AML-332 Antibiotic Resistance Profile of Blood Culture Isolates in Neutropenics in Morocco

Abstract

The emergence of bacterial resistance to antibiotics is an international health issue affecting all age groups and all clinical profiles. These multidrug-resistances lead to therapeutic impasses and pose a problem of therapeutic management, particularly in immunocompromised patients. The aim of our study is to highlight the different germs isolated in blood culture as well as their antibiotic resistance profiles in patients hospitalized on the protected side of our department. This is a prospective study lasting 6 months, from June 2021 to December 2021, carried out within the protected side of the hematology department, in 53 patients who presented an episode of febrile neutropenia and in whom a standard blood culture was performed. Of the blood cultures performed in our 53 patients, 31 (58%) blood cultures were positive, with demonstration of a bacterial infection in 20 patients, i.e., 65% of cases. The main bacterial species found are Klebsiella pneumonia in 3 cases (15%), Acinetobacter baumannii in 3 cases (15%), Escherichia coli in 4 cases (20%), and Pseudomonas aeruginosa in 2 cases (10%). Out of this total of 20 isolated germs, there were 13 infections by multidrug-resistant bacteria (MRB), i.e., 65% of the cases of bacterial infection in our sample. The incidence of MRB is 0.44 cases per 59 patients per year. The antibiogram of the main MRB isolated shows the emergence of increased resistance to the antibiotics used: Klebsiella pneumonia is resistant to penicillins A, fluoroquinolones, C2G, C3G, and gentamycin; ABRI is resistant to aminoglycosides, cephalosporins, fluroquinolones, piperacillin-tazobactam, and imipenem; PARI is resistant to piperacillin-tazobactam, ticarcillin ceftazidime, fluoroquinolones, aminoglycosides, and carbapenem; and Escherichia coli is resistant to ampicillin, amoxicillin, cefoxitin, ceftriaxone, ceftazidime, ciprofloxacin, gentamicin, and ertapenem. The acquisition of resistance to antibiotics complicates therapeutic management and exposes patients to a high risk of death from septic shock, hence the importance of prevention through strict hygiene measures, staff awareness of patient health, and the rationalization of the prescription of antibiotic therapy, as well as the implementation of a monitoring system for multidrug-resistant bacteria.