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Introduction: Nosocomial infections (NI) are common conditions among hospitalized patients. This study aimed to evaluate healthcare workers' knowledge and practices regarding infection prevention measures in intensive care units. Method: This was a descriptive, cross-sectional study conducted from April 13to June 10, 2022, among 45 healthcare workers in three university teaching hospitals of Abidjan. The parameters studied were: the theoretical and practical knowledge of healthcare workers regarding the prevention of nosocomial infections. Results: 45 healthcare workers participated. 74.7% knew the definition of a nosocomial infection and 43% identified the main risk factors for its occurrence. Sixty-five percent identified staff hands as the main mode of cross-transmission of germs between patients. Sixty-four percent of staff reported using non-sterile gloves during urinary catheter insertion. Compliance with hand hygiene before patient contact was low (31.8%) while gloves changes between patients were observed in 87.2% of cases. Deficiencies were noted in adherence to aseptic techniques before performing invasive procedures. Non-compliance was mainly attributed to shortages of supplies and personnel, and insufficient knowledge of preventive measures. Conclusion: healthcare workers’ knowledge and adherence to hygiene practices in intensive care units were insufficient.

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Introduction: Severe malaria is a life-threatening emergency and a leading cause of intensive care admission in sub-Saharan Africa, yet data from Guinean intensive care units are scarce. The aim of this study was to describe the epidemiological, clinical and outcome profile of patients admitted for severe malaria in the intensive care units of the Conakry University Hospitals. Patients and Methods: This was a retrospective, descriptive cross-sectional study conducted over 24 months, from 1 January 2024 to 31 December 2025, in the Departments of Anaesthesia and Intensive Care of Donka National Hospital and Ignace Deen University Hospital. All patients with a positive rapid diagnostic test or thick blood smear and at least one WHO severity criterion were included. Results: Forty-eight patients were included, corresponding to a hospital frequency of 13.2%. The mean age was 24.21 ± 11.25 years (range: 4–64 years), with a male-to-female ratio of 1.52. Most patients were students (54.2%), had no health insurance (91.7%) and lived outside Conakry (87%). Altered consciousness (87.5%) and seizures (62.5%) were the main presenting signs. Thrombocytopenia (83.3%) and raised creatinine (47.9%) were the most frequent laboratory abnormalities. All patients received intravenous artesunate. The main complications were acute kidney injury (41.7%) and persistent seizures (37.5%). The mean hospital stay was 7.18 ± 4.66 days. Mortality was 27.1% (13 deaths), due to septic shock in 61.5% and hypoxaemic cardiac arrest in 38.5% of casesb. Conclusion: Severe malaria in the intensive care units of Conakry mainly affects young, uninsured patients referred from outside the capital with severe neurological involvement, and carries a high mortality. Earlier referral, strict adherence to artesunate protocols and better monitoring are needed to reduce morbidity and mortality.

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Femoral and hip fracture surgery is associated with substantial perioperative pain and frequent opioid requirements. This study compared the opioid-sparing effects of anatomical fascia iliaca compartment block (FICB) performed before surgical incision with those of the same block performed at wound closure in adults undergoing femoral or hip fracture repair under general anaesthesia. In this prospective, single-centre, randomised comparative study, 68 adults classified as American Society of Anesthesiologists physical status I–III were allocated equally to preoperative FICB or postoperative FICB. Each participant received 40 mL of 0.25% plain bupivacaine by the anatomical landmark technique, together with a standardised general anaesthetic and multimodal analgesic regimen. Postoperative pain was assessed using the numerical rating scale, and the time to first request for additional analgesia and cumulative morphine consumption during the first 24 and 48 postoperative hours were recorded. Preoperative FICB significantly prolonged the mean time to first analgesic request compared with postoperative FICB (264.44±37.37 versus 116.47±36.00 minutes; p<0.001). Median morphine consumption was also lower after preoperative FICB at 24 hours (54.9 [33.6–84.6] versus 80.4 [57.6–96.0] mg; p<0.001) and 48 hours (53.32 [40.8–64.8] versus 81.6 [63.0–91.2] mg; p<0.001). Scheduled ketorolac and paracetamol consumption did not differ significantly between groups. In this study population, preoperative anatomical FICB was associated with delayed rescue-analgesic requirement and reduced early postoperative morphine consumption compared with postoperative FICB. Preoperative FICB may therefore be a useful component of multimodal analgesia for selected adults undergoing femoral or hip fracture surgery.

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Aim: to describe multidrug-resistant bacteria and their antimicrobial susceptibility patterns in ICU at Brazzaville University Teaching Hospital (CHUB). Materials and Methods: This was an observational, descriptive, and retrospective study, over 12 months, including all bacteria isolated in infected patients in ICU at CHUB. Epidemiological, clinical and bacteriological parameters were analyzed with Excel 2019. Results: 99 Bacteria were identified in 115 samples of 77 patients. Median age of patients was 48 years [32–65 years], 57.1% were females and acute generalized peritonitis represented 26% of diagnoses. Blood cultures (44.4 %), Gram-negative bacilli (77.7 %) were the most represented. E. coli (13.1%), K. pneumoniae (10.1%), A. baumannii (9.1%) and S. aureus (8.1%) were most bacteria identified. E. coli strains were extended-spectrum beta-lactamase (ESBL)- E. coli (82.4%) and carbapenem-resistant E. coli (86.4%). E. coli was resistant to third-generation cephalosporins (3GC) (86.1%), to fluoroquinolones (81.3%), to aminoglycosides (72.7%). ESBL-producing K. pneumoniae represented 76.1% and carbapenem-resistant K. pneumoniae represented 23.5% of K. pneumoniae strains. K. pneumoniae was resistant to piperacillin/tazobactam (83.3%), to aztreonam (71.4%), to quinolones (75.9%) and to aminoglycosides (66.7%). A. baumannii strains were resistant to Carbapenem (100%), to 3GC (100%), piperacillin/tazobactam (100%), aminoglycosides (92%), and quinolones (89.2%). S. aureus strains were Methicillin-resistant S. aureus in 75% and S. aureus strains were resistant to piperacillin/tazobactam (90.9%), vancomycin (88.9%), carbapenems (88.2%), 3GC (86%), quinolones (82.6%). Conclusion: The Multi-Drug-Resistant bacteria prevalence is very high in ICU at CHUB.

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Objective: To assess the anesthetic management of surgical abdominal emergencies at Donka National Hospital. Patients and Methods: This was a retrospective descriptive study conducted over a 2-year period, from January 1, 2024, to December 31, 2025. It included all medical records and operating room reports of patients of all ages who underwent emergency surgery for a surgical abdominal condition at Donka National Hospital. Obstetric surgical emergencies and incomplete medical records were excluded. Patient recruitment was exhaustive. Results: A total of 159 patients were included, representing a frequency of 35%. The mean age was 36 ± 15.2 years (range: 16–82 years), with a male-to-female sex ratio of 1.9. Generalized acute peritonitis was the most common surgical indication (50.3%), followed by acute intestinal obstruction (20.7%). ASA II-U was the predominant classification (40.9%). All patients were considered to have a full stomach. General anesthesia was administered in 98% of cases, with rapid sequence induction performed in 94% of cases and the Sellick maneuver in 98% of cases. Oropharyngeal endotracheal intubation provided airway control in 98% of cases. Intraoperative hypotension (18.9%) and delayed postoperative emergence (3.8%) were the most frequent complications. Peri-anesthetic mortality was 0.6%. Conclusion: Surgical abdominal emergencies account for a substantial proportion of operative activity at Donka National Hospital and predominantly affect young adult males. Standardized anesthetic management, rigorous preoperative resuscitation, and close interdisciplinary collaboration are essential to improve outcomes in these patients.

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Background: Pharmacogenetic variability in drug-metabolizing enzymes influences individual response to analgesics, affecting both efficacy and adverse-effect risk. Health care workers' knowledge of this variability is central to safe, individualized pain management. This study assessed their knowledge, attitudes, and practices regarding analgesic pharmacogenetics, with emphasis on knowledge relevant to individualized pain management. Methods: Descriptive cross-sectional study among 112 health care workers using a self-administered, bilingual (French/English) questionnaire. A nine-item objective knowledge score was built; attitudes and practices were rated on four-point scales. Associations were tested with the Kruskal-Wallis test, the Mann-Whitney U test, and Spearman correlation. Results: Mean knowledge score was 5.0 ± 1.2/9, moderate in 57.1% of participants and good in only 8.9%. While 93.8% recognized a link between pharmacogenetics and analgesic efficacy, only 8.9% identified the four metabolizer phenotypes and 27.7% understood that identical dosing may be inappropriate across patients. Knowledge score differed by qualification (p=0.027) and was strongly associated with prior awareness (p<0.001). Attitudes were favorable to neutral in 93.8% of respondents, while practice scores remained low in 60.7%. Conclusion: Health care workers understand the principle of pharmacogenetics but not its practical application (metabolizer phenotypes, dose adjustment), limiting the safety of pain management. Targeted training is needed.

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Introduction: Metformin intoxication, although uncommon, represents a significant cause of admission to intensive care units. This study aims to assess the clinical and therapeutic characteristics of patients admitted to the ICU at CHI Evreux for metformin intoxication. Objectives: To describe the clinical presentation and therapeutic management of patients with metformin intoxication. Patients and Methods: This retrospective study was conducted over a three year period and included 20 patients admitted to the ICU for metformin intoxication. Clinical data and management parameters were collected and analyzed. The findings were compared with previously published studies. Results: The hospital frequency of metformin intoxication was 1.56%. Patients were predominantly elderly males, with a median age of 69.5 years. The main presenting symptoms were abdominal pain, anorexia, and nausea/vomiting. All patients exhibited acute kidney injury and severe metabolic acidosis. Management required aggressive fluid resuscitation, vasopressor support, and renal replacement therapy in many cases. The mortality rate was 11.11%. Conclusion: Metformin intoxication is a severe condition requiring intensive management. The results of this study are consistent with existing literature, although some variations were observed.