This year the pediatric department moved into a newly constructed, two-story, 185-bed facility that can accommodate the large inﬂux of patients during seasonal peaks. The extra space and new layout enable improved infection prevention and control measures to help halt the spread of bacteria within the hospital. A new area in the ICU dedicated to patients with ABR means they can be isolated within the unit and receive the close monitoring they need.
It took two years for the microbiology program to be fully implemented. During that time there was no antibiotic steward on-site to advise on treatment of patients with ABR, so results had to be sent for analysis to an international network of MSF experts working with our telemedicine program. Today the antibiotic steward is Dr. Diawara Moussa Karim, who ﬁrst worked with MSF in Koutiala in 2010.
“We’ve treated lots of children with success,” said Dr. Karim. One of the most unusual cases the team witnessed was a child who was admitted with meningitis and had also developed a bacterial infection. The child was ﬁrst treated with ceftriaxone—an antibiotic that is usually successful in treating a wide variety of infections in Koutiala hospital—but their condition did not improve. A blood culture and analysis showed that the bacteria was in fact resistant to all antibiotics tested, except one very old antibiotic the team had stopped using years prior. They quickly switched the treatment accordingly, and shortly after the child was able to go home without any signs of infection—thanks to accurate diagnostics.
When a child is brought to the hospital with a fever, they are given a few basic exams. For example, doctors test blood hemoglobin levels to look for anemia and run a rapid diagnostic test for malaria. If the child has other symptoms like hypothermia, tachycardia (an abnormally fast-beating heart), a low white blood cell count, or is refusing to eat, the doctor might suspect an infection. It can take at least 24 hours to receive a positive reading from a blood culture indicating the presence of bacteria, but children admitted with symptoms this severe need treatment immediately.