[Surveillance of multidrug resistant bacteria in a Tunisian hospital].
BACKGROUND
Controlling antibiotic resistance of bacteria is a priority for public healthcare.


OBJECTIVE
This study concerned the frequency of multidrug resistant bacteria (MDRB) in a Tunisian Hospital with the aim of establishing guidelines for MDRB prevention.


METHODS
The study was conducted during two years (1 January 2005-31 December 2006). Samples collected for the clinical diagnostic were included. The MDRB concerned were: methicillin resistant Staphylococcus aureus(MRSA), Enterobacteriacae resistant to of third generation cephalosporin (ER3GC), Acinetobacter baumannii resistant to both imipenem and ceftazidime, Pseudomonas aeruginosa resistant to both imipenem and ceftazidime.


RESULTS
During the study period, 2475 bacteria were tested by disk diffusion. 597 MDRB were collected, the rate of MBR was 24.1%. These MDRB were mainly recovered in burn unit (82.6%). ER3GC (47%) and MRSA (29,2%) were the most frequent MDRB. A. baumannii and P. aeruginosa multiresistant concerned 14,8% and 9% of MDRB. MDRB were isolated mainly from blood cultures (45%). The rate of MRSA was 46.4% among 375 strains of S. aureus. ER3GC represented 25,6% among 1096 isolates. Concerning A. baumannii and P. aeruginosa, 51.7% and 20.5% were resistant to both imipenem and ceftazidime among 170 and 264 isolates. Antibiotic resistance evolution showed a decrease of resistance in 2006 versus 2005. This decrease should be explained by the improvement of hygiene measure especially hand washing with the introduction of hydro- alcoholic solutions, a better targeted antibiotherapy promoted by a close cooperation between microbiologists and clinicians.


CONCLUSIONS
The MDRB were frequent in our hospital. They were mainly isolated from the burn department. The measures of prevention already implemented are effective and must be strengthened with the continuous surveillance of MDRB.
Thabet
Lamia
L
Laboratoire de résistance aux antibiotiques, Faculté de Médecine de Tunis.
Messadi
Amen allah
Aa
Mbarek
Mondher
M
Turki
Amel
A
Meddeb
Balkis
B
Ben Redjeb
Saida
S
D040981:Acinetobacter baumannii / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D002056:Burns / Q000382:microbiology*; D002442:Ceftazidime / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D004755:Enterobacteriaceae / Q000187:drug effects; D006786:Hospitals, Urban; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D017410:Practice Guidelines as Topic; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D013211:Staphylococcus aureus / Q000187:drug effects; D014416:Tunisia / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015378:Imipenem; D002442:Ceftazidime