Molecular detection of CTX-M-15-type ß-lactamases in Escherichia coli strains from Senegal.

We aimed to detect the extended-spectrum ß-lactamases (ESBLs) secreted by clinical strains of Escherichia coli at Fann University Hospital in Dakar and to characterize them molecularly. We identified 32 isolates producing ESBLs. The CTX-M-15 gene was the most frequently detected ESBL gene, detected in 90.63% of the isolates studied.

[Defects in TOR regulatory complexes retard aging and carbonyl/oxidative stress development in yeast Saccharomyces cerevisiae].

TOR signaling pathway first described in yeast S. cerevisiae is the highly conserved regulator of eukaryotic cell growth, aging and stress resistance. The effect of nitrogen sources, in particular amino acids, on the activity of TOR signaling pathway is well studied, however its relation to carbohydrates is poor understood. The aim of the present study is expanding of our understanding of potential role of TOR regulatory complexes in development of carbonyl/oxidative stress that can result from yeast cultivation on glucose and fructose. It has been shown that the level of alpha-dicarbonyl compounds and protein carbonyl groups increased with time of yeast cultivation and was higher in cells grown on fructose that demonstrated their accelerated aging and carbonyl/oxidative stress development as compared with cells grown on glucose. The strains defective in TOR proteins cultivated in the presence of glucose as well as fructose demonstrated lower markers of the stress and aging than parental strain. Thus these data confirmed the previous conclusion on fructose more potent ability to cause carbonyl/oxidative stress and accelerated aging in S. cerevisiae as compared with glucose. However, defects in TOR regulatory complexes retard aging and development of the stress in yeast independent on the type of carbohydrate in the cultivation medium.

Assessment of trace metal contamination in mangrove ecosystems from Senegal, West Africa.

The inorganic contamination of sediment and harvested molluscs was investigated in the mangrove environment of Southern West Senegal. Trace metals were analysed in surface sediments, two bivalves (Arca senilis and Crassostera gasar) and three gastropods (Conus spp., Hexaplex duplex and Pugilina morio) collected from four stations: Dionewar, Niodor and Falia localised in the Saloum Delta, and Fadiouth from the Petite Côte. A geochemical normalisation approach by using aluminium allowed for discrimination of sediment contamination among sites. Indeed, Fadiouth appeared highly contaminated with Cd, Hg and Ni compared to the Saloum Delta. For all mangrove sites, trace metals exhibited significant higher concentrations (on a dry weight basis) in shellfish compared to sediments, excepted for Ni and Pb. The distribution pattern followed a similar global trend in molluscs regardless of the spatio-temporal variability, with the predominance of Zn (80% of total metals) followed by Cu and Cd. However, strong differences of metal bioavailability and bioaccumulation in biota were demonstrated, revealing the requirement of employing a suite of organism bioindicators to monitor metal contamination in mangrove ecosystems. From an ecotoxicological point of view, trace metal levels in sediments from the Petite Côte and the Sine-Saloum Estuary were below the effects range-low (ERL) threshold limit of the sediment quality guidelines for adverse biological effects (SQGs). On the opposite, some concerns about Cd contamination of edible shellfish from Southern West Senegal were highlighted, from both the safety point of view of local populations' health, and the chemical quality point of view of exported resources.

Are exploited mangrove molluscs exposed to Persistent Organic Pollutant contamination in Senegal, West Africa?

The surface sediments, two bivalves (Arca senilis and Crassostera gasar) and three gastropods (Conus spp., Hexaplex duplex and Pugilina morio) from two Senegalese stations, Falia (Sine-Saloum Estuary) and Fadiouth (Petite Côte), were analyzed for their pollutant organic persistent contamination (polychlorinated biphenyls PCBs; organochlorinated pesticides OCPs; polybrominated diphenyl ethers PBDEs). Results revealed significant levels of PCBs, DDTs and lindane in mangrove sediments ranging from 0.3 to 19.1, 0.3 to 15.9, and 0.1 to 1.9 ng g(-1) d.w., respectively. Among the other POPs analysed, only hexachlorobenzene, heptachlor and trans-nonachlor for OCPs, as well as BDE47 and BDE99 congeners for PBDEs were detected at very low concentrations, generally not of concern. POP levels and patterns were in good accordance with literature data available for other tropical developing countries. A seasonal quantitative difference was highlighted with higher levels of PCBs and DDTs in sediments after the wet season, likely due to the strong wash-out of residues from inland to the marine ecosystems during the rainy season. The observed pattern of DDT and its metabolites pointed out probable recent applications of DDT for public health emergencies in Senegal. Exploited molluscs were exposed to the same POP compounds as those measured in sediments. They presented OCP levels within the same range as in sediments, while significant higher concentrations of PCBs were observed in shellfish soft tissues revealing a higher bioaccumulation potential mainly due to the lipophilicity of these compounds. Finally, the influence of the reproduction cycle on POP levels through lipid content variations was highlighted, minimizing potential differences in POP bioaccumulation between shellfish species. From an ecotoxicological and public health point of view, results from this study revealed that POPs in sediments from the Petite Côte and the Sine-Saloum Estuary would not cause toxic effects and impairments in molluscs from these regions, and that no potential risk exists for human, especially local populations, through mangrove shellfish consumption.

[Parasitic and bacterial etiologies of diarrhea among people living with HIV hospitalized in Fann hospital (Senegal)]. / Etiologies Bacteriennes Et Parasitaires De Diarrhees Chez Les Personnes Vivants Avec Le VIH/SIDA Au Chnu De Fann (Senegal).

Diarrhea is the most common opportunistic infection in AIDS. We conducted at the Fann National University Hospital in Dakar, a study of all patients living with HIV, hospitalized in the the Clinical service of Infectious Diseases from 1 January 2003 to December 31, 2006, with diarrhea and having received an bacteriological and / or a parasitological examination of stools. The aim of this study was to identify the various pathogens isolated in the laboratory and responsible for those diarrhea. In total, 351 patients were collected, their average age was 39.93 years and the extreme ages 15 and 72 years. HIV1 serological profile was found in 90.77% of patients; 34.42% of patients received a dosage of CD4 count, among them 21.09% had a rate <200/mm3. Fifteen stool cultures were positive with the following breakdown: - Shigella (10 strains): 7 strains of Shigella flexneri, 2 of Shigella sp, one of Shigella sonnei; antibiotics most active on the Shigella strains were third generation cephalosporins and quinolones. - Salmonella (5 strains) with Salmonella Typhimurium and Salmonella Enteritidis, strains sensitive to an association of amoxicillin + clavulanic acid, to cephalosporins and to ciprofloxacin. 289 patients received a parasitological examination of the stools (KOP) and the positive number of KOP was 90 a 30,14% rate. The parasites most frequently found were: Cryptosporidium parvum, representing 10.38% of positive KOP, Isospora belli 6.23%, and Entamoeba coli 5.19%. These parasites were found predominantly in patients infected with HIV1 (61 cases/90). Cases of cobacterial and parasitic co-infections were also found. Diarrhea is one of the leading causes of death among people living with HIV. The etiologies of diarrhea, multiple, are yet to be identified and this should go through an improvement of the technical capacity and quality of our laboratories.

[Hand washing at Fann hospital: investigation among health workers]. / Lavage des mains au chnu de Fann: enquête auprès du personnel de soins.

INTRODUCTION: Handwashing is usually neglected in hospital settings. The objective of this study was to draw attention of health workers in Fann hospital as part of the prevention of hospital-acquired infections. MATERIALS AND METHODS: This study was carried out prospectively from April 26h to May 25th. An anonymous questionnaire was administered by 20 formed investigators to health workers, along with an inventory of available resources for hand washing in the study site allowing to collect the data by interview. RESULTS: A total of 256 health workers were investigated. The mean age was 35.3 +/- 9.4 years [range = 20-71] with a sex ratio of 0.62. As for the education level, the secondary and university predominated. The concept of Manu carrying was ignored by 59.3% of the personnel. This proportion was higher among people with low education level. Possibility of resident and transitional floras in the hand was ignored by most of the investigated personnel. The hand washing technique to be applied while putting vesicle probe was ignored by 59% of the personnel, and 34% declared using hand towel to dry hands. Half of the personnel ignored that bread soap was not recommended. The availability of hydro alcoholic solutions was variable according to the hospital wards. The lavabo/bed ratio was 1/7 and was unacceptable. CONCLUSION: In Fann hospital, the importance and the techniques of hand washing are not well known, that's why a training of the hospital's Personnel and an improvement of resources for handwashing are necessary for a good hospital's hygiene.

[Prevalence of nosocomial infections in a university hospital (Dakar, Senegal)]. / Résultats de l'enquête de prévalence des infections nosocomiales au CHNU de Fann (Dakar, Sénégal).

UNLABELLED: Nosocomial infections constitute today a great public health problem that is still ignored or poorly mastered in our health institutions. METHOD: A prevalence study initiated by the CLIN (committee for the prevention of nosocomial infections) was recently conducted at the Fann teaching hospital. A questionnaire was prepared and submitted to all patients that were hospitalized on the day of the study; the questionnaire allowed gathering a lot of information on exposure factors and clinical and microbiological arguments in favor of nosocomial infections. RESULTS: One hundred and seventy-five patients (59.9% of all available beds) participated in the study. Nosocomial infections were found mostly among people between 20 and 44 years of age and predominantly in women. Fifty-eight percent of those cases were found in the neurology unit. The infections were mostly urinary (40%) and pulmonary (25%). The germs responsible were multiresistant bacteria: Enterobacter cloacae secreting broad-spectrum betalactamase, methicillinresistant Staphylococcus aureus, and Pseudomonas aeruginosa. The infected patients were usually under antibiotic treatment (80%) with various protocols, mainly monotherapy. The antibiotics used were betalactams, fluoroquinolones, and nitroimidazoles.

[Cholera epidemic of 2004 in Dakar, Senegal: epidemiologic, clinical and therapeutic aspects]. / L'épidémie de choléra de 2004 à Dakar: aspects épidémiologiques, cliniques et thérapeutiques.

During the cholera epidemic that occurred in Dakar, Senegal in 2004, we treated a total of 593 confirmed or suspected cases in our department. The purpose of this report is to describe epidemiologic, clinical, bacteriologic and therapeutic aspects of these cases. Study was conducted at the infectious diseases clinic from October 11 to December 20, 2004. Mean patient age was 30 years and the sex ratio was 133. The likely source of contamination was food or water intake in 92% of cases. The duration of the epidemic was short (75 days). Onset was sudden in 98% of cases and the main clinical manifestations were watery diarrhoea (95%) and vomiting (78%). The mean delay between symptoms and hospitalization was 11 hours and the number of stools before admission to the hospital was greater than 10 in 23% of cases. At the time of admission 119 patients (20.1%) were severely dehydrated. A total of 250 coprocultures were performed. Results were positive in 145 cases (58%) including 112 (44%) for Vibrio cholerae 01. Antibiotic testing carried out on 36 strains demonstrated excellent sensitivity to doxycycine and pefloxacine but resistance to cotrimoxazole, amoxicilline and chloramphenicol. Oral rehydration therapy was used in most cases (61%). The mortality rate was 0.5%. Cholera is a medical emergency that can have a favourable prognosis with properly organized management.

L'epidemie de cholera de 2004 a Dakar : aspects epidemiologiques; cliniques et therapeutiques

Ce travail decrit l'epidemie de cholera qui a touche Dakar en 2004; au cours de laquelle 593 cas confirmes ou probables ont ete pris en charge dans notre service. Il se fixe pour objectif de decrire les aspects epidemiologiques; cliniques; bacteriologiques et les strategies de prise en charge de cette epidemie. Pour atteindre cet objectif; nous avons mene une etude prospective a la clinique des maladies infectieuses du 11 octobre au 20 decembre 2004. L'age moyen des patients etait de 30 ans; et le sexe ratio de 1;33. La source probable de contamination a ete alimentaire et/ou hydrique dans 92des cas. La duree de l'epidemie a ete courte (75 jours). Le debut a ete brutal dans 98des cas; et la symptomatologie clinique dominee par la diarrhee aqueuse (95) et les vomissements (78). Le delai moyen d'hospitalisation etait de 11 heures et le nombre de selles emises avant l'admission superieur a 10 dans 23des cas. A l'admission; 119 malades (20;1) ont presente une deshydratation severe. Au total 250 coprocultures ont ete effectuees; dont 145 positives (58); mettant en evidence Vibrio cholerae O1 dans 112 cas (44). Les 36 souches testees aux antibiotiques ont montre une excellente sensibilite a la doxycycline et a la pefloxacine; mais aussi une resistance au cotrimoxazole; a l'amoxicilline et au chloramphenicol. La rehydratation par voie orale a ete la regle (61). La letalite a ete de 0;5. Le cholera est une urgence medicale dont le pronostic peut etre favorable a condition que l'organisation de la prise en charge soit bonne

[Effect of nitric oxide upon apoptosis activation in immunocompetent blood cells in diabetes mellitus, type 1].

NO-synthase activity, the content of stable products of NO metabolism (nitrites and nitrates) as well as fragmented DNA as biochemical marker of apoptosis have been determined in segmentonuclear neutrophilic granulocytes and mononuclear leukocytes in blood of healthy donors and patients with type 1 diabetes mellitus. It was found that activation of apoptosis in polymorphonuclear and mononuclear blood leukocytes under diabetes mellitus was accompanied by an elevation of NO-synthase activity and the content of stable NO metabolites. This suggests an increase of proapoptotic action of nitric oxide in immunocompetent blood cells under the pathology studied.

[Antibiotic resistance of the most frequently isolated germs at the Fann University Teaching Hospital between January 1999 and December 2000]. / Résistances aux antibiotiques des principaux germes isolés au CHU de Fann entre Janvier 1999 et Décembre 2000.

Bacterial infections take up an important place in tropical pathology and have an increased death-rate. Among the causes of this strong mortality, the resistance of bacteria to antibiotics keeps a dominant part. We carried out, between January 1999 and December 2000 a study aiming to establish the distribution of the most frequently isolated germs at the Laboratory of Bacteriology of Fann Hospital, their sensibility to antibiotics and the different phenotypes of resistance. We noticed a predominance of enterobacteria (69.30%), notably Escherichia coli (56.76%) and Klebsiella pneumoniae (47.69%), but also Staphylococcus aureus (13.91%). Enterobacteria present 39.7% of resistant phenotypes to beta-lactams (E. coli: 61.75% and K. pneumoniae: 47.69%). Only the third generation cephalosporins and fluoroquinolons are constantly actives on enterobacteria, and 69% of S. aureus strains are resistant to methicillin, and so to all beta-lactams. Pseudomonas aeruginosa become difficult to overcome: 51.13% of the strains produce beta-lactamase. The quinolons are the most active antibiotics on this germ. It is very important to settle network that will be in charge to survey the evolution of these bacterial resistances.

[Place and resistance of epidemic strains of Shigella dysenteriae-1 isolated at the Fann Hospital from 1995 to 1999]. / Place et résistance de souches épidémiques de Shigella dysenteriae-1 isolées au Chu de Fann de 1995 a 1999.

Shigella dysenteriae-1 (S.d-1) takes a more and more important place in intertropical countries, with multiresistant strains to antibiotics. the objectives of the study is to determine the prevalence of S.d-1 among bacterial isolations at Fann Hospital at Dakar, and to identify the resistant profiles of the strains. This retrospective study was conducted on the strains isolated between 1995 and 1999 by examination of faeces for bacterial pathogens. the susceptibility of the strains to antibiotics was studied by disc diffusion test with Mueller Hinton agar, and detection of extended broad spectrum beta-lactamase. Shigella dysenteriae-1 represented 45.18 % of Shigella strains and was particularly isolated in winter season (from August to September), more frequently in men (sex ratio: 2 / 1). Among the strains, 72 % were resistant to beta-lactams, and the ratio of multiresistant strains represented 42 %, concerning cotrimoxazol, chloramphenicol, tetracyclin and aminopenicillins. Only one strain produced extended broad spectrum beta-lactamase. Quinolons were the most active antibiotics but have to be used rationally.

[Prerequisites and some aspects of hospitalization of patients with glomerular nephritis]. / Peredumovy ta osoblyvosti hospitalizatsiï khvorykh na hlomerulonefrit.

Data are submitted on the pattern of reasons for hospitalization, rehospitalization of patients with glomerulonephritis depending on the purpose and duration of the in-patient care over three-year activity of the regional nephrologic department. The authors have come to the conclusion that it is necessary that an expert evaluation of quality of diagnosis and treatment of glomerulonephrities patients should be carried out, which measure will, we believe, help in uncovering the existing shortcomings and their causes during stages of medical care delivery and in finding ways for improvement of the system of the nephrological service with special reference to such kinds of it as day clinics and domociliary medical services.

[Complex characterization of the quality of hospital care provided patients with glomerulonephritis (as per a regional nephrology department)]. / Kompleksna kharakterystyka iakosti statsionarnoï dopomogy khvorym na glomerulonefryt (na prykladi oblasnogo nefrologichnogo viddilennia).

Based on expert examination of 296 histories of 145 patients with glomerulonephritis the frequency of errors being made in examining of patients at the prehospital stage, in hospital, has been estimated. Kinds of errors include diagnostic errors (primarily in defining forms and variants of the disease), errors in administering treatments to patients. This necessitated raising the level of the primary link in the nephrological educational program for medical men and warrants development of alternative forms of the in-patient medical care delivery to patients with glomerulonephritis.

[Glomerulonephritis in the aspect of patient self-assessment]. / Hlomerulonefryt v aspekti samootsinky patsiienta.

It is shown that organization of dispensary follow-up of patients with glomerulonephritis fails to ensure completeness of records-taking and control of the disease course in a timely fashion. The following items were found to influence negatively the quality of specialized medical aid: too late applying of patients for medical advice, non-adherence to the physician's prescriptions and self-curing, which fact is not infrequently related to the patients' inadequate material gains and lack of care in respect of their own health. This warrants heightening of medical-and-educational activities. Risk groups to be targeted for special care include women (in spite of greater disability rates among male subjects), persons aged less than 20 and those beyond 40 years old, those persons that have not completed high education, and those residing in rural areas.