Анестезия и клинические исследования
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ISSN: 2155-6148
ISSN: 2155-6148
Frikh Mohammed, Abdelhay Lemnouer, Nabil Alem, Adil Male and Mostafa Elouennass
Background: The resistance to antimicrobial among patients with late Ventilator-associated pneumonia (VAP) has become increasingly more common in many ICUs in Morocco. There are scarce studies assessing VAP importance in Morocco.
The aim of this study is to determine the bacterial ecology and resistance profile of late VAP in intensive care units in an academic hospital of Rabat.
Methods: A total of 215 sputum samples were collected from endotracheal aspirate in patients with diagnosis of late VAP during the study period, defined from April 1st 2012 to April 2013. The bacteriology interpretations was done following the Referential of Medical Microbiology (REMIC 2010) and were quantitatively cultured with a cut-off of ≥ 10 UFC/ml for endotracheal aspiration samples.
Results: Overall, the Gram-negative bacilli (GNB) represent 81.42% of isolates, while Gram-positive was less represented with a rate of 18.56%. Non-lactose fermenting GNB made up the half of pathogens with the rate of 55.23% and the prevalence of Enteric GNB reaches 26.19%. Pseudomonas aeruginosa is the most isolates with the rate of 28.57%, followed by Acinetobacter baumannii (24.76%), Staphylococcus aureus (9.5%) and Klebsiella pneumonia (8.09%). A high level of multi-drug resistance pathogens was found with a rate of 39.52%. They included Pseudomonas aeruginosa (14.28%), Acinetobacter baumannii (19.04%) and Klebsiella pneumonia (5.71%) whereas all S. aureus were methicillin-sensitive.
Conclusion: The local bacterial pathogens isolates displayed high levels of antibiotic resistance. Enteric GNB naturally resistant to Polymyxin E and Corynebacterium species are likely to be emerging pathogens. This study significantly highlights the need to take into account these potentially drug-resistant isolates when making empiric antibiotic treatment.