[Nosocomial multidrug-resistant Acinetobacter baumannii meningitis in postoperative neurosurgery: a case study]. / Méningite nosocomiale postopératoire à Acinetobacter baumannii multirésistant en neurochirurgie : à propos d'un cas.

Acinetobacter baumannii is a prolific nosocomial pathogen renowned for its multidrug-resistant nature. However, A. baumannii is a rare cause of nosocomial meningitis, and is an even rarer cause of meningitis outbreaks in neurosurgical units. We report a case of nosocomial meningitis due to multidrug resistant A. baumannii in a postoperative neurosurgery. The diagnosis was retained on a beam of arguments clinical, biochemical and bacteriological. The evolution was unfavourable, and the patient died of multiple complications.

[Pharmaceutical analysis of antibiotic drug prescription in the burns and plastic surgery departiment of the Mohammed Military Teaching Hospital]. / Analyse Pharmaceutique de la prescription des antibiotiques au service des brules et chirurgie plastique de l'Hopital Militaire d'Instruction Mohammed V, Maroc.

Infection has long been the main cause of mortality in severely burned patients. The aim of this work is to assess the prescription of antibiotics in our Burns and Plastic Surgery Department in relation to the recommendations of the manufacturers. A summary is provided of the specific features of these products. Patients hospitalized in the Mohammed V Military Teaching Hospital, Rabat, Morocco, during the period January 2008/May 2009 and treated with antibiotics were considered. This retrospective study concerned 227 nominal medical prescriptions of antibiotics to 41 patients: 70% of the prescriptions were nondocumented. The commonest method of administration was by injection (89%). Various groups of therapeutic drugs were used: betalactamines (65%), glycopeptides (10.5%), aminosides (9%), quinolones (7%), and colistin (4.3%), plus 4.2% from other groups (metronidazole 500 mg, perfusion; fluconazol 100 mg/50 ml, injection; rifampicin 600 mg, perfusion; silver sulphadiazine, 2% fusidic acid cream). A total of 227 nominal medical prescriptions were analysed: the dosages and counter-indications were correctly respected. Three drug interactions were recorded (fluconazol-rifampicin, fluconazol-Saccharomyces boulardii, amikacin-vancomycin). This study shows the importance of the pharmaceutical analysis of prescriptions for antibiotics used in a burns unit, which are active but therefore very toxic.