Comparative study of multidrug-resistant bacterial infections in hospitals and community settings in the region of Monastir – Tunisia

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Published May 6, 2022
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Vol. 100 No. 5 (2022): Issue Mai 2022

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Hajer Rhim
Rahma Ben Trad
Ons Haddad
Yosr Kadri
Maha Mastouri

Abstract

Introduction and aim : Multidrug resistance in bacteria has become a widespread scourge. The objective of this study is to investigate
the epidemiology of multidrug-resistant bacteria (MDR) at Fattouma Bourguiba University Hospital of Monastir - Tunisia compared to the
community and to define their antibiotic resistance profiles.

Methods: It was a retrospective and descriptive study over a period of 5 years (2016-2020) conducted at the microbiology department of
Fattouma-Bourguiba University Hospital of Monastir - Tunisia. All MDR strains isolated from diagnostic microbiological samples collected from
patients hospitalized in high-risk infectious departments and from outpatients were included in our study.

Results : A total of 4324 MDR among 16353 bacteria were isolated during the study period, i.e. a resistance rate of 26.4% with a predominance
of hospital strains (80.3% versus 19.7% in the city). Third generation cephalosporin-resistant Enterobacteriaceae were the most prevalent and
were mainly represented by extended-spectrum beta- lactamases (67.1% versus 83.4% in the community). Escherichia coli was the most frequent
species (40.9%). It was frequently associated with resistance to fluoroquinolones (in more than 73% of cases). Imipenem-resistant Acinetobacter
baumannii was mostly responsible for hospital acquired infections (77%). Co- resistances concerned most of the antibiotics but spared colistin.
Methicillin-resistant Staphylococcus aureus infections were more frequent in the city (20.5% versus 19.3% in hospitals). Resistance associated was
mainly to fusidic acid (49.6%). Glycopeptides have maintained their activity and only 2% were of decreased sensitivity to vancomycin.

Conclusion : The emergence of MDR always represents a public health challenge. Thus, hygiene measures associated with an optimization
of antibiotic therapy are necessary for a better control of their diffusion.


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