Epidemiology and prevention of nosocomial pneumonia associated with Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus in Departmental Hospital Centre of Zou Collines in Benin.

BACKGROUND: An eight (8) months prospective study was carried out to control an outbreak of nosocomial pneumonia due to a Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus, in the paediatrics' unit at the Zou/Collines Departmental Hospital (CHDZ/C), (Benin). METHODS: Between 1(st) September 2004 and 30(th) May 2005 an investigation was conducted that involved the screening of all patients suspected to have nosocomial pneumonia, hospital environment sampling and the follow-up of cases until the end of hospital admission period. Isolates were identified, tested for antimicrobial susceptibility and analysed for PVL production. The study period was divided into Period I, corresponding to the outbreak period and Period II, after the complete renovation of the Unit along with hand washing promotion. RESULTS: A total of 453 patients were admitted during the period of the study; (235 during Period I and 218 during Period II) in the malnourished children sector. Twenty eight (28) cases of pneumonia due to S. aureus were discovered and PVL-producing S. aureus constituted 61% (17/28) of identified cases. The mortality rate among the PVL- producing strains was 15/17 (88%) while it was 1/11 (9%) among non PVL-producing strains. Enhanced hygiene measures helped to terminate the outbreak. CONCLUSIONS: This study showed that PVL was strongly linked to nosocomial pneumonia. PVL-producing S aureus can be controlled in the hospital by a combination of the promotion of preventive measures, decontamination of the environment and the early use of the correct antibiotic at the appropriate dose and for an adequate duration.

[Impact of water quality and environmental sanitation on the health of schoolchildren in a suburban area of Benin: findings in the Savalou-Banté and Dassa-Glazoué sanitary districts]. / Impact de la qualité de l'eau et de l'assainissement sur la santé des enfants en milieu périurbain au Bénin : cas des zones sanitaires Savalou-Banté et Dassa-Glazoué.

OBJECTIVE: Promotion of environmental hygiene and sanitation in school districts contributes to community health. The purpose of the present study using physicochemical and biological parameters was to show the impact of these hygiene and sanitation measures on the health of schoolchildren in Collines Departement of Benin. MATERIALS AND METHODS: This prospective study was carried out in three selected primary schools from 28 September to 30 December 2007. A group of 210 children (100 boys and 110 girls) was obtained by careful identification of schoolchildren who benefited from the program and simple random selection. Physicochemical and bacteriologic analysis of water distributed in schools, assessment of the clinical condition of schoolchildren and screening of their hands for pathogenic bacteria allowed us to evaluate the level of hygiene in schools. Existing sanitary equipment was evaluated by on-site visual inspection. RESULTS: Hand screening identified the presence of pathogenic microorganisms on the hands of 74% of schoolchildren. Diarrhea was observed in 30% of pupils, osteomyelitis in 15% and tooth dystrophy in 25%. Water quality analysis showed fluorine and nitrate concentrations of 3.5 mg/L and 15 mg/L respectively and demonstrated contamination by fecal bacteria, especially during storage. CONCLUSION: The present study revealed a high level of pathogenic organisms on hands and confirmed their presence in water. Training teaching staff about educating and monitoring pupils regarding sanitary standards and protocols is needed to improve the level of competency and of compliance with hygiene measures.

[Contribution of ATP-dependent potassium channels, nitric oxide and prostaglandins in increase of diaphgram arteriolar blood fow during diaphgram contraction]. / Contribution des canaux potassiques ATP-dépendant, du monoxyde d'azote et des prostaglandines dans l'augmentation du débit artériolaire lors de la contraction du diaphragme.

ATP-sensitive potassium (K(ATP)) channels and nitric oxide (NO) have been suggested to contribute in mediating active hyperemia in diaphragm. However, no data is available in the current literature concerning their comparative contributions to arteriolar dilation during muscle contraction. The aim of this study was therefore to examine, by video microscopy in rats, the effects of superfusing the muscle with Krebs solution alone (group C), or Krebs solution containing either glybenclamide (3mdeltaM, a blocker of K(ATP), group GLY), or Nwdelta-nitro-L-arginine (300 mdeltaM, a NO synthase inhibitor, group NNA), or mefenamic acid (50 mdeltaM, a prostaglandin synthesis inhibitor, group MA) on second and third order of diaphragm (A2 and A3 respectively) arteriolar dilation elicited by 3 min muscle stimulation (40 Hz, train duration: 300 milliseconds, 90 cycles per min). In group C, A2 diameters increased by 67.5 +/- 1.9% referring to baseline at the end of the stimulation. This increase was significantly reduced in groups GLY and NNA (16.7 +/- 2.5% and 47.3 +/- 2.2% respectively, p < 0.001 as compared to group C) and was more important in group GLY than in group NNA (p < 0.001). By contrast, no difference in post-contraction diameter was observed between groups C and MA. Similar results were observed in A3 vessels. These results indicate that K(ATP) are more important mediators of functional diaphragm arteriolar dilation in rat than NO, whereas prostaglandins are not involved in this phenomenon.

[Incidence of infections dues to Escherichia coli strains producing extended spectrum betalactamase, in the Zou/Collines Hospital Centre (CHDZ/C) in Benin]. / Incidence d'infections liées à Escherichia coli producteur de bêta lactamase à spectre élargi au Centre hospitalier départemental du Zou et Collines au Bénin.

OBJECTIVES: Over a 6-month period, extended-spectrum betalactamase (ESBL)-producing isolates of Escherichia coli (EC) were collected from in-patients and their environment at the Zou-Collines Hospital Centre (CHDZ/C) in Benin. The aim of this study was to determine the incidence of ESBL and to describe their phenotypic susceptibility to antibiotics in a secondary hospital (500 beds) in Benin. METHODS: From 15 May to 15 November 2005, clinical informations and samples were collected from patients suspected to have nosocomial infections. The isolates were identified, tested for antimicrobial susceptibility and analysed for the presence of ESBL genes blaTEM and blaSHV by PCR. RESULTS: One hundred ninety-seven enterobacteria were isolated from the clinical samples of 342 patients, these isolates included 143 EC and 32/143 (22%) of these isolates produced ESBL. Forty-six EC were isolated from the environment and 7 (15%) of them produced ESBL. Except for Imipenem for which the difference was not significant, the isolates producing ESBL were more resistant to the other antibiotics (especially to third generation cephalosporins: Ceftriaxone, Cefotaxime, Ceftazidime (P<0.00001)) than non-ESBL producing isolates. Both ESBL genes blaSHV and blaTEM were identified in the EC ESBL strains from patient and from the environment. CONCLUSION: This study shows the presence of ESBL genes among EC in various wards of the CHDZ/C hospital proving that there is a need to implement a strict hospital infection control program and a regular surveillance of resistance to antimicrobial agents.

[Incidence of meticillin-resistant Staphylococcus aureus in neonatal care unit of departmental hospital centre of Zou Collines in Benin]. / Incidence de Staphylococcus aureus résistant à la méticilline dans le service de néonatologie du centre hospitalier départemental du Zou et des Collines au Bénin.

UNLABELLED: Meticillin resistant Staphylococcus aureus (MRSA) is among the most important causes of nosocomial infections. It possesses a particular ability to spread in hospitals worldwide. OBJECTIVE: To analyze the proportion of MRSA among S. aureus isolated from specimen taken for diagnosis purposes. To make the medical staff aware of the problem of MRSA infections and to take a better care of patients. PATIENTS AND METHODS: During 3 months, a prospective study was carried out in the neonatal unit of centre hospitalier départemental du Zou et Collines in Benin. We identified newborn carriers of SA, particularly MRSA and factors associated with the carriage. Two hundred and ninety patients were admitted in the 3 divisions of the neonatal unit. From 195 specimens examined for diagnosis purposes 48 h after hospitalization, 112 patients were detected by nose swabbing. Concurrently, swabbing of environment was achieved. RESULTS: Among patients'specimens, 141 isolations of S. aureus were observed. The proportion of MRSA was 36% amongst diagnostic specimens. MRSA represented 39% of the environment specimens. None of the isolated MRSA produces Panton Valentine leukocidin. CONCLUSION: Our survey revealed a high level of MRSA among S. aureus isolated from diagnostic specimens. Consecutive to such findings and for decreasing nosocomial infection, an appropriate prevention program was installed, including intensive promotion of hands hygiene, correct sterilization and disinfection of materials and patients.

Modulation of adipokines and cytokines in gestational diabetes and macrosomia.

CONTEXT/OBJECTIVE: Not much is known about the implication of adipokines and different cytokines in gestational diabetes mellitus (GDM) and macrosomia. The purpose of this study was to assess the profile of these hormones and cytokines in macrosomic babies, born to gestational diabetic women. DESIGN/SUBJECTS: A total of 59 women (age, 19-42 yr) suffering from GDM with their macrosomic babies (4.35 +/- 0.06 kg) and 60 healthy age-matched pregnant women and their newborns (3.22 +/- 0.08 kg) were selected. METHODS: Serum adipokines (adiponectin and leptin) were quantified using an obesity-related multiple ELISA microarray kit. The concentrations of serum cytokines were determined by ELISA. RESULTS: Serum adiponectin levels were decreased, whereas the concentrations of leptin, inflammatory cytokines, such as IL-6 and TNF-alpha, were significantly increased in gestational diabetic mothers compared with control women. The levels of these adipocytokines were diminished in macrosomic babies in comparison with their age-matched control newborns. Serum concentrations of T helper type 1 (Th1) cytokines (IL-2 and interferon-gamma) were decreased, whereas IL-10 levels were significantly enhanced in gestational diabetic mothers compared with control women. Macrosomic children exhibited high levels of Th1 cytokines and low levels of IL-10 compared with control infants. Serum IL-4 levels were not altered between gestational diabetic mothers and control mothers or the macrosomic babies and newborn control babies. CONCLUSIONS: GDM is linked to the down-regulation of adiponectin along with Th1 cytokines and up-regulation of leptin and inflammatory cytokines. Macrosomia was associated with the up-regulation of Th1 cytokines and the down-regulation of the obesity-related agents (IL-6 and TNF-alpha, leptin, and adiponectin).

Infection patterns of Myxobolus heterospora in two tilapia species (Teleostei: Cichlidae) and its potential effects.

A Myxobolus heterospora (Baker, 1963) infection was found in 2 euryhaline tilapia species, Sarotherodon melanotheron melanotheron (Rüppel, 1853) and Tilapia zillii (Gervais, 1852), from a brackish water lake, Lake Nokoué (Benin, West Africa). The histology and ultrastructure of different levels of infection in intestinal connective tissues and wall tissues is described. A total of 391 S. melanotheron melanotheron and 222 T. zillii were examined from October 1987 to October 1989. M. heterospora was found throughout the study period, with a total prevalence of 42.19 and 26.57% for S. melanotheron melanotheron and T. zillii respectively. There was a statistically significant difference in occurrence as a function of season in S. melanotheron melanotheron but not in T. zilli, and there was a significant difference for size and sex in the former and for sex in the latter. M. heterospora induces total destruction of the intestine structure and probably leads to osmoregulatory disturbance. Further investigations of this myxosporean infection are necessary to determine its real effect on the host, since host survival and osmoregulatory rate have not yet been assessed.