[Enterobacteria ESBL urinary infections: epidemiology and resistance]

The enterobacteria secreting beta-lactamases extended spectrum [ESBL] isolated from various infections are a public health problem in hospitals. The aim of this study was to determine the epidemiology and the resistance to gentamicin and fluoroquinolones of this enterobacteria that was isolated of urinary infection. This is a retrospective study including the results of urine exam and their corresponding antibiograms. A study that concerne all enterobacteria isolated during a period of seven months from March 2010 to September 2010. From 6350 exam of urines, five hundred fifty-eight strains of enterobacteria was positive. The prevalence of ESLB enterobacteria represents 13.8%. The genus Klebsiella present 59.7% of ESBL isolates and is also the most secreting of the ESBL with 25% of Klebsiella strains. The resistance of enterobacteria to trimethoprim-sulfamethoxazole is generally high. The co-resistance of strains secreting ESBL to fluoroquinolones was 75%; that associated with gentamicin was 86%. Similarly; co-resistance to both gentamicin and fluoroquinolones was 72%. Analysis of the results shows a gradual increase in the frequency of ESBL-E isolated from urine in both middles hospitals and community. So therapeutic alternatives available for these multiresistant bacilli are particularly limited for patients living in fragile situation. Improving hospital hygiene and good clinical practice in using antibiotics are fundamental to fight against the spread of multi-drug resistant bacteria

[Epidemiology of ESBL enterobacteriaceae in urinary and pulmonary infections in the intensive care units]

The nosocomial infections are of a heavy diagnostic and therapeutic burden in intensive care unit [ICU]. The aim of this study is to determine the epidemiology of ESBL-E as an origin infections of urinary and pulmonary infections diagnosed in ICU. This is retrospective study conducted over a period of one year which runs from 1st March 2010 to end February 2011 analyzing the results of cellular and microbiological exams of urine and lung samples; and their corresponding antibiograms. Over three hundred and sixty two positive tests, 167 strains of Enterobacteriaceae were isolated [46%]; fifty six secretory Enterobacteriaceae ESBL producing were isolated with 33.5%. Separately, enterobacteriaceae accounted for 84% of bacteria isolated from urine samples against 31.3% producing about 59%, 44% of all klebsiella are producing ESBL. Multidrug resistance caused by ESBL-E is a universally finding. The results of this study show the gradual increase in their prevalence as important etiological agents of nosocomial infections and therefore their release into the local health environment. It is necessary again to emphasize the importance of hospital hygiene and good rules of antibiotics to limit the spread of MDR bacilli and avoid the therapeutic impasse