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Prevalence and Risk Factors of Fecal Carriage of Multidrug-resistant Bacteria in Children of Mohammed Vi Hospital Center (Morocco)

Khadija Aitzirri, Saadia Eddyb, Lahoucine Toufik, Yassin Ahroui, Yassin Zemrani, Nabila Soraa, Morocco

Introduction: The emergence of bacterial resistance to antibiotics is a public health issue around the world affecting adults and children. It prolongs the length of stay and worsens the prognosis of hospitalized patients. The objective of the study is to evaluate the prevalence of focal carriage of multidrug-resistant bacteria (MDRB) in children hospitalized at Mohammed VI University Hospital centre in Marrakech, and to identify the risk factors associated with this carriage.

Material and method: This is a cross-sectional prospective study including all children hospitalized on the day of the survey at the four paediatric departments. All children hospitalized in the department on the day of the study were included. Rectal swabbing was performed systematically.

Results: The results of this survey show a prevalence of MDR carriage of 42%, exceeding 75% in Neonatology and Paediatric Resuscitation. Klebsiella pneumonia was dominating (52%), followed by E.cloacae (31%), E.coli (7%) and A.baumannii (7%). These MDRB were resistant to Fluoroquinolones in 70% of cases, Trimethoprim-sulfumethexazole (65%) and Gentamicin (55%). The risk factors were the length of stay more than 48 hours, a prior antibiotic therapy in the last 6 months, and a history of hospitalization.

Conclusion: The colonization of children by MDRB can be explained by the quality of care and the hygiene policy of each establishment, but also by the pressure of selection of antibiotics. This underscores the need to respect hygiene measures during care for patients, to rationalize the prescription of antibiotics and to set up a surveillance system for MDRB bacteria.

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