Détection de souches multi-résistantes d’Escherichia coli d’origine aviaire dans la région de Rabat-Salé-Zemmour-Zaer

Antimicrobial resistance surveillance is a standard measure in the sanitary policies. In order to monitor multi-resistance within APEC strains, a study was conducted on 370 broiler chickens farms from the Rabat-Salé-Zemmour-Zaer region in Morocco. The isolation of Escherichia coli was made from lesions of avian colibacillosis. Biochemical identification, serotyping and antimicrobial susceptibility tests as well as phenotypic identifications on lactamases resistance were carried out on the isolates. Serogrouping showed that 66.7 % of the isolates belong to the dominant serotypes O78, O2 and O1. Drug sensitivity tests showed extremely high levels of resistance to oxytetracyclin (100 %), amoxicillin (90.9%), trimethoprim + sulphamethoxazol (82.2 %), enrofloxacin (75.9 %) and florfenicol (61.5 %). Low frequencies of resistances were noted for gentamicin (24.8 %), fosfomycin (16.1 %) and colistin (2%). In parallel, tests for the determination of the phenotype of resistance to beta-lactamases and cephalosporinases on 250 strains revealed that 66.1% of the strains were classified as class A penicillinases; 14.8% were class C cephalosporinases. The ESBL class A was found in 11.1% of the tested stains and only 3.7% were classified as wild-type strains. The multi-resistance is very high since 97.4% and 55.1% of the strains were respectively resistant to three and five antibacterial drugs. Keywords: Antibio-resitance, antibiotics, Escherichia coli, colibacillosis, poultry, Morocco.  La surveillance de l’antibio-résistance de germes spécifiques comme E. coli, Salmonella spp., Staph. aureus ou Campylobacter requiert une importance particulière dans la politique sanitaire humaine et vétérinaire des pays. Dans cette optique, une étude rétrospective sur l’antibio-résistance de 370 cultures d’Escherichia coli a été réalisée dans les élevages avicoles de la région de Rabat-Salé -Zemmour-Zaer. Les bactéries ont été identifiées par les mini galeries API et sérotypées par les immunsérums aviaires O1, O2 et O78. Les tests de sensibilité aux antibiotiques ont permis de distinguer entre antibiotiques connaissant de forts taux de résistance à savoir: l’oxytétracycline (100 %), l’amoxicilline (90,9 %), trimethoprim + sulphamethoxazole (82,2 %), l’enrofloxacine (75,9 %) et le florfénicol (61,5 %) et des molécules à faibles taux de résistance comme la gentamicine (24,8 %), la fosfomycine à (16,1 %) et la colistine (2,94 %). En parallèle, des tests de détermination du phénotype de résistance aux béta-lactamases et aux céphalosporinases sur 250 souches ont permis de mettre en évidence que 66,1 % des souches testées étaient classées parmi les pénicillinases classe A; 14,8 % étaient parmi les céphalosporinases C, les BLSE classe A comptaient 11,1 % et seulement 3,7 % des souches testées étaient classées phénotype sauvage. La multi-résistance reste très élevée avec une fréquence des souches résistantes à trois molécules d’antibactériens de l’ordre de 97 % et 55 % des souches sont résistantes à cinq antibiotiques. Ces résultats sont utiles aux vétérinaires praticiens, pour éviter les échecs thérapeutiques, et constituent une base de données importante en matière de pharmaco-vigilance et de l’épidémio-surveillance de l’antibio-résistance dans notre pays. Mots-clés: Antibio-résistance, antibiotiques, E. coli, BLSE, colibacillose, maladies aviaires, Maroc

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support

Identification of Eilat virus and prevalence of infection among <em>Culex pipiens L</em>. populations, Morocco, 2016

International audienceEilat virus (EILV) is described as one of the few alphaviruses restricted to insects. We report the record of a nearly-complete sequence of an alphavirus genome showing 95% identity with EILV during a metagenomic analysis performed on 1488 unblood-fed females and 1076 larvae of the mosquito Culex pipiens captured in Rabat (Morocco). Genetic distance and phylogenetic analyses placed the EILV-Morocco as a variant of EILV. The observed infection rates in both larvae and adults suggested an active circulation of the virus in Rabat and its maintenance in the environment either through vertical transmission or through horizontal infection of larvae in breeding sites. This is the first report of EILV out of Israel and in Culex pipiens populations

Mutation Screening of the BRCA1 Gene in Early Onset and Familial Breast/Ovarian Cancer in Moroccan Population

Worldwide variation in the distribution of BRCA mutations is well recognised, and for the Moroccan population no comprehensive studies about BRCA mutation spectra or frequencies have been published. We therefore performed mutation analysis of the BRCA1 gene in 121 Moroccan women diagnosed with breast cancer. All cases completed epidemiology and family history questionnaires and provided a DNA sample for BRCA testing. Mutation analysis was performed by direct DNA sequencing of all coding exons and flanking intron sequences of the BRCA1 gene. 31.6 % (6/19) of familial cases and 1 % (1/102) of early-onset sporadic (&#60; 45 years) were found to be associated with BRCA1 mutations. The pathogenic mutations included two frame-shift mutations (c.798_799delTT, c.1016dupA), one missense mutation (c.5095C&#62;T), and one nonsense mutation (c.4942A&#62;T). The c.798_799delTT mutation was also observed in Algerian and Tunisian BC families, suggesting the first non-Jewish founder mutation to be described in Northern Africa. In addition, ten different unclassified variants were detected in BRCA1, none of which were predicted to affect splicing. Most unclassified variants were placed in Align-GVGD classes suggesting neutrality. c.5117G&#62;C involves a highly conserved amino acid suggestive of interfering with function (Align-GVGD class C55), but has been observed in conjunction with a deleterious mutation in a Tunisian family. These findings reflect the genetic heterogeneity of the Moroccan population and are relevant to genetic counselling and clinical management. The role of BRCA2 in BC is also under study.</p

BRCA Genetic Screening in Middle Eastern and North African: Mutational Spectrum and Founder BRCA1 Mutation (c.798_799delTT) in North African

Background. The contribution of BRCA1 mutations to both hereditary and sporadic breast and ovarian cancer (HBOC) has not yet been thoroughly investigated in MENA. Methods. To establish the knowledge about BRCA1 mutations and their correlation with the clinical aspect in diagnosed cases of HBOC in MENA populations. A systematic review of studies examining BRCA1 in BC women in Cyprus, Jordan, Egypt, Lebanon, Morocco, Algeria, and Tunisia was conducted. Results. Thirteen relevant references were identified, including ten studies which performed DNA sequencing of all BRCA1 exons. For the latter, 31 mutations were detected in 57 of the 547 patients ascertained. Familial history of BC was present in 388 (71%) patients, of whom 50 were mutation carriers. c.798_799delTT was identified in 11 North African families, accounting for 22% of total identified BRCA1 mutations, suggesting a founder allele. A broad spectrum of other mutations including c.68_69delAG, c.181T>G, c.5095C>T, and c.5266dupC, as well as sequence of unclassified variants and polymorphisms, was also detected. Conclusion. The knowledge of genetic structure of BRCA1 in MENA should contribute to the assessment of the necessity of preventive programs for mutation carriers and clinical management. The high prevalence of BC and the presence of frequent mutations of the BRCA1 gene emphasize the need for improving screening programs and individual testing/counseling