[Prevalence of nosocomial infections in two hospitals in Conakry (Guinea)]. / Prévalence des infections nosocomiales dans deux hôpitaux de Conakry (Guinée).

INTRODUCTION: Nosocomial infections can be prevented by applying simple hygiene rules. However, they have not been sufficiently studied in the Republic of Guinea. For this purpose, we conducted a one-day study in the Conakry University Hospital surgery wards and intensive care units. METHODS: Fourteen units (12 surgical wards and 2 intensive care units) participated in the study. RESULTS: A total of 310 patients were included. A nosocomial infection was observed in 62 patients, [20%, 95%CI 15.9-24.8%]. Surgical site infections were significantly more frequent with 42/62 cases [67.7%, 95%CI 55.3-78.1%, p = 0.0001] than other types of infections (urinary tract, skin and digestive) with 20/62 cases [32.3% 95%CI 21.9-44.6%]. The average hospital stay of 29.1 ± 23.4 days [95%CI, 23.2 ± 35.04] for patients with nosocomial infection was significantly different (p = 0.0001) from that observed in patients without nosocomial infection: 15.9 ± 16.3 days [95%CI, 13.8 ± 17.9]. Staphylococcus aureus was the pathogen most commonly isolated: 32/62 (51.6%; 95%CI 39.5-63.6%). Escherichia coli infection was identified in the bladder catheters of 13 patients [20.9%, 95%CI 12.7-32.6%]. Finally, five deaths were observed among the 62 patients with nosocomial infection. DISCUSSION: This study shows that nosocomial infections are common in Conakry University Hospital. Further studies must be conducted to identify the risk factors for nosocomial infections and to propose solutions.

Case reports: Atlantooccipital and atlantoaxial traumatic dislocation in a child who survived.

A 4-year-old child with multilevel spinal injury including atlantooccipital and atlantoaxial dislocation, and thoracic spinal fractures was managed nonoperatively with no significant sequelae from the cervical injuries, but persistent paraplegia from the associated thoracic spinal fractures. Although treatment guidelines cannot be established with the result of one case, we propose an algorithm for treatment of such a rare and severe situation.