scholarly journals Bacteriological Profile of Osteomyelitis in Drepanocytic Children at the David Bernardino Pediatric Hospital from May to August 2017

2021 ◽  
Vol 2 (7) ◽  
pp. 574-579
Author(s):  
Mikka Andre ◽  
Guilhermino Joaquim
Keyword(s):  
Antibiotic Therapy ◽  
Sickle Cell ◽  
Surgical Procedure ◽  
Bone Structure ◽  
Infectious Agent ◽  
Pediatric Hospital ◽  
Sample Collection ◽  
Bacteriological Study ◽  
Bacteriological Profile ◽  
Bone Segment

Introduction: Osteomyelitis is defined as the infection of the entire bone structure caused by a pyogenic infectious agent. Depending on the evolution time, clinical and radiological findings can be classified as acute or chronic. The present study aimed to describe the bacteriological profile of osteomyelitis in patients with sickle cell disease, admitted to the Pediatric Hospital David Bernardino, in Luanda/Angola, from June 1 to October 31, 2017. Methodology: We carried out a descriptive, longitudinal and prospective study in a universe consisting of 33 children with sickle cell anemia admitted to the Surgery Service of this Hospital. Sample collection was performed during the surgical procedure. Results: We identified a higher percentage of cases in male children with 58% and in the age group from 5 to 10 years with 63.6%. The most affected bone segment was the tibia with 33.4%, followed by the humerus and femur with 30.3% each. Most patients, 66.7% of cases, were admitted to the Surgery Service before the surgical procedure. Of the samples collected for bacteriological study, only 31.3% were positive, with the most identified germs being Citrobacter spp, Enterobacter species and Proteus species, with 6.1% each. The sensitivity profile of Gram positive cocci was 100% for Ofloxacin and Cloxacillin and gram negative cocci had 100% sensitivity for Ofloxacin, Amikacin and Minocycline. There was total resistance in Gram positives to Ampicillin and 80% in Gram negatives. Most children had severe anemia (hemoglobin below 9 g), in 17 cases (69.69%), Erythrocyte Sedimentation Velocity levels between 60 to 83 mm, in 16 cases (48.5%), and levels of C-Reactive Protein (CRP) between 40 to 50 mg/L in 8 cases (24.3%). Cloxacillin was used in 60.7% of cases, followed by Cloxacillin + Gentamicin in 7 children (21.1%). Twenty-seven children (82%) underwent surgical treatment, with fenestration being the most used procedure. Conclusion: The characteristics of the patients and the disease regarding sex, age and the most affected bone are in accordance with those described in the literature. Of the 10 patients without previous antibiotic therapy had samples with bacterial growth, with identification of Citrobacter spp (2), Enterobacter sp (2) Proteus spp (2), E.Coli (1), S.Aureus (1), Proteus Vulgaris (1) and Proteus Mirabilis (1). Patients were hospitalized for more than seven (7) days, due to other pathologies during hospitalization. About 60.7% of the children were treated with Cloxacillin and 21.1% with an association of Cloxacillin with Gentamicin, with surgical debridement and fenestration being the surgical procedure performed in 82% of patients. Patients operated on and undergoing targeted antibiotic therapy had good results in 87.87% of cases; One case (3.03%) required readmission and underwent a new surgical approach.

scholarly journals Impact of nanosystems in Staphylococcus aureus biofilms treatment

2019 ◽  
Author(s):  
Rita M Pinto ◽  
Daniela Lopes-de-Campos ◽  
M Cristina L Martins ◽  
Patrick Van Dijck ◽  
Cláudia Nunes ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Economic Burden ◽  
Surgical Procedure ◽  
Healthcare Systems ◽  
World Health ◽  
Small Particles ◽  
The World ◽  
New Strategy ◽  
Health Organization

ABSTRACT Staphylococcus aureus (S. aureus) is considered by the World Health Organization as a high priority pathogen for which new therapies are needed. This is particularly important for biofilm implant-associated infections once the only available treatment option implies a surgical procedure combined with antibiotic therapy. Consequently, these infections represent an economic burden for Healthcare Systems. A new strategy has emerged to tackle this problem: for small bugs, small particles. Here, we describe how nanotechnology-based systems have been studied to treat S. aureus biofilms. Their features, drawbacks and potentialities to impact the treatment of these infections are highlighted. Furthermore, we also outline biofilm models and assays required for preclinical validation of those nanosystems to smooth the process of clinical translation.

scholarly journals Bacteriological Profile of Burn Patients and Antimicrobial Susceptibility Pattern of their Wound Isolates at Nepal Cleft and Burn Center

2019 ◽  
Vol 15 (3) ◽  
pp. 160-166
Author(s):  
Apar Lamichhane ◽  
Kiran Kishor Nakarmi ◽  
Peeyush Dahal ◽  
Surendra Jung Basnet ◽  
Pashupati Babu Pokharel ◽  
...  
Keyword(s):  
Resistant Strain ◽  
Infectious Agent ◽  
Diffusion Method ◽  
Burn Patients ◽  
Susceptibility Pattern ◽  
Burn Wound ◽  
Cross Sectional ◽  
Gram Negative ◽  
Bacteriological Profile ◽  
Acinetobacter Spp

Background: Burn infections are the major causes of morbidity and mortality in burn patients. The infectious agent could be both Gram positive and Gram negative bacteria. The aim of this research was to study the bacteriological profile of burn patients and anti-microbial susceptibility pattern of their wound isolates.  Methods: This cross-sectional study was conducted in Kirtipur Hospital, Nepal from January 1st to March 31st 2019. A total of 109 burn patients were included and their wound swabs were collected at the time of admission. All isolates were identified by standardized microbiological procedures. Anti-microbial susceptibility tests were performed by Kirby Bauer disc diffusion method. Results: Of 109 burn wound samples, 56 (59%) yielded culture growth and the Gram negative isolates were more common than Gram positives (77% vs. 23%). The most common organism isolated was Klebsiella spp. (25%) followed by Acinetobacter spp. (21%) and Staphylococcus aureus (18%). Most burn wound isolates were of resistant strain. Particularly, highly resistant strain of Acinetobacter spp. were isolated, most of which were sensitive to Tigecycline, Polymyxin B and Colistin only. Conclusion : Gram negative isolates were common in burn wound isolates and the antibiotic susceptibility pattern was different for different organisms. The use of antimicrobials should be judicious to further not escalate the problem of antimicrobial resistance in the healthcare settings.  

scholarly journals Surgery and anesthesia in sickle cell disease. Cooperative Study of Sickle Cell Diseases

Blood ◽  
1995 ◽  
Vol 86 (10) ◽  
pp. 3676-3684 ◽  
Author(s):  
M Koshy ◽  
SJ Weiner ◽  
ST Miller ◽  
LA Sleeper ◽  
E Vichinsky ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Sickle Cell Disease ◽  
General Anesthesia ◽  
Sickle Cell ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Complication Rates ◽  
Cooperative Study ◽  
Cell Disease

From 1978 to 1988, The Cooperative Study of Sickle Cell Disease observed 3,765 patients with a mean follow-up of 5.3 +/- 2.0 years. One thousand seventy-nine surgical procedures were conducted on 717 patients (77% sickle cell anemia [SS], 14% sickle hemoglobin C disease [SC], 5.7% S beta zero thalassemia, 3% S beta zero + thalassemia). Sixty-nine percent had a single procedure, 21% had two procedures, and the remaining 11% had more than two procedures during the study follow- up. The most frequent procedure was abdominal surgery for cholecystectomy or splenectomy (24% of all surgical procedures, N = 258). Of these, 93% received blood transfusion, and there was no association between preoperative hemoglobin A level and complication rates (except reduction in pain crisis). Overall mortality within 30 days of a surgical procedure was 1.1% (12 deaths after 1,079 surgical procedures). Three deaths were considered to be related to the surgical procedure and/or anesthesia (0.3%). No deaths were reported in patients younger than 14 years of age. Sickle cell diseases (SCD)-related complications after surgery were more frequent in SS patients who received regional compared with general anesthesia (adjusted for risk level of the surgical procedure, patient age, and preoperative transfusion status, P = .058). Non-SCD-related postoperative complications were higher in both SS and SC patients who received regional compared with those who received general anesthesia (P =.095). Perioperative transfusion was associated with a lower rate of SCD- related postoperative complications for SS patients undergoing low-risk procedures (P = .006, adjusted for age and type of anesthesia), with crude rated of 12.9% without transfusion compared with 4.8% with transfusion. In SC patients, preoperative transfusion was beneficial for all surgical risk levels (P = .009). Thus, surgical procedures can be performed safely in patients with SCD.

scholarly journals Creation and validation of a health guidance booklet for family members of children with sickle cell disease

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Sarah Vieira Figueiredo ◽  
Thereza Maria Magalhães Moreira ◽  
Clarice Santos Mota ◽  
Roselene Soares de Oliveira ◽  
Ilvana Lima Verde Gomes
Keyword(s):  
Educational Technology ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Family Members ◽  
Field Research ◽  
Concordance Index ◽  
Pediatric Hospital ◽  
Cell Disease ◽  
Methodological Study

ABSTRACT The aim of this study was to elaborate a booklet for health follow-up and guidance on sickle cell disease for relatives of children with this disease and validate it. It is a methodological study, conducted from May 2017 to February 2018, of the elaboration and validation of an educational technology, constructed from previous field research in a pediatric hospital in Ceará (ethical opinion nº 994.879 and nº 955.727). Validation of content and appearance occurred by specialized, technical and communication judges; after the adjustments, the evaluation by representatives of the target public took place. The analysis was through the Concordance Index. Results: the evaluation of technical judges and experts reached a Global Concordance Index of 0.93, characterizing the book as good quality. The judges of communication evaluated all items as Superior. As for family members, everyone agreed that the book was adequate. It is concluded that the booklet has been duly drawn up and validated as regards its content and its appearance. Implications for practice: this educational technology is an important instrument to be used by health professionals, aiming to contribute to increase the knowledge of the relatives of children with sickle cell disease.

scholarly journals Fever among Children with Sickle-Cell Disease: Findings from the General Pediatric Ward of the Owendo Pediatric Hospital in Libreville, Gabon

2014 ◽  
Vol 04 (04) ◽  
pp. 262-268
Author(s):  
Jean Koko ◽  
Daniel Gahouma ◽  
Simon Ategbo ◽  
Cathérine Seilhan ◽  
Armelle Pambou ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Pediatric Hospital ◽  
Cell Disease ◽  
Pediatric Ward

scholarly journals Bacteriological Study of Electronic Devices Used by Healthcare Workers at Ruhengeri Referral Hospital

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Thierry Habyarimana ◽  
Christelle Uwizeye ◽  
Emmanuel Munyeshyaka ◽  
Cedrick Izere ◽  
Joseph Mucumbitsi ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Isopropyl Alcohol ◽  
Bacterial Colonization ◽  
Electronic Devices ◽  
Healthcare Delivery ◽  
Referral Hospital ◽  
Sample Collection ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Bacteriological Study

Electronic devices have become one of the most essential accessories being used in hospitals. Those devices increase the communication and contact making healthcare delivery more efficient and quality service oriented. The study was designed to collect reliable information about the spreading of pathogens through electronic devices especially in sensitive departments. The objectives of this study were to evaluate the bacterial colonization of electronic devices and determine the effectiveness of disinfection with alcohol 70% (w/v) to reduce the bacterial colonization of electronic devices. It was a cross-sectional study where samples were collected by means of moistened swabs in sterile saline solution from 30 electronic devices used by healthcare workers at Ruhengeri Referral Hospital within four different units: maternity, neonathology, intensive care, and theater room. To evaluate the effects of disinfection using 70% isopropyl alcohol, the second sample collection was carried out after decontamination with 70% isopropyl alcohol. Samples were analyzed in the microbiology lab of INES-Ruhengeri. The result showed that Staphylococcus aureus was the most predominant with 22.5%. Lactobacillus and Citrobacter spp. were 12.5%; Pseudomonas aeruginosa, coagulase-negative Staphylococci, and Serratia marcescens were 10%; Escherichia coli was 7.5%; Klebsiella spp. and Providencia spp. were at 5%. The lowest prevalence was 2.5% of Enterobacter spp. and Salmonella spp. The threat of dissemination of isolated microorganisms is valid, since all devices evaluated in this study showed bacterial contamination of species associated to hospital-acquired infections. Special care should be taken when using electronic devices in healthcare settings in addition to disinfection to reduce the risk of transmission of bacterial agents. Further studies should evaluate the antibiotic susceptibility for better conclusive results since all isolated bacteria in this study were subjected to high resistance and were associated with nosocomial infections.

scholarly journals PURULENT SEPTIC COMPLICATIONS OF ACUTE PANCREATITIS AND THEIR PATHOGENETIC RELATIONSHIP WITH HELICOBACTER PYLORI

2021 ◽  
Vol 29 (5) ◽  
pp. 542-548
Author(s):  
I.V. Kolosovych ◽  
◽  
I.V. Hanol ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Helicobacter Pylori ◽  
Antibiotic Therapy ◽  
Positive Result ◽  
Comparison Group ◽  
Main Group ◽  
Immunoglobulin M ◽  
Septic Complications ◽  
Bacteriological Study

Objective. To study of the role of Helicobacter pylori as an etiological factor of acute pancreatitis and a marker of the development of its purulent-septic complications. Мethods. The study was conducted in the period of 2015-2020; patients with acute pancreatitis (n=124) were divided into 2 groups: the main group (66 patients with moderate severity and severe course) and the comparison group (58 patients with a mild form). All patients underwent a screening study of Helicobacter pylori in feces and serological blood test to detect antibodies, namely immunoglobulin M to Helicobacter pylori (determination of the phase of the disease - acute or chronic). In 39 (31.5%) patients of the main group, a bacteriological study of biological and biopsyspecimensof antral mucous membrane were taken and examined histologically for organisms. The selection of antibiotics for treatment was carried out taking into account the infection of patients with Helicobacter pylori and was performed using the author’s method, the effectiveness of treatment was controlled microbiologically. Results. The positive result of the express test was in 66 (100%) patients of the main group and in 39 (67.2%) patients in the comparison group. During serological examination, a positive result was obtained: 24 hours after hospitalization - in 8 (13.8%) patients in the comparison group, in 23 (34.8%) patients in the main group; after 7 days - in 9 (15.5%) patients and 42 (63.3%) patients, respectively. Helicobacter pylori is sensitive to the majority of antibiotics used to treat purulent-septic complications of acute pancreatitis; after finishing the course of antibiotic therapy, eradication was achieved in 37 (94.9%) patients of the main group. Conclusion. Positive results of a serological study of Нelicobacter pylori after 7 days from the moment of hospitalization were more common in patients of the main group (63.3%) in relation to the comparison group (15.5%) (χ<sup>2</sup>=28.9, p<0.001), which gives grounds to consider bacteria, as one of the markers of the development of purulent-septic complications of acute pancreatitis. What this paper adds The role of Helicobacter pylori (HP) in the pathogenesis of acute pancreatitis has been studied for the first time and its value as a marker for septic complications development of acute pancreatitis is shown. It allowed optimizing the etiotropic antibiotic therapy for this disease.

Telomere Lengths Correlate With Inflammatory Markers In Sickle Cell Disease

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2230-2230
Author(s):  
Emma Drasar ◽  
Jie Jiang ◽  
Kate Gardner ◽  
Jo Howard ◽  
Tom Vulliamy ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Telomere Length ◽  
Sickle Cell ◽  
Single Copy ◽  
Organ Damage ◽  
Telomerase Activity ◽  
Sample Collection ◽  
Standard Curve ◽  
King's College ◽  
Polymerase Chain

Abstract Telomeres are DNA protein structures that protect chromosome ends from degradation and fusion and are essential for maintenance of genomic integrity. Shortened telomere length has been found in DNA from patients with inherited conditions associated with premature cellular aging and acquired disorders such as cardiovascular heart disease. In vitro studies have shown that telomeres are highly susceptible to oxidative stress. We hypothesize that the elevated level of reactive oxygen species and oxidative stress generated by ongoing hemolysis in sickle cell disease (SCD) could predispose to shorter telomeres in white blood cells (WBCs), and that telomere length could be a marker of SCD severity. The study population included 126 healthy controls of mixed ethnicities and 426 patients of African descent with SCD of mixed genotypes (291 HbSS, 112 HbSC, 16 HbSβ+ thalassaemia and 7 HbSβ0 thalassemia) recruited from King’s College and Guy’s and St Thomas’ hospitals (King’s College Hospital Local Research Ethics Committee protocol 07/H0606/165). Ages ranged from 6 to 86 years for the control group and 17 to 81 years for the SCD group. Clinical and steady state laboratory data were collected from the electronic patient records and sickle cell database. Telomere length measurement was performed on DNA extracted from peripheral blood leucocytes using a monochrome multiplex quantitative polymerase chain reaction technique adapted from the method as described by Richard Cawthon (Cawthon 2009). The method compares telomere repeat sequence copy number (T) to albumin (a single copy gene, S) copy number within the same DNA sample. Three reference DNA samples were included in each run as internal quality controls. The sample DNAs were assayed in duplicate and the standard curve DNAs, in triplicate. Polymerase chain reaction was performed using a Rotorgene 6000 (Corbett Life Sciences) after which data were analysed using Rotorgene 6000 series software version 1.7. For each sample, telomere length was expressed as telomere to single copy gene ratio (TSR) which is based on the delta Ct (Cttelomere / Ctsingle-gene) derived from the standard curve. To make comparable the results from different runs, the results were approved only if the relative TSRs of the validation reference samples fell within a 5% variation. Regression analysis was performed correcting for age, gender, alpha genotype, and hydroxyurea (HU) therapy at the time of sample collection. Laboratory variables were only available for the SCD group. 57/301 (19%) of sickle cell anemia (SCA, including HbSS and HbSβ0) patients had received HU treatment for at least 3 months prior to sample collection. TSRs for the controls, study group and sub-groups was significantly negatively associated with age as has previously been shown in healthy controls and disease states (Fig 1) (p<0.0001 in all groups). Contrary to our expectations, mean TSR was significantly longer (p<0.0001) in patients with SCD (mean 2.37 range 0.14 to 4.87) compared to controls (mean 1.80 range 0.87 to 4.17). Further, within the SCD group, TSR was significantly longer (p<0.0001) in patients with SCA (mean 2.44 range 0.14 to 4.87) compared to those with HbSC (2.19 range 0.35 to 3.46). The association with sickle genotype persisted with regression analysis (p = 0.001). We postulate that the longer telomeres in patients with SCD are due to increased telomerase activity related to the underlying inflammation. This suggestion is supported by the: 1) positive association of TSR with WBC (R = 0.19 p = 0.001) and neutrophil count (R = 0.14 p = 0.02) which persisted with regression analysis (WBC, p = 0.003 and neutrophil count, p = 0.049); 2) longer TSRs in patients with SCA when compared to patients with HbSC disease who have less inflammation; 3) significantly shorter telomeres in patients on HU therapy compared to the untreated group (regression analysis p = 0.004), we propose that this is due to the anti-inflammatory effects of HU via suppression of WBC count and down-regulation of cytokines. These results could have significant implications for our understanding of the pathophysiology of SCD, particularly the role that inflammation plays in chronic organ damage in this patient group. To validate the hypothesis, future work would include correlation of telomere length with both telomerase activity and organ damage in patients with SCD. Disclosures: Howard: Sangart: Membership on an entity’s Board of Directors or advisory committees.

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