in all levels of care and the difference in availability was statistically significant as level of mental state χ2 (4) = 139.4;P
文摘Infectious spondylodiscitis in the elderly is a diagnostic and therapeutic emergency. They are mainly a functional and sometimes vital prognosis issue, with long-term chronic disabling sequelae and significant social costs. Study aim: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of infectious spondylodiscitis in the elderly in a rheumatological setting in Togo. Patients and methods: This was a multicenter, cross-sectional study conducted on the records of patients aged at least 65 years, suffering from infectious spondylodiscitis and hospitalized in four rheumatology units from their respective opening dates till December 31, 2020. Data collection lasted three months (December 1, 2020 to February 29, 2021). The diagnosis of infectious spondylodiscitis was radioclinical and laboratory-based. Results: 83 (49 women, 34 men) of the 1281 patients (6.48%) examined had infectious spondylodiscitis. The mean age at consultation was 70.59 ± 5.09 years, and the mean duration of the clinical course was 12 months. Spondylodiscitis was of tuberculous etiology (89.20%). It was most often found in the lumbar (56.62%) and dorsal (21.69%) segments. The location was multifocal in 12.05% of cases. It was associated with pulmonary involvement in 22.64% of cases. A neurological complication was identified in 48.19%. The main risk factors identified were promiscuity (48.82%), chronic alcoholism (18.07%), HIV infection (8.43%), diabetes (6.03%) and sickle cell disease (6.03%). The clinical course under medical treatment was favorable in 57 patients (68.68%). Conclusion: Infectious spondylodiscitis remains a frequent reason for hospitalization, tuberculosis being the most frequent etiology. Multifocal location, deterioration of general condition, gibbosity and neurological complications are exclusive to the elderly subject.
