DOI: 10.36347/sjams.2022.v10i01.010

Pages: 63-71

Nosocomial pneumonia is the second most common cause of nosocomial infection in the intensive care unit. They pose serious diagnostic, therapeutic and economic problems and increase the risk of death by increasing the length of stay in the ICU. Our work is a retrospective descriptive study of all patients hospitalized in the ICU who presented with ventilator-associated pneumonia (VAP) over a period of one year in the intensive care unit of Ibn Tofail Hospital in Marrakech. In our study, gram-negative bacilli were the most frequently isolated germs, with Acinetobacter baumannii predominating. Gram-positive cocci came in second place, represented by Staphylococcus aureus. In 69% of cases, the infection was polymicrobial. The resistance rate of the isolated strains was high; 95.7% of Acinetobacter baumannii were resistant to imipenem. Isolated strains of Enterobacteriaceae were resistant to the combination of amoxicillin and clavulanic acid in 53.3% of cases, to C3G in 30.7% of cases, to imipenem in 2.7% of cases, to amikacin in 1.4% of cases and to cotrimoxazole in 41.7% of cases. Staphylococcus aureus resistance was 4% to penicillin M and decreased compared to other antibiotics. The emergence of resistance to antibiotics of last resort in therapy defines multi-resistant bacteria. These were isolated in 38% of cases. Acinetobacter baumannii was the most isolated multidrug-resistant pathogen. In the light of this study, it appears that good management of antibiotic prescriptions, strict application of hygiene and asepsis measures as well as resistance monitoring within each ICU are necessary for the reduction of nosocomial pneumopathies with multi-resistant germs.