Nosocomial Pneumopathies in Critical Care of the Military Hospital Mohammed V in Rabat-Morocco: Epidemiological, Clinical and Bacteriological Characteristics

Abstract

Nosocomial infections are defined as infections acquired in a care facility, which were neither incubating nor present when the patient was admitted. Nosocomial pneumopathies are a public health problem because they are responsible for significant morbidity and mortality with a considerable additional cost. They are frequent and serious in intensive care; they are the second most common acquired infections in a hospital setting. The diagnosis of nosocomial pneumopathy is based on a range of clinical, biological, radiological and bacteriological arguments. They cause problems of diagnostic, therapeutic and economic. The objective of this work consisted of an epidemiological study of the Nosocomial Pneumopathies (NP) and to evaluate the frequency, risk factors, antibiotic resistance of bacteria isolated, and factors of excess mortality. This prospective study focused on 65 patients hospitalized in the service of intensive care of the Mohammed V military instruction hospital in Rabat over a period of 6 month from 06/04/2017 to 06/10/2017, 52 patients had nosocomial pneumonia. The results of this work showed; that the germs isolated were essentially Gram-negative bacilli (77.5%), led by Acinetobacter Baumanii (37.8%), followed by Pseudomonas aeruginosa (18.9%), and klebsiella pneumoniae (9%). Gram positive cocci (7.2%), dominated by Staphylococcus aureus (7.2%). The polymicrobial character was found in 51% of cases. These isolated germs were multiresistant. During this study, there was a very significant morbidity of pneumonia by extending the duration of hospitalization in intensive care and the duration of ventilation. A very high risk of mortality has also been noted in patients infected in case of infection by non-fermenting germs.