Epidemiology and Profile of Pathogens in an Intensive Care Unit of University Hospital Center in Marrakesh, Morocco

F. Douirek, A. Ziadi, M. Samkaoui, Nada Samkaoui
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Abstract

Background: Pathogens surveillance and antimicrobial resistance are essential for the prompt organization of therapeutic and preventive action in healthcare settings. Objectives: The aim of this study was to determine the profile of pathogens isolated among patients admitted to an intensive care unit of a major urban Moroccan city that presented nosocomial infection during their hospitalisation. Results: During the study period, 34 patients developed a nosocomial infection during hospitalisation in ICU. The mean age of patients was 42.3 ± 18.3 years (range: 18.0 - 86.0 years) and 68% were males. The main diagnoses were multiple trauma injuries (47%) and thermal burns (18%). In terms of morbidities, 9% of the patients presented diabetes. The most common sites were central line-associated bloodstream infection (38%), bloodstream infection (35%), ventilator-associated pneumonia (32%), urinary catheter-related infection (29%), and soft tissue infection (21%). Most frequently isolated pathogens were: Acinetobacter baumani (25%), followed by Klebsiella spp. (12%), Pseudomonas aeruginosa (8%), coagulase negative Staphylococcus aureus (6%), E. coli (6%), Providencia spp. (6%), Enterococcus faecalis (6%), Raoultella terrigena (4%). Conclusion: The bloodstream was the most common site and Gram-negatives were the most commonly reported causes of ICU infections. The incidence found was high, the mortality was strong, corresponding with that of developing countries. These results will allow to set up a targeted pro-gram of prevention and to estimate the efficiency of interventions.
摩洛哥马拉喀什大学医院中心重症监护病房病原体的流行病学和概况
背景:病原体监测和抗微生物药物耐药性是必要的及时组织治疗和预防行动在卫生保健机构。目的:本研究的目的是确定在摩洛哥一个主要城市重症监护病房住院期间出现医院感染的患者中分离出的病原体的概况。结果:34例患者在ICU住院期间发生院内感染。患者平均年龄为42.3±18.3岁(范围:18.0 ~ 86.0岁),男性占68%。主要诊断为多发创伤(47%)和热烧伤(18%)。在发病率方面,9%的患者表现为糖尿病。最常见的部位是中心线相关血流感染(38%)、血流感染(35%)、呼吸机相关肺炎(32%)、导尿管相关感染(29%)和软组织感染(21%)。最常见的分离病原菌为鲍曼不动杆菌(25%),其次为克雷伯氏菌(12%)、铜绿假单胞菌(8%)、凝固酶阴性金黄色葡萄球菌(6%)、大肠杆菌(6%)、普罗维登斯菌(6%)、粪肠球菌(6%)、terrigenraoultella(4%)。结论:血流是ICU感染最常见的部位,革兰氏阴性是ICU感染最常见的原因。发病率高,死亡率高,与发展中国家相当。这些结果将有助于制定有针对性的预防方案,并评估干预措施的效率。
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