Infection à Pseudomonas aeruginosa producteur de métallo-ß-enzyme, chez une diabétique amputée

The production of metallo-ß-lactamase (MBL) is the most recent mechanism of resistance of Pseudomonas aeruginosa (P. aeruginosa), a frequent nosocomial pathogen, especially in immune-compromised patients. We report the first case of isolation of such strain in the Department of Traumatology at Ibn Tofail hospital (Marrakech, Morocco) in a 52 yr-old female diabetic patient hospitalized after having an urgent diabetic foot gangrene amputation. The postoperative course was marked by a wound infection with MBL producing P. aeruginosa (positive double disk synergy test). Despite antibiotic treatment with colistin and amikacin, the outcome remained poor and the patient required reoperation. Bacteriological diagnosis through phenotypic tests that are inexpensive and well suited to structures that do not have equipment for the detection of resistance genes, is essential to the fight against such highly pathogenic bacteria for which treatment options are reduced or nonexistent.