Lachhab Zineb, Frikh Mohammed, Maleb Adil, Kasouati Jalal, Doghmi Nouafal, Ben Lahlou Yassine, Belefquih Bouchra, Lemnouer Abdelhay, Elouennass Mostafa
Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Research Team, Bacterial Epidemiology and Resistance, Mohammed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco.
Can J Infect Dis Med Microbiol. 2017;2017:4082938. doi: 10.1155/2017/4082938. Epub 2017 Mar 19.
We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases with being the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapenemase in . The antibiotherapy introduced in the first 24 hours was adequate in 72% of the cases. Bloodstream infections in ICU occur most often in patients over 55 years, with hypertension and diabetes. The bacteria involved are mainly Gram negative bacteria multiresistant to antibiotics. Early administration of antibiotics significantly reduces patients mortality.
我们于2012年12月至2013年11月进行了一项为期一年的观察性研究，以描述摩洛哥拉巴特穆罕默德五世军事教学医院重症监护病房（ICU）中菌血症的流行病学情况。该研究包括监测来自重症监护病房的所有血培养物，并研究阳性血培养物的细菌学特征及其临床意义。在此期间，共发生了46例菌血症事件，相当于每1000例患者中有15.4例。医院感染率为97%，而社区感染率为3%。菌血症最常见的来源是肺部，占33%，但在52%的病例中未确定来源。83.6%的病例分离出革兰氏阴性菌，其中 最为常见。抗生素耐药性非常高，肠杆菌科中42.5%的超广谱β-内酰胺酶（ESBLs）， 中100%的碳青霉烯酶。在72%的病例中，在最初24小时内使用的抗菌治疗是恰当的。ICU中的血流感染最常发生在55岁以上、患有高血压和糖尿病的患者中。所涉及的细菌主要是对多种抗生素耐药的革兰氏阴性菌。早期使用抗生素可显著降低患者死亡率。
