Amon-Tanoh-Dick F, Timité-Konan A M, Biafry M M, Adonis-Koffy Y L, N'Goan-Domoua A M, Assé K V, Anderson-Koua C, Lasme-Guillao E
Service de pédiatrie, CHU de Yopougon, 21 BP 632, Abidjan 21, Côte d'Ivoire.
Sante. 1999 May-Jun;9(3):145-9.
We carried out a retrospective study to investigate epidemiological and clinical aspects of patient management in a hospital environment. We studied 90 cases of non-tuberculous bacterial pleuropneumopathies in children, observed over a 5-year period, from January 1 1991 to December 31 1995, at the Pediatric Medical Unit of Yopougon University Hospital. Diagnosis was based on the association of an infectious syndrome with respiratory and digestive disorders, and was confirmed by X ray. Bacteria were isolated from pleural pus and identified in fifty-one cases. Non-tuberculous bacterial pleuropneumopathies accounted for 5.22% of all pneumopathies in children, and the sex ratio for the patients affected was 1.9. Protein and energy malnutrition, anemia, being very young and climatic factors (harmattan and rainy seasons) were identified as major risk factors. The three main bacteria identified were Staphylococcus aureus (21 cases), Streptococcus pneumoniae (19 cases) and Haemophilus influenzae (6 cases). In this series of patients, 20% of the Staphylococcus aureus strains isolated were methicillin-resistant. Patients were generally treated with a combination of penicillin A and M and aminoside, with or without a pleural drain. The outcome was favorable in 77.8% of cases, with no severe sequelae detected by X ray. Six of the children died. Bacterial pneumopathies are still common in Sub-Saharan Africa and the patient being very young is indicative of a poor prognosis.
我们开展了一项回顾性研究，以调查医院环境中患者管理的流行病学和临床情况。我们研究了1991年1月1日至1995年12月31日这5年期间在约普贡大学医院儿科医疗单元观察到的90例儿童非结核性细菌性胸膜肺炎病例。诊断基于感染综合征与呼吸和消化系统疾病的关联，并通过X线得到证实。从胸腔脓液中分离出细菌并在51例中鉴定出来。非结核性细菌性胸膜肺炎占儿童所有肺炎病例的5.22%，受影响患者的性别比为1.9。蛋白质和能量营养不良、贫血、年龄过小以及气候因素（哈马丹风和雨季）被确定为主要危险因素。鉴定出的三种主要细菌为金黄色葡萄球菌（21例）、肺炎链球菌（19例）和流感嗜血杆菌（6例）。在这一系列患者中，分离出的金黄色葡萄球菌菌株有20%对甲氧西林耐药。患者通常接受青霉素A和M与氨基糖苷类药物联合治疗，有或没有胸腔引流。77.8%的病例预后良好，X线未检测到严重后遗症。6名儿童死亡。细菌性肺炎在撒哈拉以南非洲仍然很常见，年龄过小的患者预后较差。
