[ Pneumopathies acquises sous ventilation mécanique : caractéristiques microbiologiques au CHU Hassan II De Fès ]
Volume 20, Issue 3, June 2017, Pages 781–786
Ghita Yahyaoui1, Zineb Taki2, and Mustapha Mahmoud3
1 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
2 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
3 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
Original language: French
Copyright © 2017 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: to take stock of epidemiology, diagnostic methods and the ecology and bacterial resistances of nosocomial respiratory infections, in order to propose preventive measures to improve the management of patients under mechanical ventilation. Type of study: retrospective, analytical, epidemiological over a period of 30 months, from 1 January 2014 to 31 June 2016 conducted in the laboratory of microbiology of University hospital HASSAN II of Fez. Patients and methods: All distal protected specimens (PDP), and bronchoalveolar lavages (BAL) positive from intubated patients hospitalized in resuscitation services. The identification of the bacterial strains as well as the antibiogram was carried out by automated method and the phenotypes of resistance were determined by the diffusion methods in MH agar medium according to the recommendations of the CASFM / EUCAST. Results: A total of 905 respiratory specimens were received of which 547 were positive (60%). VAPs were due to bacteria that were potentially resistant to antibiotics. Acinetobacterbaumanii was the most represented bacterium responsible for 33% of pneumonia acquired under mechanical ventilation. Conclusion: In our series, potentially multi-resistant antibiotic bacteria and especially Gram-negative bacilli were the pathogens most often responsible for VAPs. The choice of the probabilistic antibiotic therapy of the early PAVM must take into account all the risk factors of bacteria potentially multi-resistant to the antibiotics and not only its time of appearance.
Author Keywords: Pneumonia acquired under mechanical ventilation, Nosocomial infection, Antibiotherapy, protected distal sampling, bronchoalveolar lavage, Acinetobacterbaumanii.
Volume 20, Issue 3, June 2017, Pages 781–786
Ghita Yahyaoui1, Zineb Taki2, and Mustapha Mahmoud3
1 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
2 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
3 Département de Microbiologie, Laboratoire Central d’Analyses Médicales, CHU Hassan II de Fès, Morocco
Original language: French
Copyright © 2017 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objectives: to take stock of epidemiology, diagnostic methods and the ecology and bacterial resistances of nosocomial respiratory infections, in order to propose preventive measures to improve the management of patients under mechanical ventilation. Type of study: retrospective, analytical, epidemiological over a period of 30 months, from 1 January 2014 to 31 June 2016 conducted in the laboratory of microbiology of University hospital HASSAN II of Fez. Patients and methods: All distal protected specimens (PDP), and bronchoalveolar lavages (BAL) positive from intubated patients hospitalized in resuscitation services. The identification of the bacterial strains as well as the antibiogram was carried out by automated method and the phenotypes of resistance were determined by the diffusion methods in MH agar medium according to the recommendations of the CASFM / EUCAST. Results: A total of 905 respiratory specimens were received of which 547 were positive (60%). VAPs were due to bacteria that were potentially resistant to antibiotics. Acinetobacterbaumanii was the most represented bacterium responsible for 33% of pneumonia acquired under mechanical ventilation. Conclusion: In our series, potentially multi-resistant antibiotic bacteria and especially Gram-negative bacilli were the pathogens most often responsible for VAPs. The choice of the probabilistic antibiotic therapy of the early PAVM must take into account all the risk factors of bacteria potentially multi-resistant to the antibiotics and not only its time of appearance.
Author Keywords: Pneumonia acquired under mechanical ventilation, Nosocomial infection, Antibiotherapy, protected distal sampling, bronchoalveolar lavage, Acinetobacterbaumanii.
Abstract: (french)
Objectifs: Faire le point sur l’épidémiologie, les méthodes diagnostiques ainsi que sur l’écologie et les résistances bactériennes des infections respiratoires nosocomiales, afin de proposer des mesures de prévention permettant d’améliorer la prise en charge des patients sous ventilation mécaniques. Type d’étude: Il s’agit d’une étude rétrospective, analytique, épidémiologique sur une durée de 30 mois, du 1er janvier 2014 au 31 juin 2016 menée au laboratoire de microbiologie du CHU HASSAN II de Fès. Matériel et méthodes: Tous les prélèvements distaux protégés (PDP), et lavages broncho-alvéolaires (LBA) positifs des patients intubés hospitalisés aux services de réanimation. L’identification des souches bactériennes ainsi que l’antibiogramme étaient réalisés par méthode automatisée et les phénotypes de résistance étaient déterminés par les méthodes de diffusion en milieu gélosé MH selon les recommandations du CASFM/EUCAST. Résultats: Au total, 905 prélèvements respiratoires étaient reçus dont 547 étaient positifs (60%). Les PAVM étaient dues à des bactéries potentiellement résistantes aux antibiotiques. Acinetobacterbaumanii était la bactérie la plus représentée, responsable de 33% des pneumopathies acquises sous ventilation mécanique (PAVM). Conclusion: Dans notre série, les bactéries potentiellement multi résistantes aux antibiotiques et en particulier les bacilles à Gram négatif étaient les pathogènes les plus souvent responsables des PAVM. Le choix de l’antibiothérapie probabiliste des PAVM précoces doit prendre en compte l’ensemble des facteurs de risque de bactéries potentiellement multi résistantes aux antibiotiques et pas seulement son délai d’apparition.
Author Keywords: Pneumonie acquise sous ventilation mécanique, Infection nosocomiale, Antibiothérapie, prélèvement distal protégé, lavage broncho-alvéolaire, AcinetobacterBaumanii.
How to Cite this Article
Ghita Yahyaoui, Zineb Taki, and Mustapha Mahmoud, “Ventilator-associated pneumonia : Microbiological characteristics in the university hospital HASSAN II of Fez, Morocco,” International Journal of Innovation and Applied Studies, vol. 20, no. 3, pp. 781–786, June 2017.
