Bacteriological Profile of Pneumopathies in Chronic Renal Failure at the University Hospital Center of Point-G in Mali

Introduction: Chronic renal failure (CKD) is defined as a glomerular filtration rate (GFR) of less than 60 ml/min/1.73m2 for more than 3 months [1]. Infectious complications are a major source of morbidity in patients with chronic renal failure. In Mali, we have no data on pneumopathies in this population, hence the interest of this study. The objective of this work was to determine the frequency of pneumopathies in patients with chronic renal failure, describe the clinical radio-types, identify the microorganisms involved, and assess the renal prognosis of pneumopathies. Materials and Methods: This was an 18-month prospective and descriptive study from January 1, 2018 to June 30, 2019 conducted in the nephrology and hemodialysis department of the University Hospital of Point G. Included were patients hospitalized during our study period with CKD associated with pneumopathy on a chest X-ray. Not included were all patients hospitalized outside the study period, all CKD cases without pneumonia, patients with incomplete records, and non-consenting patients. Results: We examined 1111 patients, 35 of whom presented an image on chest X-ray related to pneumopathy, a frequency of 3.15% of cases. Twenty-one men (60%) and 14 women (40%) with a sex ratio of 1.5. The mean age was 46.8 ± 13.9 years with extremes of 23 and 76 years. The types of pneumopathy on the chest X-ray were: alveolar pneumopathy: 23 cases (65.7%), pleuropneumopathy: 10 cases (28.6%) and cavitary pneumopathy: 2 cases (5.7%). Cytobacteriological sputum examination was positive in 65.7%;leukocytes (68.6% of cases). The germs found were: Klebsiella pneumoniae (25.7% of cases), Escherica coli (11.4%), Pseudomonas aeruginosa (5.7%), Staphylococcus aureus (5.7%), Citrobacter freundi (5.7%), Enterococus sp. (2.9%), Enterobacter cloacae (2.9%), Candida albicans (5.7%). The search for acid-alcohol-resistant bacilli (BAAR) in sputum was positive in 4 cases (11.4%). There was an association between the results of cytobacteriological examination of sputum and the results of BAAR testing of sputum (p = 0.046).

Accidental Ingestion of Petroleum in Children at the University Hospital of Brazzaville

Introduction: Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. Objectives: Improving the management of accidental petroleum ingestion in children, describe the socio-demographic characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors associated with the occurrence of petroleum pneumopathy. Patients and Methods: We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, i.e. in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi2 and Odds ratio. The materiality threshold was set at 5%. Results: Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary education level n = 49 (62.8%). The mode of ingestion was self-ingestion (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxygen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. Conclusion: The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication for behavior change with an emphasis on careful storage of toxic products and to refrain from harmful actions when faced with petroleum intoxication.