感染症と治療ジャーナル

抽象的な

Prevalence and Factors Associated with Death in Healthcare-Associated Bacteremia in the Fann National University Hospital, Infectious and Tropical Diseases Department

Daye KA, Ndéye Maguette Fall, Aminata Massaly, Khady Sall, Ngoné Diaba Diop, Aboubacar Sidikh Badiane, Daouda Thioub, Khardiata Diallo, Ndèye Aissatou Lakhe, Viviane Marie Pierre Cisse, Assane Diouf, Louise Fortes, Moussa Seydi

Background: Healthcare-associated bacteremia is a real public health problem because of its high morbidity and mortality. The objectives of this study were to describe the characteristics of bacteremia and to identify death – associated factors.

Methods: This was a retrospective, descriptive and analytical study based on the records of patients hospitalized in the department of infectious and tropical diseases, whose diagnosis of healthcare-associated bacteremia was retained during the study period from January 1, 2016 to December 31, 2017.

Results: Fifty-two cases of healthcare-associated bacteremia were collected. The hospital prevalence was 2.6%. Male sex was predominant with a sex ratio=1.2. The average age was 42 ± 16 years. Twenty-two patients were HIV-infected. The majority of patients (32 cases) had been on antibiotics before their current hospitalization. Regarding the reasons for hospitalization, pulmonary signs dominated the series, followed by neurological and gastrointestinal signs with respectively 27, 26 and 18 cases. Invasive devices were dominated by peripheral venous catheters (100%) followed by urinary catheterization (87%). The main germs found were Staphylococci (26.6%), Enterobacter spp (23.5%), Klebsiella pneumonia (18.7%) and Escherichia coli (14.1%). Staphylococci were highly resistant to cefoxitin (88.2%) and methicillin (70%). There was a high level of resistance of gram-negative bacilli to 3^rd line cephalosporin. Case fatality was 35%. Acute renal failure (p=0.01) and male gender (p=0.05) were associated with the occurrence of death.

Conclusion: Healthcare-associated bacteremia is a real public health problem. Standard hygiene measures play an important role in the control of these infections.