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Phenotypic Characterization of Carbapenemase-Producing Enterobacteriaceae Strains in a Referral teaching hospital in yaoundé, Cameroon

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Open Journal of Medical Microbiology 2023年第1期13卷 52-67页

作者： Cecile Ingrid Djuikoue Paule Dana Djouela Djoulako Rodrigue Kamga Wouambo Charlène Nkouankou Tomi Christiane Possi Kiyang Murielle Chantale Tchitchoua Vynnie Manuella Nyatchoutou Blondelle Kitio Messeu Herman Koyouo Tagne Cedric Dylan Seugnou Nana Nadjia Benhamed Hortense Gonsu Kamga Benjamin D. Thumamo Pokam Faculty of Health Sciences Université des Montagnes Bangangté Cameroon Faculty of Medicine Sorbonne Université Paris France Division of Hepatology Department of Medecine II Leipzig University Medical Center Leipzig Germany University of Sciences and Technology Oran Algeria Bacteriology Unit University Teaching Hospital Yaounde Cameroon Department of Medical Laboratory Science Faculty of Health Sciences University of Buea Buea Cameroon

Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. They are nowadays more encountered routinely in hospitals and cause high morbidity and mortality due to limited therapeutic alternatives. This study sought to determine the prevalence of CPE in yaoundé teaching hospital, Cameroon, and the associated risk factors. Materials and Method: To achieve this goal, a descriptive cross-sectional study coupled to an analytical component with consecutive collection of Enterobacteria strains was carried out during a three-month period (from 27th July to 24th October 2018) in the University teaching hospital of yaoundé, Cameroon. The oxidase and biochemical identification tests using a miniaturized Api 20 E system were performed on colonies grown on Eosin Methylene Blue (EMB) medium and subcultured on nutrient agar. Drug susceptibility testing was carried out according to the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2018.V.2.0). The detection of carbapenemase production was performed by the CA-SFM 2018 algorithm for the screening of carbapenemase-producing enterobacteriaceae and its classification by inhibitory synergy tests. Results: Out of the 104 isolates, Escherichia coli (50%) was the most prevalent species, followed by Klebsiella pneumoniae (37.5%) and Citrobacter frendii (12.5%). Drugs susceptibility patterns showed a high resistance to penicillins group (97.4% to amoxicillin), cephalosporins (68.4% to cefotaxim, 58.1% to cefixim, 60.7% to ceftazidim, 57.1% of cefoxitin) and aztreonam (55.7%). However, 11.9% carbapenems related resistance was noticed: 14.4% to imipenem, 13.8% to ertapenem and 7.5% to meropenem. Numerous co-resistance to quinolones (65.8%), fluoroquinolones (49.6%), aminoglycosides (49.6%) and cotrimoxazole (71.8%) were also observed. From 104 isolates, AmpC production represented 23.08% (25/104) and 36.54% (38/104) were ESBL-isolates. The ove

关键词： Enterobacteriaceae Antibiotics Carbapenemase Resistance

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Epidemiological Profile of Obesity among Health Staff at the yaoundéCentral hospital and at the yaoundéUniversity teaching hospital

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World Journal of Cardiovascular Diseases 2019年第8期9卷 511-523页

作者： Sylvie Ndongo Amougou Liliane Linda Yangou Tchangoum Marie Ntep Gweth Dieudonné Danwe Camille Mba Maadjjhou Samuel Kingue Jean Claude Mbanya Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon yaoundé University teaching hospital Yaoundé Cameroon Higher Institute of Medical Technology Yaoundé Cameroon yaoundé Central hospital Yaoundé Cameroon

Background: Obesity is a real pandemic and with ever increasing prevalence. Health professionals play a vital role in the fight against this condition. They are also affected by obesity and could be even more affected than the general population. These health workers sometimes have a wrong perception of their own weight which interferes with their ability to counsel their patients. The purpose of this study was to determine the prevalence and factors associated with obesity among health care workers and increase their awareness of the problem. Methodology: This was a cross-sectional study conducted at the yaoundé Central hospital (YCH) and the yaoundé University teaching hospital (YUTH) during a 6 months period. The data were collected through a questionnaire structured according to WHO STEP wise approach to chronic disease risk factor surveillance (STEPS). We measured weight, height, waist circumference, and blood pressure according to the WHO STEPS procedure. The Chi square test and logistic regression were used to measure the association between the qualitative variables. A p value 0.05 was considered statistically significant. Results: A total of 350 health personnel participated in this study. The prevalence of obesity was 30.3%. That of abdominal obesity was 46.9%. The factors independently associated to overall obesity were age > 40 years [OR = 2.22 95% CI (1.28 - 3.87)], nursing assistant profession [OR = 2.31 95% IC (1.21 - 4.41)] and high blood pressure [OR = 3.38 95% CI (1.16 - 9.84)] and to abdominal obesity, age > 40 years [OR = 3.35 95% CI (1.96 - 5.71)], female gender [OR = 5.47 95% CI (2.95 - 10.14)], marriage [OR = 1.84 95% CI (1.08 - 3.14)], and High blood pressure [OR = 3.76 95% CI (1.01 - 13.94)]. Conclusion: Obesity is very common among YCH and YUTH staff. Staff awareness and the introduction of proper lifestyle promotion programs are more than ever needed to win the fight against obesity.

关键词： Epidemiological Profile Obesity Health Personnel yaoundé

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Acute Metabolic Complications of Diabetes in the Oueme-Plateau Provincial teaching hospital: Epidemiological, Clinical, Paraclinical and Evolutionary Aspects

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Open Journal of Internal Medicine 2024年第1期14卷 83-92页

作者： Finangnon Armand Wanvoegbe Comlan Jules Gninkoun Hubert Dedjan Kouessi Anthelme Agbodande Van Carrel Yongolo Prosper Singbo Elisé Boko Manchouhoud Alalade Adele Cakpo Ingrid Thomas Angele Azon Kouanou Internal Medicine Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Endocrinology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Endocrinology Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Internal Medicine Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin

Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute metabolic complications (AMC) of diabetes in the endocrinology department of the Oueme-Plateau Provincial teaching hospital. Methods: This was a descriptive cross-sectional study with data collection based on the medical records of patients presenting with acute metabolic complications of diabetes in the endocrinology department of the Oueme-Plateau Provincial teaching hospital during the 3 years study period (from January 2020 to December 2022). Results: Over 788 patients hospitalized during the study period, 157 had an acute metabolic complication of diabetes, which is a hospital prevalence of 19.9%. Among these 157 cases, 140 were suitable for analysis and therefore constituted our study sample. The mean age of the patients was 49.9 ± 14.7 years, with 19 as minimum and 90 years as maximum. Most of them were women (52.4%). Hypertensive diabetics accounted for 54.9% of cases. Ketoacidosis was the most common complication (62.1%), followed by hyperosmolar hyperglycemic syndrome (23.6%) and hypoglycemia (14.3%). Infection (69.3%) and therapeutic noncompliance (22.9%) were the most common triggers. The average length period of their hospital stay was 7.1 ± 5.1 days, and the outcome was satisfactory in 87.9% of the cases. Unfortunately, there were 3.6% deaths during hospitalization. Conclusion: Acute metabolic complications of diabetes were dominated by ketoacidosis. Infection was the dominant factor in decompensation. Therapeutic education of diabetic patients as well as clinical and biological monitoring must be more stringent and rigorous.

关键词： Acute Metabolic Complications Diabetes Ketoacidosis Porto-Novo

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Cystic Degeneration of Uterine Myoma Simulating Ovarian Cancer in Postpartum: A Case Report at the teaching hospital of Angre

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1522-1528页

作者： Roland Adjoby Ndrin Denis Effoh Soh Victor Koffi Okoin Paul José Loba Ngolo Alassane Soro Yapo Privat Akobé Ramata Kouakou-Kouraogo Michelle Gadji Obstetric Gynecology Department of Angres teaching hospital Abidjan Cte dIvoire

The transformation of uterine fibroids is common in relation to their development. Giant forms of cystic degeneration are rare. They raise diagnostic difficulties with other pelvic tumors, such as ovarian tumors and leiomyosarcomas. Magnetic resonance imaging specifies the original organ, the volume and the main relationships of fibromyoma with adjacent structures. The diagnosis of certainty is based on laparotomy coupled with histology. The authors illustrate these difficulties by observing a giant cystic degenerative fibroma in a 26-year-old G1P1 woman in the postpartum period.

关键词： Fibromyoma Uterine Neoplasia Pelvic Tumor MRI

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Surgical Site Infections in Trauma and Orthopaedics at Bouaké teaching hospital (Côte d’Ivoire)

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Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah Aya Adelaïde Natacha Kouassi Kouamé Innocent M’bra Kouamé Jean-Eric Kouassi Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké teaching hospital. Method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. Multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： Surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Antibiotic Susceptibility Patterns of Bacteria Associated with Sepsis among hospitalized Patients in the yaoundé University teaching hospital—Cameroon

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Open Journal of Medical Microbiology 2023年第1期13卷 101-115页

作者： Lavoisier Christian Ngassa Yimtchi Benjamin D. Thumamo Pokam Abange William Baiye Anicette Chafa Betbeui Hontense Kamga Gonsu Watching Djakissam Department of Medical Laboratory Sciences Faculty of Health Sciences University of Buea Buea Cameroon Bacteriology Laboratory Yaoundé University Teaching Hospital Yaoundé Cameroon Department of Biomedical Sciences Faculty of Health Sciences University of Buea Buea Cameroon Department of Microbiology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background and Objective: In developing countries, the steep increase in septicaemia cases is a major health problem that creates the biggest challenge for clinicians in the selection of appropriate antimicrobial agents. This is further complicated by the development of resistance in organisms to antimicrobial agents, which is the mainstay of treatment. The aim of this study was to determine the antimicrobial resistance patterns of bacterial isolates associated with sepsis among hospitalized patients including the detection of Methicillin Resistance Staphylococcus aureus (MRSA) and Extended Spectrum Beta lactamases (ESBLs). Methods: A cross-sectional study was carried out for 5 months at the yaounde University teaching hospital. Bacterial species were isolated from 150 blood samples collected from hospitalized patients. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disc diffusion method. The isolates were tested for methicillin resistance and ESBLs. Results: The prevalence of septicaemia was 16% (24/150) among hospitalized patients. In our study, 75% (18/24) of infections were caused by Gram- negative and 25% (6/24) by Gram-positive bacteria. Klebsiella spp., Escherichia coli, and Staphylococcus aureus were the most common isolates. The antibiotic susceptibility patterns of the isolates showed that Gram-negative bacteria were highly resistant to Amoxicillin clavulanic acid and ceftriaxone while the Gram- positive bacteria were highly resistant to minocycline. Fifty percent (3/6) of the isolated S. aureus were methicillin-resistant and 27.8% (5/18) of the isolated Enterobacteriaceae were ESBLs producers. In multivariable logistic regression analysis, temperature above 37.9℃ (AOR = 4.455;95% Cl = 1.458 - 15.693;p = 0.033) and being under respiratory assistance (AOR = 4.311;95% Cl = 1.458 - 12.749;p = 0.008) were significantly associated with septicaemia. Conclusion: The Occurrence of multidrug-resistant strains in this study emphasizes the

关键词： Septicaemia ESBLs MRSA Antimicrobial Resistance yaoundé

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Prevalence and Factors Associated with Low Back Pain among Healthcare Workers in Two hospitals in yaoundé-Cameroon: A Cross-Sectional Study

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 89-107页

作者： Brian Gweha Ahmadou Musa Jingi Baudelaire Fojo Talongong Claude Tayou Madeleine Singwé-Ngandeu Department of Clinical Sciences Faculty of Health Sciences The University of Bamenda Bamenda Cameroon Faculty of Medicine and Biomedical Sciences The University of Yaound Yaound Cameroon The Rheumatology Unit The Yaound Central Hospital Yaound Cameroon The Hematology Laboratory The Yaound University Teaching Hospital Yaound Cameroon

Background: Low back pain (LBP) is a very common health problem amongst the general population and a major cause of disability that affects work performance and well-being. Healthcare workers (HCWs) are especially at risk of developing LBP because of physical and emotional factors. Little is known about the burden of LBP in Cameroon. Objective: To determine the prevalence of low back pain and identify its associated factors among healthcare workers. Methods: A cross-sectional study using a self-administered questionnaire was conducted among healthcare workers in the yaound Central hospital and the yaound University teaching hospital. The questionnaire collected data regarding recent, past year and lifetime occurrences of LBP, socio-demographics and work conditions. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 26. Results: A total number of 268 HCWs participated in the study, including 197 (73.5%) females and 71 (26.5%) males. The mean age of the study participants was 40.60 8.38 years (extremes of 20 and 65 years). The lifetime, annual, and point prevalences of LBP among the participants were 67.5% (CI: 61.6 - 73.1), 61.5% (CI: 55.6 - 67.1) and 35.7% (CI: 29.7 - 41.5) respectively. Multivariate analysis confirmed a moderate stress level, a sedentary lifestyle, working in the medicine and specialities department, lifting heavy objects and bending to work as associated factors to LBP. Most sufferers had a minimal functional disability (65.7%) while 34.3% had a moderate to severe disability. Conclusions: Healthcare providers have a considerably high prevalence of low back pain. Factors associated with LBP found in this study were similar to those widely recognized in the literature. A substantial proportion of healthcare providers are suffering from functional disability associated with low back pain, affecting their social and work lives. There is a need for multilevel interventions to prevent and control low back pain in this hi

关键词： Prevalence Associated Factors Low Back Pain Healthcare Workers yaoundé

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Post Episiotomy Morbidity among Parturient in Alex Ekwueme Federal University teaching hospital Abakaliki, Ebonyi State

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1144-1160页

作者： John Chinedu Obasi Ayodele Adegbite Olaleye Boniface N. Ejikeme John O. Egede Charles Nwambeke Edene Enemma Christian Enemma Victor Onuchukwu Emmanuel Onyekelu Nathan C. Ekpe Wendy Oliobi Emmanuel C. Uwakwe Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital AbakalikiNigeria

Background: Episiotomy is a very common obstetric surgery, and it could be associated with serious complications. However, these complications largely are not noticed due to the shift of attention from mother to baby, after a successful delivery. Objective: To identify the morbidities associated with episiotomies and factors associated with such morbidities. Method: This was a questionnaire based cross sectional descriptive study among women who attended the Obstetric Department of Alex Ekwueme Federal University teaching hospital Abakaliki Ebonyi State, between 1st July and 31st Nov, 2023. The study population consisted of parturients who had episiotomies in their previous confinements, attending either the antenatal clinic or the postnatal clinic at Alex Ekwueme Federal University teaching hospital Abakaliki Ebonyi State. Results: Macrosomia was the most common indication of episiotomy at a rate of 31.6%. The majority of episiotomies were performed on the parturients in their first confinement at a rate of 64.5% and the majority of repairs were performed by the Registrar at a rate of 65.0%. Informed consent was obtained from 45.79% of parturients while 54.21% were not informed before the episiotomy was administered. Only 55.3% of the parturient received analgesia before episiotomy was administered. The majority of the parturients had their episiotomy repaired between 10 - 15 minutes at a rate of 40.3%. Postoperative pain at the rate of 44.5% was the most common complication and dyspareunia as a form of sexual complication was the commonest at a rate of 31.3%. Conclusion: The parturient needs to be properly counselled before administration of episiotomy and adequate analgesia should be given, as episiotomy is a surgical procedure. Proper training of health workers on both the technique of administering and repairing episiotomy is important. Restrictive use of routine episiotomy in primigravidae is advised to reduce the rate of episiotomy.

关键词： Episiotomy Vulva Pains Primigravidae Morbidities Analgesia

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Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA teaching hospital (Togo)

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Open Journal of Urology 2024年第1期14卷 20-26页

作者： Musapudi Éric Mbuya Komi Hola Sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho Kodjo Tengue Tchilabalo Matchonna Kpatcha Urology and Andrology Department Kara Teaching Hospital Kara Togo Urology and Andrology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Surgery Department University Clinics of Lubumbashi Lubumbashi DRC Aneho Prefectural hospital Center Aneho Togo Urology and Andrology Department Kpalime Prefectural Hospital Center Kpalime Togo Urology and Andrology Department Sokodé Regional Hospital Center Sokodé Togo Urology and Andrology Department Sylvanus Olympio Teaching Hospital Lomé Togo

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara teaching hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara teaching hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

关键词： Internal Urethrotomy Urethral Stenosis Kara Togo

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Association between the Different Phenotypes of Polycystic Ovary Syndrome and the Outcome in in Vitro Fertilization at Human Reproductive Center Paul et Chantal Biya-yaoundé

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 18-28页

作者： Ngono Akam Vanina Ngah Minala Belinga Etienne Belinga Etienne Mpono Pascale Nyada Serges Onana Y. Kasia Cho Joselyne Kasia Florence Adjessa Abega Kasia Jean Marie Gynaecological Endoscopic Surgery and Human Reproductive teaching hospital Yaoundé Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was to study the association between PCOS phenotypes and IVF/ICSI results in women admitted to Gynaecological Endoscopic Surgery and Human Reproductive teaching hospital (CHRACERH). Material and Method: We carried out a cohort study with historical-prospective data collection over a period of seven years (January 2016 to March 2023) at Chracerh. PCOS patients were subdivided into 4 subgroups A, B, C and D. Results: We recruited 128 patients including 64 PCOS patients divided into four phenotypes and 64 non-PCOS patients constituting the control group. Phenotype D without hyperandrogenism had used the lowest dose of gonadotropins, i.e. 1939.7 ± 454.3 IU, and had produced a greater quantity of estradiol on the day ovulation was triggered (6529.8 ± 4324.8 ng/ml). The average number of punctured follicles and mature oocytes were higher in the phenotype D group. Ovarian hyperstimulation syndrome (OHSS) occurred mainly in phenotype D (3/35), with an estimated prevalence of 2.3%. The fertilization rate seemed lower in the hyperandrogenic phenotypes A, B, C compared to the group without hyperandrogenism without significant difference (p = 0.461). The biological pregnancy rate and live birth rate were comparable between the different groups. Conclusion: Phenotype D used less dose of gonadotropins. Biological pregnancy and live birth rates were comparable between the different phenotypes.

关键词： Phenotype Polycystic Ovarian Syndrome IVF/ICSI Prognosis CHRACERH

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