[Acquired bacteraemias at the intensive care unit]

Acquired bacteraemias in intensive care unit (ICU) have some serious consequences in terms of morbidity, mortality and costs. The emergence of multiresistant germs in ICUs, and the therapeutic difficulties that ensue, participate in the aggravation of the prognosis of these infections. The aim of this work was to study the epidemiological aspects of acquired bacteraemias in ICU and the responsible germs sensitivity, to determine strategies of adequate antimicrobial treatment. During the period of study, 31 positive blood cultures collected from 19 patients were considered to be true bacteraemias, giving an incidence rate of 6.3 for 100 admissions. The mean age of our patients was 27.7 years old. There were 16 men and 3 women. Traumatology was the underlying pathology in 52.63% of cases. The origin of the infection was unknown in 84.2%. Flavobacterium spp was the most frequent germ (42%), followed by Pseudomonas aeruginosa (26.2%), and Staphylococcus negative coagulase (10.6%). Only one anaerobic germ was isolated. Flavobacterium spp and Pseudomonas aeruginosa were in general sensitive to most antibiotics used with the exception of aminosides. Staphylococci negative coagulase were methi - resistant. The sensitivity of the anaerobic germ was not tested. The antimicrobial treatment was adapted in 84.2% of cases; the association ciprofloxacine-cefotaxime could be a good alternative in serious infections to Gram negative bacteria. The global death rate among our patients was 42%. The death was directly related to bactereamia in only 15.3% of cases. The existing committee for nosocomial infections control should be more effective in our hospital. The role of this committee is to carry out microbiological surveillance, to recommand and make sure of the application of preventive measures against nosocomial infections, to promote the accessibility of antibiotics such as imipeneme, aztreonam, ceftazidime, vancomycine...., and to propose an appropriate antimicrobial treatment strategy; these measures could reduce notably the morbidity and mortality related to nosocomial infections in general and bactereamias in particular.