Suchergebnisse

The objective of this study is to establish the frequency of multi-drug resistant bacteria (MDR) isolated at the Avicenne Military Hospital as well as their levels of resistance to antibiotics. This is a retrospective study conducted over 7years (2015 to 2021), at the Avicenne Military Hospital. Were collected all bacteriological samples received for diagnostic purposes, from patients hospitalized for at least 48 hours. The identification of the bacterial strains was based on the study of their morphological, cultural, and biochemical characteristics on the BD Phoenix™ i100 Automated System, which also allows susceptibility testing. Detection of resistance phenotypes was completed by the conventional method of disc diffusion in an agar medium. The interpretation was based on CA-SFM/EUCAST guidelines. The overall frequency of MDR bacteria is 14,3% with a large predominance of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (54,1%) followed by Acinetobacter baumannii resistant to ceftazidime and/or imipenem (28,1%), methicillin-resistant Staphylococcus aureus (9,3%), then Enterobacteriaceae resistant to carbapenems (5,2%), and finally Pseudomonas aeruginosa resistant to ceftazidime and/or imipenem which represented 3.3% of the MDR bacteria isolated. Co-resistance levels in MDR bacteria are high. The increasing frequency of multi-drug resistant bacteria highlights the importance of an appropriate antibiotic strategy and the necessity of the implementation of antibiotic resistance monitoring.

Objectives: Our study aims to assess the contribution of the Filmarray Meningitis/Encephalitis panel in the diagnosis and management of infectious meningitis by comparing it to conventional culture, while highlighting the epidemiology of the pathogens involved. Methods: This is a retrospective study that was carried out on 115 CSF samples from patients clinically suspected of meningitis and analyzed by conventional methods and by the Filmarray M / E panel test. This work was carried out over a period of 36 months from January 2018 toDecember2020 at the microbiology laboratory of the Avicenne Military Hospital in Marrakech. Results: 115 samples were documented. The filmarray M/E panel detected at least one pathogen in 26 samples, representing a positivity rate of 22.6%. The infectious agents implicated in meningitis were predominated by viruses (52%, n=14), followed by bacteria (44%, n=11); yeasts are clearly in the minority making 4% (n=1) of the positive samples. The cultures were positive in 6 cases. Streptococcus pneumoniae was the most involved microbial agent, constituting a rate of 50% (n=3) of the bacteria detected in the cultures. The concordance rate was 75% for the detection of Streptococcus pneumoniae. In this study, only one sample was positive on the filmarray Meningitis / Encephalitis panel and negative on culture. Conclusion: The Syndromic Meningitis / Encephalitis FilmArray-type multiplex PCR is a simple, rapid and reliable diagnostic tool allowing the implementation of an early and adapted therapeutic strategy. However, given the importance of susceptibility testing, the use of molecular tests should be carried out in addition to conventional microbiology.

A.baumannii is an opportunistic bacterium that has emerged in recent decades as a causative agent of potentially epidemic nosocomial infections. This bacterium has been able to develop an impressive resistance against the majority of antibiotics, which explains the therapeutic difficulties encountered. The objective of this work is to determine, through a retrospective study, the epidemiological profile, and the antibiotic resistance of A.baumannii strains isolated from diagnostic specimens made at Avicenne military hospital of Marrakech, and follow their evolution over 5 years (2012-2017). A.baumannii accounted for 3.75% of all isolated organisms during this period (n = 183). All hospital services were concerned, with a predominance of reanimation units (66% of isolates). The results obtained showed that these pathogens originate in 53% of the protected specimen brush and the main infectious sites were pneumopathies and urinary tract infections. An increase in the resistance of A.baumannii isolates for all antibiotics tested was observed (Ceftazidime 87%, Céfépime98%, Imipenem 84%, Ciprofloxacin 96% and Gentamicin 61%). However, all strains remained sensitive to Colistin. These results confirm the multidrug-resistant nature of A.baumannii and its nosocomial nature. This resistance represents a serious therapeutic and epidemiological problem, hence the need for the establishment of a system for monitoring the microbial environment of the hospital and the strict application of preventive measures.

Bacterial multi-resistance is currently a major problem in our hospitals, because of the morbidity and mortality it generates mainly in intensive care and intensive care settings, and also a current medical problem. The objective of this study was to describe the epidemiological profile, frequency, and resistance status of bacteria resistant to Carbapenems at the Avicenne military hospital in Marrakech, over a period of 7 years from 2015 to 2021. This is a retrospective descriptive study of all the highly resistant bacteria identified from the database of the microbiology department at the HMA in Marrakech. The results show that the general prevalence of these HRBs was 7.54%, with a clear predominance of Carbapenem-resistant Acinetobacter baumannii (53.4%), followed by Carbapenem-resistant Klebsiella pneumoniae (20.68%), then Carbapenem-resistant Enterobacter cloacae (9.57%), and finally Carbapenem-resistant Pseudomonas aeruginosa (6.17%). The general evolution of isolated HRBs was marked by the gradual and continuous increase in the prevalence of these bacteria during the study period, with a peak in 2020, when the prevalence reached 13.98%. High co-resistance has been found to several antibiotic molecules, which can be administered as an alternative. The rationalization of the prescription of antibiotics and the rigorous application of hygiene and prevention rules will make it possible to limit the emergence of these multi and highly resistant bacteria in our care structures. Knowledge of the bacteriological profiles and rates of resistance to antibiotics of this type of bacteria will allow treatment more adapted to each hospital context, and better targeted.