RESUMO
BACKGROUND: Diarrhoea is a public health problem, especially in developing countries where it is the second leading cause of child mortality. In Low Income Countries like in Mali, self-medication and inappropriate use of antibiotics due to the scarcity of complementary diagnostic systems can lead to the development of multidrug-resistant bacteria causing diarrhoea. The objective of this work was to determine the microorganisms responsible for diarrhoea in children under 15 years of age and to characterize their sensitivity to a panel of antibiotics used in a peri-urban community in Mali. The study involved outpatient children visiting the Yirimadio Community Health Centre and diagnosed with diarrhoea. Stool samples from those patients were collected and analysed by conventional stools culture and the susceptibility to antibiotics of detected bacteria was determined by the disc diffusion method in an agar medium. RESULT: Overall, 554 patients were included. Children under the age of 3 years accounted for 88.8% (492 of 554) of our study population. Two bacterial species were isolated in this study, Escherichia coli 31.8% (176 of 554) and Salmonella 2.9% (16 of 554). In the 176, E. coli strains resistance to amoxicillin and to cotrimoxazole was seen in 93.8% (165 of 176) and 92.6% ( 163 of 176), respectively. The ESBL resistance phenotype accounted for 39,8% (70 of 176) of E. coli. Sixteen (16) strains of Salmonella were found, of which one strain (6.3%) was resistant to amoxicillin and to amoxicillin + clavulanic acid. Another one was resistant to chloramphenicol (6.3%). Two strains of Salmonella were resistant to cotrimoxazole (12.5%) and two others were resistant to cefoxitin (12.5%). CONCLUSIONS: The data suggest that E. coli is frequently involved in diarrhoea in children under 3 years of age in this peri-urban setting of Bamako, Mali, with a high rate of resistance to amoxicillin and cotrimoxazole, the most widely used antibiotics in the management of diarrhoea in this setting.
Assuntos
Antibacterianos , Saúde Pública , Criança , Humanos , Pré-Escolar , Mali , Combinação Trimetoprima e Sulfametoxazol , Escherichia coli , Farmacorresistência Bacteriana , Amoxicilina , Diarreia , Combinação Amoxicilina e Clavulanato de Potássio , SalmonellaRESUMO
Vulvovaginal candidiasis (VVC) is a fungal infection caused by yeasts of the genus Candida that leads to vulvar pruritus and vaginal discharge. METHOD: In order to evaluate the epidemiological and etiological Profile of vvc, we carried out a cross-sectional study among women in consultation in the gynecological department of the CHU-Gabriel Toure in Bamako. Two swabs were taken from each woman for mycological diagnosis. The presence of yeasts and pseudo-filaments was observed on direct examination. The culture was performed on Sabouraud-Chloramphenicol medium and at 37°C for 24 to 48 hours. Identification was based on the macroscopic and microscopic characteristics of the colonies, the germinative tube test and the Vitekâ¢2 instrument. of the colonies, the germinative tube test and the VITEK® 2 instrument. RESULT: A total of 240 women were included with a mean age of 31.5 ± 3.15 [15-64 years]. Married women represented 91.67% (n=220) and 51.25% were housewises. Pruritus 49.17% (118/240) and dyspareunia 42.08% (101/240) were the most frequent clinical signs. Previous use of antifungals was demonstrated in 85.83% of women. Candida species were confirmed in 60.42% (145/240) of cases. C. albicans was the most frequent species followed by C. famata, C. dubliniensis, C. krusei.. This study allowed us to identify the most frequent cases of C. albicans, followed by C. famata, C. dubliniensis, and C. krusei..Further studies are still needed to characterize the antifungal susceptibility profile of the Candida species involved.
La candidose vulvo-vaginale (CVV) est une infection fongique causée par des levures du genre Candida provoquant du prurit vulvaire et des pertes vaginales. MÉTHODE: Afin d'évaluer le profil épidémiologique et étiologique des CVV, nous avons réalisé une étude transversale chez les femmes en consultation dans le service de gynécologie du CHU-Gabriel TOURE de Bamako. Deux écouvillons vaginaux ont été prélevés sur chaque femme pour le diagnostic mycologique. La présence de levures et de pseudo-filaments a été observée à l'examen direct. La culture a été réalisée sur milieu Sabouraud-Chloramphénicol et à 37°C pendant 24 à 48 heures. L'identification a été basée sur les caractéristiques macroscopiques et microscopiques des colonies, le test du tube germinatif et l'instrument VITEK® 2. RÉSULTAT: Un total de 240 femmes ont été incluses avec un âge moyen de 31,5 ans ± 3,15 [15-64 ans]. Les femmes mariées représentaient 91,67% et 51,25% étaient des menagères. Le prurit 49,17 % et la dyspareunie 42,08 % (101/240) étaient les signes cliniques les plus fréquents. La prise antérieure d'antifongiques a été retrouvée chez 85,83% des femmes. La présence des espèces de Candida a été confirmée dans 60,42 % des cas. L'espèce C. albicansétait lus fréquente suivies de C. famata, C. dubliniensis, C. krusei.. CONCLUSION: Les résultats de cette étude permettent d'élargir les connaissances sur l'épidémiologie du CVV au Mali. D'autres études restent nécessaires pour caractériser le profil de sensibilité aux antifongiques des espèces de Candida impliquées.
RESUMO
In vitro and ex vivo cultivation of Plasmodium (P) falciparum has facilitated active research into the malaria parasite toward the quest for basic knowledge and the discovery of effective drug treatments. Such a drug discovery program is currently difficult for P. malariae simply because of the absence of in vitro and ex vivo cultivation system for its asexual blood stages supporting antimalarial evaluation. Despite availability of artemisinin combination therapies effective on P. falciparum, P. malariae is being increasingly detected in malaria endemic countries. P. malariae is responsible for chronic infections and is associated with a high burden of anemia and morbidity. Here, we optimized and adapted ex vivo conditions under which P. malariae can be cultured and used for screening antimalarial drugs. Subsequently, this enabled us to test compounds such as artemether, chloroquine, lumefantrine, and quinine for ex vivo antimalarial activity against P. malariae.
