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

OCCURRENCE OF CARBAPENEMASES AND EXTENDED-SPECTRUM Î’ETA-LACTAMASES IN UROPATHOGENIC ENTEROBACTERIACEAE ISOLATED FROM A COMMUNITY SETTING, SETTAT, MOROCCO

Objective: Urinary tract infections (UTIs) are still commonly diagnosed in outpatients as well as in hospitalized patients. In this study, weinvestigated the prevalence and performed molecular characterization of extended-spectrum-β-lactamases (ESBL) and carbapenemases produced byEnterobacteriaceae isolates that cause community UTIs in Settat city, Morocco.Methods: From January 2012 to December 2013, all uropathogenic community Enterobacteriaceae isolates were collected from the microbiologylaboratory of Hassan II Hospital, Settat, Morocco. Antibiotic susceptibility testing was performed as recommended by Clinical and LaboratoryStandard Institute. Phenotypic identification of ESBL and carbapenemase producer isolates was confirmed by the double-disk synergy test and themodified Hodge test, respectively. Molecular characterization of β-lactamase genes was performed using polymerase chain reaction (PCR), followedby sequencing of the obtained products.Results: Among 153 isolates, 31 (20.26%) were multi-drug resistant (MDR). Nine strains (5.88%) were ESBL producers, of which Klebsiellapneumoniae (n=5; 20.83%), Escherichia coli (n=3; 3.15%), and Enterobacter cloacae (n=1; 9.09%) species were identified. The results of ESBLencodinggene detection by sequencing revealed the presence of CTX-M-15 (n=9) in association with other β-lactamase genes such as temoneira 1 (n=8) and sulfhydryl variable 1 (n=5). According to the modified Hodge test and PCR, three isolates (1.96%) were positive carry the blaConclusion: The emergence of MDR uropathogenic Enterobacteriaceae isolates in our community is highly alarming. Strict measures will be required to control the further spread of these uropathogenic isolates. Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community.OXA-48 gene.Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community.Objective: Urinary tract infections (UTIs) are still commonly diagnosed in outpatients as well as in hospitalized patients. In this study, we investigatedtheprevalenceandperformedmolecularcharacterizationofextended-spectrum-β-lactamases(ESBL)andcarbapenemasesproducedby Enterobacteriaceae isolates that cause community UTIs in Settat city, Morocco. Methods: From January 2012 to December 2013, all uropathogenic community Enterobacteriaceae isolates were collected from the microbiology laboratory of Hassan II Hospital, Settat, Morocco. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producer isolates was confirmed by the double-disk synergy test and the modified Hodge test, respectively. Molecular characterization of β-lactamase genes was performed using polymerase chain reaction (PCR), followed by sequencing of the obtained products. Results: Among 153 isolates, 31 (20.26%) were multi-drug resistant (MDR). Nine strains (5.88%) were ESBL producers, of which Klebsiella pneumoniae (n=5; 20.83%), Escherichia coli (n=3; 3.15%), and Enterobacter cloacae (n=1; 9.09%) species were identified. The results of ESBL- encodinggenedetectionbysequencingrevealedthepresenceofCTX-M-15(n=9)inassociationwithotherβ-lactamasegenessuchastemoneira1 OXA-48 (n=8) and sulfhydryl variable 1 (n=5). According to the modified Hodge test and PCR, three isolates (1.96%) were positive carry the bla gene.  Conclusion:TheemergenceofMDRuropathogenicEnterobacteriaceaeisolatesinourcommunityishighlyalarming.Strictmeasureswillberequiredto control the further spread of these uropathogenic isolates. Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community

Antibiotic resistance profiling of Uropathogenic Enterobacteriaceae, Casablanca, Morocco

Introduction: the urinary tract infection is a pathology frequents as well in community as at the hospital. In last years, there has been increased the incidence of antibiotic resistance in Uropathogenic Enterobacteriaceae. This development explains the need for periodic regional surveillance of this resistance to antibiotics, which poses a real problem of public health, because it affects several molecules ranging from β-lactam to quinolones. Objective: the aims of this study is to determine the profile of antibiotic resistance of Uropathogenic Enterobacteriaceae isolated from medical analysis laboratories in Casablanca, Morocco. Materials and methods: This is a prospective study that was conducted on patients who visited medical analysis laboratories in Casablanca city, for urinalysis test from 01 January 2017 to 30 December 2018 (a two full years). The culture was performed according to the usual techniques, and the antibiogram was done according to the recommendations of the Antibiogram Committee of the French Society of Microbiology. The statistical analysis was performed using Microsoft Excel (Microsoft 2016). Results: During our study, we reported 18% of urinary tract infections, Sex ratio F/M was 1.79. In addition, Enterobacteriaceae were the most common germs. Of all the strains isolated, we noted a predominance of Escherichia coli with 75.41%) and Klebsiella ssp with 17.05%. In the course of this study period, we observed high rates of resistance to the main classes of antibiotics, and an overall increase between 2017 and 2018 in this resistance to the majority of β-lactam antibiotics, quinolones and aminoglycosides for almost all species of Uropathogenic Enterobacteriaceae. However, amikacin was the most active molecule against the Uropathogenic Enterobacteriaceae strains isolates. Conclusion: The development of resistance of Uropathogenic Enterobacteriaceae to antibiotics is a worrying phenomenon that exposes us to difficulties in the therapeutic management of infections. The current control of antimicrobial resistance is a real emergency and requires the involvement of public awareness before government instructions

Molecular characterization of penicillin non-susceptible Streptococcus pneumoniae isolated before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco

Abstract Background Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, especially among children and the elderly. The ability to effectively treat pneumococcal infection has been compromised due to the acquisition of antibiotic resistance, particularly to β-lactam drugs. This study aimed to describe the prevalence and molecular evolution of penicillin non-susceptible S. pneumoniae (PNSP) isolated from invasive diseases before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco. Methods Isolates were obtained from the Microbiology Laboratory of Ibn Rochd University Hospital Centre of Casablanca. Serogrouping was done by Pneumotest Kit and serotyping by the Quellung capsular swelling. Antibiotic susceptibility pattern was determined by disk diffusion and E-test methods. The PNSP were analyzed by pulsed-field gel electrophoresis (PFGE) and by genotyping of pbp1a, pbp2b, and pbp2x genes. Results A total of 361 S. pneumoniae isolates were collected from 2007 to 2014. Of these isolates, 58.7% were obtained before vaccination (2007–2010) and 41.3% after vaccination (2011–2014). Of the 361 isolates, 80 were PNSP (22.2%). Generally, the proportion of PNSP between pre- and post-vaccination periods were 31 and 13% (p = 0.009), respectively. The proportion of PNSP isolated from pediatric and adult (age > 14 years) patients decreased from 34.5 to 22.9% (p = 0.1) and from 17.7 to 10.2% (p = 0.1) before and after vaccine implementation, respectively. The leading serotypes of PNSP were 14 (33 vs. 57%) and 19A (18 vs. 14%) before and after vaccination among children. For adults, serotypes 19A (53%) and 23F (24%) were the dominant serotypes in the pre-vaccination period, while serotype 14 (22%) was the most prevalent after vaccination. There were 21 pbp genotypes in the pre-vaccination period vs. 12 for post-vaccination period. PFGE clustering showed six clusters of PNSP grouped into three clusters specific to pre-vaccination period (clusters I, II and III), two clusters specific to post-period (clusters V and VI) and a cluster (IV) that contained clones belonging to the two periods of vaccination. Conclusion Our observations demonstrate a high degree of genetic diversity among PNSP. Genetic clustering among PNSP strains showed that they spread mainly by a restricted number of PNSP clones with vaccine serotypes. PFGE clustering combined with pbp genotyping revealed that vaccination can change the population structure of PNSP

Antibacterial activity of cinnamon essential oils and their synergistic potential with antibiotics

The objective of this study was to evaluate the antibacterial activity of Cinnamomum cassia (cinnamon) essential oil (EO) alone and in combination with some classical antibiotics against three multidrug-resistant bacteria, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, to search a possible synergy. The antibacterial activity of all tested compounds was determined by agar disc diffusion and minimum inhibitory concentration assays. The checkerboard method was used to quantify the efficacy of cinnamon EO in combination with these antibiotics. Fractional inhibitory concentrations were calculated and interpreted as synergy, addition, indifferent, or antagonism. A synergistic interaction was shown against S. aureus with the combination cinnamon EO and ampicillin or chloramphenicol and against E. coli when cinnamon EO was combined with chloramphenicol. However, the combination of cinnamon oil and streptomycin displayed additive effects against all bacteria stains. The combinations of cinnamon EO and antibiotics can be used as an alternative therapeutic application, which can decrease the minimum effective dose of the drugs, thus reducing their possible adverse effects and the costs of treatment

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