Staphylococcus aureus bacteremia in the Dakar Fann university hospital

Objectives. - The purpose of this report was to describe epidemiological, clinical, and bacteriological findings in cases of Staphylococcus aureus bacteremia at the Infectious Diseases Clinic in Dakar. Materials and methods. - This retrospective study was carried out on data recorded between January 1, 1996 and December 31, 2002. The diagnosis of bacteremia was based on isolation of bacteria from blood culture. Bacterial susceptibility was studied with an antibiogram. Resistance to methicillin was assessed with a disk containing 5 mug of oxacillin on Mueller Hinton Agar containing 5% of NaCl. Results. - One hundred and thirty cases of S. aureus bacteremia were recorded. The mean age of patients was 31 years. Nosocomial bacteremia occurred in 22% of the cases. HIV infection was noted in 38 patients (29%). The death rate was 24%. Nosocomial and community-acquired strains were resistant to methicillin, respectively, in 72% and 51% of the cases. Bacteremias due to methicillin-resistant S. aureus strain were nosocomial infections in 23% of the cases. Most of the strains (80-100%) were susceptible to fusidic acid, gentamycin, erythromycin, and pefloxacin. All of them were susceptible to vancomycin. Conclusion. - Such a high rate of MRSA bacteremia, in particular among nosocomial bacteremia, makes it essential to reinforce preventive measures in our hospitals and to provide them with effective drugs against MRSA, such as vancomycin. (C) 2004 Elsevier SAS. Tons droits reserves.