The bacteriological profile of the burned patients in the center of burns in CHU Mohamed VI Marrakech (about 123 cases).

The bacterial nosocomial infection is one of the leading causes of morbidity and mortality for burned patient; we conducted a retrospective study of 123 patients hospitalized in the burns center CHUMED VI of Marrakechover a period of 3 years, from January 1st, 2013 to December 31st, 2016. The criteria for nosocomial infection were those of the Center for Disease Control in Atlanta in 1988. Incidence rates were calculated. The bacterial ecology of the department was described as also antibiotype. The predominancy of the population was male. The cumulative incidence was 103 infections per 1000 days of treatment. Regarding the characteristics of bacterial infections, infected sites were skin (69%), blood (18%), urinary tract (12%) and lungs (1%). The main organisms were: Staphylococcus sp. (37.7%), Pseudomonas aeruginosa (19.8%), Enterococcus faecalis and Proteus mirabilis (18.5%). Staphylococci were resistant méticillo-in 22% of cases. Pseudomonas and Acinetobacter were multi-resistant (66%). The establishment of the bacterial ecology of the service, helped us set the right rules of prescription of antibiotics, which was based on the infected site, the type of organism, its sensitivity, the molecule used and the pharmacokinetics particular patient burned. The two main organisms being Staphylococcus and Pseudomonas aeruginosa, antibiotics used in the Service will then beta-lactams, glycopeptides, fluoroquinolones and aminoglycosides. Finally, to control the epidemic risk posed by the emergence of resistant organisms is necessary to combine the practice of good antibiotic therapy and prevention.

Primary anal mucinous adenocarcinoma: a case series.

Primary mucinous adenocarcinoma is a rare malignancy of the anus (3% of anal cancers), the pathogenesis of which is better understood by immunohistochemistry. We reviewed cases of primary mucinous adenocarcinoma of the anus from 2000 to 2009 in the Hepatogastroenterology Department of the University Hospital Centre of Marrakech. Three cases were identified who were males with the mean age of 68years, and presented with a chronic anal fistula. Two cases had anal pain. Clinical examination revealed multiple fistulae in two cases with a secretion simulating 'cooked grains of tapioca'. Diagnosis was confirmed by histopathology and immunohistochemical profile (CK7 positive/CK20 negative). Imaging revealed a retro-rectal collection with thickening of the anal wall without metastasis (two cases). One patient underwent abdominoperinal resection without recurrence.