Abstract:
Highly Resistant Bacteria Emerging to Antibiotics (HRBEA) are
commensal bacteria of the digestive tract and they resist to many antibiotics
with transferable mechanisms between bacteria. The HRBEA are the
Carbapenem-resistant Enterobacteriaceae (CRE) and Enterococcus
faecium Resistant to glycopeptids (ERG).
The control of the HRBEA's diffusion is a serious public
health issue, actually these resistances are spreading continuously all over
the world.
In our retrospective and prospective study, which starts from
January 1, 2018 to April 30, 2019, the HRBEA isolation rate was 3%, with a
percentage of 1,96 % for CRE and 17,14% for VRE. For this study, we have used
large and small scale microbiology service equipment such as ovens, optical
microscope, as well as pastors pipettes, blades and strips, benzene beaks,
culture and isolation media, the Walkaway automation,...etc. The isolation, the
identification of these germs were carried out according to the conventional
methods of bacteriology, by classical techniques and by Walkaway automation,
and the antibiogram according to the CLSI recommendations.
Salmonella Heidelberg was the most isolated species
(40.47%) caused by the epidemic that cracks down in the nursery service,
followed by Klebsiella pneumoniae, Enterobacter cloacae, and
Providencia stuartii for the CRE. In all VRE, the Enterococcus
faecium was the major isolated sort.
These HRBEA were isolated from different types of samples,
mainly stool (40.47%), urine for CRE and urine (42.37%), blood cultures for
VRE. Regarding hospitalization services, these HRBEA were found mainly in
nursery services (48.80%), medical resuscitation and pediatrics for CRE, and in
the center of burns (44.44%), nursery, and pediatrics for VRE.
An important attention given to the hygiene and a
rationalization of the antibiotics utilization are factors that promote a
better control of the infections due to these germs.
Our recommendations: the application of preventive measures
and the establishment of a special program to control the HRBEA's diffusion can
reduce the rate of these germs transmission.
Keywords: CHUC, HRBEA, (CRE, VRE),
Antibiotics bacteria resistance, prevention, HRBEA epidemiology.
: ÕÎáãá
Ç
ÊÇÏÇÖãáÇ
äã ÏíÏÚáá
ÉãæÇÞãæ
íãÖåáÇ
ÒÇåÌáá
ÉÈÞÇÚÊã
ÇíÑíÊßÈ íå
)BHRe( ÉÆÔÇäáÇ
ÉíæíÍáÇ
ÊÇÏÇÖãáá
ÉÏÔÈ
ÉãæÇÞãáÇ
ÇíÑíÊßÈáÇ
)
EPC( ÉíæÚãáÇ
ÊÇÓæÑíáá
ÉÌÊäãáÇ
ÊÇäíÈÇÈÑßáÇ
Úã ÞÇæÊÊ BHRe
.ÇíÑíÊßÈáÇ
äíÈ áÞäáá
ÉáÈÇÞáÇ
ÉãæÇÞãáÇ
ÊÇíá Úã
ÉíæíÍáÇ
.)
ERG(
ÊÇÏíÊÈÈæßíáÌáá
ÉãæÇÞãáÇ
ÉíæÚãáÇ
ÇíÑíÊßÈáÇæ
.ãáÇÚáÇ
ÁÇÍä ÚíãÌ í
ÉãæÇÞãáÇ
åÐå åí ÑÔÊäÊ
ÊÞæ í ÉãÇÚáÇ
ÉÍÕáá
ÉíÞíÞÍ
ÉáßÔã áËãí
BHRe ÑÇÔÊäÇ
äÇÞÊÅ äÅ
Úã %
BHRe 3 áÒÚ áÏÚã
äÇß 2019 áíÑÈ 30
ìáÅ 2018 ÑíÇäí 1
äã ÏÊãÊ
íÊáÇæ
íáÈÞÊÓãáÇæ
íÚÌÑ ÑËÈ
ÇäÊÓÇÑÏ í
|
ÉÑíÈßáÇ
ÉíÑåÌãáÇ
ÁÇíÍáÇ ãáÚ
ÉãÏÎ ÊÇÏÚã
ÇäãÏÎÊÓÇ
ÉÓÇÑÏáÇ åÐå
í .VRE
|
á %
|
17.14
|
æ
|
EPC á % 1.96
|
ÉÈÓä
|
ÉáÒÚáÇæ
ÉÇÞËáÇ
ØÆÇÓææ äÓäÈ
ÊÇåææ
ÍÆÇÕáÇæ
ÍÆÇÑÔáÇæ
ÑæÊÓÇÈ
ÊÇÕÇã ßáÐßæ
íÆæÖáÇ
ÑåÌãáÇæ
äÇÑáÇ áËã
ÉÑíÛÕáÇæ
ÊÇíäÞÊáÇ
ÞíÑØ äÚ °
ãíËÇÑÌáÇ
ãáÚá
ÉíÏíáÞÊáÇ
ÞÑØáá ÇðÞæ
ãíËÇÑÌáÇ
åÐå ÏíÏÍÊæ
áÒÚ ÁÇÑÌÅ
ãÊ ÎáÅ ... The Walkaway
PLC
.CLSI
ÊÇíÕæÊá
ÇðÞæ
ÉíæíÍáÇ
ÊÇÏÇÖãáÇæ
Walkaway ãßÍÊ
ÊÇÏÍææ
ÉíÏíáÞÊáÇ
ÉíæÆÑáÇ
áÇíÓÈáß
ÇåíáÊ
ÉäÇÖÍáÇ
ìæÊÓã ìáÚ
ÁÇÈæáÇ
ÊÇÈæä ÈÈÓÈ )% 40.47(
ÉáÒÚáÇ ÚÇæä
ÑËß
ÛÑÈáÏíÇå
áÇíäæãáÇÓáÇ
äÇß
ÚÇæäáÇ
äã ÉíÒÇÑÈáÇ
ÉíæÚãáÇ äÇß
VREs ÚíãÌ í .EPC
Üá Providencia stuartii æ
Enterobacter
cloacae
.ÈáÇÛáÇ í
ÉáæÒÚãáÇ
)% 42.37(
áæÈáÇæ EPC á
áæÈáÇæ )% 40.47(
ÒÇÑÈáÇ
ÉÕÇÎæ
ÊÇäíÚáÇ äã
ÉáÊÎã ÚÇæä
äã BHRe åÐå
áÒÚ ãÊ
48.80(
ÉäÇÖÍáÇ
ÊÇãÏÎ í íÓíÆ
Ñ áßÔÈ BHRe
åÐå ìáÚ
ÑæËÚáÇ ãÊ
ÁÇÔÊÓáÇÇ
ÊÇãÏÎÈ
ÞáÚÊí Çãí .VRE
á ãÏáÇ
ÊÇÇÞËáÇæ
.VRE
á áÇØáÇ ÈØ
ÉäÇÖÍáÇ )% 44.44(
ÞæÑÍáÇ ØÓæ
íæ EPC á
áÇØáÇ ÈØæ
íÈØáÇ
ÔÇÚäáÅÇæ
)%
åÐå ÉØÓÇæÈ
ìæÏÚáÇ ìáÚ
ÉÑØíÓáÇ
äíÓÍÊ ìáÅ
íÖÊ áãÇæÚ
íåæ ÉíæíÍáÇ
ÊÇÏÇÖãáÇ
ãÇÏÎÊÓÇ
ÏíÔÑÊæ
ÉÇÙäáá ãåã
ãÇãÊåÇ
ßÇäå
.ãíËÇÑÌáÇ
.ãíËÇÑÌáÇ
åÐå áÇÞÊäÇ
áÏÚã äã ááÞí
ä äßãí BHR
ÑÇÔÊäÇ
ÉÍÇßãá
ÌãÇäÑÈ ÚÖææ
ÉíÆÇÞæáÇ
ÑíÈÇÏÊáÇ
ÞíÈØÊ äÅ
:ÇäÊÇíÕæÊ
.ÉíÇÞæáÇ
BHRe ÊÇíÆÇÈæ
ÉíÑíÊßÈáÇ
ÉíæíÍáÇ
ÊÇÏÇÖãáÇ
ÉãæÇÞã )ERV
BHRe (EPC CHUC
:ÉíÍÇÊãáÇ
ÊÇãáßáÇ
| 
