title: [Comparative study of antibiotic resistance in bacteria isolated from burned patients during two periods (2005-2008, 2008-2011) and in two hospitals (Hospital Aziza Othmana, Trauma and Burn Center)].
abstract: BACKGROUND
  Continuous monitoring of the bacterial flora and antibiotic resistance of the main bacteria involved in nosocomial infections helps improve treatment and prevention strategies.
  
  
  OBJECTIVE
  To compare the bacteriological profile and antibiotic susceptibility of the main bacterial isolates within the burned patients over two periods of 3 years and in two hospitals.
  
  
  METHODS
  During two three-year periods: period 1 (P1): 1/7/2005-30/6/2008 and period 2 (P2): 1/7/2008-30/6/2011) and in two hospitals: Hospital Aziza Othmana (HAO) and the traumatology and burn center (CTGB), 2153 and 3719 non-repetitive strains were isolated from burn patients from different samples. The transfer of the intensive care unit was made on 01/07/2008 from the Hospital Aziza Othmana to CTGB. The study of antibiotic sensitivity was performed according to CA-SFM.
  
  
  RESULTS
  During the period P1, Pseudomonas aeruginosa was the main bacteria isolated (18%) followed by Staphylococcus aureus (14%) and Acinetobacter baumannii (12%). After the transfer of intensive care burn unit to the traumatology center, ecology bacterial varied with S. aureus (20%) in the first place followed by P. aeruginosa (15%) and Proteus mirabilis (11%). The study of the evolution of antibiotic susceptibility showed an overall downward trend of resistance in the second half of 2008, immediately after the transfer of service in the new hospital structure. The rate of ceftazidim resistant Klebsilella pneumoniae decreased from 80.4% to 50%, Similarly the resistance of P. aeruginosa to ceftazidime and imipenem decreased respectively from 61% to 39.4% and from 63.3% to 37.1%. Nevertheless, the reduction of resistance was followed by a rapid increasing during the year 2009 to reach overall rates of resistance previously observed in the hospital Aziza Othmana. Concerning S. aureus, the rate of MRSA (methicillin-resistant S. aureus) showed no significant variation throughout the study period: 60% versus 56.3% at HAO and CTGB. A. baumannii brings up the problem of mutirésistance: 92.7% of strains were resistant to ceftazidime and 63.9% to imipenem during P1 with an emphasis on resistance to imipenem during P2 increased to 89.3%.
  
  
  CONCLUSIONS
  Resistance is a problem in the intensive care burn unit. Preventive measures have to be taken.
authors.affiliation: Universite Tunis, El Manar, Tunisie.
authors.forename: Lamia
authors.initials: L
authors.lastname: Thabet
authors.forename: Ayoub
authors.initials: A
authors.lastname: Zoghlami
authors.forename: Jalel
authors.initials: J
authors.lastname: Boukadida
authors.forename: Abdelraouef
authors.initials: A
authors.lastname: Ghanem
authors.forename: Amen Allah
authors.initials: AA
authors.lastname: Messadi
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D002053:Burn Units; D024881:Drug Resistance, Bacterial; D006801:Humans; D014416:Tunisia