[Prevalence and bacteriologic profile of soft tissue infections]

The soft tissue infections are frequent in practice daily, the responsible agents belong to various bacterial families. The aim of our study is to determine the prevalence of these infections: identify the responsible bacteria, and determine their profile of sensibility to antibiotics. Retrospective study among 140 patients diagnosed in our service, between January 2007 and July 2008. Over a period of 18 months, 140 patients were hospitalized for soft tissue infections, 21[15%] had a grave infection. Prevalence of these infection is 9.3% over all purulent samples, they are dominated by the abscess [42,1%]. These infections largely sit in the lower limbs [45%]. The average age of patients was 45 +/- 18.5 years, a sex ratio [M/F] = 2.5. The distribution of micro-organisms showed a predominance of staphylococci [43.5%], represented largely by Staphylococcus aureus [32,9], Enterobacteria after [21,17%], and streptococci [17%], concerning the sensitivity to antibiotics, S. aureus are most sensitive to methicillin; The rate of methicillin resistance was 7,14% for S. aureus isolates. Enterobacteria presents high resistance to beta-lactames, most species of streptococci isolated was resistant to teracyclines and sulfamethoxazole-trimethoprim. Through this study we notice that the severe infections of the soft tissue are rare but deserve more vigilance because of their high mortality, many of our bacterial strains are resistant to beta-lactam, this resistance is amplified by the massive and uncontrolled use of antibiotics, and represents a public health problem, hence the need for rational prescription of antibiotics guided by the antibiogram

[Hospital acquired infections due to Klebsiella pneumaniae]

Nosocomial urinary tract infections are one of the most common hospital acquired infections and often due to multi-drug resistant bacteria. Control of spread is still priority measure of public health. To describe an outbreak caused by an extended spectrum beta-lactamase Klebsiella pneumoniae and research of its hospital reservoir. Over 12 days period, extended spectrum beta-lactamase Klebsiella pneumoniae was isolated from 5 in-patients with urinary tract infection. General warning was given and outbreak investigation was conducted. The five strains had the same antibiotype characterized by colistin, amikacin, fosfomycin and imipenem sensibility. Investigation has shown index case and the absence of identified environmental reservoir suggests that transmission was effective by hands. Eradication of epdemic strain was obtained by geographical and technical isolation and amelioration of hygiene conditions. Swift identification of an outbreak by phenotypical characterization of isolated strains allowed the control of this outbreak