Klebsiella pneumoniae Nosocomial Infection in an African Pediatrics Health Center: Case of Campus-Teaching Hospital in Togo

Nadiedjoa Kokou Douti, M. Fiawoo, M. Salou, Kossi M Senagbe, M. Hemou, E. Sanni, D. Y. Atakouma, B. Bakondé, M. Prince-david
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Abstract

Background: The target of our study was to analyze clinical, para-clinical and environmental aspects of a nosocomial infection that occurred at the pediatrics division at Campus Teaching Hospital. Methods: This was a prospective study initiated after observation of some suspicious cases of nosocomial infection amongst patients. Forty-one children from 29 days to 15 years of age admitted to the Pediatrics Division at Campus Teaching Hospital for a period of 3 months (from April 1 to June 31, 2016) were taken into account in this study. In our study, we included all sick children who showed a reappearance of severe infectious syndrome after 3 days of admission and whose blood cultures were positive. During this period of study, 20 nurses and six medical doctors were questioned as regards to hands clean during the discharge of their work. Studied parameters were: age, sex, initial treatment, bacteria found, sensibility of bacteria, swab results on medical materials in use and hands care. Results: During the study, 41 cases of blood cultures were identified, out of which 30 (73.17%) tested positive to  Klebsiella pneumoniae . The most concerned range of age was between 1 and 5 (56.09%). The initial diagnoses were dominated by 27 malaria (65.85%) and gastroenteritis fever (17.08%). All isolated cases of  Klebsiella pneumoniae in our study were multi-resistant but sensitive to colistin. Two children out of 30 infected by  Klebsiella pneumoniae died. During the period of study, health staff on duty did not regularly practise proper hands hygiene. Conclusions: The case of nosocomial infection is very common in African health centers and it should draw the attention of health officials. Int J Clin Pediatr. 2018;7(4):51-54 doi: https://doi.org/10.14740/ijcp313w
非洲儿科卫生中心肺炎克雷伯菌医院感染:以多哥校园教学医院为例
背景:本研究的目的是分析发生在校园教学医院儿科的一起医院感染的临床、准临床和环境因素。方法:这是一项前瞻性研究,是在观察了一些可疑的医院感染病例后开始的。本研究纳入校园教学医院儿科住院3个月(2016年4月1日至6月31日)的41名29天至15岁的儿童。在我们的研究中,我们纳入了所有入院3天后再次出现严重感染综合征且血培养呈阳性的患儿。在这一研究期间,对20名护士和6名医生进行了关于下班时洗手情况的询问。研究参数为:年龄、性别、初始治疗、细菌发现、细菌敏感性、使用中医疗材料拭子结果和手部护理。结果:共检出血培养病例41例,其中肺炎克雷伯菌阳性30例(73.17%)。最受关注的年龄段为1 ~ 5岁(56.09%)。初诊以27例疟疾(65.85%)和肠胃炎热(17.08%)为主。本研究中分离的肺炎克雷伯菌均对粘菌素多重耐药但敏感。感染肺炎克雷伯菌的30名儿童中有2名死亡。在研究期间,当值医护人员没有定期进行适当的手部卫生练习。结论:医院感染病例在非洲卫生中心非常普遍,应引起卫生官员的重视。国际儿科临床杂志,2018;7(4):51-54 doi: https://doi.org/10.14740/ijcp313w
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