Molecular characterization of extended spectrum β-lactamase-producing Escherichia coli in a university hospital in Morocco, North Africa

Introduction: β-Lactams are among the most widely prescribed antibiotics in human medicine. However, because of their massive and usually inappropriate use, resistance to these drugs has increased markedly, especially due to extended-spectrum β-lactamase (ESBL) production.Objectives: The aims of this study were to determine the prevalence of urinary Escherichia coli strains isolated from urine samples taken from patients diagnosed with urinary tract infections (UTIs), to evaluate their current antimicrobial susceptibility pattern and to look for blaSHV, blaTEM and blaCTX-M genes in these multi-drug resistant isolates.Subject and methods: A retrospective survey was made over 3 years from 2010 to 2012. It included all uropathogenic E. coli strains isolated from urine samples taken from consulting and hospitalized patients in the Avicenne Teaching Hospital in Marrakech, Morocco.Results: E. coli was the etiologic agent in 63% of reported UTIs due to Enterobacteriacae. In all, the prevalence of ESBL-producing E. coli reached 6% of all urinary Enterobacteriaceae isolates in 2012. The bacterial resistance rates of ESBL-producing E. coli isolates were as follows: amoxicillin/clavulanic acid (100%), trimethoprim/sulfamethoxazole (76%), gentamicin (66%), ciprofloxacin (82%) and amikacin (56%). None of these strains was resistant to carbapenems. The ESBL production patterns observed included single production of CTX-M (70%), SHV (12%) and TEM (0%). Some ESBL-producing E. coli isolates produced combinations of 2 ESBLs belonging to different groups: CTX-M+SHV (12%) and CTX-M+TEM (6%).Conclusion: The results of this work report, for the first time in the Marrakech region, the ESBL production pattern with CTX-M being most common among the ESBL-producing urinary E. coli. Moreover, a major finding is the production of multiple ESBL types by some urinary E. coli isolates.KEYWORDS Urinary; Extended-spectrum β-lactamase (ESBL); E. coli; Antibiotics; Resistanc

The Inhibitive Effect of 2-Phenyl-3-nitroso-imidazo [1, 2-a]pyridine on the Corrosion of Steel in 0.5 M HCl Acid Solution

Abstract: The effect of 2-phenyl-3-nitroso-imidazo[1,2-a]pyridine (PNIP) on the corrosion inhibition of carbon-steel in 0.5 M HCl was studied by weight loss and different electrochemical techniques such as electrochemical impedance spectroscopy (EIS), potentiodynamic polarization. The obtained results showed that PNIP effectively reduces the corrosion rate of carbon steel. Inhibition efficiency (E%) increases with inhibitor concentration to attain 88% at 10 -3 M. Adsorption of that PNIP on the carbon steel surface in 0.5 M HCl follows the Langmuir isotherm model. E% values obtained from various methods used are in good agreement. SEM characterization of the steel surface is made

Evaluation de la qualité et de la composition chimique de trois huiles extraites à partir de pépins d’agrumes cultivés dans l’oriental du Maroc

In eastern Morocco, new cooperatives of citrus fruit technological transformation begin to be installed. The seeds resulting from these transformation processes remain without any valorization. This study concerns the physico-chemical characterization of three different citrus seed oils (Citrus limon (Citron), Citrus aurantium (Bigarade) and Citrus clementina (Clementine de Berkane)), cultivated in eastern Morocco. The seed oils were mechanically extracted by oil press and the oil yield, quality indices (acidity, peroxide, saponification, and refraction indices), polyphenol contents, antioxidant activity and fatty acid profile were analyzed. The mechanical yield varies between 15% for Bigarade seed oil and 29% for Lemon seed oil. The acidity, peroxide, saponification, and refraction indices varied between 0.55 - 0.57% of oleic acid, 5.77 to 10.34 meqO2/kg of oil, 116.67 and 173.53 mg KOH /g and 1.4699-1.4718 for the 3 studied seed oils, respectively. The polyphenols varied from 565 to 913 mg / 100g and the antioxidant activity ranged between 30 and 50%. The fatty acid profiles, of the analyzed citrus seed oils, presented 5 major fatty acids with the dominance of linoleic acid (C18: 2) which presented 34% for Clementine and Lemon seed oils and 35.5% for Bigarade seed oil.  Au niveau de la région de l’oriental du Maroc, de nouvelles coopératives commencent à s’installer et sont actives dans la transformation technologique des agrumes. Les pépins issus de ces procédés de transformation restent sans valorisation. Cette étude porte sur la caractérisation physico-chimique d’huiles de pépins des fruits de 3 espèces d’agrume Citrus limon (Citron), Citrus aurantium (Bigarade) et Citrus clementina (Clémentine), cultivées au niveau de la région de l’oriental du Maroc. Les huiles de pépins sont extraites mécaniquement par une presse à huile de type vis sans fin, le rendement en huile, l’acidité, les indices de qualités (d’indice de peroxyde, de saponification et de réfraction), la teneur en polyphénols, l’activité antioxydante ainsi que le profil des acides gras ont été déterminés. Le rendement d’extraction par pressage varie entre 15 % pour l’huile de pépin de Bigarade et 29 % pour huile de pépin de Citron. Pour les 3 huiles de pépins étudiées, l’acidité, l’indice de peroxyde, l’indice de saponification et indice de réfraction varient entre 0,55-0,57 % d’acide oléique, 5,77-10,34 meqO2/kg d’huile, 116,67 et 173,53 mg KOH/g et 1,4699-1,4718 respectivement. La teneur en polyphénols change de 565 à 913 mg d’acide caféique/100g d’huile et le pourcentage d’inhibition s’oscille entre 30 et 50 %. Les profils des acides gras, des huiles de pépin d’agrumes analysées, présentent 5 principaux acides gras avec la dominance de l’acide linoléique (C18 :2) dont les teneurs sont 34% pour les huiles de pépin de Clémentine et de Citron et 35,5% pour l’huile de pépin de Bigarade

VOLVULUS DU SIGMOIDE ET POST-PARTUM

The sigmoid volvulus during pregnancy is very rare and difficult to diagnose. It is often responsible for the mortality of the parturient and of the fetus. We report a case of sigmoid volvulus with postnatal complications. A multiparous woman aged 45, was admitted with a bowel obstruction and generalized abdominal spasm at 3 days postpartum. A laparotomy examination revealed a dolichocolon complicated by a sigmoid volvulus undergoing necrosis, with the presence of some pseudomembranes. Sigmoidectomy with proximal colostomy was performed according to Hartmann, following which the restoration of continuity was secured within two months. Sigmoid volvulus complicating pregnancy is a rare occurrence with a reserved maternal-fetal prognosis, the diagnosis should be suspected with the appearance of persistent abdominal pain associated with an occlusive syndrome. Urgent surgical intervention is required to reduce as far as possible fetomaternal morbidity and mortality.Le volvulus du sigmoïde au cours de la grossesse est très rare et difficile à diagnostiquer. Elle peut s’accompagner d’une mortalité maternelle et fœtale importante. Nous rapportons un cas de volvulus du sigmoïde compliquant les suites de couches. Une multipare de 45 ans, s'est présentée avec un syndrome occlusif et défense abdominale généralisée à J3 du post-partum. Une laparotomie exploratrice a mis en évidence un dolichocôlon compliqué par un volvulus du sigmoïde nécrosé, avec présence de quelques fausses membranes. Une résection sigmoïdienne avec colostomie proximale selon Hartmann a été pratiquée, le rétablissement de la continuité a été réalisé deux mois plus tard. Le volvulus du sigmoïde compliquant la grossesse est une entité rare avec un pronostic materno-fœtal réservé, le diagnostic doit être suspecté devant une douleur abdominale persistante associée à un syndrome occlusif. L’intervention chirurgicale s’impose en urgence pour réduire, au maximum, la morbidité et la mortalité maternofoetale

Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 Following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project.

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3+0 schedule constrains generalizability and data from these settings are needed

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Background: Invasive pneumococcal disease remains an important health priority owing to increasing disease incidence caused by pneumococci expressing non-vaccine serotypes. We previously defined 621 Global Pneumococcal Sequence Clusters (GPSCs) by analysing 20 027 pneumococcal isolates collected worldwide and from previously published genomic data. In this study, we aimed to investigate the pneumococcal lineages behind the predominant serotypes, the mechanism of serotype replacement in disease, as well as the major pneumococcal lineages contributing to invasive pneumococcal disease in the post-vaccine era and their antibiotic resistant traits. / Methods: We whole-genome sequenced 3233 invasive pneumococcal disease isolates from laboratory-based surveillance programmes in Hong Kong (n=78), Israel (n=701), Malawi (n=226), South Africa (n=1351), The Gambia (n=203), and the USA (n=674). The genomes represented pneumococci from before and after pneumococcal conjugate vaccine (PCV) introductions and were from children younger than 3 years. We identified predominant serotypes by prevalence and their major contributing lineages in each country, and assessed any serotype replacement by comparing the incidence rate between the pre-PCV and PCV periods for Israel, South Africa, and the USA. We defined the status of a lineage as vaccine-type GPSC (≥50% 13-valent PCV [PCV13] serotypes) or non-vaccine-type GPSC (>50% non-PCV13 serotypes) on the basis of its initial serotype composition detected in the earliest vaccine period to measure their individual contribution toward serotype replacement in each country. Major pneumococcal lineages in the PCV period were identified by pooled incidence rate using a random effects model. / Findings: The five most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to two or more countries. The five most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to two or more countries. These serotypes were associated with more than one lineage, except for serotype 5 (GPSC8). Serotype replacement was mainly mediated by expansion of non-vaccine serotypes within vaccine-type GPSCs and, to a lesser extent, by increases in non-vaccine-type GPSCs. A globally spreading lineage, GPSC3, expressing invasive serotypes 8 in South Africa and 33F in the USA and Israel, was the most common lineage causing non-vaccine serotype invasive pneumococcal disease in the PCV13 period. We observed that same prevalent non-vaccine serotypes could be associated with distinctive lineages in different countries, which exhibited dissimilar antibiotic resistance profiles. In non-vaccine serotype isolates, we detected significant increases in the prevalence of resistance to penicillin (52 [21%] of 249 vs 169 [29%] of 575, p=0·0016) and erythromycin (three [1%] of 249 vs 65 [11%] of 575, p=0·0031) in the PCV13 period compared with the pre-PCV period. / Interpretation: Globally spreading lineages expressing invasive serotypes have an important role in serotype replacement, and emerging non-vaccine serotypes associated with different pneumococcal lineages in different countries might be explained by local antibiotic-selective pressures. Continued genomic surveillance of the dynamics of the pneumococcal population with increased geographical representation in the post-vaccine period will generate further knowledge for optimising future vaccine design. / Funding: Bill & Melinda Gates Foundation, Wellcome Sanger Institute, and the US Centers for Disease Control

Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04-0.06) for all ages, 0.05 (0.04-0.05) for <5 years of age, 0.08 (0.06-0.09) for 5-17 years, 0.06 (0.05-0.08) for 18-49 years, 0.06 (0.05-0.07) for 50-64 years, and 0.05 (0.04-0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3+0 schedule constrains generalizability and data from these settings are needed