Nosocomial Infections in a Morocco Burn Unit

Abstract

Introduction: The bacterial nosocomial infection remains a common cause of death in patients who have sustained a severe burn injury. Material and Methods: We conducted a prospective study of 45 patients hospitalized in the ICU burns Hospital IBN-ROCHD of Casablanca over a period of six months, from 1 January 2014 to 30 June 2014. The criteria for nosocomial infection were those of the Center for Disease Control in Atlanta in 1988. Result: Incidence rates were calculated. The bacterial ecology of the service was described as also antibiotype. The population was predominantly male (14 women and 31 men). Their average age was 39 years; the occurrence of 17 nosocomial infections in 45 patients appeared from this study. 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 méthicillin-resistant 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. Conclusion: Finally, controlling the epidemic risk posed by the emergence of resistant organisms is necessary to combine the practice of good antibiotic therapy and prevention.

Epidemiology of burn wound bacterial infections at a Meknes hospital, Morocco

“…Our study showed S. aureus to be a common cause of nosocomial infection, similar to previously published results [ 6 , 13 ]. Essayagh et al.…”

“…[ 16 ], which reported a higher incidence of burn injuries in male (64%) than in female (36%) subjects. The mean ± SD age was 22.5 ± 18.84 years, a result which correlates with the results reported by other studies [ 6 , 16 ]. This could be because the 16- to 59-year age group is the most active and is exposed to hazardous environments at both work and home [ 11 , 13 ].…”

“…Our study showed a high prevalence of MDR bacterial infections among burn patients compared to studies from other countries, such as Tunisia [ 11 ], Egypt [ 3 ], Iran [ 5 ] and India [ 10 ]. This difference might be attributed to antibiotic misuse, different hospital strategies for the management of infections, hygiene protocols and geographic climate variation [ 5 , 6 , 8 , 11 , 13 ].…”

“…Treatment of MDR bacterial infection is frequently complicated by limited susceptibility to antimicrobial drugs and the spread of antibiotic resistance during therapy. In the last few years, Morocco has identified as a country with one of the highest rates of antimicrobial resistance [ 6 , [20] , [21] , [22] ]. In our study, there were high rates of resistance to all available antimicrobial drugs among bacteria isolated from Mohammed V Hospital.…”

“…These infections in burn patients are a major cause of morbidity and mortality [ 2 ]. Factors that predispose patients to increased risk of infection and complications include the nature of the burn, increased risk of infectious complications due to the burn, lengthy hospital stay, use of catheters and other invasive devices and immunocompromising effects of burns [ [2] , [3] , [4] , [5] , [6] ]. The great challenges in treating these bacterial infections is their resistance to antimicrobial treatments.…”