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Incidence and Predictors of Peripheral Venous Catheter-Related Complications in Hospitals in Burkina Faso

Open Journal of Emergency Medicine 2021年第4期9卷 196-208页

作者： Imbe Ignace Yaro mikaila kaboré Martin Lankoande Farid Belem Ismael Guibla Ahmed Ouattara Charles Ilboudo Papougnézambo Bonkoungou Kongnimissom Apoline Sondo Raweleguinbasba Armel Flavien kaboré Nazinigouba Ouedraogo Medical Emergency Department Yalgado Ouédraogo Teaching Hospital Ouagadougou Burkina Faso Anesthesia Resuscitation Ward Regional Hospital of Ziniaré Ziniaré Burkina Faso Infectious Diseases Department Yalgado Ouédraogo Teaching Hospital Ouagadougou Burkina Faso Health Sciences Training and Research Unit Joseph KI-Zerbo University Ouagadougou Burkina Faso Anesthesia Resuscitation Department Sanon Souro Teaching Hospital Bobo-Dioulasso Burkina Faso Anesthesia Resuscitation and Emergency Department Yalgado Ouédraogo Teaching Hospital Ouagadougou Burkina Faso Anesthesia Resuscitation and Emergency Department Tengandogo Teaching Hospital Ouagadougou Burkina Faso

Introduction: Peripheral venous catheters (PVCs) are the most commonly used medical devices in hospitals for the administration of medications. Their use can lead to complications of varying severity. Objective: Determine the incidence and factors associated with the occurrence of PVC-related complications. Methods: This was a two-month prospective observational study conducted in the Medical Emergency Department (MED) of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. All patients admitted during the study period who had a PVC inserted and removed were included in the study. Logistic regression analysis was used to identify the factors associated with the occurrence of complications. Results: In total, 459 PVCs were inserted and removed in 415 patients hospitalized at the Medical Emergency Department during the study period. The placement of 37.7% (n = 173) of PVCs resulted in complications in 131 patients (31.6%). For 644.3 days of catheterization, the incidence density was estimated at 6.5 complications per 1000 patient days. Phlebitis (24.0%), infection (5.7%), and accidental removal (2.8%) were the most frequently identified complications. The average age of the patients was 46.8 ± 18.9 years with a sex ratio of 1.22. The average patient hospitalization duration was 2.5 ± 2.6 days. In multivariate analysis, the factors significantly associated with the occurrence of complications after PVC insertion were patient’s state of agitation during the procedure (aOR = 12.59;95% CI = 4.12 - 38.49), placement of the PVC at the elbow bend (aOR = 2.17;95% CI = 1.86 - 5.52), multiple attempts

关键词： Peripheral Venous Catheter Complications Risk Factors Emergencies

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Microbiological Assessment and Antimicrobials’ Use in an Infectious Diseases Department in Mali

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Advances in Microbiology 2021年第8期11卷 384-398页

作者： mikaila kaboré Issa Konaté Yacouba Cissoko Ibrehima Guindo Bintou Coulibaly Meli Hermine Aboubacar Alassane Oumar Mariam Soumaré Assetou Fofana Abdoulaye Zaré Mohamed Aly Cissé Dramane Sogoba Omar Magassouba Hama Hamidou Issa Fodé Kouyaté Sounkalo Dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory and Biomedical Research Department National Institute of Public Health Bamako Mali Faculty of Pharmacy University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory of Biomedical Analysis University Teaching Hospital of Kati Kati Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were Mycobacterium tuberculosis (42.2%) mainly in sputum;Escherichia coli (24.2%) and Klebsiella pneumoniae (7.8%) commonly in urine and Gardnerella vaginalis (7.0%) exclusively in vaginal secretions. Candida albicans (5/8) and Cryptococcus neoformans (3/8) were the most common fungi while Plasmodium falciparum (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, i.e. 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiol

关键词： Antimicrobial Microbiology Infectious Diseases Mali

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Neuropsychic Disorders Unmasking the Coexistence of Fahr Syndrome and Neuromeningeal Cryptococcosis

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Case Reports in Clinical Medicine 2020年第11期9卷 329-334页

作者： mikaila kaboré Issa Konaté Yacouba Cissoko Souleymane P. Coulibaly Jean-Paul Dembélé Assetou Fofana Mariam Soumaré Hermine Méli Dramane Sogoba Oumar Magassouba Adama Sissoko Mohamed Aly Cissé Abdoulaye Zaré Bintou Coulibaly Fodé Kouyaté Moïse Nguemeni Sounkalo Dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Psychiatry Department Point “G” University Teaching Hospital Bamako Mali Neurology Department Point “G” University Teaching Hospital Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifestations, neuropsychic disorders with or without meningeal signs. The objective was to describe a rare association between Fahr syndrome and neuromeningeal cryptococcosis which can be expressed by the same clinical symptomatology in the context of co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). Presentation: A 37-year-old patient without pathological history, who presented behavioral disorders that led to a fight with those around her and a psychiatric consultation. Then, she was hospitalized in the infectious diseases Department upon discovery of her HIV status and viral hepatitis B. She was logorrheic with behavioral disturbances and subsequently presented with tonic-clonic convulsions. Laboratory tests and imaging have concomitantly discovered Fahr syndrome due to pseudohypoparathyroidism and neuromeningeal cryptococcosis. The correct management of these two pathologies enabled stabilization of the patient’s clinical condition with regular monitoring for HIV-HBV coinfection. Conclusion: Farh syndrome and neuromeningeal cryptococcosis are two different entities but sometimes similar symptoms and risk factors. Treatment of metabolic disorders combined with anticryptococcal therapy improved the prognosis.

关键词： Neuropsychic Disorders Neuromeningeal Cryptococcosis Fahr Syndrome Pseudohypoparathyroidism HIV

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