Surface decontamination effectiveness at the "Université des Montagnes" Teaching Hospital: Monitoring in the biomedical analysis laboratory.

Background: Many infections in healthcare facilities are associated with the microbiological quality of the work environment, generally due to poor sanitation. Aim: In order to evaluate the effectiveness of a decontamination protocol (cleaning + disinfection) applied at the "Université des Montagnes" Teaching Hospital, the present study assessed the variation of bacterial loads on surfaces subsequent to decontamination. Susceptibility of bacteria to disinfectants was also evaluated in the same frame. Methodology: This work was conducted with an adjusted bacterial detection/enumeration and susceptibility test protocols and standard bacterial identification protocols. Sampling on surfaces was performed by wet swabbing before cleaning, between cleaning and disinfection and after disinfection. Results: Major findings revealed the predominance of Staphylococcus (75.5%) on target surfaces. High bacterial loads recorded on these surfaces before decontamination became undetectable after cleaning with the detergent "Pax lemon". The majority of isolates (98%) were susceptible to the disinfectants tested, (Surfanios® 0.25% and sodium hypochlorite 0.12%). Conclusion: Overall, these findings indicated process effectiveness on the subjected bacterial populations and suggest the use of either Surfanios® (0.25%) or sodium hypochlorite (0.12%) for work surfaces hygiene, justifying the use of these products in this department for surface decontamination. Also, cleaning with the detergent "Pax lemon" and disinfection with sodium hypochlorite may be sufficient for the types of surfaces subjected in the present research.

Ophthalmic Manifestations in Chronic Inflammatory Rheumatic Diseases at a Referral Hospital of Yaounde, Cameroon.

PURPOSE: To determine the profile of ophthalmic manifestations in chronic inflammatory rheumatic diseases (CIRD). METHODS: Observational study at the Yaounde Central Hospital and Innel Medical Centre (2004 to 2012). RESULTS: The study population (n = 36) consisted of 14 men and 22 women with average age of 47.9 ± 17.2 years. Cases of CIRD were rheumatoid arthritis (n = 16), systemic lupus erythematosus (n = 8), ankylosing spondylitis (n = 8), mixed connective tissue disease (n = 2), scleroderma (n = 1), and juvenile idiopathic arthritis (n = 1). Ophthalmic manifestations found in 22 (61.1%) patients were dry eye syndrome (n = 7), cataract (n = 6), anterior uveitis (n = 6), glaucoma (n = 4), and suspected maculopathy (n = 1). No association was found between steroids used and supcapsular cataract (p = 0.06) or glaucoma (p = 0.06). CONCLUSION: Ocular manifestations occurred in 61.1% of CIRD. Dry eye syndrome and anterior uveitis were commonly observed.

Rheumatoid polyarthritis suspected in an HIV patient with scleritis, peripheral ulcerative keratitis, and anterior uveitis.

INTRODUCTION: Scleritis and peripheral ulcerative keratitis are ocular manifestations found in many inflammations and infections. Therefore, their association should prompt a search for inflammatory or infectious causes that may be life-threatening, especially in the context of AIDS due to HIV infection. FINDINGS: We report the case of a 37-year-old female, first seen in 2011 with a nodular scleritis in the right eye and a peripheral ulcerative keratitis, a necrotizing scleritis, and a granulomatous anterior uveitis in the left eye, in the context of chronic polyarthropathies that had evolved over 6 months. The patient was diagnosed with AIDS (HIV) in 2008 and was on antiretroviral therapy for the past 2 years. Ophthalmic workup was negative for opportunistic infections and potential causes of scleritis and peripheral ulcerative keratitis, and the patient was unresponsive to topical antibacterial and anti-inflammatory treatment. Ocular lesion resolution and articular swelling improvement was observed less than 6 weeks after sulfasalazine treatment. Based on American College of Rheumatology/European League Against Rheumatism classification criteria, and considering the good response to the treatment (sulfasalazine), diagnosis of rheumatoid arthritis was made in the absence of confirmatory lab tests results. CONCLUSION: In the context of ocular manifestations associated with polyarthropathies, coexisting pathologies should be considered. Diagnostic workup of chronic inflammatory rheumatism should be carried out, even in the context of HIV/AIDS.