[Nosocomial septicemias due to multiresistant enterobacteria: preliminary considerations in 32 cases observed in the African hospital environment]. / Septicémies nosocomiales à enterobactéries multirésistantes aux antibiotiques: considérations préliminaires à propos de 32 cas observés in milieu hospitalier africain.

In hospital settings in Africa the many other concerns of sanitary officials and the lack of available resources often make hospital hygiene and nosocomial infection secondary problems. To illustrate the importance of these issues in an African pediatric setting, this report describes a series of 32 cases of nosocomial septicemia that occurred within a 2-month period in the Pediatric Department of Principal Hospital in Dakar. There were 10 deaths. The infecting organisms were similar to those observed in industrial countries. Klebsiella Pneumoniae was identified in 16 cases, Escherichia coli in 5, and an association of both bacteria in 5. A profile of beta-lactamase enzymes with a classic epidemiologic spectrum was observed in 15 of 21 strains of Klebsiella pneumoniae and in 3 of 10 strains of Escherichia coli. The authors discuss the conditions that may have encouraged the outbreak of septicemia, regret the lack of a service to monitor hospital hygiene, and propose prophylactic measures using laboratory tests that are feasible in a hospital setting in Africa.

[Broad spectrum beta-lactamases: results in Principal Hospital of Dakar (February 1st 1992 - February 1st 1993)]. / Béta-lactamases à spectre élargi: bilan sur un an à l'Hôpital Principal de Dakar (1er Février 1992 - 1er Février 1993).

The intensive, unreasonable use of antibiotics makes resistant strains growing particularly in hospital areas where the selection pressure is important. During the last years, the outstanding event was the emergence of resistant strains against 3rd generation of cephalosporin. In many cases this resistance is linked with Extended broad spectrum Beta-lactamase. After the description of a simple method to detect these particular strains, the authors report the epidemiologic situation in Hopital Principal of Dakar from February 1992 to January 1993. The emergence of these resistant strains creates heavy problems in intensive care services and Pediatrics. As conclusion, principal measures to prevent this phenomen are exposed.