[ Epidémiologie et résistance aux antibiotiques des isolats de Pseudomonas aeruginosa dans un hôpital pédiatrique marocain: implications thérapeutiques ]
Volume 11, Issue 2, November 2014, Pages 283–290
Mehdi Chinbo1, Mariame Moutachakkir2, Amal Addebbous3, Noureddine El Khoudri4, Laila Chabaa5, and Nabila Soraa6
1 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
2 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
3 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
4 Laboratoire d'écologie humaine, Faculté des sciences Semlalia, Université Cadi AYAAD, Marrakech, Maroc
5 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Morocco
6 Professeur agrégé en Microbiologie et chef de service de Microbiologie, Service de Microbiologie, Hôpital Arrazi, CHU Mohamed VI, Marrakech, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pseudomonas aeruginosa infections in pediatric units are redoubted because of their high level of morbidity and mortality and the increased risk of therapeutic failure. Our aim was to access the profile of antibiotic resistance among P. aeruginosa isolats and guide the choice of an adapted antibiotic therapy against P. aeruginosa pediatric infections. A descriptive study has been conducted over a period of 4 years at the Mother - Child department of the University Hospital of Marrakech (Morocco). 168 stains of P. aeruginosa were isolated. P. aeruginosa infections were frequently occurred on an immunosuppression context. Specimens were dominated by pus (29.7%). P. aeruginosa bacteremia represented 20.8%. Multidrug-resistant P. aeruginosa stains (MDR) has represented 25.6% of all isolates. The highest rate of multidrug resistance has concerned pediatric and neonatal intensive care units (66.1%). The most active antibiotics were amikacin, imipenem, and ciprofloxacin. The cephalosporinase phenotype conferring resistance to ceftazidime was involved in 15 % of the strains. The imipenemase phenotype conferring resistance to all beta-lactams has concerned 4.7% of isolates. The antibiotic combinations piperacillin/tazobactam-amikacin has been chosen as an empirical antibiotic therapy against invasive P. aeruginosa infections in pediatric units. This study showed a high frequency of multidrug resistant P. aeruginosa in pediatric intensive care units. Monitoring of local epidemiology and antibiotic resistance of P. aeruginosa is fundamental to guide the clinicians to choose an appropriate antibiotic therapy.
Author Keywords: Pseudomonas aeruginosa, pediatric unit, multidrug resistance, antibiotics.
Volume 11, Issue 2, November 2014, Pages 283–290
Mehdi Chinbo1, Mariame Moutachakkir2, Amal Addebbous3, Noureddine El Khoudri4, Laila Chabaa5, and Nabila Soraa6
1 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
2 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
3 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Maroc
4 Laboratoire d'écologie humaine, Faculté des sciences Semlalia, Université Cadi AYAAD, Marrakech, Maroc
5 Laboratoire de microbiologie, Hôpital Mère enfant, CHU Mohammed VI, Université Cadi AYYAD, Marrakech, Morocco
6 Professeur agrégé en Microbiologie et chef de service de Microbiologie, Service de Microbiologie, Hôpital Arrazi, CHU Mohamed VI, Marrakech, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Pseudomonas aeruginosa infections in pediatric units are redoubted because of their high level of morbidity and mortality and the increased risk of therapeutic failure. Our aim was to access the profile of antibiotic resistance among P. aeruginosa isolats and guide the choice of an adapted antibiotic therapy against P. aeruginosa pediatric infections. A descriptive study has been conducted over a period of 4 years at the Mother - Child department of the University Hospital of Marrakech (Morocco). 168 stains of P. aeruginosa were isolated. P. aeruginosa infections were frequently occurred on an immunosuppression context. Specimens were dominated by pus (29.7%). P. aeruginosa bacteremia represented 20.8%. Multidrug-resistant P. aeruginosa stains (MDR) has represented 25.6% of all isolates. The highest rate of multidrug resistance has concerned pediatric and neonatal intensive care units (66.1%). The most active antibiotics were amikacin, imipenem, and ciprofloxacin. The cephalosporinase phenotype conferring resistance to ceftazidime was involved in 15 % of the strains. The imipenemase phenotype conferring resistance to all beta-lactams has concerned 4.7% of isolates. The antibiotic combinations piperacillin/tazobactam-amikacin has been chosen as an empirical antibiotic therapy against invasive P. aeruginosa infections in pediatric units. This study showed a high frequency of multidrug resistant P. aeruginosa in pediatric intensive care units. Monitoring of local epidemiology and antibiotic resistance of P. aeruginosa is fundamental to guide the clinicians to choose an appropriate antibiotic therapy.
Author Keywords: Pseudomonas aeruginosa, pediatric unit, multidrug resistance, antibiotics.
Abstract: (french)
Les infections à Pseudomonas aeruginosa en milieu pédiatrique sont redoutables du fait de leur morbi-mortalité élevée et le risque accru d´impasse thérapeutique. L´objectif de l´étude est de déterminer le profil de résistance aux antibiotiques des isolats de P. aeruginosa et guider le choix d´une association antibiotique adaptée pour le traitement des infections à P. aeruginosa chez l´enfant. Une étude descriptive a été menée sur une période de 4 ans au niveau du Pôle Mère- Enfant du CHU de Marrakech (Maroc). 168 souches de P. aeruginosa ont été isolées. Les infections à P. aeruginosa surviennent principalement sur un terrain d´immunodépression. Les sites d'isolement étaient dominés par les pus (29,7%), suivis des bactériémies (20,8%). Les souches multirésistantes (PAMR) ont représenté 25,6% de l´ensemble des isolats. Les taux de multirésistance les plus élevés ont concerné les services de réanimation pédiatrique et néonatale (66,1%). Les antibiotiques restant actifs étaient l´amikacine, l´imipenème, et la ciprofloxacine. Le phénotype céphalosporinase conférant la résistance à la céftazidime a concerné 15% des souches. Le phénotype imipenèmase conférant la résistance à l´ensemble des Bêtalactamines a concerné 4,7% des souches. L´association pipéracilline/tazobactam-amikacine a été retenue pour une antibiothérapie probabiliste visant les infections invasives à P. aeruginosa chez l´enfant. Ce travail rapporte une fréquence élevée des souches de P. aeruginosa multi résistants en milieu de soins intensifs pédiatriques. La surveillance étroite de l´épidémiologie locale et de l´état des résistances aux antibiotiques du P. aeruginosa est fondamentale pour guider le clinicien vers le choix d´une antibiothérapie appropriée.
Author Keywords: Pseudomonas aeruginosa, pédiatrie, multirésistance, antibiotiques.
How to Cite this Article
Mehdi Chinbo, Mariame Moutachakkir, Amal Addebbous, Noureddine El Khoudri, Laila Chabaa, and Nabila Soraa, “Epidemiology and antimicrobial resistance of Pseudomonas aeruginosa isolates in a Moroccan pediatric hospital: therapeutic guidelines,” International Journal of Innovation and Scientific Research, vol. 11, no. 2, pp. 283–290, November 2014.
