Military Hospital Of Marrakech Research Articles

Monoclonal gammapathies: Epidemiological, immunochemical and etiological analysis of a series of 50 cases

During the period from September 2022 to January 2023, 50 cases of monoclonal gammopathy (GM) were collected at the Avicenne military hospital in Marrakech. The average age of the patients was 62 years. Thirty patients were male and 20 were female. The etiological diagnosis could be established for the 50 observations: 5 were classified as GM of undetermined significance (GMSI), 42 were classified as myeloma, two case of Waldenström's disease and one case of AL amyloidosis. The clinical symptomatology was dominated by bone pain in 78% of patients with a deterioration in general condition in 43%. The most frequently found biological abnormalities were anemia in 62% of patients, renal failure in 48% of patients and 19% had hypercalcemia. A monoclonal peak was found in the electrophoreses of 45 patients (90%), of whom 6 migrated to the beta zone and 39 migrated to the gamma zone. The IgG Kappa isotype was the most frequent with a rate of 56%, followed by IgG Lambda (27%), IgA Kappa (8%), IgA Lambda (3%), IgM Lambda (3%) and lambda free light chains (3%).

Acinetobacter baumannii: Epidemiological profile and antibiotic resistance in patients from the intensive care unit of Avicenne military hospital in Marrakech

Acinetobacter baumannii: Epidemiological profile and antibiotic resistance in patients from the intensive care unit of Avicenne military hospital in Marrakech

Epidemiological, clinical and biological profile of COVID-19 in patients hospitalized at the Avicenne Military Hospital in Marrakech

In late December 2019, a series of cases of viral pneumonia caused by a novel coronavirus emerged in Wuhan, China, and quickly spread to all continents. This coronavirus, identified in respiratory tract samples, was named SARS-CoV-2 for Severe Acute Respiratory Syndrome Coronavirus-2 by the ICTV (International Committee on Taxonomy of Viruses). The disease it causes was designated COVID-19 for Coronavirus Disease 2019 by the Word Health Organization. Most often, SARS-CoV-2 infection is responsible for a mild or moderate form, with the most typical clinical presentation being that of a febrile respiratory infection with dry cough, dyspnea, fatigue, and myalgia. Approximately 10-15% of cases are severe, and 5% are critical. Cases of reinfection have been described. Treatment for COVID-19 is currently symptomatic, relying on supportive care. The present study aims to investigate the demographic, clinical, and diagnostic aspects, as well as the study of risk factors associated with SARS-CoV-2 infection among 318 patients admitted to the Avicenne Military Hospital in Marrakech during the first wave of the pandemic. This is a retrospective descriptive and analytical study involving 318 cases of SARS-CoV-2 infection, diagnosed at the microbiology-virology department, and followed up in various non-intensive care units of the Avicenna Military Hospital in Marrakech, during the period of the first wave of the epidemic in Morocco, schematically between March 22, 2020, and July 19, 2020. For patients who developed pneumonia, 20% were diabetic and 13.3% were hypertensive. A quarter of patients with pneumonia experienced desaturation upon admission. In the multivariate logistic regression model, risk factors associated with the development of pneumonia and the various disease outcomes included advanced age and absence of a history of contact with a confirmed case. In the univariate analysis, hyperleukocytosis, neutrophilia, lymphopenia, eosinopenia, anaemia, hyperferritinaemia with elevated aspartate aminotransferase, hyponatraemia and fasting hyperglycaemia were significantly associated with a higher risk of an unfavourable outcome. Patients who presented with pneumonia on admission had an unfavourable outcome during their hospitalisation compared with patients who did not develop pneumonia. The statistically significant risk factors associated with an unfavourable outcome were advanced age (>60 years) with p <0. 001: OR=1.194; 95%IC= [1.114-1.278], absence of contact with a confirmed case (p <0.001 : OR= 43.138; 95%IC= [8.893-209.263]), presence of comorbidity (P<0.001 : OR=11. 503; 95%CI= [3,306-40,028]), mainly diabetes (P<0.001: OR=16,971; 95%CI= [4,267-67,504]) and arterial hypertension (P<0.001: OR=18,812; 95%CI= [3,977-88,954]). The study of the epidemiological, clinical and biological characteristics of COVID 19 at the Avicenne military hospital in Marrakech has enabled us to gain a better understanding of the profile of our patients with SARS-CoV-2 infection, and then to detect shortcomings in terms of prophylaxis, diagnosis and management, in order to be able to provide the necessary solutions aimed at further improving the quality of care for this population.

Adult niemann-pick disease: A case report

Adult niemann-pick disease: A case report

Epidemiological aspects and resistance profile of bacteremia in the region of Marrakech

Introduction: bacteremia in hospitals is a major public health problem that can lead to mortality and morbidity. The aim of our study is to establish the bacteriological profile of bacteremia and the state of antibiotic resistance in order to optimize probabilistic antibiotherapy at the Avicenna military hospital in Marrakech. Materials and methods: This is a descriptive retrospective study spanning a period of 5 years (January 2019 - December 2023), conducted in the laboratory of bacteriology-virology and molecular biology of the Avicenna Military Hospital in Marrakech, on the all bacteria isolated from blood cultures in hospitalized patients. Results: During this period, we collected 839 blood cultures, 140 of which resulted to isolate a bacterium. The predominant causative organism was Staphylococcus aureus (27%), The resistance profile of the strains was as follows: 3.57% for methicillin for Staphylococcus aureus and 50% for staphylococcus coagulase negative. Regarding Enterobacteria; 30.28% were producing ESBL, ciprofloxacin resistance was involved in 41.8% of Enterobacteria while all strains were sensitive to kanamicin. The resistance of Acinetobacter baumanii was 100% to ciprofloxacin, and 91% to ticarcillin, ceftazidime, imipenem and amikacin while remaining 100% sensitive to colistin. Conclusion: surveillance of bacteria’s epidemiological characteristics and their antibiotic susceptibility profile should be continuous for appropriate adaptation of initial empirical treatment of bacteraemia.

PERIPHERAL FACIAL PARALYSIS: BENEFIT OF EARLY TREATMENT, A RETROSPECTIVE STUDY ABOUT 47 CASES

Introduction: Peripheral facial paralysis is a relatively common pathology which concerns both the general practitioner and the ENT specialist, the ophthalmologist, the neurologist and the pediatrician. The difficulty in therapeutic management lies in the lack of randomized and controlled studies. The functional and aesthetic after-effects can be the source of psychological suffering. Material and method: This is a retrospective study, carried out within the ENT and CCF department of the Avicenne Military Hospital in Marrakech over a period of 5 years from January 2016 to December 2020. Data collection was carried out from the medical records of 47 patients hospitalized in the department during the study period. The texts were entered using the MICROSOFT OFFICE WORD2007 software and the graphics were entered using the MICROSOFT OFFICE EXCEL 2007 software. Results: The age of our patients varied between 10 to 69 years, with a clear predominance of the age group of 45-60 years and an average age of 42 years, the majority of these patients, i.e. 87% were male. The monthly distribution showed a greater frequency in Winter. As for the antecedents, diabetes is the most common (34% of cases) followed by recurrence of PFP in 17% of cases. Regarding the severity diagnosis, the majority of our patients had stage IV (45% of our PFP). Although the etiologies are multiple, in our study, refrigerated PFs dethroned them with more than 68% of cases, followed by herpetic PFs which were recorded in 11% of cases. As for the pick-up time, it is 55.3% in the first three days, and fortunately so. The bases of therapy were corticosteroid therapy and facial physiotherapy. Regarding the evolution of our patients, 35 cases had a complete recovery, 9 patients had an incomplete recovery including 3 with synkinesias and spasms and 3 cases did not recover. Our results showed that this same good development is correlated with the precocity of treatment. Conclusion: PFPs are certainly often benign, they always require rapid and appropriate treatment. This pathology unfortunately causes functional, aesthetic and undoubtedly psychological after-effects requiring continuous long-term monitoring.

Study of the Quality of Life of Diabetic Patients Treated at the HMA

Introduction: Maintaining or improving quality of life is a major issue in health care, particularly in the context of chronic diseases such as diabetes. The SF-12 is a generic quality of life questionnaire applicable to patients with diabetes. The aim of this study is to assess the quality of life of diabetic patients using a generic SF-12 questionnaire and to detect factors related to this concept. Materials and methods: This is a descriptive, cross-sectional and analytical observational study that involved 130 diabetic patients followed up in the Endocrinology, Diabetology and Metabolic Diseases Department at the Avicenne Military Hospital in Marrakech. Results: The average age of our population was 50.5 years, with extremes ranging from 7 to 80 years. Females were predominant (52%). The average age of diabetes was 9.55 years (extremes ranging from 15 days to 35 years). The majority of cases (63%) had a history of ketoacidosis and (43%) had a history of hypoglycemia. The results showed that diabetes negatively affects the quality of life of diabetic patients and that the factors associated with their quality of life are multiple : factors related to socio-demographic characteristics (age and sex), socio-economic characteristics (profession, socio-economic level), co-morbidities (hypertension, dyslipidemia, obesity, sedentary lifestyle), and factors related to the disease itself and its acute (hypoglycemia, ketoacidosis) and chronic complications (occlusive arterial disease of the lower limbs (PAOD), myocardial infarction (MI)). Discussion: In order to improve the quality of life of diabetic patients, it is necessary to improve their level of education, to ensure a global management of the diabetic person, of the complications related to diabetes and to implement education strategies and programs as well as community interventions.

Cutaneous Candidiasis at the Avicenne Military Hospital in Marrakech: A Five-Year Assessment

Background: Candidiasis is a disease caused by yeasts of the genus Candida. They can be mucocutaneous or deep. The objective of this work is to describe the epidemiology of cutaneous candidiasis. Patients and Method: This retrospective study covers five years (01/2017 to 12/2021). It includes all superficial and deep samples sent to or taken from the mycology-parasitology laboratory of the Avicenne military hospital in Marrakech. Results: In our series, Candida onychomycosis was most common in women. The age group most affected by Candida onychomycosis was between 45 and 60. The majority of patients were outpatients. Onychomycoses were mainly found on the fingers. For epidermomycosis, the sex ratio was 1. No cases were affected by epidermomycosis in the 16 to 30 age group. Most patients with epidermomycosis were outpatients. Involvement of hairless skin accounted for 41.66% of all epidermomycosis diagnosed. For Candida otitis externa, the average age was 44.18 years. The sex ratio M/F was 0.75. Eleven patients were outpatients. The most frequently isolated species was Candida albicans. Conclusion: Candidiasis is an opportunistic infection favored by several factors. The Candida albicans species remains the most common cause of candidiasis, although non-albicans species are increasingly present with the emergence of new strains.

Clinical and Etiological Profiles of Pericardial Effusions in the Military Hospital of Marrakech

Objective: To provide a description of the clinical, etiological, and therapeutic aspects of pericardial effusions in Marrakech. Material and methods: This is a retrospective and cross-sectional study conducted in the cardiology department of the Avicenna military hospital from January 2014 to August 2018 of patients hospitalized for pericardial effusion, confirmed by echocardiography-doppler. Results: The study included 52 patients. The mean age was 43.6 ± 4.2 years (ranging from 24 to 81 years) with a sex ratio of 1.4. Exertional dyspnea and chest pain were the main symptoms. Sinus tachycardia was the main electrocardiographic sign. Pericardial effusion was moderate in 24 patients (46.15%). Pericardiocentesis was required in 8 cases (15.4%). The etiologies of the effusion were: idiopathic/viral (77%), tuberculosis (15.4%), neoplastic (3.8%), lupus and rheumatism (3.8%). Conclusion: Pericardial effusions mainly concern young subjects, their diagnosis is based on echocardiography, the treatment is according to the cause, tuberculosis is epidemic in our context but its frequency is decreasing in favor of more inflammatory/viral causes.

Evaluation of the immuno-hematological qualification of the blood donation at the Avicenne military hospital in Marrakech

Blood transfusion is a therapeutic act that consists of administering blood, or one of its cellular or plasma components, from one or more healthy subjects called "donors" to a sick subject called "recipient. Transfusion safety is ensured by controlling all stages of the transfusion chain, from the collection of blood, its preparation and biological qualification, to the performance of the transfusion act and even the follow-up of the recipients. The basis of immunohematological safety is the compatibility between the erythrocyte characteristics of the donor and those of the recipient. Donation Biological Qualification (DQ) laboratories have a duty and an obligation to ensure maximum reliability and sensitivity of results. They must therefore put in place the human, technical, material, computer and organizational resources, method validation, traceability of operations and risk analysis of all stages of the analysis process, to guarantee reliable results obtained in a timeframe compatible with the optimal use of the blood products. Thus, the work methodology within the immunohematology laboratory must be structured in procedures and operating modes in order to respect the standards of the reference system and to reduce the causes of errors to a minimum. Our work focused on the evaluation of the immunohematological qualification of blood donations within the blood transfusion center (CTS) at the Avicenne military hospital (HMA) in Marrakech, including the state of the premises, personnel and techniques used in the QBD service with the following goals · Review the level of qualification within the CTS of HMA. · To highlight the techniques of immunohematological qualification of blood donation per-formed at the CTS at the Avicenne Military Hospital in Marrakech compared to what is done nationally and internationally. · To draw the phenotypic profile of ABO, RHD and Kell blood groups in a representative population of donors from the city of Marrakech and regions, recruited over a period of 5 years. · The study of the prevalence of phenotypic markers, blood donations collected in the blood transfusion center of the HMA in Marrakech between the years 2016-2017-2017-2018-2019-2020, led to the following results: · For the ABO system, group O is the most frequent (50.47%), followed by group A (30.14%), then group B (15.45%) and lastly group AB (3.93%). · The standard Rhesus system (D); the Rh positive phenotype (D+) predominates largely (89.21%) while the Rh negative (D-) is about 10.79%. · Of the 7713 donations studied, only 3130 were used to study the prevalence of Rh phenotypes. For the remaining 4583 donations, phenotyping was not performed because of a stockout of gel cards. The Ccee phenotype is the most frequent (40.31%). · For the Kell system, the prevalence of K anti-gen was 8.17%. · For the IAT: no IAT was positive in the donors. · In our series, there was no return of the incident report form (IRF) and no traceability of the number of adverse transfusion reactions (ADR). This study allowed us to highlight several shortcomings concerning · The lack of trained personnel · Insufficient techniques in terms of precision, sensitivity and specificity · The lack of high level technical automatons · Occasional reagent stockouts due to supply delays. However, the transfusion system of the Avicenne Military Hospital of Marrakech (HMA) is still lacking in new techniques that have proven their worth in the development of this field; namely · HLA histocompatibility typing. · The research of antiplatelet antibodies: HPA; · Molecular biology: by gene amplification (PCR) from genomic DNA, in particular when hemagglutination shows its limits in the con-text of transfusion medicine. In the light of this work, a list of recommendations has been proposed in order to overcome these dysfunctions and to ensure a better immunohematological safety, in front of the various situations envisaged during the daily practice by reinforcing the operational and technical capacities of the blood transfusion service. Furthermore, the improvement of automation and computerization will reduce the risk of human error, by automatically handling certain phases of the process. However, whatever the degree of automation safety, its quality is strictly linked to the pre-analytical phase of sample collection, sample acceptability and collection information entry, for which particular attention should be paid.

A study on vaginal infections among reproductive-aged women in the region of Marrakech, Morocco

Purpose: The principal aim of this study was to establish the microbial epidemiology of vaginal infections and to study the susceptibility of strains isolated to antibiotics. The secondary aim was to orient probabilistic antibiotic therapy. Methods: This is a retrospective descriptive study, covering a period of 9 years, from 2013 to 2022, conducted in the Bacteriology Department of the Avicenne Military Hospital in Marrakech. Results: The number of vaginal swabs taken in our study over a period of 9 years (2013-2022) was 693, of which 131 cases of vaginal infections were diagnosed, i.e. 19%. On fresh examination the presence of Trichomonas vaginalis was observed in 15 samples or 2.1%. Direct examination after Gram staining showed the presence in 33.4% of cases of clue cells suggestive of Gardnerella vaginalis; Gram-positive Coccis were present in 22.1%, yeasts in 17%, and Gram-negative bacilli in 5%. The distribution by species showed the predominance of clues cells evoking Gardnerella vaginalis which represented 35% of the isolates, followed by Streptococcus agalactiae at 28%, Candida albicans at 10%, and Escherichia coli and Proteus mirabilis by 5%. Conclusion: Our study showed the great microbial diversity of female genital infections with a predominance of bacterial vaginosis due mainly to Gardnerella vaginalis but also an important frequency of bacterial vaginitis represented essentially by Streptococcus agalactiae, Escherichia coli and Klebsiella pneumoniae.

Role of procalcitonin in predicting occurrence of bacteraemia: About 109 cases

The aim of this study was to evaluate procalcitonin (PCT) levels in the predicting of bloodstream infections in a large population of patients with positive blood cultures (BC) in the unit care of Avicenna military hospital of Marrakech. Material and Methods: This prospective study was carried out using clinical and routine laboratory data collected at the Clinical Microbiology and biochemistry from laboratory of Avicenna military hospital – Marrakech, Morocco, between January 2019 and December 2021. Results: 109 cases were collected from laboratory data of Avicenna military hospital in Marrakech. Most of patient were male with 79 cases (72.5%), blood cultures were positive in all cases. Procalcitonin were positive in the majority of patients with a 105 cases (96%). Klebsiella sp. was the most frequent germ in gram negative bacilli with a rate of 25 cases (23%) Coagulase-negative Staphylococcus was the most frequent germ in gram-positive cocci with a rate of 23 cases (21%).

INTUSSUSCEPTIONS IN ADULTS (ABOUT 06 CASES)

Background : Intussusception in adults is a rare condition that is difcult to diagnose due to its clinical polymorphism. Its diagnosis has become easier thanks to advances in medical imaging. The treatment of intussusceptions in adults is surgical because of the high incidence of causative organic lesions. Our work is a prospective study which aims to determine theObjective : clinical and etiological peculiarities of acute intussusceptions in adults, to specify the diagnostic and therapeutic difculties and to draw practical conclusions regarding the optimal therapeutic management of this rare condition. Our work is a retrospective study,Materials and methods: covering a series of 06 cases of acute intussusception operated on in the visceral surgery department of the Avicenne Military Hospital in Marrakech, over a period of 6 years, from January 2014 to May 2020. Data relating to clinical features, diagnosis, treatment and histological reports were collected and analyzed. Six cases of acute intussusceptions in adults were collected over a period of six years, amountingResults: one case per year. The average age was 52 with a female predominance of 66%. Four out of 6 patients had been seen urgently. The diagnosis was made preoperatively in all cases, ie 100% by using ultrasonography and CT. The ultrasound showed a "target" image in one case and a "pseudo- kidney" image in another. CT made it possible to make the diagnosis in all cases, and objectied an etiological diagnosis in 4 patients, ie 66.6% of cases. The pure enteric form was the most frequent (3 out of 6 cases), ie 50% of cases. There was one case of intestinal necrosis. Bowel resection was performed in 6 cases, or 100%. The cause of intussusception was found in all patients, including a benign tumor cause in 66.6% of cases. The immediate postoperative follow-up was straightforward in all patients We can conclude that the acute intussusception in adults is aConclusion: rare entity that should be considered in any patient with subacute abdominal pain. And we propose that oncological resection should be carried out in all cases of intestinal intussusception without attempting reduction regardless the site of the invagination, In view of the high rate of malignancy.

Pulmonary bacterial superinfections in covid-19 patients hospitalized for severe acute respiratory syndrome (SARS) in the intensive care unit

The objective of this study is to describe the bacteriological and biochemical profile of bacterial pulmonary superinfections in COVID 19 patients hospitalized in the ICU (Intensive Care Unit) of the Avicenna military hospital of Marrakech. A descriptive retrospective was study was conducted, including all covid 19 patients admitted to the intensive care unit for respiratory distress syndrome. 338 samples were tested of which 118 came back positive. Of the 118 samples, 82 (69.5%) were BAL and 36 (30.5%) sputum. None of the PDPs, bronchial aspirates, and pleural punctures came back positive. The most frequently found germs are: Acinetobacter baumanii at 28.8%, followed by K. pneumoniae at 18.6%, Pseudomonas aeruginosa, and Staphylococcus aureus (14,4% each). Multi-drug resistant bacteria were found in 62 samples (52%). The most frequent MDR-bacteria were: Acinetobacter baumanii resistant to imipenem (29/118) 24.8%. The CRP (C-reactive protein) achieved in all our patients was high in 100% of cases. Values ​​ranged from 30 to 564 mg/L with an average of 195.13 mg/L. Meanwhile, Procalcitonin performed in 55 of our patients (72% of cases) was positive in 45 patients (82% of cases). Values ​​ranged from 0.1 to 60 ug/L with an average of 11.19 ug/L.

IMPACT OF COVID-19 PANDEMIC ON INTESTINAL PARASITIC INFECTIONS: EXPERIENCE OF PARASITOLOGY AND MYCOLOGY LABORATORY OF AVICENNA MILITARY HOSPITAL IN MARRAKECH

Intestinal parasitic infections (IPIs) are a worldwide public health threat that remains frequent, especially in countries where hygienic conditions are precarious. The Covid-19 pandemic that the world is experiencing since March 2020 was associated with the establishment of a set of hygienic measures. The aim of this study is to highlight a possible impact of those measures on the prevalence of IPIs by evaluating the results of stool specimens examinations for patients of the Avicenna military hospital in Marrakech for a period extended from 2017 to 2022. The overall prevalence of IPIs was found to be 32%. The prevalence of protozoa infections was much higher than the prevalence of helminthic infections (95% vs. 5%). Amongst the protozoa, blastocystis hominis (BH) was the most common parasite. Our study showed a fall in the overall prevalence of IPIs starting from 2020 and a consequent drop in the prevalence of the most incriminated protozoa in parasitic diarrheas: entamoeba histolytica histolytica and giardia intestinalis. Those findings show the effectiveness of the hygiene measures, implemented during covid-19 pandemic, on the carriage of these parasites. The replacement of Entamoeba histolytica histolytica by blastocystis hominis in terms of pathogenicity could be explained by the reactivation of the carriage of BH due to the imbalance of the intestinal flora caused by the use of alcohol and bleach for sanitization. Therefore the present study highlights the positive impact of hygienic measures, carried out during covid-19 pandemic, on the prevalence of IPIs and leads us to emphasize the need to pursue those measures even outside the pandemic.

Bacteriological profile of purulent otitis media at the Avicenna Military Hospital in Marrakech

Bacteriological profile of purulent otitis media at the Avicenna Military Hospital in Marrakech

Bacteriological profile of purulent otitis media at the Avicenna Military Hospital in Marrakech

Chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage from the middle ear. It is an avoidable cause of hearing loss, especially in developing countries. We conducted a prospective study over 8 years (1 January 2014 - 1 January 2022), Including 250 patients consulting the Oto-Rhino-Laryngology Department of the Avicenna Military Hospital in Marrakesh, in collaboration with the Laboratory of Microbiology. It included all non-redundant bacterial species isolated from pus of purulent chronic ear infections sent to the microbiology laboratory. The cytobacteriological analysis was carried out according to the conventional techniques and / or automated method of BD PhoenixTM. The antibiotic sensitivity study was carried using the diffusion method in agar medium according to the recommendations of the CA-SFM. There were 147 men and 103 women with a sex ratio of 1.4. The mean age of the patients was 34 years (8 to 82 years). The second and fourth decades represent the most affected age groups. The bacteriological profile was dominated by Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (32%) and Proteus mirabilis (13%). These different isolates represented low antibiotic resistance levels but all remained sensitive to fluoroquinolones. Five strains of enterobacteria produced derepressed cephalosporinase, and nine strains of Enterobacteria carrying extended spectrum Beta lactamase enzymes. No strain of Pseudomonas resistant to ceftazidime was isolated. Gram positive cocci accounted for 38% of the strains. In view of the bacteriological and the sensitivity profiles of the species found in chronic otitis, antibiotics based on fluoroquinolones are recommended.

THYME HONEY VIRTUES ON BURN WOUNDS HEALING IN YOUNG CHILDREN: A RETROSPECTIVE PRELIMINARY STUDY AND LITERATURE REVIEW

Clinicians have been searching for ways to obtain proper wound healing with an accessible cost. Honey is an ancient traditional remedy for the treatment of infected wounds. We evaluated burn wound healing and antibacterial properties of locally produced Thyme honey on different types of burns in young children (<2 Years Old).This experimental study was conducted over a period of 2 years, in the Department of Plastic Surgery and Burns at the Avicenna Military Hospital of Marrakech on young children. This series includes 20 hospitalized children with ages between 6 months and 2 years, suffering different burn types and areas. All the patients received topical thyme honey based protocol.The average length of hospitalization was 12 days with an average time for burn wound coverage of 2 weeks. All of our patients resulted a flat healing without hard bulges or disfiguring complications. We concluded that using of thyme honey dressings on burns wounds results a comparable healing time to modern dressings with proper healing and a cheaper cost.

Bacteriological Profile of Urinary Tract Infections at the Avicenne Military Hospital in Marrakech

Urinary tract infection is the attack of a tissue of the urinary tract by one or more micro-organisms. It is a major public health problem. The objective of this work is to propose, based on updated data, the microbial ecology of urinary tract infection at the Avicenne Military Hospital in Marrakech, and to follow the antibiotic sensitivity profile of uropathogenic bacteria. This is a retrospective descriptive study over 4 years from January 2014 to December 2018, which was conducted on urinary cytobacteriological examinations from hospitalized patients and outpatients, treated at the microbiology laboratory of the Military Hospital Avicenne of Marrakech. Of the 17607 ECBUs that were examined, the diagnosis of urinary tract infection was retained in 2349 (13%). 75% of the ECBUs came from hospitalized patients and 25% from outpatients, with a sex ratio of 1.1. The analysis of the ECBU showed that Enterobacteriaceae constituted 80% of the positive urine isolates, with a predominance of Escherichia coli (62%), followed by Klebsiella pneumoniae (13%). The reading and interpretation of the antibiograms showed that Escherichia coli was resistant to aminopenicillin associated with clavulanic acid in 51% of the cases against 55% for Klebsiella pneumoniae. The resistance of enterobacteriaceae to fluoroquinolones is about 33% for Escherichia coli, 30% for Klebsiella spp, while for the Trimmethoprim+Sulfamethoxazole combination more than half of the strains were resistant. On the other hand, aminoglycosides still have a good activity profile on enterobacteriaceae. The prevalence of BMR is 6.5%, represented by enterobacteriaceae producing extended spectrum betalactamases (ESBL) isolated in 89% of cases, with a predominance of Escherichia coli (52%) followed by klebsiella pneumoniae (22%) and Enterobacter cloacae (16%). Then the ceftazidime-resistant Pseudomonas aeruginosa (PARC) occupies the 2nd place with 5%, and finally methicillin-resistant Staphylococcus aureus (MRSA) and imipenem-resistant Acinetobnacter baumanii (ABRI) which occupy the 3rd place with rates at 3%. These BMR constitute a worrying problem, hence the need for rigorous application of hygiene rules and rational prescription of antibiotics. The knowledge of bacteriological profiles and the use of targeted antibiotic susceptibility testing will allow a management adapted to each hospital context.

A Case Report of a <i>Microsporum gypseum</i> Tinea Capitis Diagnosed at the Laboratory of Parasitilogy-mycology of the Avicenne Military Hospital of Marrakech

Historically, tinea capitis has been a problem among the population in general and in Morocco in particular. It is still a significant reason for consultation in routine medical practice, particularly among the population living in poor hygienic conditions. It is an infection almost exclusively of preschool and school-age children, due to changes in sebaceous secretion and skin pH during puberty, affecting both sexes, with a female predominance. Inflammatory cases or Kerion are caused by zoophilic species such as <i>Trichophyton mentagrophytes, Trichophyton verrucosum, Microsporum canis</i>, and less frequently by <i>Microsporum gypseum</i>. The identification of the species makes it possible to pinpoint the source of contamination and to condition the prophylaxis. Aware of the rarity of inflammatory tinea capitis caused by M. gypseum, we thought it would be interesting to report a new case diagnosed in the Parasitology-Mycology laboratory of the Avicenne Military Hospital in Marrakech, while focusing on the epidemiological, clinical and mycological characteristics of this dermatophyte through a review of the literature.