Staphylococcus aureus: epidemiology and prevalence of methicillin resistant strains in Morocco

To evaluate the place of S. aureus among the microorganisms isolated in the laboratory of bacteriology of the hospital Sheik Zaid [HCZ]. To determine the different cases of SARMS, in HCZ and hospital military Mohammed V [HMMV] in order to institute an epidemiological suprvision of them. During a retrospective survey achieved in two years [1/4/06 to 3/3/08], the microbial ecology and the sensitivity of S. aureus to the antibiotics have been analyzed. 1433 strains have been isolated in different withdrawals and departments of the HCZ among which, there were 86 strains of S. aureus [6.7%]. This case reached 10% in the intensive care unit. In the other units, the frequencies of S. aureus were weaker. The case of S. aureus also depended on the withdrawal nature:19% in the pus, 10.7% in the blood culture, 6.1% for the needle aspiration liquids, 4.6% for the pulmonary sample.. The two establishments, HCZ and HMMVS, permitted us to isolate 185 strains of S. aureus. 25 strains [13.5%] proved to be resistant to the methicillin [SARM]. These strains essentially came from intensive care unit [15/25] follow-ups of the surgery units [5/25] and of medicine units [5/25]. The SARMS gave rates raised of the resistances to other antibiotics: between 64 and 76% for erythromycin, gentamicin, fusidic acid, fluoroquinolone and trimethoprim-sulfamethoxazole. The frequency of the S. aureus and the SARMS remains weak in Morocco. On the other hand, the resistance of the SARMS to other antibiotics is troubling. It is absolutely necessary to master the diffusion of these stumps for the control of the epidemics to multiresistants bacteria

New resistance mechanism of escherichia coli to beta-lactamins

Escherichia coli is the germ most frequently isolated in espicially urinary infections. The perpetual change of its sensitivity profile to beta-lactamins is [due to several evolution factors. Some strains have acquiered resistance by gene mutation or by acquisition of movable genetic material. Also phenomenon as impermeability, excretion by efflux system or modifying penicillin liaison proteins could be seen but the production of beta-lactamases remains the most frequent mechanism of resistance that has been describe until now. The authors report, through this observation, a case of a particular strain of Escherichia coli that has been isoleted from urine of an hospitalized patiente. This strain presented an hyperproduction of cefalosporinases, which is a recently discovered mechanism of resistance. In one hand, specific bacteriologic tests as synergy test, antagonism test and the use of cloxacillin added antibiogramme on Mueller-Hinton medium were carried out and have allowed to display the phenotypic aspect of this mechanism. In the other hand, its genetic aspect was mentionned through a new literature data. The authors have also underlined the importance of the antibiogramme prior to any prescription of antibiotics which could put pressure on the germ leading to a selection of individual resistant, to this kind of difficul not controlled resistance and many potential complications ensue from it

[Technical detection of Helicobacter pylori: place of the antigen research in the stools]

Infection with Heliobacter pylori is the origin of different severe gastroduodenal affections, including ulcerative diseases. A large number of technical methods are available for the detection of this disease. Some are called [invasive] which require the use of endoscopy and gastric biopsy in order to obtain a sample to be analyzed. Others are [non invasive], which do not need a gastric access. The basic principles of these different techniques are reviewed. We precisely explored here the specificity, sensibility also weak and strong points of each technique. A special attention have been given to the technique based on the stool antigen research, as it is a non invasive, simple to be used, cheap, with a good sensibility and specificity results

Infections bacteriennes communautaires aux urgences

The most frequent community infections caused by bacteria that are found at medical emergencies are urinary infections and meningiti. This study's aim is to determine the type and frequency of the bacteria isolated at the emergencies, and to test their sensitivity against different antibiotics. Material and methods: We have studied in a prospective way 220 bacteriological samples of 200 patients at the medical emergencies during 7 months from the begining of June 2001 till Janury 2002. Each patient was tested according to the signs he presented and to the available technical means. We did: 100 spinal punctures [US], 82 cytological bacteriological urinary examination [ECBU], 21 blood-culture, 8 pus, 6 effusion liquids, 3 plate culture of faeces. Klebsillea and Echerichia coli are responsible for most of the urinary infections. The bacteria found showed a very high level of resistance [almost 100%] against ampicillin and [60%] against amoxicillin / calvolanic acid. However they were sensitive to fluoroquinolons and to 3 rd generation cephalosporins. Pneumococus is the most frequent germ for purulent meningitis. Isolated bacteria were all sensitive to penicillin G. The progression of resistance to antibiotics of the principal community bacteria implies to rationalize the use of antibiotics, and to monitor regularly the resistance of these bacteria, and also to make new therapeutical recommendations based on the local epidemiological data

staphylocoques methicillino-resistants en milieu hospitalier: Sensibilite aux antibiotiques

The methicillin-resistant Staphylococci [MRS] have an important place in the nosocomial infection. They are remarquably resistant to many antibiotics except for glycopeptids who keep their activity. However, resistant cases have been signaled in the last few years. This work was designed to assess the resistance of MRS to glycopeptids and to other antibiotics. Material and methods: 40 MRS were isolated from hospitalized patients, their resistance for glycopeptids has been studied by the E-test methods. resistance to the other antibiotics [used in the staphylococcus infections], showed, 27 to 75%. Relating to glycopeptids, no resistance to Vancomycin, 5% to Teicoplanine. 10% of the MRS studied had an intermediate sensitivity for this last. this situation indicates that it is necessary to pay attention for the MRS nosocomial infections. Many studies showed that measures relatively within our reach proved to be utility for overcoming such infections. Also glycopeptids must not be prescribed expect in necessary cases after a bacteriological examination

[Frequency and antimicrobial resistance of bacteria isolated from hospital]

A sample of 4418, swabs from different origins [blood, pus and urines] isolated during a period of three years was subjected to a bacteriological analysis. The results revealed a high frequency of negative gram Bacillus. Klebsiella came in the frist rank, with 38,5% of isolated germs. These were followed by Echerichia coli [17,2%], Pseusomonas [15,9%] and Proteus [10,4%]. Positive coagulase Staphylococci represent only 13,1%. Positive Cocci Gram are less frequent. The investigation of the sensitivity of most isulated germs [Klebssiella, Pseudomonas and Staphylococci] to antibiotic revealed a polyresistance to the tested product. However, this resistance varies as a function of the nature of germ and swab

Frequence des gastro-enterites a rotavirus chez le jeune enfant hospitalise

We evaluated at 13,5% the frequency of Rotaviruses gastroenteritis in children under 2 years old, hospitalized at the C.H.U. of Rabat. The frequency is high in children under one year old, especially in newborns under one month old. Seasonal variation of this infection was observed, with maximal frequency in automn. In the end, it appears that malnutrition and artificial feeding, have important roll in determination of this affection

Haemophilus influenzae et resistance au antibiotiques: a propos de 25 cas de meningite

In this paper, we studied the resistance of haemophilus influenzae to the antibiotics by the production of Beta-lactamase. Among the 25 isolated strains from cephalorachidic liquid of newborn babies suffering from purulent meningitis, three are resistant to the ampicilline by producing Beta-lactamase. One of the three samples shows a multiresistance. It is particularly resistant to the chloramphenicol. In the lignt of these results and a review of the litterature, a therapeutic conduct of the H. influenze meningitis is proposed