Prevalence of Enterobacteriaceae producing carbapenemase (OXA-48) responsible for urinary tract infections in Casablanca.

In recent years, we have witnessed the appearance of strains increasingly resistant to antibiotics. The large-scale spread of this resistance in the community today suggests that it will become a major public health problem shortly. Among the resistant strains are Enterobacteriaceae, which are responsible for numerous infections, particularly urinary tract infections. The present study focused on the phenotypic and genotypic characterization of uropathogenic enterobacteria isolated from the community environment. Our study included a total of 78 strains collected from UTIs during the year 2019. The confirmation of the species was performed by the Biomérieux VITEK system. The study of their antibiotic resistance was carried out by the method of diffusion on agar Mueller Hinton according to the recommendations of SFM-EUCAST 2019.The search for resistance genes bla(NDM, KPC, OXA-48) was performed by PCR. The results obtained showed that out of 78 samples of urinary enterobacteria, E.coli species dominated by a percentage of 58%, followed by K.pneumonia at 33%, and E.cloacae 8%. The study of antibiotic resistance profile showed high resistance to penicillins 91% followed by cephalosporins 58%. Carbapenems have a low activity on the studied strains with resistance percentages of 41% and 33% for imipenem and ertapenem respectively. The carbapenems resistance study allowed the detection of the blaOXA-48gene in three strains among the studied strains

Detection of Carbapenemase Encoding Gene and Resistance to Cefiderocol in Hospital and Community eXtensive Drug Resistance and Carbapenem-Resistant Strains in Morocco.

(Pa) remains among clinically-significant Gram-negative species. The carbapenems are often the last resort for treating infections due to multidrug resistant isolates such as Pa. The carbapenems' efficacy is increasingly compromised by the emergence and the rapid spread of Pa carrying carbapenemases which represent a serious threat to public health. This study aimed to establish the resistance profile and to identify carbapenemase genes in isolates with imipenem resistant phenotypes. Among 134 Pa isolates collected both in the community (46) and hospital (88) from January 2021 to December 2021 in Morocco, 18 (8 were from the community and 10 from the hospital settings) were carbapenem resistant. The identification of these strains has been confirmed using matrix assisted laser desorption ionization-time of flight (MALDI-TOF). The antibiotic susceptibility testing against 16 antibiotics was carried out and interpreted according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (2021). The worrying antibiotics resistance profiles, which spread to cefiderocol for two isolates, were obtained for all isolates, which were eXtensive Drug Resistance showing highly resistant to all antibiotic categories tested, even to ceftolozane-tazobactam. Colistin (100% susceptible) and cefiderocol (88.88%) were the most active agents against carbapenem-resistant Pa (CRPa). Phenotypic detection by NP-CARBA and NG-CARBA tests of metallo‑β‑lactamase (MβL) production was confirmed by PCR amplification and sequencing. Three CRPa isolates coharboring - (two isolates) and - (one isolate) genes were detected. In this study, we describe the coexistence of these MβL genes and the cefiderocol resistance in CRPa strains in Morocco. The alarming antibiotic resistance patterns of all these CRPa isolates and their resistance genes emphasize the importance of antimicrobial susceptibility testing in the choice of antibiotics for treating Pa infections