Profil bacteriologique des infections urinaires chez les patients insuffisants renaux chroniques hospitalises au service de nephrologie

Introduction: L’infection urinaire recouvre des réalités cliniques diverses : la cystite aiguë non compliquée, la bactériurie asymptomatique, voire dessituations à risque comme la pyélonéphrite, la prostatite, l’urétrite, ou une uropathie. Les infections de l’appareil urinaire restent parmi les problèmes les plus fréquents auxquels doit faire face le néphrologue. Elle occupe une place de choix en pathologie néphrologique par leur fréquence dans les deux sexes et à tous les âges. Patients et méthodes: Il s’est agi d’une étude transversale et descriptive menée de janvier 2017 à décembre 2018 dans le service de néphrologie et d’hémodialyse du Centre Hospitalier et Universitaire Sylvanus Olympio de Lomé. L’objectif était de déterminer la fréquence et le profil bactériologique des infections urinaires chez les patients présentant une IRC. Résultats: Sur 118 patients, 54 (45,76%) ont présenté une infection urinaire. L’âge moyen était de 44,08 ans +/- 12,65 ans avec des extrêmes de 18 à 71 ans. Il y avait une prédominance masculine avec un sex ratio de 1,56. Quatre-vingttreize virgules deux pourcent (93,2%) des patients étaient au stade 5 de l’IRC. Parmi les germes isolés, Escherichia coli était retrouvé chez 32 patients (59,2%) suivi de Klebsiella chez 15 patients (27,8%). Les bactéries productrices de beta lactamase à spectre élargi (BLSE) étaient identifiées dans 18,5% des cas. Elles étaient sensibles aux céphalosporines de 3e génération dans 59,2% et aux quinolones dans 33,3%, à l’imipénème dans 27,7% et à l'amoxicilline-acide clavulanique dans 18,5% des cas. Conclusion: La fréquence de l’infection urinaire en milieu de néphrologie au Togo est très élevée. Mots clés: Infection Urinaire, Insuffisance rénale chronique, Togo English Title: Bacteriological profile of urinary tract infections in patients with chronic renal failure hospitalized in the nephrology department English Abstract Introduction: Urinary infection covers a variety of clinical realities: uncomplicated acute cystitis, asymptomatic bacteriuria, and even risk situations such as pyelonephritis, prostatitis, urethritis, or uropathy. Infections of the urinary tract remain among the most common problems facing the nephrologist. It occupies a prominent place in nephrological pathology by their frequency in both sexes and at all ages. Methods: This was a cross-sectional and descriptive study conducted from January January 2017 to December 2018 in the nephrology and hemodialysis department of the Sylvanus Olympio University Hospital in Lomé. The objective was to determine the frequency and bacteriological profile of urinary tract infection in patients with CKD. Results: Of 118 patients, 54 (45.76%) had urinary tract infection. The average age was 44.08 years old +/- 12.65 years old with extreme ages of 18 to 71 yearsold. There was a male predominance with a sex ratio of 1.56. 93.2% of the patients were at stage 5 of CKD. Among isolated organisms, Escherichia coli was found in 32 patients (59.2%) and Klebsiella in 15 patients (27.8%). 18.5% of the bacteria were a broad-spectrum betalactamase-producing bacterium. The isolated bacteria were susceptible to third generation cephalosporins in 59.2% and quinolones in 33.3%, imipenem in 27.7% and amoxicillin-clavulanic acid in 18.5% of cases. Conclusion: The frequency of urinary infection in nephrology medium in Togo is very high. Keywords: Urinary infection, Chronic KidneyDisease, Tog

Prevalence of SARS-CoV-2 among high-risk populations in Lomé (Togo) in 2020.

BackgroundIn December 2019, the COVID-19 outbreak began in China and quickly spread throughout the world and was reclassified as a pandemic in March 2020. The first case of COVID-19 was declared in Togo on March 5. Two months later, few data were available to describe the circulation of the new coronavirus in the country.ObjectiveThis survey aimed to estimate the prevalence of SARS-CoV-2 in high-risk populations in Lomé.Materials and methodsFrom April 23, 2020, to May 8, 2020, we recruited a sample of participants from five sectors: health care, air transport, police, road transport and informal. We collected oropharyngeal swabs for direct detection through real-time reverse transcription polymerase chain reaction (rRT-PCR) and blood for antibody detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests.ResultsA total of 955 participants with a median age of 36 (IQR 32-43) were included, and 71.6% (n = 684) were men. Approximately 22.1% (n = 212) were from the air transport sector, 20.5% (n = 196) were from the police sector, and 38.7% (n = 370) were from the health sector. Seven participants (0.7%, 95% CI: 0.3-1.6%) had a positive rRT-PCR test result at the time of recruitment, and nine (0.9%, 95% CI: 0.4-1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n = 15), 95% CI: 0.9-2.6%.ConclusionThe prevalence of SARS-CoV-2 infection among high-risk populations in Lomé was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening