[Epidemiology of burn wound infection in Rabat, Morocco: Three-year review]. / Épidémiologie de l'infection des plaies des brûlés de Rabat, Maroc : expérience de trois ans.

OBJECTIVE: To determine the bacteriological profile of burn wounds in patients hospitalized in the burn unit of the Military Hospital in Rabat and describe their sensitivity to antibiotics. MATERIAL AND METHODS: This prospective study was conducted from July, 2009, through March, 2011, in the hospital bacteriology laboratory, in collaboration with the burn unit. At each admission, a questionnaire was completed to collect the patient's data. Bacteriological samples were collected from burn wounds at admission and every time the bandage was changed. Identification of bacteria was based on their culture, morphological, and biochemical characteristics. Antibiotic susceptibility was determined with the agar diffusion method, in accordance with the recommendations of the French Society of Microbiology. Statistical analysis was performed with SPSS Version 13 (Statistical Package for the Social Sciences) software. RESULTS: The study included 58 burn patients. Their mean age was 38.2 ± 15.5 years; the mortality rate was 13.8%, and the prevalence of infection 43.1%. We identified 126 non-redundant bacterial strains from the 112 samples collected, most often Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae, and Staphylococcus spp. CONCLUSION: Heightened vigilance and rigorous application of hygiene rules, together with continuous epidemiological surveillance of burn wound bacteria, are essential to optimize empiric antibiotic therapy.

[Nosocomial multidrug-resistant Acinetobacter baumannii meningitis in postoperative neurosurgery: a case study]. / Méningite nosocomiale postopératoire à Acinetobacter baumannii multirésistant en neurochirurgie : à propos d'un cas.

Acinetobacter baumannii is a prolific nosocomial pathogen renowned for its multidrug-resistant nature. However, A. baumannii is a rare cause of nosocomial meningitis, and is an even rarer cause of meningitis outbreaks in neurosurgical units. We report a case of nosocomial meningitis due to multidrug resistant A. baumannii in a postoperative neurosurgery. The diagnosis was retained on a beam of arguments clinical, biochemical and bacteriological. The evolution was unfavourable, and the patient died of multiple complications.

[Frequency and antibiotic susceptibility of bacteria identified in urine]. / Fréquence et sensibilité aux antibiotiques des bactéries isolées dans les urines.

OBJECTIVE: The authors had for aim to evaluate the frequency of isolation and the antibiotic susceptibility of bacteria responsible for urinary infections among in and out-patients. METHODS: A retrospective study was carried out at the Microbiology Laboratory of the Mohammed-V Military Instruction Hospital in Rabat, on bacteria isolated from 896 positive cytobacteriologic examinations of urine, from January 1 to December 31, 2005. RESULTS: Among the 7472 urinary samples, 896 answered the criteria of urinary infection (12%). Urinary infections were more frequent in in-patients (57.8%; sex-ratio F/M=1:16). Enterobacteria were the most frequent (85%) and especially Escherichia coli (44.7%). Gram positive bacteria (11.6%) were more frequently Staphylococcus saprophyticus (3.1%). E. coli was highly resistant to amoxicillin, and sulfamethoxazole, whereas quinolones and aminosides maintained a good activity and third generation cephalosporines remain active (97% of susceptibility). Among the enterobacteria present, 3.2% were resistant to third generation cephalosporines with extended spectrum betalactamase.

[Bacteriological aspects of osteitis in a university hospital]. / Les aspects bactériologiques des ostéites dans un hôpital universitaire.

INTRODUCTION: The aim, of our retrospective study, was to determine the epidemiological and susceptibility profile of bacterial osteitis isolates in the Rabat Mohammed V Military Hospital, to optimize the probabilistic antibiotherapy. MATERIALS AND METHODS: A study was made from August 2004 to December 2005. All the positive specimen for the etiologic diagnosis of osteitis and osteoarthritis were included. RESULTS: During this period, 85 osteitis cases were documented. 123 isolates were collected. 31 cases of osteitis allowed for the isolation of at least 2 bacteria (36.5%). The Gram positive cocci rate was 54.5%, the Gram negative bacilli rate 39.8%, and the Gram positive bacilli rate 5.7%. The distribution by groups was staphylococcus spp 46.4%, enterobacteriaceae 25.2% and non-fermenting Gram negative bacilli 12.9%. The most frequently isolated species were Staphylococcus aureus (23,6%) followed by Pseudomonas aeruginosa (8.9%), and Klebsiella pneumoniae (5.7%). All the S. aureus isolates were susceptible to oxacillin and 30.8% of the coagulase negative staphylococci were resistant. The enterobacteriaceae resistance rates were 64.5% for clavulanic acid-amoxicillin and 16% for third generation cephalosporin and ciprofloxacin. The non-fermenting Gram negative bacilli resistance rate was 37.5% for ceftazidim, 62.5% for ticarcillin, and 12.5% for imipenem. CONCLUSION: Our results show the potential efficient therapy for community osteitis, using the traditional association: methicillin-aminosides and oral relay with fluoroquinolones. In nosocomial osteitis, the antibiotherapy must be modulated according to the identification and an antibiogram.