Etude de la flore bactérienne contaminant les téléphones mobiles avant et après la désinfection: comparaison entre les professionnels soignants de l’hôpital militaire d’instruction Mohammed V de Rabat et les témoins

Introduction: L'objectif de notre travail était évaluer la contamination microbienne des téléphones  mobiles utilisés par les personnels soignants des différents services de l'hôpital militaire d'instructions Mohammed V de Rabat et la comparer à celui d'une population témoin et aussi démontrer l'efficacité des solutions hydroalcoolique dans la désinfection de ces téléphones mobiles. Méthodes: Il s'agit d'une étude descriptive transversale réalisée sur une période de 9 mois entre  septembre 2010 et juin 2011, dans le service de bactériologie de l'hôpital militaire d'Instruction  Mohammed V. Résultats: L'étude bactériologique a été faite sur 240 téléphones mobiles dont 50%  provenaient de personnels de sante. Le taux de contamination bactérienne de tous les téléphones mobiles était de 100%. Les cultures des bactéries isolées au niveau des téléphones mobiles du personnel médical étaient plus polymorphes que celles de la population témoin (p=0,028). Parmi 437 bactéries isolées:  223(51%) provenaient de téléphones de personnels de santé et 214(49%) de téléphones de la population témoin avec une différence qui n'était pas statistiquement significative(p>0,05) sauf pour les isolats  deStaphylocoque à coagulase négative et Staphylococcus aureus. Les bactéries isolées étaient représentées par: Staphylocoque à coagulase (57,7%), Staphylococcus aureus (18,1%),   Corynebacterium sp (18,8%),Bacillus sp (2,3%) et autres (2,2%).La différence entre la prévalence des bactéries isolées selon les services et les fonctions des personnels de santé n'était pas statistiquementsignificative (p>0,05). La désinfection des téléphones portables par la solution hydroalcoolique a réduit à 99,5% le nombre des colonies.Conclusion: Ce travail montre que les téléphones portables pourraient jouer un rôle dans la transmission des infections nosocomiales et communautaires. Dans le cadre de prévention de ces risques, il faut  sensibiliser les utilisateurs des téléphones mobiles l'importance du lavage des mains et l'utilisation des solutions hydro alcoolique pour désinfecter aussi bien les téléphones portables que les mains

Pathologie infectieuse et infertilité du couple. Apport de la biologie moléculaire dans le diagnostic d’infertilité

Les infections touchant le tractus urogénital de l’homme ou de la femme sont une des causes majeures de l’infertilité. Parmi les agents pathogènes recensés, les microorganismes responsables d’IST notamment C. trachomatis qui représente une cible prioritaire de l’action diagnostique. En effet, la découverte d’une anomalie chromosomique permettra de préciser la conduite à tenir vis-à-vis du patient et parfois de sa famille. Un conseil génétique dont l’intérêt humain et matériel est loin d’être négligeable pourra alors être donné. Le fait de trouver une cause génétique à une infertilité de couple permet d’éviter une errance diagnostique qui, diminue les chances d’être pris en charge correctement. Le diagnostic d’une anomalie génétique responsable d’une infertilité pose d’emblée la question de son éventuelle transmission à la descendance par les techniques d’assistance médicale à la procréation et du risque de voir naître un enfant atteint par une affection grave. Mots clés : Infections, infertilité, diagnostic, biologie moléculaire 

Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh

Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus

Dengue fever in Morocco: result of surveillance during the year 2017 and first imported cases

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. The vector aedes albopictus has been revealed recently in the town of Rabat. Morocco established a program of active surveillance of dengue fever comprising many hospitals and laboratories across the kingdom. The purpose of this work is to describe the result of the surveillance of the dengue virus (DENV) infection during the year of 2017 among Moroccans and tourists who presented in our hospital with clinical signs of infection and to report the first confirmed positive cases of Dengue.From 20 December 2016 to 20 December 2017, 21 patients were hospitalized for suspicion of DENV infection. Half of them were returning from Côte d’Ivoire which is a popular tourist and business country for Moroccans and where an outbreak of DENV was confirmed on July 2017. Fever, headache, arthralgia-myalgia and malaise in addition to the notion of return from an endemic country justify in clinicians the demand for analysis of detection of dengue virus by RT-PCR.Dengue infection was confirmed in two patient both coming from Côte d’Ivoire, a Moroccan and an Ivorian who were staying in Abidjan during the period of the outbreak of 2017

HLA-B*44 allele associated with clinical parameters in HIV-1 infected Moroccan cohort

Background: The human leukocyte antigen-B*44 (HLA-B*44) allele has been reported to have promising results in the control of human immunodeficiency virus-1 (HIV-1) infection and associated with protection against HIV-1 disease progression. In the Moroccan HIV-1 infected patients, the contribution of this allele has not been established. This study aimed to evaluate the distribution of HLA-B*44 allele among HIV-1-infected in Morocco. Additionally, investigate HLA-B*44 allele association with demographical and HIV clinical parameters.Methods: One hundred and sixty-seven HIV-1 infected, antiretroviral naive individuals were enrolled in this study. The HLA-B*44 allele screening was performed using the PCR amplification.Results: Of the 167 individuals genotyped, 26 (16%) of them expressing the HLA-B*44 allele. Clinical stages at diagnosis, median pre-treatment HIV viral load (pVL) and CD4 T cell counts differ significantly (p = 0.0001, p=0.001 and p=0.0001 respectively) between the patients who had been expressing the HLA-B*44 allele and patients who had not been expressing this allele. The presence of HLA-B*44 allele was significantly associated with pVL and CD4 T cell counts (p=0.004 and p=0.0001 respectively). The bivariate analysis has showed that the expression of the HLA-B*44 allele was strongly associated with advanced HIV infection (Odd ratio (OR) 0.12 (95% confidence interval (CI) 0.04-0.37), p=0.0001).Conclusions: Author have described for the first time in Morocco the association of the HLA-B*44 allele with the clinical parameters of HIV infection. These results expand the knowledge of the distribution and effect of this allele in the Moroccan population

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Simultaneous detection of Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae by quantitative PCR from CSF samples with negative culture in Morocco

Bacteriological cultures from cerebrospinal fluids (CSF) have less sensitivity and specificity compared to quantitative PCR (RT-PCR), and multiple facts still conduct to the increase of negative culture. The aims of this study are to determine the molecular epidemiology and the simultaneous detection of bacterial meningitis in Morocco by using RT-PCR and compared this molecular approach with culture method to improve the etiological diagnosis of meningitis. The CSFs were collected over one-year period in 2018 in different hospitals covering all regions of the Kingdom of Morocco, from patients with suspected meningitis. The results showed the confirmation rate per culture recorded a rate of 33% and the RT-PCR of 70%. Molecular epidemiology is predominant of Neisseria meningitidis followed by Streptococcus pneumoniae and a dramatic reduction in meningitis due to Haemophilus influenzae following the introduction of conjugate vaccine in 2007. Also, the epidemiological profile shows a sex ratio M/F of 1.4 and a median age of 2 years. The national distribution showed a predominant of meningococcal disease followed by pneumococcal disease, especially a dominance of N. meningitidis over S. pneumoniae in two regions and a slight predominance of S. pneumoniae in the other two regions over N. meningitidis. Our research shows that culture in our country has less sensitivity and specificity than RT-PCR in diagnosis of bacterial meningitis and that molecular biology technique at bacteriology laboratories is desirable for diagnosis, early management of meningitis cases and in the context of the surveillance of meningitis in Morocco in parallel with culture

Epidemiology and antibiotic resistance profile of bacterial meningitis in Morocco from 2015 to 2018

Over a 4-year study period from 2015 to 2018, altogether 183 isolates of bacterial meningitis were collected from 12 hospitals covering the entire Moroccan territory. Neisseria meningitidis represented 58.5%, Streptococcus pneumoniae 35.5%, and Haemophilus influenzae type b 6%. H. influenzae type b mainly affected 5-year-olds and unvaccinated adults. N. meningitidis serogroup B represented 90.7% followed by serogroup W135 with 6.5%. Decreased susceptibility to penicillin G (DSPG) for all isolates accounted for 15.7%, with 11.6% being resistant to penicillin G (PG) and 4.1% decreased susceptibility. Cumulative results of all strains showed 2.7% decreased susceptibility to amoxicillin and 3.3% resistant, 2.2% of isolates were resistant to third-generation cephalosporin and 2.2% were decreased susceptible, 5.5% were resistant to chloramphenicol and 2.7% were resistant to rifampin. The frequency of DSPG observed in our study is more common in S. pneumoniae than in N. meningitidis (P < 0.05). These isolates have been found to be highly susceptible to antibiotics used for treatment and prophylaxis chemotherapy and the observed resistance remains rare. The impact of introduction of conjugate vaccines against H. influenzae type b and S. pneumoniae (PCVs) is an advantage in reducing meningitis cases due to these two species. © 2020 Akademiai Kiado, Budapest

Dengue fever in Morocco: result of surveillance during the year 2017 and first imported cases

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. The vector aedes albopictus has been revealed recently in the town of Rabat. Morocco established a program of active surveillance of dengue fever comprising many hospitals and laboratories across the kingdom. The purpose of this work is to describe the result of the surveillance of the dengue virus (DENV) infection during the year of 2017 among Moroccans and tourists who presented in our hospital with clinical signs of infection and to report the first confirmed positive cases of Dengue.From 20 December 2016 to 20 December 2017, 21 patients were hospitalized for suspicion of DENV infection. Half of them were returning from Côte d’Ivoire which is a popular tourist and business country for Moroccans and where an outbreak of DENV was confirmed on July 2017. Fever, headache, arthralgia-myalgia and malaise in addition to the notion of return from an endemic country justify in clinicians the demand for analysis of detection of dengue virus by RT-PCR.Dengue infection was confirmed in two patient both coming from Côte d’Ivoire, a Moroccan and an Ivorian who were staying in Abidjan during the period of the outbreak of 2017

Advanced Non-small Cell Lung Cancer: EGFR Mutation Analysis Using Pyrosequencing and the Fully Automated qPCR-Based Idylla System

Background Epidermal growth factor receptor (EGFR) mutation status is of a major clinical significance in non-small cell lung cancer (NSCLC) management, as it guides therapeutic decision making to target patients for a better response to therapy. This implicates the introduction of EGFR mutation analysis as the standard of care for Moroccan NSCLC patients, which in itself entails the implementation of targeted methods for routine EGFR mutation analysis in our laboratories. In this study, we aimed to present 2 targeted methods for EGFR mutation identification and to determine the prevalence and spectrum of EGFR mutations in NSCLC Moroccan patients. Methods A retrospective investigation of a cohort of 340 patients was undertaken to analyze somatic EGFR mutations in exons 18 to 21 using pyrosequencing and the Idylla TM system. Results Of the enrolled patients, 70.9% were males and 29.1% were females. Predominately, 92% of cases had adenocarcinoma, and 53.7% of patients self-reported a history of smoking. Overall, 73 patients (21.7%) harbored an EGFR mutation, the most prevalent of which were the exon 19 deletions (53.4%) followed by exon 21 substitutions (31%). Exon 18 mutations and exon 20 alterations occurred in 8.1% and 6.7% of the positive EGFR mutation cases, respectively. Of the analyzed cases, all of the EGFR-mutated patients had adenocarcinoma. EGFR mutation prevalence was significantly higher in females (females vs males: 38.4% vs 14.5%, P < .001) and non-smokers (non-smokers vs non-smokers: 36% vs 10.3%, P < .001). The featured pyrosequencing and the Idylla TM system are targeted methods endowed with high sensitivity and specificity as well as other compelling characteristics which make them great options for routine EGFR mutation testing for advanced NSCLC patients. Conclusion These findings underline the imperious need for implementing quick and efficient targeted methods for routine EGFR mutation testing among NSCLC patients, which is particularly useful in determining patients who are more likely to benefit from targeted therapy