The hyperhemolysis paradigm that describes overlapping "hyperhemolytic-endothelial dysfunction" and "high hemoglobin-hyperviscous" subphenotypes of sickle cell disease (SCD) patients is based on North American studies. We performed a transversal study nested in the CADRE cohort to analyze the association between steady-state hemolysis and vascular complications of SCD among sub-Saharan African patients. In Mali, Cameroon, and Ivory Coast, 2407 SCD patients (1751 SS or sickle β-zero-thalassemia [Sβ], 495 SC, and 161 sickle β-thalassemia [Sβ]), aged 3 years old and over, were included at steady state. Relative hemolytic intensity was estimated from a composite index derived from principal component analysis, which included bilirubin levels or clinical icterus, and lactate dehydrogenase levels. We assessed vascular complications (elevated tricuspid regurgitant jet velocity [TRV], microalbuminuria, leg ulcers, priapism, stroke, and osteonecrosis) by clinical examination, laboratory tests, and echocardiography. After adjustment for age, sex, country, and SCD phenotype, a low hemoglobin level was significantly associated with TRV and microalbuminuria in the whole population and with leg ulcers in SS-Sβ adults. A high hemolysis index was associated with microalbuminuria in the whole population and with elevated TRV, microalbuminuria, and leg ulcers in SS-Sβ adults, but these associations were no longer significant after adjustment for hemoglobin level. In conclusion, severe anemia at steady state in SCD patients living in West and Central Africa is associated with elevated TRV, microalbuminuria, and leg ulcers, but these vascular complications are not independently associated with indirect markers of increased hemolysis. Other mechanisms leading to anemia, including malnutrition and infectious diseases, may also play a role in the development of SCD vasculopathy.

Background: Tieghemella heckelii (Sapotaceae) is a medicinal plant used in Africa, particularly in Côte d'Ivoire for treating various diseases including infections. Identification of prospective antibacterial compounds from stem bark of this plant as a result of its medicinal virtue, led to screening activity against methicillin resistant bacteria. Methods: Six extracts (hexane, chloroform, ethyl acetate, ethanol, methanol and sterile distilled water) were prepared and tested on methicillin resistant Staphylococcus aureus (MRSA) using broth microdilution method for activity assessment. From this experiment, the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of the plant extracts were determined in sterile 96-well microplates in order to search for both bacteriostatic and bactericidal effects. Afterwards, data analysis was performed using GraphPad Prism5 software (One-way ANOVA and Turkey Multiple Comparison test). The results were then presented as Mean ± SD for experiment repeated three times. Results: Four extracts (ethyl acetate, methanol, ethanol and sterile distilled water) showed credible potency, with strong, significant, and moderate growth inhibition of the MRSA tested. The MIC values which varied from 45 μg/mL to 97 μg/mL according to microbial phenotype, resolutely established the activity of the plant extracts. Additionally, the MBC values which varied, depending on the type of bacteria strain, revealed the bacteriostatic and bactericidal effects of the active extracts against Methicillin-resistant Staphylococcus aureus. Conclusion: The present study is a confirmation of the therapeutic potential of Tieghemella heckelii and its promising contribution to the discovery of a novel antibacterial drug pertaining to these resistant strains.

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Aims:The objective of this study is to detect the prevalence of qnr genes in broad-spectrum betalactamase producing Klebsiella pneumoniae, involved in hospital and community-acquired infections. Study Design: It is a retrospective study. Place and Duration of Study: Bacteriology and virology laboratorie of Institut Pasteur, Abidjan, Côte d'Ivoire. Methodology: From January 2011 to June 2016, 350 Klebsiella pneumoniae were isolated from various clinical specimens and identified by conventional bacteriological tests. Antibiotic resistance (beta-lactams, quinolones and aminoglycosides) and detection of broad-spectrum beta-lactamases Tahou et al; MRJI, 20(2): 1-7, 2017; Article no.MRJI.34085 2 were assessed by the diffusion method and the synergy test, respectively. Molecular characterization of quinolone resistance genes (qnr A, qnr B and qnr S) was performed by the conventional polymerase chain reaction (PCR). Results: Of the 350 Klebsiella pneumoniae isolates, 91(26%) were detected as ESBL producer, 36.2% (n=33) recovered from urine, 24.2% (n=22) from pus and 20.8% (n=19) from blood culture respectively. 46(33%) strains were idenifed to carry qnr genes, qnrB predominate 33(71%), followed by qnr 12(26.1%) and qnrA 1(2.2%). The strains exhibited high resistance to most of the agents tested, expect imipemen, low resistance to amikacin 4.1%, moderate to cefoxitin 31.8% and 54.9% with amoxicillin-clauvanic acid. Conclusion: Although these observed prevalences are small proportions, this can be seen as a warning signal for the future. The emergence and dissemination of resistance genes in Côte d'Ivoire could pose a public health problem. Thus, the establishment of a relevant resistance surveillance policy to better control the circulation of multidrug-resistant strains is necessary. Original Research Article

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