Adel El Mekes1, Kawtar Zahlane2, Loubna Ait Said2, Ahmed Tadlaoui Ouafi3, Mustapha Barakate4. 1. Laboratory of Medical Analysis, Ibn Tofail Hospital, University Hospital Center-Mohammed VI, Marrakesh, Morocco; Laboratory of Biology and Biotechnology of Microorganisms, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco. 2. Laboratory of Medical Analysis, Ibn Tofail Hospital, University Hospital Center-Mohammed VI, Marrakesh, Morocco. 3. Laboratory of Biotechnology and Molecular Bioengineering, Faculty of Science and Technology Gueliz, Cadi Ayyad University, Marrakesh, Morocco. 4. Laboratory of Biology and Biotechnology of Microorganisms, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco. Electronic address: mbarakate@uca.ma.
Abstract
BACKGROUND: Intensive care units (ICUs) are considered epicenters of antibiotic resistance. The aim of this study is to determine clinical risk factors, epidemiology and the causative agents of multi-drug resistant bacteria in the ICU of the University Hospital in Marrakesh-Morocco. METHODS: A one year case control study was carried out in our 10-bed clinical and surgical ICU from March 2015 to March 2016. The epidemiological surveillance was done by collecting data in the medical records with the help of a questionnaire. The antibiotic susceptibility testing was used following the recommendations of the Antibiogram Committee of the French Society of Microbiology and the European Committee for Antimicrobial Susceptibility Testing, 2015. RESULTS: Among the 479 admitted patients, 305 bacteria were isolated and identified as Acinetobacter baumannii (31%), Enterobactereacae species (30%), and Staphylococcus (24%), P. aeruginosa (10%) and other bacterial strains (5%). The rate of MDR bacteria acquisition was 41% (124/305) with domination of A. baumannii resistant to imipenem (70%) and followed by Extended Spectrum β-lactamases producing Enterobacteriaceae, P. aeruginosa resistant to Ceftazidime, and Methicillin-resistant S. aureus (18%, 7%, and 5% respectively). The distribution of the common nosocomial infections were dominated by pneumonia, bacteremia, and catheter-related blood stream infections (39%, 29%, and 17%) respectively. Multivariate analysis identified lack of patient isolation precautions (OR: 7.500), use of quadri or triple therapy (OR: 5.596; OR: 5.175), and mechanical ventilation (OR: 4.926), as the most significant clinical and epidemiological factors associated with acquisition of MDR bacteria. The attributable mortality, in this ICU, of patients with MDR bacteria, is about 12%. CONCLUSIONS: The incidence of MDR was higher compared with that of developed countries. The implementation of standard infection control protocols, active surveillance of MDR and generation of data on etiological agents and their antimicrobial susceptibility patterns are urgently needed in our hospital.
BACKGROUND: Intensive care units (ICUs) are considered epicenters of antibiotic resistance. The aim of this study is to determine clinical risk factors, epidemiology and the causative agents of multi-drug resistant bacteria in the ICU of the University Hospital in Marrakesh-Morocco. METHODS: A one year case control study was carried out in our 10-bed clinical and surgical ICU from March 2015 to March 2016. The epidemiological surveillance was done by collecting data in the medical records with the help of a questionnaire. The antibiotic susceptibility testing was used following the recommendations of the Antibiogram Committee of the French Society of Microbiology and the European Committee for Antimicrobial Susceptibility Testing, 2015. RESULTS: Among the 479 admitted patients, 305 bacteria were isolated and identified as Acinetobacter baumannii (31%), Enterobactereacae species (30%), and Staphylococcus (24%), P. aeruginosa (10%) and other bacterial strains (5%). The rate of MDR bacteria acquisition was 41% (124/305) with domination of A. baumannii resistant to imipenem (70%) and followed by Extended Spectrum β-lactamases producing Enterobacteriaceae, P. aeruginosa resistant to Ceftazidime, and Methicillin-resistant S. aureus (18%, 7%, and 5% respectively). The distribution of the common nosocomial infections were dominated by pneumonia, bacteremia, and catheter-related blood stream infections (39%, 29%, and 17%) respectively. Multivariate analysis identified lack of patient isolation precautions (OR: 7.500), use of quadri or triple therapy (OR: 5.596; OR: 5.175), and mechanical ventilation (OR: 4.926), as the most significant clinical and epidemiological factors associated with acquisition of MDR bacteria. The attributable mortality, in this ICU, of patients with MDR bacteria, is about 12%. CONCLUSIONS: The incidence of MDR was higher compared with that of developed countries. The implementation of standard infection control protocols, active surveillance of MDR and generation of data on etiological agents and their antimicrobial susceptibility patterns are urgently needed in our hospital.
Authors: Mahmoud M Bendary; Doaa Ibrahim; Rasha A Mosbah; Farag Mosallam; Wael A H Hegazy; Naglaa F S Awad; Walaa A Alshareef; Suliman Y Alomar; Sawsan A Zaitone; Marwa I Abd El-Hamid Journal: Antibiotics (Basel) Date: 2020-12-30
Authors: Ohoud Aljuhani; Khalid Al Sulaiman; Adel Alshabasy; Khalid Eljaaly; Abdulrahman I Al Shaya; Haytham Noureldeen; Mohammed Aboudeif; Bodoor Al Dosari; Amina Alkhalaf; Ghazwa B Korayem; Muneera M Aleissa; Hisham A Badreldin; Shmeylan Al Harbi; Abdullah Alhammad; Ramesh Vishwakarma Journal: BMC Infect Dis Date: 2021-11-01 Impact factor: 3.090
Authors: Barbara Barduchi Oliveira da Silva; Moacyr Silva Júnior; Fernando Gatti de Menezes; Eduardo Juan Troster Journal: Einstein (Sao Paulo) Date: 2022-04-22