Multi-drug resistant bacteria carriage on admission in a surgery reanimation of Antananarivo

Abstract

Nosocomial infections (NCIs) are a major problem when they are caused by multi-drug resistant (MDR) bacteria. Surgery reanimations are a site frequently concerned by the emergence and spread of these germs but we found limited data of MDR bacteria in patients hospitalized in surgery reanimation. This is a first prospective, observational at the Hospital, in the surgical reanimation, from August to October 2017. The aims of this study are to screen the carriage of MDR bacteria on patient admitted in the surgical reanimation of the University Hospital Center Joseph Ravoahangy Andrianavalona (UHC-JRA), to determine the risk factors associated with the antimicrobial resistance. Nasal carriage of Methicillin resistant Staphylococcus aureus (MRSA) and fecal carriage of extended-spectrum ?-lactamase producing (ESBL) Enterobacteria, Imipenem-resistant Acinetobacter baumannii, multi-resistant Pseudomonas aeruginosa(MDR P. aeruginosa) and Carbapenem resistant Enterobacteria (CRE) were assessed among patients within 24 hours of surgery reanimation admissions. Among 99 newly admitted patients, 80.80 % (80/99) were colonized with at least one MDR. The colonization prevalence with MRSA was 66.66 % (60/99) with PLP2a in 90 % (45/50). The colonization prevalence with ESBL was 44.44 % (44/99). ESBL-producing Escherichia coli were the most common bacteria isolated from 34 patients (34.34 %) followed by ESBL-producing Klebsiella pneumoniae and ESBL-producing Enterobacter cloacae. Indeed, the surgery reanimation patients have a high rate of colonization by MDR bacteria. The risk of infection, transmission and dissemination of resistant germs are important and requires adequate hygiene measures.