[Epidemio-clinicalappearances of care-associated infections in the resuscitation unit of Gabriel Touré teaching hospital (Bamako)]

An infection is said to be associated with care (IAS) when it occurs during or after a patient's management (PEC). A delay of at least 48 hours after admission is commonly accepted to distinguish a nosocomial infection from a community infection.in 2009, WHO estimated that 1.4 million people were sick in the world afterhospital-acquired infections. This prevalence remains largely underestimated in Sub - Saharan Africa, and particularly in Mali, which led us to initiatethiswork, whichaimed to describe the epidemiological and clinical aspects of nosocomial infections, determine their frequency and identify the germs responsible.

MATERIAL AND METHODS

This was a prospective study, over 12 months from January 1st to December 31st, 2016, in the resuscitation department of CHU Gabriel Touré. Including all patients with a temperature greater than or equal to 38 ° C occurring after at least 48 hours of admission. The data were collected through the surveycards and medical records. The input and analysis made respectivelyfrom Epi info software and the 2016 Office Pack (Word, Excel, Power Point).

RESULTS

Duringourstudy of 200 hospitalized patients we collected 35 IAS cases, aprevalence of 17.5%. The male sex was predominant with 60.5% and a sex ratio = 1.53. The average age was 34.28 ± 19.11 yearsold. The traumatized head with 10 cases (28.5%) were the most represented, followed by surgery postoperative 7 cases (20%) and burned 5 cases (14.2%). We carried out 51 samples (15 bronchial samples all positive, 13 ECBUs of which 11 positive, 7 blood cultures, one positive, 12 swabs all positive). The diagnoses retainedwere: ventilated lungdisease 12 cases (34.3%), urinary infection alone 8 cases (22.9%), 6 cases (17.1%) of surgical site infection, 6 cases (17.1%) ) of soft tissue infection and 3 cases (8.6%) of pneumopathy associated with urinary tract infection. The germs found were multidrug-resistant bacilli (BMR), for bronchial samples (Klebsialla pneumoniae, Acinetobacter baumanii, Echerichia coli). ECBU were found 08 cases of Echerichia coliand 01 case of enterococcusfaecalus, and 2 cases of association Echerichia coli and enterococcus faecalus; blood cultures: staphylococcus aureus. The swabsfound: Klebsialla pneumonia, Echerichia coli, Acinetobacter baumanii enterobacter, cloecae, Staphylococcus aureus, Providencia stuartii, Proteus mirabilis. The average duration of treatment of patients with IAS was 8 days with extremes of 2 to 15 days. The mortality was 57.1%.

CONCLUSION

This study allowed us to notice a resistance of different germs to antibiotics. It is therefore necessary to change the behavior of our health care facilities in order to meet this challenge.