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RÉSUMÉ
Introduction. L’étude avait pour objectif de répertorier les différentes bactéries isolées dans les produits pathologiques des patients hospitalisés dans un service de Maladies Infectieuses et de déterminer le profil de sensibilité des germes aux antibiotiques. Méthodes. Il s’est agi d’une étude transversale descriptive de juin 2017 à juillet 2019 dans le service de Maladies Infectieuses du Centre Hospitalier Universitaire (CHU) du Point « G ». Elle a concerné tous les prélèvements pathologiques des patients hospitalisés, envoyés au laboratoire pour analyse bactériologique dont la culture s’est révélée positive avec un antibiogramme. Les données ont été analysées par le logiciel SPSS. Résultats. Au total, 194 bactéries ont été isolées après culture des produits pathologiques de 152 patients hospitalisés. L’âge moyen des patients étaient de 42,8 ± 12,5 ans avec des extrêmes de 9 ans et 79 ans. Le sex-ratio était de 1,08. La majorité des patients provenait de la ville de Bamako (79,1%). Les entérobactéries constituaient le groupe de microorganismes le plus identifié (68,6%), suivies des Cocci Gram positifs (19,6%) et les Bactéries Gram négatifs non fermentant (11,8%). Au moins deux germes ont été isolés chez 23,7% des patients. Parmi les entérobactéries, E. coli (46,6%) et K. pneumoniae (33,8%) étaient les souches les plus fréquemment retrouvées, suivies de Enterobacter spp (3,1%). Les Bacilles Gram négatifs non fermentant étaient principalement représentés par Acinetobacter baumannii (60,9%), Pseudomonas aeruginosa (17,4%) et Pseudomonas spp (17,4%). Staphylococcus aureus (36,9%), Enterococcus sp (18,4%) et Streptococcus sp (13,2%) étaient les plus prédominants dans les liquides pathologiques parmi les Cocci Gram positif. Conclusion. Une surveillance microbiologique régulière des infections bactériennes permet de déterminer la fréquence des germes isolés ainsi que leur sensibilité aux antibiotiques utilisés dans les traitements probabilistes.
ABSTRACT
Introduction. The aim of the study was to list the different bacteria isolated in the pathological products of patients hospitalized in an Infectious Diseases department and to determine the sensitivity profile of germs to antibiotics. Methods. This was a descriptive cross-sectional study from June 2017 to July 2019 in the Infectious Diseases department of the University Hospital Center (CHU) of Point "G". It concerned all pathological samples from hospitalized patients, sent to the laboratory for bacteriological analysis, the culture of which proved positive with an antibiogram. The data was analyzed by SPSS software. Results. A total of 194 bacteria were isolated after culture of pathological products from 152 hospitalized patients. The average age of the patients was 42.8 ± 12.5 years with extremes of 9 years and 79 years. The sex ratio was 1.08. The majority of patients came from the city of Bamako (79.1%). Enterobacteriaceae were the most identified group of microorganisms (68.6%), followed by Gram-positive Cocci (19.6%) and non-fermenting Gram-negative bacteria (11.8%). At least two germs were isolated in 23.7% of patients. Among enterobacteriaceae, E. coli (46.6%) and K. pneumoniae (33.8%) were the most frequently found strains, followed by Enterobacter spp (3.1%). Non-fermenting Gram-negative Bacilli were mainly represented by Acinetobacter baumannii (60.9%), Pseudomonas aeruginosa (17.4%) and Pseudomonas spp (17.4%). Staphylococcus aureus (36.9%), Enterococcus sp (18.4%) and Streptococcus sp (13.2%) were the most predominant in pathological fluids among Gram-positive Cocci. Conclusion. Regular microbiological monitoring of bacterial infections makes it possible to determine the frequency of isolated germs as well as their sensitivity to antibiotics used in probabilistic treatments.
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References
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References
Asokan GV, Ramadhan T, Ahmed E, Sanad H. WHO Global Priority Pathogens List: A Bibliometric Analysis of Medline-PubMed for Knowledge Mobilization to Infection Prevention and Control Practices in Bahrain. Oman Med J. 2019;34(3):184‑93.
Levy SB. Factors impacting on the problem of antibiotic resistance. Journal of Antimicrobial Chemotherapy. 2002;49(1):25‑30.
Lusti-Narasimhan M, Pessoa-Silva CL, Temmerman M. Moving forward in tackling antimicrobial resistance: WHO actions. Sex Transm Infect. 2013;89 Suppl 4:iv57-59.
Omulo S, Thumbi SM, Njenga MK, Call DR. A review of 40 years of enteric antimicrobial resistance research in Eastern Africa: what can be done better? Antimicrobial Resistance and Infection Control. 2015;4(1):1.
Okeke IN, Aboderin OA, Byarugaba DK, Ojo KK, Opintan JA. Growing Problem of Multidrug-Resistant Enteric Pathogens in Africa. Emerg Infect Dis. 2007;13(11):1640‑6.
Aminov R. A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future. Frontiers in Microbiology [Internet]. 2010 [cité 8 sept 2022];1. Disponible sur: https://www.frontiersin.org/articles/10.3389/fmicb.2010.00134
Saga T, Yamaguchi K. History of antimicrobial agents and resistant bacteria. JMAJ - Japan Medical Association Journal. 2009;52(2):103‑8.
Shears P. Antibiotic resistance in the tropics. Epidemiology and surveillance of antimicrobial resistance in the tropics. Trans R Soc Trop Med Hyg. 2001;95(2):127‑30.
Konate I, Kaboré M, Guindo I, Cissoko Y, Hamidou Issa H, Dembélé JP. Profil bactériologique et pronostique des pneumonies bactériennes non tuberculeuses chez les patients VIH au Mali. Revue Malienne d’Infectiologie et de Microbiologie 2022;17:46‑53.
Shinga Wembulua B, Lakhe A, Diallo Mbaye K, Ndikou Aw N, Cisse Diallo VMP, Ka D, et al. Profils de Sensibilité aux Antibactériens des Isolats Sanguins Chez 74 Patients Infectés Par le VIH Hospitalisés à la Clinique des Maladies Infectieuses et Tropicales du Chu de Fann, Dakar de 2013 à 2016. Med Trop Sante Int. 2021;1(2):mtsibulletin.n1.2021.88.
Hailemariam M, Alemayehu T, Tadesse B, Nigussie N, Agegnehu A, Habtemariam T, et al. Major bacterial isolate and antibiotic resistance from routine clinical samples in Southern Ethiopia. Sci Rep. 2021;11(1):19710.
Kouegnigan Rerambiah L, Ndong JC, Mbakob Mengue Massoua P, Medzegue S, Elisee-Ndam M, Mintsa-Ndong A, et al. Antimicrobial profiles of bacterial clinical isolates from the Gabonese National Laboratory of Public Health: data from routine activity. Int J Infect Dis. 2014;29:48‑53.
Nejjari C, El Achhab Y, Benaouda A, Abdelfattah C. Antimicrobial resistance among GLASS pathogens in Morocco: an epidemiological scoping review. BMC Infect Dis. 2022;22(1):438.
Birru M, Woldemariam M, Manilal A, Aklilu A, Tsalla T, Mitiku A, et al. Bacterial profile, antimicrobial susceptibility patterns, and associated factors among bloodstream infection suspected patients attending Arba Minch General Hospital, Ethiopia. Sci Rep. 2021;11(1):15882.
Carroll M, Rangaiahagari A, Musabeyezu E, Singer D, Ogbuagu O. Five-Year Antimicrobial Susceptibility Trends Among Bacterial Isolates from a Tertiary Health-Care Facility in Kigali, Rwanda. Am J Trop Med Hyg. 2016;95(6):1277‑83.
Lagacé-Wiens PRS, Adam HJ, Poutanen S, Baxter MR, Denisuik AJ, Golden AR, et al. Trends in antimicrobial resistance over 10 years among key bacterial pathogens from Canadian hospitals: results of the CANWARD study 2007-16. J Antimicrob Chemother. 2019;74(Suppl 4):iv22‑31.
Mhondoro M, Ndlovu N, Bangure D, Juru T, Gombe NT, Shambira G, et al. Trends in antimicrobial resistance of bacterial pathogens in Harare, Zimbabwe, 2012-2017: a secondary dataset analysis. BMC Infect Dis. 2019;19(1):746.
Lockhart SR, Abramson MA, Beekmann SE, Gallagher G, Riedel S, Diekema DJ, et al. Antimicrobial Resistance among Gram-Negative Bacilli Causing Infections in Intensive Care Unit Patients in the United States between 1993 and 2004. J Clin Microbiol. 2007;45(10):3352‑9.
Sader HS, Farrell DJ, Flamm RK, Jones RN. Antimicrobial susceptibility of Gram-negative organisms isolated from patients hospitalized in intensive care units in United States and European hospitals (2009-2011). Diagn Microbiol Infect Dis. 2014;78(4):443‑8.
Gajdács M, Burián K, Terhes G. Resistance Levels and Epidemiology of Non-Fermenting Gram-Negative Bacteria in Urinary Tract Infections of Inpatients and Outpatients (RENFUTI): A 10-Year Epidemiological Snapshot. Antibiotics (Basel). 2019;8(3):E143.
Dagnew M, Yismaw G, Gizachew M, Gadisa A, Abebe T, Tadesse T, et al. Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients attending Gondar University Hospital, Northwest Ethiopia. BMC Res Notes. 2013;6:283.