Title : Epidemiological profile and antibiotic resistance patters of Enterobacteriaceae in a moroccan surgical ICU
Abstract:
Background: Enterobacteriaceae infections are a significant cause of morbidity in intensive care units, with increasing antimicrobial resistance posing major therapeutic challenges.
Objective: To describe the epidemiological profile, infection sites, and antibiotic resistance patterns of Enterobacteriaceae isolates in the ICU of the Department of Anesthesia and Intensive Care (P33 ward) at University Hospital Ibn Rochd, Casablanca, from 2019 to 2022.
Methods: A retrospective study was conducted including all patients with documented Enterobacteriaceae infections during the study period. Data on demographics, isolated species, infection sites, and antibiotic susceptibility were analyzed.
Results: Over four years, the incidence of Enterobacteriaceae infections was 11% (212/1881 hospitalized patients), with an average patient age of 43 years (range: 15–90) and a male predominance (77.8%, sex ratio 3.5). A total of 305 isolates were identified, mainly Klebsiella pneumoniae (37%), Escherichia coli (18%), and Raoultella terrigena (16%). The most frequent infection sites were the lungs (28%), urinary tract (22%), surgical sites (17%), and bloodstream (16%). Antibiotic resistance was high, particularly for fluoroquinolones, amoxicillin, and third-generation cephalosporins, while carbapenems (imipenem, meropenem) and amikacin retained good activity against most isolates. Notably, resistance trends in K. pneumoniae fluctuated over the years, with persistent high resistance to fluoroquinolones and β-lactams.
Conclusion: Enterobacteriaceae infections in our ICU predominantly affect younger male patients and are mainly caused by K. pneumoniae and E. coli. High resistance rates to commonly used antibiotics underscore the urgent need for strengthened antimicrobial stewardship and continuous local surveillance to guide empirical therapy.
