Benchamkha Yassine, Dhaidah Ouafaa, Dahazze Adil, Meriem Quaboul, Elamrani Moulay Driss, Ettalbi Salwa
Department of Plastic and Reconstructive Surgery in CHU Mohamed VIMarrakech, Morocco.
Int J Burns Trauma. 2017 Oct 25;7(6):72-79. eCollection 2017.
The bacterial nosocomial infection is one of the leading causes of morbidity and mortality for burned patient; we conducted a retrospective study of 123 patients hospitalized in the burns center CHUMED VI of Marrakechover a period of 3 years, from January 1, 2013 to December 31, 2016. The criteria for nosocomial infection were those of the Center for Disease Control in Atlanta in 1988. Incidence rates were calculated. The bacterial ecology of the department was described as also antibiotype. The predominancy of the population was male. The cumulative incidence was 103 infections per 1000 days of treatment. Regarding the characteristics of bacterial infections, infected sites were skin (69%), blood (18%), urinary tract (12%) and lungs (1%). The main organisms were: Staphylococcus sp. (37.7%), Pseudomonas aeruginosa (19.8%), Enterococcus faecalis and Proteus mirabilis (18.5%). Staphylococci were resistant méticillo-in 22% of cases. Pseudomonas and Acinetobacter were multi-resistant (66%). The establishment of the bacterial ecology of the service, helped us set the right rules of prescription of antibiotics, which was based on the infected site, the type of organism, its sensitivity, the molecule used and the pharmacokinetics particular patient burned. The two main organisms being Staphylococcus and Pseudomonas aeruginosa, antibiotics used in the Service will then beta-lactams, glycopeptides, fluoroquinolones and aminoglycosides. Finally, to control the epidemic risk posed by the emergence of resistant organisms is necessary to combine the practice of good antibiotic therapy and prevention.
细菌医院感染是烧伤患者发病和死亡的主要原因之一;我们对2013年1月1日至2016年12月31日期间在马拉喀什CHUMED VI烧伤中心住院的123例患者进行了一项为期3年的回顾性研究。医院感染的标准采用1988年亚特兰大疾病控制中心的标准。计算发病率。描述了该科室的细菌生态学及抗菌型。患者以男性为主。累积发病率为每1000天治疗中有103例感染。关于细菌感染的特征,感染部位为皮肤(69%)、血液(18%)、尿路(12%)和肺部(1%)。主要病原体为:葡萄球菌属(37.7%)、铜绿假单胞菌(19.8%)、粪肠球菌和奇异变形杆菌(18.5%)。葡萄球菌对甲氧西林耐药的病例占22%。假单胞菌和不动杆菌多重耐药(66%)。该科室细菌生态学的建立有助于我们制定正确的抗生素处方规则,该规则基于感染部位、病原体类型、其敏感性、所用药物分子以及烧伤患者的特殊药代动力学。由于两种主要病原体是葡萄球菌和铜绿假单胞菌,因此该科室使用的抗生素将包括β-内酰胺类、糖肽类、氟喹诺酮类和氨基糖苷类。最后,为了控制耐药菌出现带来的流行风险,有必要将良好的抗生素治疗实践与预防措施相结合。