Medical Analysis Laboratory Research Articles

Testing for nephrological diseases in pediatrics – the role of point-of-care devices and the medical analysis laboratory in the current context

Background and objectives. Nephrological diseases in children are common, representing an important burden on patients and healthcare. The purpose of this study is to evaluate the transition of the most recent advances in the in vitro diagnostics (IVD) field, including point-of-care (POC) testing methods, to the clinical practice in pediatrics. Materials and methods. Testing indications for pediatric nephrological diseases were identified in the available clinical guidelines and, for comparison, the developments in the IVD field were reviewed based on scientific literature about testing methods, performance evaluation, and POC testing implementation. Results. Testing in the context of nephrological diseases is widely addressed in the available clinical guidelines. While performant POC tests have been developed, the recommendations for testing do not address this progress, nor their integration with traditional laboratory tests. For example, urine dipstick testing has a central role in the management of urinary tract infections of children and it is a basis for clinical decisions, the same method being available for both POC and laboratory tests. Conclusions. Specific testing recommendations for nephrological conditions must be elaborated, based on the availability of the methods and their performances. Implementing POC testing is a challenge, but it can provide benefits for both the patient and the healthcare systems, in addition to the standard laboratory testing.

Primary care monitoring of HbA1c tests in type 2 diabetic patients in Northern France and impact of the successive COVID-19 pandemic containments

BackgroundFrench health authorities recommend the testing of HbA1c every 3 to 6 months in patients with diabetes. The successive containments linked to the SARSCoV-2 pandemic may have had a profound impact on the follow-up of diabetic patients in primary care. The objective of this study was to investigate the effect of containments on the volume of HbA1c assays and on HbA1c values of type 2 diabetic patients monitored in primary care in Northern France compared to usual seasonal variations. MethodsEpidemiological study of a multicentre retrospective cohort, collecting the number and the value of HbA1c assays from type 2 diabetic patients, carried out in 73 private medical analysis laboratories in Northern France region between October 1, 2018 and October 31, 2022. ResultsA total of 196,744 patients and 828,037 tests were included. The first and third containments were associated with a significant decrease in the mean number of performed HbA1c tests, the decrease in the 2nd containment did not reach significance. We observed a significant decrease in HbA1c testing during the winter holiday season and the summer months. The variations in HbA1c values were not substantial compared to seasonal variations.

Estimating the Carbon Footprint of Healthcare in the Canton of Geneva and Reduction Scenarios for 2030 and 2040.

Switzerland, a wealthy country, has a cutting-edge healthcare system, yet per capita, it emits over one ton of CO2, ranking among the world's most polluting healthcare systems. To estimate the carbon footprint of the healthcare system of Geneva's canton, we collected raw data on the activities of its stakeholders. Our analysis shows that when excluding medicines and medical devices, hospitals are the main greenhouse gas emitter by far, accounting for 48% of the healthcare system's emission, followed by nursing homes (20%), private practice (18%), medical analysis laboratories (7%), dispensing pharmacies (4%), the homecare institution (3%), and the ambulance services (<1%). The most prominent emission items globally are medicines and medical devices by far, accounting for 59%, followed by building operation (19%), transport (11%), and catering (4%), among others. To actively reduce Geneva's healthcare carbon emissions, we propose direct and indirect measures, either with an immediate impact or implementing systemic changes concerning medicine prescription, building heating and cooling, low-carbon means of transport, less meaty diets, and health prevention. This study, the first of its kind in Switzerland, deciphers where most of the greenhouse gas emissions arise and proposes action levers to pave the way for ambitious emission reduction policies. We also invite health authorities to engage pharmaceutical and medical suppliers in addressing their own responsibilities, notably through the adaptation of procurement processes and requirements.

Cholesterol in Human Body: Importance and Dosage

For a healthy life, specialists recommend us to take care of what food we eat and to what extent we do it and how we approach a satisfying lifestyle. Cholesterol is not a bad thing, but often, in large quantities it becomes dangerous for human body. The medical world is faced with frequent changes in the concept of "normal values" of cholesterol, but also with a continuously developing pharmaceutical industry in this field, and the tendency is in this sense, towards an individualized treatment. This aspect in presented in our paper, which aims to describe the role of cholesterol in the functioning of human body; preventing the occurrence of heart diseases due increasing the level of cholesterol in the body and creating a healthy lifestyle that can reduce cholesterol levels. The paper presents some case studies on laboratory investigations of values cholesterol that includes determinations, studying and the research of medical equipment (Cobas Integra 400 Plus analyser), but also the results obtained during practice in the medical analysis laboratory.

Assessment of Vitamin D, Calcium, Cholesterol, and Phosphorus status in Obese and Overweight patients in Kenitra city (Morocco)

Obesity and vitamin D deficiency have both been identified as major public health problems around the world. Overweight and obesity can cause many complications, including cardiovascular complications, but can also disrupt phosphocalcic metabolism, the objectives of our work are first of all: To write the phosphocalcic profile, the lipid balance as well as the dosage of vitamin D in an obese and overweight population, and to understand if the insufficiency in vitamin D is a cause or consequence of obesity. This is a descriptive cross-sectional study. It took place at the Mimosas Kenitra, Medical Analysis Laboratory for 18 months. The population concerned includes subjects Men and women aged between 20 years and 70 years who have BMI (Weight/height2)&gt;25. Patients who are morbidly obese present a vitamin D deficiency of 60%, while 30% of obese patients with vitamin D deficiency were normal. The work of this thesis evaluated the phosphocalcic balance as well as the concentration of vitamin D.

Evaluation of the physicochemical quality and antimicrobial performance of amoxicillin and amoxicillin + clavulanic acid discs used in Burkina Faso

Antibiotic discs used in medical analysis laboratories are sourced from multiple manufacturers and suppliers and must meet stringent quality requirements. This study aimed to assess the quality and performance of amoxicillin and amoxicillin + clavulanic acid discs used in Burkina Faso. An evaluation of the use of antibiotic discs was initially conducted in the 20 sentinel laboratories for antimicrobial resistance surveillance in Burkina Faso. Then, various brands of amoxicillin and amoxicillin + clavulanic acid discs samples were collected from medical laboratories and local distributors. Quality control tests (identification and assay) were performed by high-performance liquid chromatography according to the validated method adapted from the USP monograph. The performance of the discs was assessed by testing their efficacy against Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 strains. Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 were resistant to 30% of amoxicillin + clavulanic acid discs and to 55.6% of amoxicillin discs collected. In addition, only 22.2% and 45.5% of amoxicillin and amoxicillin + clavulanic acid discs tested met the specifications for amoxicillin contents. No brand of amoxicillin + clavulanic acid discs collected met the specifications for clavulanic acid content. Extending this study to a larger number of antibiotics would enable better documentation of the antibiotic disc quality..

Evaluation of Analytical and Clinical Performance and Usefulness in a Real-Life Hospital Setting of Two in-House Real-Time RT-PCR Assays to Track SARS-CoV-2 Variants of Concern.

Since the end of 2020, multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) have emerged and spread worldwide. Tracking their evolution has been a challenge due to the huge number of positive samples and limited capacities of whole-genome sequencing. Two in-house variant-screening RT-PCR assays were successively designed in our laboratory in order to detect specific known mutations in the spike region and to rapidly detect successively emerging VOCs. The first one (RT-PCR#1) targeted the 69-70 deletion and the N501Y substitution simultaneously, whereas the second one (RT-PCR#2) targeted the E484K, E484Q, and L452R substitutions simultaneously. To evaluate the analytical performance of these two RT-PCRs, 90 negative and 30 positive thawed nasopharyngeal swabs were retrospectively analyzed, and no discordant results were observed. Concerning the sensitivity, for RT-PCR#1, serial dilutions of the WHO international standard SARS-CoV-2 RNA, corresponding to the genome of an Alpha variant, were all detected up to 500 IU/mL. For RT-PCR#2, dilutions of a sample harboring the E484K substitution and of a sample harboring the L452R and E484Q substitutions were all detected up to 1000 IU/mL and 2000 IU/mL, respectively. To evaluate the performance in a real-life hospital setting, 1308 and 915 profiles of mutations, obtained with RT-PCR#1 and RT-PCR#2, respectively, were prospectively compared to next-generation sequencing (NGS) data. The two RT-PCR assays showed an excellent concordance with the NGS data, with 99.8% for RT-PCR#1 and 99.2% for RT-PCR#2. Finally, for each mutation targeted, the clinical sensitivity, the clinical specificity and the positive and negative predictive values showed excellent clinical performance. Since the beginning of the SARS-CoV-2 pandemic, the emergence of variants-impacting the disease's severity and the efficacy of vaccines and therapies-has forced medical analysis laboratories to constantly adapt to the strong demand for screening them. Our data showed that in-house RT-PCRs are useful and adaptable tools for monitoring such rapid evolution and spread of SARS-CoV-2 VOCs.

Serological Analysis of HBsAg and Anti-HCV Antibody in Patients Received at the Mali Hospital Laboratory

Introduction: Viral hepatitis is a public health threat that has long been underestimated. This infectious disease is the seventh cause of death in the world and even ahead of HIV in terms of epidemiological prevalence. Objective: highlight the seroprevalence of hepatitis B and C viral infections in patients seen in the medical analysis and pathology laboratory department of the Mali hospital. Method: This is a prospective and retrospective study that took place from July 2021 to August 2022. This study included 1540 samples from eligible patients with HBsAg, Anti HBe IgG Antibody, Anti HBc Antibody, HBe Ag, Antibody Anti HBs and/or anti-HCV antibodies. Results: These different methodologies allowed us to have the results of 1540 samples concerning this study. The female sex was more represented with 62.92% compared to the male sex or 37.08%. The HBSAg was mainly found positive in the male sex with 5.45%. The average age was 38 ± 17 years with extremes ranging from 2 to 92 years. The age group 21-39 years was the most represented with 47.47% and the most affected by the positivity of the HBSAg with 5.65%. 64.03% of our patients were married and also with increasing positivity for HBS Ag and anti-HCV Ac with 5.91% and 0.91% respectively. The seroprevalence of HBV, HCV and HVB/HCV co-infection were 10.06, 0.9% and 0.84% respectively. Conclusion: Hepatitis B remains largely unknown to the general public but also to many medico-social actors. This lack of knowledge represents a major obstacle to prevention and screening. It also has as a corollary the stigmatization of people who are affected, in romantic encounters or at work in particular. A high seroprevalence of HBsAg obtained indicates the spread of hepatitis B in the Malian population.

Decrease on malaria clinical cases from 2017 to 2019 in Franceville, Southeast Gabon, Central Africa.

In Gabon, malaria remains a major public health problem. All malaria cases with axillary temperature ≥ 37.5°C with a parasites density ≥ 1200/μL are serious cases and must be treated as a medical emergency. Thus, early diagnosis is essential for successful treatment. Because of the impact of malaria on the population, the surveillance of malaria infections in hospitals is urgently needed. The aim of this study was to to assess of clinical cases of malaria in a private health structure in Franceville between 2017 and 2019. For that, we conducted a retrospective study using data on malaria cases recorded in a private medical analysis laboratory in Franceville, southeast Gabon. Malaria was diagnosed in this laboratory using a Rapid Diagnostic Test and confirmed by microscopic analysis. Analysis of 2518 patient forms revealed an increase in malaria prevalence in Franceville between 2017-2019. The global clinical cases was 26.1% (658/2015). Children under 5 years (44.0%) and patients aged 5-14 years (40.1%) were more affected than patients aged ≥15 years (18.8%, P=0.0001). Malaria infection was also significantly dependent on season and gender. We observed at least three Plasmodium species and the predominant Plasmodium species was P. falciparum 80.0%, followed by P. ovale (19.5%) and P. malariae (17.8%). Our study showed that malaria remains a public health priority for the population of Franceville and that the prevalence of clinical cases of malaria at the laboratory decrease between 2017 and 2019. Our results highlight the need for strategies to control malaria in Franceville, adapted to epidemiological contexts and environmental constraint.

Comparative Study of the Antibacterial and Cytotoxic Activity of Leaves, Trunk and Roots of Schumanniophyton Magnificum

Aims: Schumanniophyton magnificum is a plant reputed traditionally to treat numerous urogenital infections linked to several germs, notably: Escherichia coli, Staphylococcus aureus, Neisseria gonhorhea, Treponema palidum, Candida albican. This study aims to evaluate and compare the in vitro antibacterial and cytotoxic activities of the leaves, trunk and roots of S. magnificum in order to determine the parts displaying the best activity.&#x0D; Study Design: This is an experimental study.&#x0D; Location and Duration of the Study: The work was conducted at the Pharmacochemistry and Natural Substances Laboratories of the Faculty of Medicine and Pharmaceutical Sciences, University of Douala for the extraction and at the Medical Analysis Laboratory of the Douala General Hospital for antibacterial test as well as Biomedical Chemistry Research Center of Rhodes University in South Africa for cytotoxic essay. All the experiments were carried out from the 15th November 2020 to the 31th May 2021.&#x0D; Methodology: The in vitro Antibacterial activity essay was conducted on two strains, one Gram+ bacteria: Staphylococcus aureus and one Gram- bacteria: Escherichia coli, while cytotoxicity was evaluated on HeLa cell line.&#x0D; Results: The root wood extract and the root bark extract presented a good antibacterial activity (MIC = 195.31 µg/mL) and average activity (MIC = 390.63 µg/mL) respectively with E. coli. The different extracts were found to be bactericidal against the tested micro-organisms. At the concentration of 20 µg/mL, all extracts tested did not significantly reduce HeLa cells, with an inhibition rate ranging from 13.5 to 37.6%, suggesting a low cytotoxicity of S. magnificum extracts towards these human cells line.&#x0D; Conclusion: This is the first comparative report on the antibacterial and cytotoxic study conducted on the different parts of S. magnificum. It appears from this study that these results could justify the use of the stem bark of S. magnificum in the traditional pharmacopeia for the treatment of urogenital infections. However, the roots wood having presented the best antibacterial activity (MIC = 195.31 µg/mL), it would be beneficial to suggest this plant part to the local populations for the treatment of bacterial diseases specific to E. coli and S. aureus, after the preclinical and clinical tests are carried out.

Glucose-6-Phosphate Dehydrogenase Deficiency in Icteric Newborns at the Essos-Yaound&amp;#233;-Cameroon Hospital

Background: Glucose-6-phosphate dehydrogenase deficiency is an enzymopathy characterized by insufficient production of reduced glutathione (GSH), a molecule known for its antioxidant role. This lack of GSH leads to a deficit in the elimination of peroxide ions from the red blood cells, causing thereby hemolytic accidents, which can be fatal if not properly managed. In neonates, the clinical picture is most often that of neonatal jaundice. Objectives: This study aimed to determine the place of G6PD deficiency as a cause of neonatal jaundice at Essos Hospital Centre. Methods: We conducted a prospective descriptive study over three months. Blood samples taken from newborns aged 0 to 28 days were analyzed in the medical analysis laboratory of the Essos Hospital Centre in Yaoundé. We carried out a determination of the enzymatic activity of G6PD, a blood count and the determination of the bilirubin level. The results obtained were analysed using R statistical software version 4.1.1. Linear regression analyses were used to assess correlations between the variables of interest. Results: Sixty-nine icteric neonates constituted our study population, with a total of 40 boys (58%) and 29 girls (42%) with a sex ratio of 1.37 in favour of boys. The prevalence of G6PD deficiency in icteric children was 50.72%. The mean hemoglobin was 15.3 ± 3.08 g/dL and the mean red blood cell count was 4.52 ± 1.01 × 106/mm3. The mean total bilirubin was 122 ± 48.3 mg/L with a maximum of 308 mg/L and the mean free bilirubin was 104 ± 46.6 mg/L with a maximum of 292 mg/L. Furthermore, after linear regression analysis, we obtained a positive and significant correlation between G6PD enzymatic activity and hemoglobin level (r = 0.33; p ≤ 0.001), G6PD red blood cell level (r = 0.26; p Conclusion: Neonatal jaundice in G6PD-deficient children is a real public health problem and the prevention of hemolysis in children requires an early diagnosis of the enzyme disorder and good follow-up of the children.

SOME DATA REGARDING THE INCIDENCE AND SUSCEPTIBILITY OF DIFFERENT PATHOGENS INVOLVED IN UTI

Objectives. The urinary tract infections (UTIs) is the most common type of infection, after respiratory tract infections, being more common in women, approximately 50-60% of whom have at least one episode of UTI during their lifetime. Other risk factors are old age, diabetes, kidney stones, urinary tract obstructions, and procedures such as urinary catheterization. Uropathogenic strains of E. coli are most commonly implicated in the etiopathogenesis of UTI, other pathogens being represented by Proteus mirabilis, Staphylococcus saprophyticus, Staphylococcus epidermidis, Klebsiella pneumoniae, group B streptococci (involved, for example, in UTI in patients with diabetes mellitus) and Pseudomonas aeruginosa (found in patients who underwent urinary catheterization). The study aimed to test the sensitivity at antibiotics of bacteria isolated from urine samples of patients with urinary tract infections from a medical analysis laboratory, in the period 2022-2023. Methods. The urine samples obtained were initially analyzed macroscopically, from the point of view of turbidity and chromatic aspect. Later, they were centrifuged and examined under an optical microscope to assess the cellularity. Sectors were sown from the urine samples on CLED, CPS and bile-esculin culture media. After being seeded, the plates were introduced to the thermostat, where they were left for 24 hours at 36-37 °C. The antibiotic susceptibility of the bacterial strains was tested by means of the diffusimetric method, using special Muller-Hinton media. Results. The most common pathogen isolated in urine cultures was E. coli 83%, followed by Klebsiella pneumoniae (7%) and Enterococcus spp. (4%), 3 strains of Proteus mirabilis, 2 of Klebsiella oxytoca and 1 of Proteus vulgaris were also isolated. Regarding the susceptibility at the tested antibiotics, it has been obtained the following results: to AmoxicilinClavulanic Acid-77% Gentamicine-96%, Nitrofurantoin-88%, Trimethoprime/Sulfamethoxazole- 79% Cefazolin-71%, Cefuroxime-81% Levofloxacine-92%, Ciprofloxacine-91%, Norfloxacine-83%, Fosfomycin-99%. Conclusions. The isolated strains showed more than 90% sensitivity to Gentamicine, Levofloxacine and Ciprofloxacine. Also, an increased sensitivity (over 80%) was recorded to Cefuroxime and Nitrofurantoin.

Clinical Characteristics and Treatment Outcomes of HIV+ and HIV- Tuberculosis Patients Followed and Treated at the Regional Hospital of Oyem, Northern Gabon: A Two-Year Retrospective Study

Background: The objective of this study was to analyse the clinical characteristics of HIV+ and HIV- tuberculosis patients followed and treated at the Oyem Regional Hospital Centre (ORHC).&#x0D; Materials and Methods: During this study conducted between January 2019 and December 2021, data collection was based on the exploitation of medical records and registers of results from the medical analysis laboratory of the regional hospital of Oyem, in which there were personal data (gender and age) of the patients, the status of HIV infection, clinical characteristics (pulmonary or extra pulmonary TB), and finally, the therapeutic outcomes of the patients after anti-tuberculosis and antiretroviral treatment. Binomial test following the Normal distribution was used to find an association between the percentages of extrapulmonary TB and TB+/HIV+ co-infection.&#x0D; Results: In this study, 128 confirmed TB cases were selected. While 54 (42.19%) were co-infected with TB+/HIV+, 74 patients (57.81%) were monoinfected with TB+/HIV+. Among all these patients, 93 (72.66%) were reported to have extra pulmonary TB and 35 (27.34%) had pulmonary TB. A normal binomial test showed that TB+/HIV+ co-infection was significantly associated with extrapulmonary TB (p=0.04). Patients were put on anti-tuberculosis treatment according to the manufacturers' indications. Despite a total of 15 deaths (8.93%) in both mono- and co-infected patients, there was a favourable outcome, with 35 patients (27.34%) declared cured. With 8 deaths, mortality was higher in the co-infected than in the non-HIV infected TB patients who recorded 7 deaths.&#x0D; Conclusion: By indicating a relatively high prevalence of HIV infection in TB patients, this study showed that TB+/HIV+ co-infection was associated with extra pulmonary TB, the severe form of the disease, and increased mortality in patients, hence the need to strengthen joint activities to control this co-infection.

Reconsidering vitamin D optimal values based on parathyroid hormone levels in a North Algerian cohort: stratification by gender and season.

There is no consensus defining the vitamin D optimal values. The aim of this study is to establish vitamin D optimal values in the Northern Algerian population, based on its skeletal effects as represented by the inverse relationship between 25-hydroxy vitamin D (25(OH) D) and parathyroid hormone (PTH). 451 healthy volunteers of both genders, aged 19 to 79years, were enrolled in a cross-sectional study conducted at the medical analysis laboratory of the University Hospital of Blida, Algeria. 25(OH) D was assessed by a sequential competitive immuno-fluoroassay technique. Determination of vitamin D optimal values was performed based on the kinetic relationship between 25(OH) D and PTH, as explored by inverse nonlinear regression on a spline plots curve. The optimal value represents the 25(OH) D level at which PTH ceases to increase and reaches a virtual plateau. In men and women, respectively, the 25 (OH) D thresholds are estimated at 25.0ng/ml and 30ng/ml, above this value, PTH stabilizes in a virtual plateau, estimated at 22.3pg/ml and 26.8pg/ml. In warm and cold seasons, respectively, the 25 (OH) D cut-offs are estimated at 30.0ng/ml and 25.0ng/ml, from these values, the PTH stabilizes in a virtual plateau, estimated at 21.5pg/ml and 27.7pg/ml. In this study, the optimal values of 25(OH) D were defined for the first time in a North Algerian adult population. The optimal value is 25.0ng/ml in men and 30.0ng/ml in women.

Hepatitis B and Delta Co-Infection: Prevalence and Serological Characteristics in Mauritania

Background: Hepatitis B is one of the major public health concerns worldwide. In Mauritania, its prevalence in the general population is very high. The hepatitis D virus (HDV) borrows the envelope from the hepatitis B virus (HBV) during its infectious cycle. We thus observe co-infections during which the two viruses are acquired simultaneously and superinfections by HDV in patients who are already chronic carriers of the B virus. Objective: to assess the prevalence of HBV and HDV infection Material and Methods: this is a prospective descriptive study, conducted from January 1 to November 30, 2017 in the two medical analysis laboratories in Nouakchott. Patients were included: all patients of both sexes and of all ages carrying HBsAg presenting to the two medical analysis laboratories during this period. Results: in 1 month, 211 patients with HBsAg were notified out of a total of 1675 patients screened, i.e. a prevalence of 12.59%. HBV/HDV co-infection is 31.30%. The average age was 36 years with extremes [8 and 66]. The male/female sex ratio was 1.45. The mean HBV viral load was 2.68 ± 1.31 log IU/ml [range: 478.63 IU/ml ± 20.41]. The majority (94.9%) of patients were HBeAg negative. Conclusion: HBV/HDV co-infection remains very high in our country. This study indicates that the significant morbidity of the two viruses associated with limited knowledge of the mode of transmission, constitute factors of vulnerability.

Resistance profile of bacteria to antibiotics in city laboratories

IntroductionBacteria are the causative agents most frequently described in infections. Therefore, antibiotic resistance is a real public health problem. Thus, bacterial infections are becoming one of the major threats to public health in the world. The objective of this study is to evaluate the frequency of isolation of bacteria and to study the sensitivity of bacteria isolated in different biological samples at the level of city laboratories in the entire population (women, men and children).Patients and methodsThis is a prospective descriptive study carried out in city medical analysis laboratories. The inclusion criteria were all positive samples from the examinations performed: urinary examination, vaginal swab, urethral swab, pus, sputum, semen. The exclusion criteria concerned patients with negative examinations and other microorganisms (viruses, mycoses and parasites). Data collection was carried out using an information sheet. An antibiogram is carried out to study the resistance of bacteria. Data processing was carried out and statistically analyzed at a risk of 5%.ResultsOut of a total of 8,594 samples identified, 2,465 strains isolated were responsible for bacterial infections with a prevalence of 28.7%. A clear predominance was noted in the female sex with 1710 (69%) versus 755 (31%) in the male. The F / M sex ratio was 2.2. The most affected of the patients were those over 60 years of age with an enrollment of 832 (33.7%). 1954 strains were Gram negative bacilli or a frequency of 79.3%, 462 strains were Gram positive coccis or a frequency of 18.7% and 49 strains were Gram negative coccis or a frequency of 2%. The distribution of isolates according to the type of sample revealed a predominance of urine samples with a frequency of 1703 (69%), followed by vaginal samples with a frequency of 276 (11.2%), urethral samples with a frequency of 166 (6.8%), sputum with a frequency of 154 (6.2%) and others. The bacteriological profile was largely dominated by Escherichia coli 1410 (57.2%), Klebsiella pneumoniae 355 (14.4%), Staphylococcus sp 294 (12%), Enterococcus sp 109 (4.4%), Streptococcus sp85 (3,4%). For Enterobacteriaceae, the lowest sensitivities in out‐of‐hospital settings were recorded with Amoxicillin followed respectively by Ticarcillin, Cefalotin, and Amoxicillin‐clavulanic acid. High sensitivities have been observed for Imipenem, Colistin, Furan, and Aminoglycosides.ConclusionAt the end of the study, the results showed an increase in the resistance of bacteria. This rise could be linked to selection pressure due to the overuse of antibiotics. Regular monitoring is essential to define effective and appropriate therapeutic strategies, limiting the emergence and dissemination of very resistant strains.

Determination of the prevalence of Mycoplasma hominis and Ureaplasma species in Bacterial vaginosis patients in association with antibiotic resistance profile in Franceville, Gabon

BackgroundGenital mycoplasma are only considered pathogenic at a certain level and are often associated with other pathological situations such as bacterial vaginosis (BV). They may lead to infertility as well as other gynaeco-obstetrical and neonatal problems. Despite numerous reported resistances, macrolides are required to treat pregnant women while non-pregnant women are managed with tetracyclines and fluoroquinolones. This study aimed to establish the prevalence and resistance rates of Mycoplasma hominis (Mh) and Ureaplasma spp. (Uu) in BV positive (BV+) women. Material and methodsVaginal secretions were collected from women aged 14–56 years consulting for a cytobacteriological examination of the vaginal swab associated with a simultaneous search for genital mycoplasma in the medical analysis laboratory of the Research and Medical Analysis Unit (URAM) of CIRMF in Franceville, Gabon. BV was diagnosed using the Nugent score while genital mycoplasma identification and antibiotic susceptibility testing were performed using the Mycoplasma IST 2 kit. ResultsOf the 462 women included in this study, 60.18% (278/462, p = 0.00002) were both BV+ and genital mycoplasma carriers, including 5.19% (24/462) pregnant women. Overall mycoplasma carriage was 33.12% (153/462) for Uu, 1.95% for Mh and 25.11% (116/462) for mixed infections (Uu + Mh). The BV + patients most affected by mycoplasma were those whose age varied from 25 to 35 years with 27.49% (127/462, p = 0.980), those not using condoms with 39.40% (182/462, p = 0.014, OR = 2.35), those non-pregnant but capable of bearing children with 53.90% (249/462, p = 0.967, OR = 1.02). In the overall population, 83.66% and 51.63% of Uu strains were highly resistant to Ciprofloxacin and Azithromycin respectively; 100% and 55.56% of Mh strains were resistant to Azithromycin and Tetracycline respectively; while strong resistance has been observed in mixed infections to Ciprofloxacin (97.41%), Azithromycin (81.90%), Ofloxacin (69.83%) and Tetracycline (68.97%). ConclusionThe prevalence of genital mycoplasma infections is very high in women with bacterial vaginosis. Given the numerous emerging resistance rates to most classes of antibiotics available for the treatment of genital mycoplasma infections in our study, it would be advisable for therapeutic prescriptions to be made based on laboratory results.

Incidence of Viral Hepatitis in Military Personnel Performing External Missions

Soldiers on missions are at risk of contracting major infectious diseases. Some of the most common food or water-borne diseases include diarrhea (bacterial and protozoan), hepatitis A, and typhoid fever, all of which pose serious threats to communities. The studied group consists of 102 people who performed missions in the theater of operations in Mali between December 2020 and September 2021. The tests were performed in the medical analysis laboratory of the Military Emergency Hospital. The group consists of male with an average age of 35-45 years. Analyzes were performed in the fields of microbiology, virology and biochemistry. negative on departure and return only one person was positive, Ac anti HCV remained the same (97 negative people and 5 positive), Ac anti HAV were present in all military personnel returned from the mission, only one soldier returned with Ag Hbe positive (those in which Ag Bhs was also positive), Ac anti Hbs positive in all military. Following the analyzes performed, we came to the conclusion that the protection measures taken in the theaters of operations are effective, as there is no contamination on the studied group with endemic germs of the area.

Apport de la spectrométrie de masse Maldi-TOF pour identifier les dermatophytes

AbstractMaldi-TOF mass spectrometry represents a major technical advance and an alternative to the relatively laborious and complex identification of dermatophytes by macroscopic and microscopic morphology, which requires highly skilled mycologists, an expertise that is becoming scarce in medical analysis laboratories. Provided that the dermatophyte has been successfully isolated in culture and that an adequate (i.e., comprehensive and in keeping with the current nomenclature) Maldi-TOF mass spectrometry reference spectra database is available, Maldi-TOF MS is relatively cheaper and offers a comparable accuracy to that of DNA sequencing for the identification of dermatophytes. The use of this new identification tool is likely to support to the ongoing dermatophytes taxonomic clarification. The taxonomic clarification will further contribute to a better understanding of the epidemiology of dermatophytes and the impact of the species involved on the outcomes of patients with dermatophytoses.

Étude comparative en soins primaires du taux d'INR dans la cible thérapeutique chez des patients traités par warfarine ou fluindione pour une fibrillation atriale. L’étude FLOWER (FLuindione Or WarfarinE – Result INR)

IntroductionThe aim of our study was to compare the time spent within the target INR or Time in Therapeutic Range (TTR) of patients treated with fluindione to that of patients treated with warfarin for non-valvular atrial fibrillation (NVAF) and followed in general practice, with the hypothesis of a better TTR with warfarin, which is the VKA most commonly prescribed in France. MethodLiberal nurses and general practitioners working in the Auvergne region recruited patients treated with fluindione or warfarin for NVAF. Patients' INRs (International Normalized Ratios) were recorded by medical analysis laboratories for 6 months. The primary endpoint was TTR, the secondary endpoint the number of hemorrhagic and/or thromboembolic events. ResultsOf the 342 participants with a mean age of 75.3 ± 9.8 years, 239 (70%) were treated with fluindione and 103 (30%) with warfarin. The mean number of INRs achieved per patient was 9.2 ± 4.0 in the fluindione group and 9.3 ± 4.0 in the warfarin group (p=0.73). The median TTR of fluindione was 81.9% [63.5; 94.1] and that of warfarin was 81.3% [65.6; 92.6] (p=0.98). Twenty-eight of 263 patients reported hemorrhage (10.6%) and 4 reported thromboembolic events (0.8%), with no significant difference between the groups. ConclusionThe TTRs of patients treated for NVAF with fluindione versus warfarin do not differ significantly over an observation period of 6 consecutive months in a patient population comparable to that of the publications in this field. However, these TTRs are significantly higher than those reported in the literature, with no difference between the two treatments.The TTRs of patients treated for VANF with fluindione versus warfarin do not differ significantly over a 6-month observation period in a patient population comparable to that of the publications in this indication.