ABSTRACT
A retrospective multicentric study was carried out over a period of 2 years [1999-2000]. 2659 strains of pseudomonas aeruginosa were collected from 4 university hospitals [charles Nicolle Hospital, pediatric Hospital and national center of Bone Marrow Transplantation in Tunis, Habib Bourguiba Hospital in Sfax]. Epidemiological profile and antibiotic susceptibility were analyesd. All bacteria were identified by conventional methods and antibiotic susceptibility tests were performed according to CA-SFM guidelines. The strains were recovered essrntially from surgical wards [33%] and intensive care units [22%]. Pseudomonas aeruginosa was isolated mainly from pus [36%] urine [32%]and respiratory samples [18%]. 25% of strains were resistant to ticarcilline, 18% to cefsulodine, 9% to ceftazidime, 14% to imipenem and amikacin and 25% to ciprofloxacin. Moreover, the resistance rates varied from hospital to hospital and from unit to another. The resistant strains were isolated particularly from urology and intensive care units: respectively 62% and 39% for ticarcilline; 26% and 13% for ceftazidime. The acquired resistance to b-lactams seems largely due to penicillinase production. The frequency of resistance to ceftazidime was the lowest and seem associated to chromosomal cephalosporinase over production
Subject(s)
Drug Resistance, Microbial , Microbial Sensitivity Tests , Retrospective Studies , Multicenter Studies as TopicABSTRACT
From February 1998 to July 1999, 81 central venous catheters were placed in 41 patients 28 years old [5 to 51 years]. We used the subclavicular anatomic way [Aubaniac] in all cases. The total duration of catheter placement was 2905 days [median of 31 days, range 1 to 165 days]. We observed 1 pneumothorax [1,2%], 3 venous thrombosis [3,7%] and 1 arterial puncture [1,2%]. Catheter-related infections were seen in 8 catheters [2,7 per 1000 catheter-days]. Candida was encountered in 4 cases [50%], Gram-positive cocci in 2 cases [25%], and Gram-negative bacilli in 2 cases [25%]. The improvment of preventive ways, diagnosis techniques [simultaneous quantitative cultures, differential positivity time], and therapeutic methods [treatment without removal of the catheter, antibiotic lock technique, catheter exchange by guidewire] should allow a better treatment of catheter-related infections