Acinetobacter infections prevalence and frequency of the antibiotics resistance: comparative study of intensive care units versus other hospital units

Introduction: This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods: This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Results: During the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n=6352) and 9.6% of Gram negative rods (n=4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p <0.05) except for colistin, tetracycline and rifampicin. Conclusion: This paper shows that solving the problem of prevalence and high rate of multidrug resistant Acinetobacter infection which represents a therapeutic impasse, requires the control of the hospital environment and optimizing hands hygiene and antibiotics use in the hospital.Pan African Medical Journal 2016; 2

La rupture spontanée des anévrismes de l’artère splénique à propos d’un cas et revue de la littérature.

Les anévrismes de l’artère splénique sont rares et représentent le troisième site des anévrismes intra-abdominaux et la première localisation des artères viscérales. Nous rapportons un cas de rupture spontanée d’un anévrisme de l’artère splénique pris en charge au service des urgences chirurgicales viscérales « E » complété par une revue de la littérature. Ils se distinguent des autres anévrismes par une étiopathogénie variée et une symptomatologie peu évocatrice. La majorité des anévrismes de l’artère splénique sont asymptomatiques, cependant les anévrismes de l’artère splénique peuvent se manifester par des douleurs épigastriques ou de la partie supérieure de l’hypochondre gauche. De nos jours, beaucoup d'anévrismes de l'artère splénique ont été diagnostiqués et traités chirurgicalement avec succès, grâce aux différents moyens diagnostiques tels que l'échographie, le scanner et l’artériographie, cette dernière étant l’examen de référence. La conduite à tenir devra dépendre de la localisation, du diamètre, des rapports de l'anévrisme avec les organes de voisinage, du type d’intervention élective ou urgente et de savoir si la localisation anévrismale est unique ou multiple. La rupture constitue l'accident évolutif majeur des anévrismes de l’artère splénique, elle peut se présenter sous plusieurs formes cliniques que l’on peut regrouper en fonction de leur topographie (rupture intra-péritonéale, dans un viscère creux et dans un viscère plein). Les anévrismes de l’artère splénique peuvent être traités par embolisation, cependant plusieurs complications peuvent se voir suite au traitement par embolisation

Small-Cell neuroendocrine carcinoma of nasopharynx: A case report

Extra pulmonary small cell carcinomas are extremely rare, accounting for 0.1-0.4% of all malignancies and 2.5-4% of small cell carcinomas. In the head and neck region, the most common primary sites are the larynx, salivary gland, nasal cavity, paranasal sinus, tonsil, and oral cavity. Small cell carcinomas occurring in nasopharynx are extremely rare, to our best knowledge, only four cases of primary nasopharyngeal small cell carcinoma has been described in English literature. We report another case of nasopharyngeal small cell carcinoma arising in a 46-year-old woman. She accused, for five months, nasal blockage, right hypoacousia, exophthalmos and reduced visual acuity. Cerebral and facial magnetic resonance imaging showed an extensive mass of the nasopharynx with the invasion of sphenoidal body, the diagnosis of disseminated small cell carcinoma of nasopahrynx was established. The patient received three courses of systemic chemotherapy; unfortunately, she died after the third course. The prognosis of such entity is poor and is similar to that for patients with extensive small cell lung cancer

AGGRESSIVE MULTIPLE MYELOMA IN A YOUNG ADULT: A CASE REPORT

Multiple Myeloma is a blood cancer type B characterized by clonal proliferation of malignant plasma cells, the median age at diagnosis is 70 years, cases among younger patients are rare, and less than 0, 3 % patients are younger than 30 years in most series. We report a case of a 25-year- old women; she was suffering of a sacred pain radiating towards the left lower limb and fatigue for three months, a magnetic resonance imaging for dorso-lumbar spine showed an expansive process and multiple osteolytic lesions in 2nd, 3rd and 4th sacred vertebras. She underwent a laparotomy that revealed a heavy mass invading the sacrum and the rectum. The histological examination with immunocytochemistry analysis revealed a plasmocytoma and the diagnosis of symptomatic multiple myeloma stage III was established then she received 2 courses of chemotherapy. Despite the rarity of multiple myeloma among young patients, this diagnosis should be evoked when clinical, biological and radiological signs are in favor. It appears that there is no difference between younger and elderly patients on the presentation of the disease, although a longer survival has been reported among young patients

Place of Colistin-Rifampicin Association in the Treatment of Multidrug-Resistant Acinetobacter Baumannii Meningitis: A Case Study

Treatment of Acinetobacter baumannii meningitis is an important challenge due to the accumulation of resistance of this bacteria and low meningeal diffusion of several antimicrobial requiring use of an antimicrobial effective combination to eradicate these species. We report a case of Acinetobacter baumannii multidrug-resistant nosocomial meningitis which was successfully treated with intravenous and intrathecal colistin associated with rifampicin

Exceptional association of two species of bacteria causing mediastinitis: Haemophilus influenzae (H. influenzae) and Aggregatibacter aphrophilus (A. aphrophilus)

Abstract Background Post cardiac surgery mediastinitis is the major infectious complication, despite the development of surgical techniques and the application of strict preventive measures. The Haemophilus influenzae mediastinitis is very rare. The mediastinitis caused by the association between Haemophilus influenzae and Aggregatibacter aphrophilus has never been described to our knowledge. Case presentation We report the case of an exceptional combination of Haemophilus influenzae and Aggregatibacter aphrophilus in a patient operated for single bypass which is complicated by mediastinitis the 10th day after the surgical act. Conclusion The conclusion to be drawn from this work is to think in unusual seeds in case of mediastinitis post cardiac surgery for the elaboration of recommendations for antibiotic prophylaxis

Phytochemical and pharmacological variability in Golden Thistle functional parts: comparative study of roots, stems, leaves and flowers

<p><i>Scolymus hispanicus</i> or the Golden Thistle, locally known as ‘Guernina’ or ‘Taghediwt’, is one of the most appreciated wild vegetables in Morocco. This study aims to characterise the functional chemical and pharmacological variability of <i>Scolymus hispanicus</i> parts (roots, stems, leaves and flowers). The chemical analysis revealed higher content of α-tocopherol in the flowers (2.79 ± 0.07 mg/100 g) and lead to the identification of 3 flavonoids and 13 phenolic acids, with high content of gallic acid in leaves (187.01 ± 10.19 mg/kg); chlorogenic (936.18 ± 92.66 mg/kg) and caffeic (4400.14 ± 191.43 mg/kg) acids in flowers, roots were much more higher in sinapic acid (0.25 ± 0.03 mg/kg) compared to the other parts. Moreover, <i>Scolymus hispanicus</i> ethanolic extracts exhibited interesting antioxidant and antimicrobial properties, promising anti-amylase and anti-glucosidase activities and relevant diuretic effect that confirms its traditional uses.</p