Nosocomial Bacterial Infections in Covid-19 ICU at Ibn Rochd University Hospital Casablanca Morocco.

BACKGROUND: The aim is to determine the prevalence of bacterial nosocomial infections (NI) and its associated factors in COVID-19 ICU. METHODS: A descriptive retrospective study, from April to August 2020, was carried on patients with respiratory distress following SARS-Cov-2 infection presenting a sign of bacterial infection. RESULTS: A total of 29 patients (33% of hospitalized patients) contracted a NI, their age was 65 years ± 13.90 and sex-ratio M/F was 2.62. All patients had an invasive device: central line (65%), bladder catheter (72%), and mechanical ventilation (76%). The time of NI occurring was 5 to 8 days. Charlson comorbidity index was 4 - 6 in 18 patients (62%). Of the 35 samples taken, 45 bacteria were isolated: multi drug resistant A. baumannii and P. aeruginosa accounted for 24.4%. Of all, 16 deaths were recorded (55, 17%). CONCLUSIONS: NI is common in COVID-19 ICU and can be predicted by risk factors that should be managed.

[Bilateral adrenal hemorrhage on apixaban in primary antiphospholipid syndrome]. / Hémorragie bilatérale des surrénales sous apixaban dans le syndrome primaire des antiphospholipides.

Adrenal hemorrhage is a classical but rare complication of antiphospholipid syndrome, revealing diagnosis in one third of the cases. Anti-vitamin K therapy is the standard treatment but direct oral anticoagulants are discussed as an alternative. In the latest recommendations, it is advised not to use direct oral anticoagulants in the setting of antiphospholipid syndrome. We present a case of bilateral adrenal hemorrhage revealing primary antiphospholipid syndrome with triple positive antibody profile, in 53-year-old women treated by apixaban for previous venous thromboembolism.