Bacterial ecology related to healthcare in a Moroccan intensive care unit: A prospective analysis of 53 cases

Abstract

Introduction: This study aims to determine the incidence of healthcare-related infections in our structure, identify the different types of healthcare-related infections in order of frequency, and understand the bacterial ecology. Materials and methods: We conducted a prospective observational, descriptive study, which included all patients over 16 years of age who were hospitalized in the Intensive Care Unit (ICU) A4 of the Hassan II University Hospital of Fez. The study was performed over a period of 12 months, from May 2021 to May 2022. Patients hospitalized in the ward during this period were all monitored throughout their stay. The study included those who developed a healthcare-related infection, regardless of the site of the infection. We excluded all patients who did not present with a healthcare-related infection and those who were discharged from intensive care or died within the first 48 hours. Results: Seven hundred and sixty-four patients were admitted to ICU A4 during the study period from May 2021 to May 2022. Out of these, 53 patients developed healthcare-related infections, resulting in an incidence rate of 6.9%. The average age of our patients was 47.42 years, with a significant male predominance. A total of 120 healthcare-related infections were documented during this study period. Bacteremia accounted for the highest percentage at 64.2%, followed by infections related to catheters and pneumopathies acquired under mechanical ventilation, both at 60.4%. Additionally, surgical site infections comprised 22.6%, while urinary tract infections accounted for 18.9%. The average time of infection onset associated with care, compared to hospitalization, was 5.85 days. The evolution was favorable in 13 (24.5%) cases, and unfortunately, there was a significant mortality rate of 40 (75.5%) patients. The isolated germs were mainly Acinetobacter baumannii, with a rate of 88 (61.11%) cases, followed by enterobacteria, which made up 44 (30.55%) cases. In third place comes Pseudomonas aeruginosa with a rate of 13 (9.02%), followed by enterococci with a rate of 10 (6.94%), and Staphylococcus with a rate of eight (5.55%). four (2.77%). Conclusion: Healthcare-related infections are frequent in ICUs and can be serious. The severity of these infections is due to both the infection itself and the compromised immune defense mechanisms of the patient, which reflect their overall health condition. Moreover, prevention is still the best weapon.