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Treating osteoarticular infections in a Role 2 in Chad: a bacterial epidemiological study
  1. Thomas Demoures1,
  2. C Choufani1,2,
  3. C Contargyris3,
  4. A Caubere2,
  5. L Mathieu4 and
  6. O Barbier1,2
  1. 1Orthopaedic Surgery, Begin Military Training Hospital, Saint Mande, Île-de-France, France
  2. 2Orthopedic and Traumatology department, Sainte Anne Military Teachin Hospital, Toulon, France
  3. 3Intensive Unit Care, Laveran Military Teaching Hospital, Marseille, Provence-Alpes-Côte d'Azur, France
  4. 4Department of Orthopaedic, Trauma and Reconstructive Surgery, Percy Military Teachnig Hospital, Clamart, France
  1. Correspondence to Pr O Barbier, Orthopedic and Traumatology, Hopital d'Instruction des Armees Begin, Saint Mande, France; olive.barbier{at}gmail.com

Abstract

Introduction The treatment of osteoarticular infections in Africa is a medical and surgical challenge due to the difficulties in managing antibiotic therapy after the surgical procedure. The objectives of this study were to identify the types of bacteria in osteoarticular lesions in patients treated in Chad and to determine the spectrum of resistance encountered and the efficacy of available antibiotics.

Material and methods This is a retrospective study of all intraoperative osteoarticular and soft tissue samples taken in a French Role 2 Medical Treatment Facility of N'Djamena during surgery for chronic osteoarticular infections, in Chad, for 1 year.

Results A total of 160 bacterial strains were identified, with a predominance of Gram-negative bacillus (GNB) and staphylococcus infections. Among staphylococci, 80% were methicillin-sensitive streptococci which were generally multidrug-sensitive. Enterococci were resistant to third-generation cephalosporins, first-generation fluoroquinolones and gentamycin. Among GNB, there was a predominance of enterobacteria compared with non-fermenting GNB, of which 52% were multidrug-resistant and produced extended spectrum beta-lactamases (ESBL).

Conclusion Staphylococcus aureus infections are most often sensitive to available antibiotics and therefore have better prognoses than infections caused by other bacteria. In contrast, in half of the cases of GNB, infections were caused by bacteria producing ESBL, thus posing the problem of multidrug-resistance, the risks of which are increased in precarious situations. Therefore, the type of bacteria appears to be a major prognostic factor in the treatment of osteoarticular infections in a Role 2 in Chad. This criterion will need to be considered before any treatment decisions are made.

  • epidemiology
  • diagnostic microbiology
  • trauma management

Data availability statement

Data are available in a public, open access repository. Data are available in a public.

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Data availability statement

Data are available in a public, open access repository. Data are available in a public.

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Footnotes

  • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

  • Contributors TD, CCo, AC and CCh planned the study. OB and LM conducted a survey, submitted the study and are responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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