Les aspects bactériologiques des ostéites dans un hôpital universitaire

Abstract

Introduction The aim, of our retrospective study, was to determine the epidemiological and susceptibility profile of bacterial osteitis isolates in the Rabat Mohammed V Military Hospital, to optimize the probabilistic antibiotherapy. Materials and methods A study was made from August 2004 to December 2005. All the positive specimen for the etiologic diagnosis of osteitis and osteoarthritis were included. Results During this period, 85 osteitis cases were documented. 123 isolates were collected. 31 cases of osteitis allowed for the isolation of at least 2 bacteria (36.5%). The Gram positive cocci rate was 54.5%, the Gram negative bacilli rate 39.8%, and the Gram positive bacilli rate 5.7%. The distribution by groups was staphylococcus spp 46.4%, enterobacteriaceae 25.2% and non-fermenting Gram negative bacilli 12.9%. The most frequently isolated species were Staphylococcus aureus (23,6%) followed by Pseudomonas aeruginosa (8.9%), and Klebsiella pneumoniae (5.7%). All the S. aureus isolates were susceptible to oxacillin and 30.8% of the coagulase negative staphylococci were resistant. The enterobacteriaceae resistance rates were 64.5% for clavulanic acid-amoxicillin and 16% for third generation cephalosporin and ciprofloxacin. The non-fermenting Gram negative bacilli resistance rate was 37.5% for ceftazidim, 62.5% for ticarcillin, and 12.5% for imipenem. Conclusion Our results show the potential efficient therapy for community osteitis, using the traditional association: methicillin-aminosides and oral relay with fluoroquinolones. In nosocomial osteitis, the antibiotherapy must be modulated according to the identification and an antibiogram.