Étude Bactériologique des Infections Urinaires chez l’Adulte au Laboratoire de Microbiologie de l’Hôpital National de Zinder

ABSTRACT Introduction. les infections urinaires(IU) sont le deuxieme site infectieux en infectiologie. La part de l’antibiotherapie pour traiter les infections urinaires est de 12 % des prescriptions d’antibiotiques(ATB). Cette situation  represente un impact ecologique tres important car responsable d’une pression de selection de souches bacteriennes resistantes. Objectif. etudier Le profil bacteriologique et la sensibilite aux antibiotiques  d’isolats de culture d’urine au laboratoire de microbiologie de l’Hopital National de Zinder (HNZ). Materiels et Methodes. Etude descriptive transversale realisee au laboratoire de microbiologie de l’HNZ incluant tous les patients ayant realise un examen cytobacteriologique des urines(ECBU) entre Avril et juillet 2014. L’identification des bacteries est basee sur des caracteres morphologiques, culturaux, biochimiques et antigeniques. L’antibiogramme est realise selon la technique de diffusion en milieu gelose. Resultats. au total 376 echantillons d’urine etaient analyses provenant des patients vus en consultations 334(88,82%) et des patients hospitalises 42(11,17%) dont 232(61,71%) hommes et 144(38,29%) femmes. Sur les 376 echantillons d’urine, 100(26,59%) etaient positifs dont 75(75%) hommes et 25 femmes (25%).Les principales especes bacteriennes isolees etaient E. coli 51(51%), K. pneumonia 24 (24%)  et P.mirabilis11 (11%). La resistance d’E. Coli aux antibiotiques etait respectivement de 52,94% pour la  ciprofloxacine, 58,82%pour l’ofloxacine, 23,52% pour les cephalosporines de 3e generation (ceftriaxone),82,35% pour le trimethoprime-sulfamethoxazole,100% pour l’amoxicilline,52,94% pour  l’amoxicilline + clavulanate, 100% pour la Doxycylline et 5,88% pour la Gentamycine. Conclusion. dans notre etude E. coli est l'uropathogene predominant  avec un taux de resistance aux antibiotiques tres alarmant d’ou la necessite d’une surveillance etroite  de l’epidemiologie de la resistance des bacteries aux antibiotiques. RESUME Introduction. Urinary tract infections (UI) are the second infectious site in infectious diseases. The share of antibiotic therapy to treat urinary tract infections accounts for 12% of antibiotic prescriptions. This situation represents a very important ecological impact because it is responsible for a selection pressure of resistant bacterial strains such as E. coli. Objective. To study the bacteriological profile and antibiotic sensitivity of urine culture isolates in the microbiology laboratory of Zinder National Hospital. Materials and Methods: cross-sectional descriptive study carried out in the HNZ microbiology laboratory including all patients who performed an ECBU between April and July 2014. The identification of bacteria is based on morphological, cultural, biochemical and antigenic characters. The antibiogram is performed according to the diffusion technique in agar medium. Results. A total of 376 urine samples were analyzed from patients seen in consultations 334 (88.82%) and hospitalized patients 42 (11.17%), including 232 (61.71%) men and 144 (38.29%). %) women. Of the 376 urine specimens, 100 (26.59%) were positive, of which 75 (75%) were men and 25 were women (25%) The main bacterial species isolated were E. coli 51 (51%), K. pneumonia 24 (24%) and P.mirabilis11 (11%). The resistance of E. Antibiotic levels were 52.94% for ciprofloxacin, 58.82% for ofloxacin, 23.52% for cephalosporins 3rd generation (ceftriaxone), 82.35% for trimethoprim-sulfamethoxazole, of 100% for amoxicillin, 52.94% for amoxicillin + clavulanate, 100% for Doxycylline and 5.88% for Gentamycin. Conclusion. In our study E. coli is the predominant uropathogenic with a very alarming rate of antibiotic resistance. Hence the need for close local surveillance of the epidemiology of bacterial resistance to antibiotics.