[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.

[Epidemiological features of multidrug resistant bacteria isolated from urine samples at the Mohammed V Military Teaching Hospital in Rabat, Morocco]. / Epidémiologie des bactéries multi- résistantes isolées des urines a l'Hôpital Militaire d'Lnstruction Mohammed V de Rabat (Maroc).

Hospital-acquired multidrug resistant bacteria infections are a serious public health issue causing increased morbidity, mortality and care cost. These risks underscore the need for health care institutions to maintain active panels to monitor, prevent, and manage hospital-acquired infections. The purpose of this study was to assess the epidemiology of urinary tract infection involving multidrug resistant bacteria at the Microbiology Laboratory of the Mohammed-V Military Teaching Hospital in Rabat. Study was carried out retrospectively on bacteria isolated from 10,243 urinary samples collected from January 1 to December 31, 2008. A total of 1,439 non-redundant bacteria (14.1%) meeting the criteria of urinary infection were identified. One hundred and three of the 1,439 bacteria isolated (7%) were multidrug resistant. Multidrug-resistant bacteria were more common in in-patients (63.1%). Mean patient age was 53.8 +/- 18.2 and the M/F sex ratio was 2.2. The most common multi-drug resistant bacteria were Enterobacteria producing extended spectrum bêta-lactamase (54.4% including 40.8% of Klebsiella pneumonia) and non-fermenting bacteria (45.6% including 26.2% of Pseudomonas aeruginosa. and 19.4% of Acinetobacter baumannii. These bacteria were resistant to the most commonly used antibiotics but remained highly sensitive to colistin, imipenem and amikacin.

[Frequency and antibiotic susceptibility of bacteria identified in urine]. / Fréquence et sensibilité aux antibiotiques des bactéries isolées dans les urines.

OBJECTIVE: The authors had for aim to evaluate the frequency of isolation and the antibiotic susceptibility of bacteria responsible for urinary infections among in and out-patients. METHODS: A retrospective study was carried out at the Microbiology Laboratory of the Mohammed-V Military Instruction Hospital in Rabat, on bacteria isolated from 896 positive cytobacteriologic examinations of urine, from January 1 to December 31, 2005. RESULTS: Among the 7472 urinary samples, 896 answered the criteria of urinary infection (12%). Urinary infections were more frequent in in-patients (57.8%; sex-ratio F/M=1:16). Enterobacteria were the most frequent (85%) and especially Escherichia coli (44.7%). Gram positive bacteria (11.6%) were more frequently Staphylococcus saprophyticus (3.1%). E. coli was highly resistant to amoxicillin, and sulfamethoxazole, whereas quinolones and aminosides maintained a good activity and third generation cephalosporines remain active (97% of susceptibility). Among the enterobacteria present, 3.2% were resistant to third generation cephalosporines with extended spectrum betalactamase.

[Serratia rubidaea bacteremia]. / Bactériémie à Serratia rubidaea.

Serratia rubidaea is an opportunist pathogenic bacterium, it is rarely identified in man, and when so, generally found in the respiratory tract, wounds, feces, bile, but also in blood. S. rubidaea can be responsible for infection, particularly in debilitated patients, receiving broad spectrum antibiotics or after undergoing extensive surgery, or invasive procedures. We report the case of a 54-year-old, nicotinic patient, with no previous medical history, admitted for complete arrhythmia due to auricular fibrillation. The patient had been carrying an arterial catheter for two weeks. Two hemocultures were positive in the first 48 hours with identification of Serratia rubidaea. S. rubidaea features inductible chromosomal betalactamase of the cephalosporinase type, resistant to ampicilline and cefalotin. The treatment combined gentamycin 160 mg/d and ciprofloxacin 400 mg/d for 10 days. The evolution was favourable.