Infections communautaires chez les diabétiques Malgaches hospitalisés à de l’Hôpital Joseph Raseta de Befelatanana, Antananarivo, Madagascar

Introduction. Our goal was to describe the epidemiological, clinical, biological and issue profiles of community-acquired infections in Malagasy diabetic patients in order to improve their management. Patients and methods. This is a monocentric retrospective and descriptive study achieved from 1st January to 31 October 2012 in the Endocrinology’s unity of the Joseph Raseta Befelatanana Hospital, Antananarivo. We recruited all diabetic patients admitted for communityacquired infections in this unity during this period. Results. We selected 108 patients. The mean age was 54.43 years (16 to 90 years) and the sex ratio (male / female) 0.86. Infection revealed the diabetes in 34.26% of cases. The type 2 diabetes accounted for 81.48% of our patients. The average time of hospitalization was 15.9 days (1 - 75 days). The most frequent infections were community-acquired pneumonia in 19.44 cases (n=21), diabetic foot infections in 14.81 cases (n=16) and pyelonephritis in 12.04 cases (n=13). The average blood glucose on admission was 351 mg/dL (85 - 714 mg/dL). Principals organisms found were tubercle bacilli and gram-negative bacteria (Citrobacter freundii, Proteus mirabilis, Klebsiella pneumoniae, Escherichia coli, Enterobacter spp). The mortality rate was 10.18%. The average length of stay was 16.02 days (1 - 120 days). Conclusion. Infections were frequent cause of hospitalization at diabetics. They were dominated by respiratory, cutaneous and urinary infections. They were responsible for an important mortality and a long length of hospitalization. Thus, their tracking and their prevention are important by the improvement of the patient’s education.