Epidemiological Aspects of Nosocomial Infections in the Intensive Care Unit of the Akanda Army Training Hospital in Gabon from 2019 to 2022

Introduction: The development of preventive and therapeutic strategies to combat nosocomial infections (NI) in intensive care involves monitoring their microbial ecology, studying their antibiotic resistance and their transmission modalities. The aim of our study was to analyze the epidemiological aspects of NI in patients hospitalized in intensive care from 2019 to 2022. Patients and Method: A retrospective study, with descriptive and analytical aims, was carried out on 493 records of patients hospitalized in intensive care from January 2019 to December 2022. Included were all patients hospitalized for more than 48 hours in intensive care with confirmed presence of an IN. Clinical, biological, paraclinical and therapeutic information was collected on a standardized Epi-Info 7.3 form and analyzed by Excel Microsoft Office 2019. Results: The rate of IN was 11.7% (58/493 patients) for a mean time of onset of 10.5 days. Of the 78 cases of IN recorded, 42% had a urinary location and 34% pulmonary. The bacteriological profile of the 79 germs was composed of 77% Gram-negative bacilli (GNB), 22.7% Gram-positive cocci (GPC). The main urinary germs were Escherichia coli, Klebsiella pneumoniae in 31.4%, at the pulmonary level Acinetobacter baumanii in 29.6%, Klebsiella pneumoniae and Pseudomonas aeruginosa in 14.8%. BMR represented 39.2% of the isolated strains, ESBL Enterobacteriaceae 45.1%, Acinetobacter baumanii 29%, Pseudomonas Aeruginosa 25.8%. Methicillin-resistant Staphylococci aureus (MRSA) were not found. Conclusion: The majority of NIs are due to invasive medical devices. Handling remains the main culprit. Enterobacteriaceae dominate, with Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumanii (BMR) at the top of the list. Resistance to commonly used antibiotics (ATBs) and the low availability of suitable ATBs constitute a significant mortality factor. Therefore, measures to curb the emergence of resistant pathogens must be adopted.