Infections Du Site Opératoire À l’Hôpital National De Zinder, Niger: Aspects Épidémiologiques Et Bactériologiques

Autor: Harissou Adamou, Ibrahim Amadou Magagi, Mansour Adamou, Lawan Ousmane, Maazou Halidou, Moussa Taofik, Mahamadou Doutchi, Mahamane Lawali Yahaya, Abdoul Salam Ouedraogo, Karamba Sylla
Rok vydání: 2020
Předmět:
Zdroj: European Scientific Journal ESJ. 16
ISSN: 1857-7431
1857-7881
DOI: 10.19044/esj.2020.v16n6p576
Popis: Objectif : Rapporter les caracteristiques epidemiologiques et bacteriologiques des infections du site operatoire (ISO) dans les services de chirurgie de l'hopital national de Zinder, Niger. Patients et methodes : Il s’agissait d’une etude transversale qui s’est deroulee sur une periode de 5 mois (Mai a Aout 2016) aux services de chirurgie et de laboratoire de l’Hopital National de Zinder (HNZ) au Niger incluant tous les patients operes et ayant developpe une ISO. Resultats : Durant l’etude, 485 patients avaient ete operes et 38 cas d’ISO etaient enregistres soit une incidence de 7,83 %. L’âge median etait de 31,5 ans (8-78 ans). Le sexe masculin etait majoritaire avec un sexratio de 6,6 (33/5). Les urgences chirurgicales representaient 57,9% des cas (n=22). Selon la classification d’Alte Meier, 13 cas (34,2%) etaient consideres comme une chirurgie contaminee et 21 cas (55,3%) une chirurgie sale. Les ISO etaient superficielles dans 36,8% (n=14), profondes dans 42,1% (n=16). Sur les 38 prelevements analyses, 33 cultures etaient positives soit 86,8%. Les enterobacteries representaient 69,7% (n=23), les Cocci a Gram positif 24,2% (n=8). Escherichia coli etait l’espece predominante avec 45,5% (n=15), suivie de Staphylococcus aureus avec 18,2% (n=6). La majeure partie des cultures positives provenait du service de chirurgie viscerale 15 cas (45,5%) puis de l’urologie et de traumatologie-orthopedie avec respectivement 10 cas (30,3%) et 8 cas (24,2%). La quasi-totalite des enterobacteries etait resistante aux antibiotiques usuels (amoxicilline, amoxicilline-acide clavulanique) et plus de 84% etaient resistantes a la ceftriaxone. En general les bacilles Gram negatifs etaient sensibles a l’imipeneme (100%), la colistine (93,8%), l’aztreonam (68,7%) et le chloramphenicol (47,8%). Les cocci-Gram positifs etaient sensibles a la vancomycine, au chloramphenicol et a l’erythromycine dans respectivement 100% ; 62,5% et 57,1%. Conclusion : Les infections du site operatoires representent un probleme majeur. La frequence des ISO rend indispensable la mise en place d'une equipe multidisciplinaire pour la surveillance de celles-ci. Le fort taux de resistance aux antibiotiques usuels doit susciter des actions preventives et systematiser l’examen bacteriologique en cas de suppurations postoperatoires. Objective: To report the epidemiological and bacteriological characteristics of surgical site infections (SSI) in the surgical departments of Zinder National Hospital. Patients and methods: This was a cross-sectional study that took place over a period of 5 months (May to August 2016) at the Zinder National Hospital (HNZ) Surgical and Laboratory Services in Niger including all patients operated on and having developed an SSI. Results: During the study, 485 patients had been operated on and 38 cases of ISO were recorded with an incidence of 7.83%. The median age was 31.5 years (8-78 years). The male sex was in the majoritywith a sex ratio of 6.6 (33/5). Surgical emergencies accounted for 57.9% of cases (n = 22). According to Altemeier's classification, 13 cases (34.2%) were considered as contaminated surgery and 21 cases (55.3%) were dirty surgery. Surgical site infections were superficial in 36.8% (n = 14), deep in 42.1% (n = 16). Of the 38 samplings analyzed, 33 cultures were positive, i.e. 86.8%. The enterobacteria accounted for 69.7% (n = 23), Gram-positive Cocci 24.2% (n = 8). Escherichia coli was the predominant species with 45.5% (n = 15), followed by Staphylococcus aureus with 18.2% (n = 6). The majority of positive cultures came from the visceral surgery department 15 cases (45.5%) followed by urology and orthopedic trauma with respectively 10 cases (30.3%) and 8 cases (24.2%). Virtually all enterobacteria were resistant to the usual antibiotics (amoxicillin, amoxicillinclavulanic acid) and more than 84% were resistant to ceftriaxone. In general Gram-negative bacilli were sensitive to imipenem (100%), colistin (93.8%), aztreonam (68.7%) and chloramphenicol (47.8%). Gram-positive cocci were sensitive to vancomycin, chloramphenicol and erythromycin in 100%, respectively; 62.5% and 57.1%. Conclusion: Surgical site infections represent a major problem. The frequency of SSI makes it essential to set up a multidisciplinary team to monitor them. The high rate of resistance to the usual antibiotics must provoke preventive actions and systematize the bacteriological examination in case of postoperative suppuration.
Databáze: OpenAIRE
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