Ta Ahoyo

Variability of antibiotic susceptibility and toxin production of Staphylococcus aureus strains isolated from skin, soft tissue, and bone related infections.

BackgroundStaphylococcus aureus is an opportunistic commensal bacterium that mostly colonizes the skin and soft tissues. The pathogenicity of S. aureus is due to both its ability to resist antibiotics, and the production of toxins. Here, we characterize a group of genes responsible for toxin production and antibiotic resistance of S. aureus strains isolated from skin, soft tissue, and bone related infections.ResultsA total of 136 S. aureus strains were collected from five different types of infection: furuncles, pyomyositis, abscesses, Buruli ulcers, and osteomyelitis, from hospital admissions and out-patients in Benin. All strains were resistant to benzyl penicillin, while 25% were resistant to methicillin, and all showed sensitivity to vancomycin. Panton-Valentine leukocidin (PVL) was the most commonly produced virulence factor (70%), followed by staphylococcal enterotoxin B (44%). Exfoliative toxin B was produced by 1.3% of the strains, and was only found in isolates from Buruli ulcers. The tsst-1, sec, and seh genes were rarely detected (≤1%).ConclusionsThis study provides new insight into the prevalence of toxin and antibiotic resistance genes in S. aureus strains responsible for skin, soft tissue, and bone infections. Our results showed that PVL was strongly associated with pyomyositis and osteomyelitis, and that there is a high prevalence of PVL-MRSA skin infections in Benin.

Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012

BackgroundData on nosocomial infections in hospitals in low-income countries are scarce and often inconsistent. The objectives of this study were to estimate the prevalence of nosocomial infections and antimicrobial drug use in Benin hospitals.MethodsAll hospitals were invited to participate in the first national point prevalence study conducted between 10–26 October 2012 using the protocol developed by the “Hospitals in Europe Link for Infection Control through Surveillance” (HELICS) project. Infection prevalence rates and the proportion of infected patients and exposure to antimicrobials were assessed.ResultsOverall, 87% (39/45) of hospitals participated. Of 3130 inpatients surveyed, 972 nosocomial infections were identified among 597 patients, representing an overall prevalence of infected patients of 19.1%. The most frequent infections were related to the urinary tract (48.2%), vascular catheter use (34.7%), and surgical site (24.7%). 64.6% of patients surveyed were treated with antibiotics, including a significant proportion (30%) of non-infected patients and a high proportion of self-medication (40.8%). Resistance of leading nosocomial pathogens to antimicrobials included methicillin-resistance (52.5%) among Staphylococcus aureus, vancomycin resistance among enterococci (67.5%), cefotaxime resistance among Escherichia coli (67.6%), and ceftazidime resistance among Acinetobacter baumannii (100%) and Pseudomonas aeruginosa (68.2%).ConclusionsBenin has high nosocomial infection rates and calls for the implementation of new national infection control policies. Patient safety education and training of all individuals involved in healthcare delivery will be critical to highlight awareness of the burden of disease. The high use of antimicrobials needs to be addressed, particularly their indiscriminate use in non-infected patients.

Staphylococcus sciuri outbreak at Tertiary Hospital in Benin

Background: Infections due to Staphylococcus sciuri in hospitalized patients seem to be emerging in different countries. Their incidence and clinical impact with inpatients have not been studied in Benin. Objective: The aim of this study was to estimate the prevalence of Staphylococcus sciuri during bloodstream infection and to assess the importance of the hospital environment as a possible secondary reservoir of multiresistant bacteria capable of colonizing or infecting patients. Patients and methods: Between June and December 2008, clinical information and samples were collected from patients suspected to have nosocomial bloodstream infections at a tertiary hospital in Benin. The isolates were identified, tested for antimicrobial susceptibility. Particularly attention was paid to Staphylococcus sciuri and factors associated with the carriage. Concurrently, swabbing of environment was achieved. MALDI TOF of abundant proteins was applied to identify and to discriminate Staphylococcus sciuri isolates. Results: Nosocomial bactereamia incidence rate was 2, 58 cases per 1000 patient-days. The proportion of Staphylococcus sciuri among coagulase negative staphylococci was 24.5% and represented 15% of the environment specimens. Catheter was the commonest source of nosocomial bacteremia (41%). The frequency of resistance to methicillin for Staphylococcus aureus isolates was 36% and 44% for Staphylococcus sciuri isolates. Mass spectra were specific for five groups of S. sciuri isolates. Conclusion: Our survey revealed a high level of Staphylococcus sciuri among Coagulase Negative Staphylococcus isolated from blood specimen. There is a need to institute strict hospital infection control policy and a regular surveillance of resistance to antimicrobial agents.

Influence of fishing technique on organochlorine pesticide accumulation in fish and its possible human health risk in the republic of Benin.

In Bénin different techniques are used for large-scale commercial fishing, Acadjas (enclosures constructed in the river) and Whédos (holes made in the river banks). This study aimed at assessing the extent of contamination related to these fishing techniques. Fish contained residues of DDT and its metabolites, α-endosulfan, dieldrin, aldrin, endrin and lindane. Pesticide levels were similar in fish from Acadjas and Whédos, except for higher α-endosulfan levels in fish from the Whédos. Comparing pesticide intake levels through fish consumption with tolerable daily intake levels showed that in all cases risk for human health is low.

Serratia Marcescens outbreak on a general pediatric ward in Benin.

Background Serratia marcescens. : Increasing reports in the literature document the existence of nosocomial transmission of The consequences of infections associated to this bacterium can be severe, so it was important to establish strategies for prevention. This study aimed to provide the prevalence of this bacterium in a hospital environment and to examine the main factors increasing the risk of cross contamination. Methods : Various specimen obtained from 790 hospitalized children aged from 0 to 7 years were examined and 940 others samples taken from hands of medical personnel, and various hospital surfaces were also screened for Serratia marcescens presence. Susceptibilities to antimicrobial agents were tested by the disk diffusion method according to NCCLS guidelines. Aggressive infection control measures were instituted. Results: About 123 (38%) patients were infected by Serratia marcescens , including septicaemia 65 (52.85%), 31 (25.2%) urinary tract infections, 12 (9.75% ) pneumonia and 15 ( 12.2%) others infections. From hospital environment, 108/940 (11.50%) isolates were obtained. Antimicrobial susceptibility testing revealed that 56% of strains displaying multi resistance. Infected patients were cohorted and placed on contact precautions. Investigation by the infection control team revealed that the distributors of antiseptic were the main path of Serratia marcescens dissemination. Conclusions: A substantial proportion of cases appeared to be of medical devices origin. New infection control policies and engineering plans were initiated on the basis of our results. Antimicrobial resistance is particularly harmful to infectious disease management in low-income countries since expensive second-line drugs are not readily available.

Nosocomial Pneumonia Associated to PVL-Producing Staphylococcus aureus in Children in Benin

We determined the type of toxins produced by Staphylococcus aureus strains and the possible source of contamination during an outbreak of nosocomial pneumonia in a Paediatric service in Benin. Data of 37 patients admitted in the malnourished unit who were diagnosed with pneumonia according to WHO definition and with radiological evidence of a pulmonary infiltrate were collected within six weeks. Pneumonia was further confirmed by the identification of corresponding pneumonia-related S. aureus. Samples were also collected from hospital personnel, the environment, and the food fed to the patients. Pulsed field gel electrophoresis (PFGE) was used to compare the bacterial profile from different sources. Among the 37 patients admitted during this period, 17 developed pneumonia and 10 were associated with S. aureus strains. Nine patients infected with S. aureus PVL-producing strains had underlying diseases and developed an acute multilobar pneumonia, which was fulminating and rapidly became fatal in all except the oldest child. Most of the isolates found on sick children were similar to those from special nutrients consumed by children and on the personnel at the hospital. The highly probable relationships between children contamination and isolate presence in the special nutrient underline the rapid and disastrous dissemination of some PVL-producing isolates in this paediatric unit.

P276: Impact of nosocomial infection prevention program at departmental hospital center of Zou Collines, Benin

tively 23%, 43%, 45%, 47%, 53%, 55%. The increase of hand disinfection of 30% (p < 10 -5 ) was noticed because of the use of alcohol solution. The demographics data were almost identical in all six year. Urinary infections were the most prevalent; a reduction of 15% was noticed among infection related to catheter. Conclusion

P207: A cluster of panton- and valentin- producing Staphylococcus aureus infection at a departmental hospital in Benin: possible association with consumption of contaminated food

A three-month period in 2005, two distinct types of methicillin-sensitive Staphylococcus aureus (one producing of Panton-Valentine leukocidin (PVL) and the other not) were isolated from bronchial specimens of paediatric inpatient unit at the Zou/Collines Departmental Hospital (CHDZ/C), who had been previously cared for by the nurses. The source of outbreak was probably a faulty contamination of specific food consumed by patients.