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ID: <

10670/1.j8bh24

>

·

DOI: <

10.26226/morressier.58f5b031d462b80296c9d2ab

>

Where these data come from
Nosocomial pneumonia with multiresistant germs and probabilistic antibiotic therapy in Medical Resuscitation: year 2013-2014

Abstract

Background and Goal of Study: Nosocomial pneumonia remains a major complication occurringin an intensive care setting, especially in artificially ventilated patients. Their incidence is constantlyincreasing, despite the regular appearance of new therapeutics. This is due to changes in patientcare and recruitment practices.It is a retrospective descriptive and analytical study carried out at the Medical Reanimation Serviceof the Ibn Rushd Hospital in Casablanca, spread over a period of 12 months, between January andDecember 2014.Materials and Methods: We analyzed all the bronchial samples taken in the Diagnosis ofnosocomial pneumonia.The statistical analysis was carried out using SPSS 22.0 and EXCEL 2011.Results and Discussion: An incidence of 37.9% The average age of patients in our series was43.30 years with extremes ranging from 16 to 83 years. 66.4% of the patients included in the serieswere male The most widely prescribed antibiotics for initial probabilistic antibiotic therapy were:Amikacin (53% of prescriptions), Imipenem (52% of prescriptions), Colimycin (49% of prescriptions)and Rifampicin (38% % Of prescriptions). Of the patients in our series, 75.7% received antibiotictherapy within 24 hours of admission and 24.3% after 24 hours. The average duration of treatment inour patients was 14.3 days. Our patients could not benefit from a therapeutic deescalation.Thefactors associated with mortality in intensive care were sought in univariate analysis. A value of p <0.05 was considered as the threshold of significance. Charlson scores, APACHE II scores, SAPS II,SOFA, duration of intubation, sedation, The late occurrence of pneumonia were factors correlatedwith excess mortality.Conclusion(s): Nosocomial pneumonia with multiresistant germs and probabilistic antibiotic therapyin Medical Resuscitation are a great dilemma for intensivists in the daily practice. Some data aremore correlated to mortality even if a probabilistic antibiotherapy managed earlier for nosocomialpneumonia as Charlson score, APACHEII, SAPS II, SOFA, duration of intubation and sedation andthe timing of occurence pneumonia.

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