évolution récente du profil épidémiologique des entérobactéries uropathogènes productrices de β-lactamases à spectre élargi à Marrakech, Maroc

摘要

Introduction: Urinary tract infection by extended-spectrum β-lactamase producing enterobacteriaceae (ESBL-E) is a growing infection risk and may even lead in many cases to therapeutic impasses because of their multidrug resistance. Aim of the study: Follow, over a 5-year period, the evolution of the epidemiological profile of uropathogenic ESBL-E and describe their current level of antibiotic resistance. Materials and methods: A retrospective work was made over a period of 5years (from 1st January 2008to 31st December 2012). It focused on all the ESBL-E strains isolated from all the urinary samples at the microbiology laboratory of Avicenne hospital, Marrakech (Morocco). Results: We noticed in 5years, an important increase in the prevalence of ESBL-E. The higher prevalence of ESBL-E (51%) was recorded in the urology department. The study of the antibiotic resistance of the ESBL-E had shown antibiotic co-resistances to the ciprofloxacin (82%), to sulfamethoxazole-trimethropim (85%), to gentamicin (74%), to amikacine (51%). Our results also showed, for the first time in our region, an emergence in the resistance of enterobacteria producing ESBL to imipenem (10%). Conclusion: The significant increase in the prevalence of ESBL-E has become a concern at the hospitals and in community medicine as well. The study of the resistance of ESBL-E strains antibiotics showed high rates of co-resistance to antibiotics, including the usual urology molecules. Level of proof: 5.