DOI: 10.36347/sjams.2022.v10i01.011

Pages: 72-78

Nosocomial pneumonia (NP) is the second most common cause of nosocomial infection in the intensive care unit (ICU). They pose significant diagnostic, therapeutic and economic problems and increase the risk of death by increasing the length of stay in the ICU. The emergence of resistance to last-resort antibiotics in therapy defines multi-resistant bacteria (MRB). Our work is a retrospective descriptive and analytical study spread over one year (from 1 to 30 December 2019) which focused on patients admitted to the intensive care unit of Ibn Tofail Hospital in Marrakech and who presented with a nosocomial MRB pneumopathy. BMRs were isolated in 38% of cases. Imipenem-resistant Acinetobacter baumanii (IRBA) was the most isolated multi-resistant pathogen. The high level of co-resistance to other antibiotic families leaves little room for treatment. The risk factors found to play a role in the acquisition of BMR NPs were: age between 36 and 45 years, length of hospital stay between 10 and 20 days, presence of co-morbidity, radiological picture suggestive of NPs and broad spectrum antibiotic therapy. Measures to prevent NP are increasingly being adopted as an indicator of quality of care in intensive care units worldwide. Thus, reducing the incidence of NP and MRB should be a goal for all hospitals. In our context, measures to control MRBs must be reinforced by hygiene measures and precautions, in particular the identification of infected or colonised patients, the technical and geographical isolation of patients carrying MRBs and the use of appropriate treatment. Thus, regular epidemiological surveillance is necessary to guide management and define an adequate prevention strategy adapted to the context.