Burn unit: colonization of burn wounds and local environment.

BACKGROUND: We present the results of a comparative prospective study of the resistance profile of strains isolated from pathological material of patients hospitalized in the burn unit of the military hospital in Rabat and from their environment over a period of one and a half years (July 2009-February 2011). METHODS: The study concerned 125 pathological products from patients (40 men, 20 women; mean age 38±14.8 years; range 2 to 80 years) hospitalized with burns. This allowed the isolation of 86 non-redundant bacterial strains during the first period and 50 during the second. RESULTS: The dominant species were Acinetobacter baumannii (15.6%), followed by Pseudomonas aeruginosa (13.8%) and Staphylococcus aureus (11%). During the second period, we noted the abundance of A. baumannii (15.5%), followed by P. aeruginosa (11.3%) and Klebsiella pneumoniae (8.5%). Of the 104 environmental samples of burn patients, 139 microorganisms were isolated. Coagulase-negative staphylococcus was the most abundant strain in the two study periods (69.2% and 64.6%). CONCLUSION: All species showed an almost identical sensitivity to the various antibiotics tested.

[Carbapenemases among Klebsiella pneumoniae: sensitivity, E-test and Hodge test]. / Carbapénémases chez Klebsiella pneumoniae : antibiogramme, E-test et test de Hodge.

Carbapenems are the major weapons in the treatment of nosocomial infections. Since 1996, there have been an emergence and dissemination of carbapenem resistance in the world, especially among Enterobacteriaceae. Resistance is due to one or several mechanisms including production of carbapenemases. A prospective study was carried out from April to September 2011 at the Laboratory of Microbiology of Military Teaching Hospital in Rabat. The aim of this study was to search by phenotypic methods carbapenemases production in Klebsiella pneumoniae at Laboratory of Microbiology of the HMIMV of Rabat by disc diffusion for susceptibility to imipenem (IMP) and ertapenem (ETP), E-test and Hodge test; 211 strains of K. pneumoniae were analyzed. The samples were most frequently obtained from the urinary tract (63.8%); pus (16.5%) and blood cultures (11.8%); 27% of the strains produced extended spectrum of beta-lactamase (ESBL); 3 strains were resistant to ertapenem by disc diffusion. Investigations of these 3 strains in E-test shown that they were resistant to ertapenem but susceptible to imipenem. Tested by Hodge method, 3 strains gave repeatedly positive results. Thus, rate of K. pneumoniae producing KPC type in our study is 1.42%. Our study shows the evidence of K. pneumoniae type carbapenemase (KPC) in Military Teaching Hospital of Rabat. However, the gene encoding the type of resistance must be determined by molecular methods.

[Bacterial epidemiology in the burns unit at military teaching hospital Mohamed V of Rabat]. / Épidémiologie bactérienne à l'unité des brûlés de l'Hôpital militaire d'instruction de Rabat.

We aimed to establish the ecology of the Burns Unit of the Military Teaching Hospital Mohammed V of Rabat. We present results of a retrospective study of four years (March 2006-June 2010) on all micro-organisms isolated from patient samples. During the study period, we analyzed 307 samples corresponding to isolate bacterial strains from 288 non-redundant and 5 yeasts among which 4 corresponded to Candida albicans. The bacteriological profile of the isolated stumps showed a change between 2006 and 2010. Staphylococcus aureus in 2007 and 2008 (52.3%, 33.9%) was in 3rd position in 2010 (10.5%). Acinetobacter baumannii found in 3rd position or below (3.7%, 11.6%, 15.3%), between 2006 and 2008, reached the summit in 2009 and 2010 (22.6% and 23.7%). Pseudomonas aeruginosa, strain dominant in 2006 (33.3%) maintained its second position in 2007, 2008 and 2010 (19.8%, 18.6%, 18.4%) while it was third in 2009 (14.3%). Study of the resistance in antibiotics of the main isolated bacteria showed a stability of the profile of resistance. In conclusion, an epidemiological surveillance of bacteria is necessary, in the burns unit and in the hospital, to guide better the probability antibiotic treatment.

[Antibacterial activity of antiseptics used at Military Teaching Hospital Mohamed V of Rabat]. / Activité antibactérienne des antiseptiques utilisés à l'Hôpital militaire d'instruction Mohamed V de Rabat.

Antiseptics have a major role against the infections and their prevention. The good management of antiseptics allows the reduction of antibiotics use and thus the emergence of resistant bacterial strains. The evaluation of the antibacterial activity of three antiseptics (povidone iodine [PVPI], iodized alcohol and alcohol 70 degrees) used at HMIMV and taken from pharmacy was based on AFNOR method NF T 72-150. The analysis of their chemical properties were done by standardized methods (manganimetry, Bunsen's method, test to determine sodium thiosulfate levels [or sodium thiosulfate test] and Guy Lussac alcoholmeter). Our results were compared with those obtained in another two university hospitals of Rabat: Hospital of Speciality and Ibn Sina. The frequencies of resistant bacterial strains were respectively 4.6%, 30.7% and 15.4% to PVPI, alcohol iodized and alcohol 70 degrees . Our results have shown that the PVPI is the best antiseptic in our hospital.