RESUMO
Introduction: Bacteremia is associated with high lethality in HIV-infected patients. The widespread use of cotrimoxazole prophylaxis and misuse of antibiotics promote antibacterial resistance. Only few studies have considered this issue in HIV-infected patients. Thus, the objective of this study was to describe the etiology and antibacterial susceptibility patterns of bloodstream isolates in patient living with HIV. Material and methods: This is a retrospective cross-sectional and descriptive study conducted at the clinic of Infectious and Tropical Diseases of Fann university hospital from March 2013 to December 2016. Data were collected from patients' files according to a pre-establish survey form made of demographic, clinical, bacteriological and biological parameters. Results: Seventy-four cases of bacteremia were registered, 51.4% of which in women. Participants' median age was 45 years old [18-73 years old] and average CD4 count 83.3 cells/µl. The most commonly isolated bacteria were coagulase negative staphylococci (14%) followed by Escherichia coli (10%) and Klebsiella pneumoniae (10%). Rates of methicillin resistance for coagulase negative staphylococci and Staphylococcus aureus were 35.7% (5/14) and 22% (2/9), respectively. The most frequent ESBL producing germs were Escherichia coli 50% (5/10), Klebsiella pneumoniae 40% (4/10) and Enterobacter sp 25% (2/8). Pseudomonas sp were the most (22.2%) germs resistant to carbapenems. Conclusion: The result of this study advocates the need for ongoing surveillance of antibacterial resistance in HIV-infected patients and empirical antibiotic therapy based on surveillance data.
Assuntos
Bacteriemia , Infecções por Escherichia coli , Infecções por HIV , Adolescente , Adulto , Idoso , Antibacterianos/farmacologia , Bacteriemia/tratamento farmacológico , Coagulase/uso terapêutico , Estudos Transversais , Escherichia coli , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Infecções por HIV/complicações , Hospitais Universitários , Humanos , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal/epidemiologia , Adulto JovemRESUMO
Tuberculosis remains a problem of public health, in spite of the numerous significant advances noted in the diagnosis in recent years. The involvement of the thoracic wall is a rare extra lung shape. Its clinical presentation is not specific and a collected thoracic tumefaction is the main clinical demonstration. The diagnosis is improved by the use of non-invasive tools such as the Xpert MTB/Rif® test with a good sensibility on the pus. Medical care is based on medical treatment and sometimes associated with surgical treatment.
La tuberculose demeure un problème de santé publique, malgré les nombreuses avancées significatives notées dans le diagnostic ces dernières années. L'atteinte de la paroi thoracique est une forme extrapulmonaire rare. Sa présentation clinique est non spécifique, et une tuméfaction thoracique collectée en est la principale manifestation clinique. Le diagnostic est amélioré par l'utilisation d'outils non invasifs tels que le test Xpert MTB/Rif® avec une bonne sensibilité sur le pus. La prise en charge repose sur le traitement médical quelquefois associé à un traitement chirurgical.
