Sepsis observed in the infectious diseases department of the Yalgado Ouedraogo CHU (University Hospital) in Ouagadougou: clinical and evolutionary epidemiological aspects

Abstract

Sepsis is a public health issue around the world, particularly in developing countries. The aim of this study is to describe the clinical epidemiological and evolutionary characteristics of sepsis observed in the infectious diseases department of the Yalgado Ouedraogo CHU.

Patients and method:   this is a descriptive cross-sectional study with retrospective collection with a descriptive aim on sepsis patients hospitalized in the infectious diseases department of the CHU Yalgado Ouédraogo of Ouagadougou from January 1, 2015 to December 31, 2019.

Results: A total of 81 files were collected. Most of the patients came from the town of Ouagadougou (96%). The mean age was 32 ± 9 years. Forty-seven patients were male against 34 female, representing a sex ratio = 1.4. Twelve percent of the patients were infected with HIV. Clinically, fever was found in 63% of our patients. Heart rate was greater than 90 cycles / min in 73% of patients; the respiratory rate was greater than 20 cycles / min in 80% of patients; leukopenia (300 to 3300 / mm³) was found in 17%. Hyperleukocytosis (12,000 to 31,480 / mm³) was found in 10%. Signs of the severity of sepsis were found in 29.6% of patients. Signs of severity were dominated by failure of higher functions (obnubilation or coma) and failure of coagulation (thrombocytopenia less than 100,000 / mm³). The causes of sepsis were dominated by dengue (42%), malaria (23%), and bacterial infections (14%). Bacteria isolated in blood culture were dominated by Enterobacteriaceae (41.6%), half of which produced Extended Spectrum Betalactamase (ESBL). A carbapenemase-producing strain has been observed among strains of Escherichia coli. Sixteen percent of the bacterial strains were strains of Staphylococcus aureus including a methicillin-resistant (MRSA) strain. Twenty-two deaths have been recorded, i.e. a fatality of 27%. 

Conclusion: dengue, malaria, and bacterial infections were the most common causes of sepsis in the infectious disease department. The high prevalence of ESBL-producing strains, and the emergence of strains resistant to carbapenems, are worrying and require measures to be taken to improve hospital hygiene and the prescription of antibiotics. Also the severity of sepsis requires the establishment of intensive care units in infectious disease departments for their management.