L'Infection Nosocomiale en Reanimation des Brules

As nosocomial bacterial infection is a major cause of morbidity and mortality among burn patients, we carried out a retrospective study of 84 patients hospitalized in the intensive care unit at the Mohamed V Military Teaching Hospital in Rabat, Morocco, over a period of three years (1 Jan. 2001-31 Dec. 2003). The nosocomial infection criteria we used were those of the Atlanta Center for Disease Control (1988). Frequency rates were calculated. The infected population was compared to the uninfected population and the bacterial ecology of the hospital was described, as also the antibiotype. It was found that 87 nosocomial infections occurred in 27 patients. The cumulative infection rate was 103 infections per 100 patients admitted and the nosocomial infection rate was 27 nosocomial infections per 1000 days of treatment. Regarding bacterial infections, the areas infected were the skin (77.0%), the blood (13.8%), the urinary tract (8.0%), and the lungs (1.1%). The main germs were Staphylococcus sp. (33.3%), Pseudomonas aeruginosa (23%), Enterococcus faecalis, and Acinetobacter (8%). Staphylococcus was methicillin-resistant in 22.2% of cases, and Pseudomonas and Acinetobacter were multi-resistant (60% of cases). On the basis of our study and after a comparison of the infected and uninfected populations, we concluded that the predictive factors for the occurrence of nosocomial infections were age, the body/mass index, the abbreviated burn severity index, and the initial filling. By isolating these parameters, we were able to create an equation predicting the occurrence of nosocomial infection in burn patients.