Background: Pathogens surveillance and antimicrobial resistance are essential for the prompt organization of therapeutic and preventive action in healthcare settings. Objectives: The aim of this study was to determine the profile of pathogens isolated among patients admitted to an intensive care unit of a major urban Moroccan city that presented nosocomial infection during their hospitalisation. Results: During the study period, 34 patients developed a nosocomial infection during hospitalisation in ICU. The mean age of patients was 42.3 ± 18.3 years (range: 18.0 - 86.0 years) and 68% were males. The main diagnoses were multiple trauma injuries (47%) and thermal burns (18%). In terms of morbidities, 9% of the patients presented diabetes. The most common sites were central line-associated bloodstream infection (38%), bloodstream infection (35%), ventilator-associated pneumonia (32%), urinary catheter-related infection (29%), and soft tissue infection (21%). Most frequently isolated pathogens were: Acinetobacter baumani (25%), followed by Klebsiella spp. (12%), Pseudomonas aeruginosa (8%), coagulase negative Staphylococcus aureus (6%), E. coli (6%), Providencia spp. (6%), Enterococcus faecalis (6%), Raoultella terrigena (4%). Conclusion: The bloodstream was the most common site and Gram-negatives were the most commonly reported causes of ICU infections. The incidence found was high, the mortality was strong, corresponding with that of developing countries. These results will allow to set up a targeted program of prevention and to estimate the efficiency of interventions.
References
[1]
Aranaz-Andrés, J.M., Aibar-Remón, C., Vitaller-Murillo, J., Ruiz-López, P., Limón-Ramírez, R. and Terol-García, E. (2008) Incidence of Adverse Events Related to Health Care in Spain Results of the Spanish National Study of Adverse Events. Journal of Epidemiology and Community Health, 62, 1022-1029.
https://doi.org/10.1136/jech.2007.065227
[2]
Ak, O., Batırel, A., Ozer, S. and Colakoglu, S. (2011) Nosocomial Infections and Risk Factors in the Intensive Care Unit of a Teaching and Research Hospital: A Prospective Cohort Study. Medical Science Monitor, 17, PH29-PH34.
https://doi.org/10.12659/MSM.881750
[3]
Vu, D.P., Heiman, F.L., Mattias, L., Behzad, N., Quynh, D.D., Lennart, E., et al. (2016) Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units. PLOS ONE, 11, e0147544.
https://doi.org/10.1371/journal.pone.0147544
[4]
Kollef, M.H. and Fraser, V.J. (2001) Antibiotic Resistance in the Intensive Care Unit. Annals of Internal Medicine, 134, 298-314.
https://doi.org/10.7326/0003-4819-134-4-200102200-00014
[5]
Alberti, C., Brun-Buisson, C., Burchardi, H., Martin, C., Goodman, S., Artigas, A., et al. (2002) Epidemiology of Sepsis and Infection in ICU Patients from an International Multicentre Cohort Study. Intensive Care Medicine, 28, 108-121.
https://doi.org/10.1007/s00134-001-1143-z
[6]
Baviskar, A.S., Khatib, K.I., Rajpal, D. and Dongare, H.C. (2019) Nosocomial Infections in Surgical Intensive Care Unit: A Retrospective Single-Center Study. International Journal of Critical Illness and Injury Science, 9, 16-20.
https://doi.org/10.4103/IJCIIS.IJCIIS_57_18
[7]
Agarwal, R., Gupta, D., Ray, P., Aggarwal, A.N. and Jindal, S.K. (2006) Epidemiology, Risk Factors and Outcome of Nosocomial Infections in a Respiratory Intensive Care Unit in North India. Journal of Infection, 53, 98-105.
https://doi.org/10.1016/j.jinf.2005.10.021
[8]
Ding, J.G., Sun, Q.F., Li, K.C., Zheng, M.H., Miao, X.H., Ni, W., et al. (2009) Retrospective Analysis of Nosocomial Infections in the Intensive Care Unit of a Tertiary Hospital in China during 2003 and 2007. BMC Infectious Diseases, 9, Article No. 115. https://doi.org/10.1186/1471-2334-9-115
[9]
Kołpa, M., Wałaszek, M., Gniadek, A., Wolak, Z. and Dobroś, W. (2018) Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. International Journal of Environmental Research and Public Health, 15, Article 112.
https://doi.org/10.3390/ijerph15010112
[10]
Choudhuri, A.H., Chakravarty, M. and Uppal, R. (2017) Epidemiology and Characteristics of Nosocomial Infections in Critically Ill Patients in a Tertiary Care Intensive Care Unit of Northern India. Saudi Journal of Anaesthesia, 11, 402-407.
https://doi.org/10.4103/sja.SJA_230_17
[11]
Ling, M.L., Apisarnthanarak, A. and Madriaga, G. (2015) The Burden of Healthcare-Associated Infections in Southeast Asia: A Systematic Literature Review and Meta-Analysis. Clinical Infectious Diseases, 60, 1690-1699.
https://doi.org/10.1093/cid/civ095
[12]
Cai, Y., Venkatachalam, I., Tee, N.W., Tan, T.Y., Kurup, A., Wong, S.Y., et al. (2017) Prevalence of Healthcare-Associated Infections and Antimicrobial Use among Adult Inpatients in Singapore Acute-Care Hospitals: Results from the First National Point Prevalence Survey. Clinical Infectious Diseases, 64, S61-S67.
https://doi.org/10.1093/cid/cix103
[13]
Legras, A., Malvy, D., Quinioux, A.I., et al. (1998) Nosocomial Infections: Prospective Survey of Incidence in Five French Intensive Care Units. Intensive Care Medicine, 24, 1040-1046. https://doi.org/10.1007/s001340050713
[14]
Appelgren, P., Hellström, I., Weitzberg, E., et al. (2001) Risk Factors for Nosocomial Intensive Care Infection: A Long-Term Prospective Analysis. Acta Anaesthesiologica Scandinavica, 45, 710-719.
https://doi.org/10.1034/j.1399-6576.2001.045006710.x
[15]
Aly, N.Y., Al-Mousa, H.H. and Al Asar, S.M. (2008) Nosocomial Infections in a Medical-Surgical Intensive Care Unit. Medical Principles and Practice, 17, 373-377.
https://doi.org/10.1159/000141500
[16]
Gastmeier, P., Sohr, D., Just, H.M., Nassauer, A., Daschner, F. and Rüden, H. (2000) How to Survey Nosocomial Infections. Infection Control & Hospital Epidemiology, 21, 366-370. https://doi.org/10.1086/501774
Jarvis, W.R. (2001) Infection Control and Changing Health-Care Delivery Systems. Emerging Infectious Diseases, 7, 170-173. https://doi.org/10.3201/eid0702.010202
[19]
Datta, P., Rani, H., Chauhan, R., Gombar, S. and Chander, J. (2014) Healthcare Associated Infections: Risk Factors and Epidemiology from an Intensive Care Unit in Northern India. Indian Journal of Anaesthesia, 58, 30-35.
https://doi.org/10.4103/0019-5049.126785
[20]
Meric, M., Willke, A., Caglayan, C. and Toker, K. (2005) Intensive Care Unit-Acquired Infections: Incidence, Risk Factors and Associated Mortality in a Turkish University Hospital. Japanese Journal of Infectious Diseases, 58, 297-302.
[21]
Pellizzer, G., Mantoan, P., Timillero, L., Allegranzi, B., Fedeli, U., Schievano, E., et al. (2008) Prevalence and Risk Factors for Nosocomial Infections in Hospitals of the Veneto Region, North-Eastern Italy. Infection, 36, 112-119.
https://doi.org/10.1007/s15010-007-7092-x
[22]
Kaye, K.S. and Pogue, J.M. (2015) Infections Caused by Resistant Gram-Negative Bacteria: Epidemiology and Management. Pharmacotherapy, 35, 949-962.
https://doi.org/10.1002/phar.1636
[23]
Zahlane, K., Soraa, N., Idmoussa, A., Labaali, A. and Aitsaid, L. (2014) Beta-Lactam Resistance Profile in Bacterial Isolates at Ibntofail Hospital. CHU Mohammed VI, Marrakech (Morocco). Revue Tunisienne d’Infectiologie, 8, 57-64.
