Epidemiology of Staphylococcus aureus infections and nasal carriage at the Ibn Rochd University Hospital Center, Casablanca, Morocco

AbstractInfections caused by Staphylococcus aureus are a major problem in hospitals. The multidrug resistance and the nasal carriage of S. aureus play a key role in the epidemic of these infections. In this prospective study, 160 S. aureus strains were isolated from pathological samples of patients (79 cases) and nasal swabs (81) of cases and controls from January to July 2007. The susceptibility to 16 antibiotics, including cefoxitin, was determined by the agar diffusion method, and methicillin resistance was confirmed by amplifying the mecA gene by polymerase chain reaction (PCR). The prevalence of methicilin-resistant S. aureus (MRSA) was high in the burns (57.7%) and dermatology (39.4%) wards, and the MRSA strains isolated were extremely multi-resistant, but all of them were still susceptible to vancomycin. The rate of S. aureus nasal carriage was high in both cases and controls, in state, MRSA nasal carriage was more common among people infected with S. aureus

A review of Group B Streptococcus maternal-fetal infection

For a long time, infectious diseases have been a major public health problem, mainly maternal fetal infections linked to neonate’s mortality. Streptococcus agalactiae (GBS) infection is one of the main infections, which threat mother-infant health. One of the major challenges that remains to be addressed is therapeutic care strategy, further, the emergence of antibiotic resistant bacteria which constitute a major challenge for clinicians. Concerning GBS an antibiotic prophylaxis regimen is adopted to reduce the vertical transmission of bacteria from mother to neonate and avoid the appearance of complications related to GBS infection such as early onset disease and late onset disease that can lead to stillbirths. Like most bacteria, GBS is susceptible to first-line antibiotics, and in case of resistance, therapy is based on second and third-line antibiotics. The drug susceptibility testing of microorganisms is therefore essential in the therapeutic strategy, because it not only facilitates the orientation of treatment but also help to set up a system supervising the expansion of resistant strains. This present paper constitutes a literature review on Streptococcus agalactiae maternal-fetal infection and summarizes some epidemiological studies on the emergence of this bacterium as well as it provides the prevalence of its resistance to antibiotics and outlines some vaccine development strategies

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

Early neonatal respiratory distress revealing meningitis caused by Streptococcus pneumoniae serotype 17F: a case report

Background: Streptococcus pneumoniae (S. pneumoniae) is the first leading cause of invasive diseases such as meningitis, bacteremia and pneumoniae in children. In this case we report an early neonatal respiratory distress revealing meningitis caused byS. pneumoniae Serotype 17F through vertical transmission, in the newborn of 3 hours of live. Case description: A male late preterm newborn was born by vaginal delivery at a gestational age of 34 weeks. At 3 hours of life, he was admitted for early moderate neonatal respiratory distress in the Neonatal Medicine and Resuscitation Service.Cerebrospinal fluid culture yielded S. pneumoniae belonging to serotype 17F while the blood culture was negative. The same pneumococcal serotype was recovered from the high vaginal swab of the mother. Both isolates were found susceptible to all tested antibiotics except tetracycline and chloramphenicol to which the strain was resistant. Antibiotherapy management of the child included ceftriaxone at 150mg/kg/day for 21 days, in combination with gentamycin at 5 mg/kg/day for 5 days. ciprofloxacin was added at 40mg/kg/day in two doses for a period of three weeks as the baby presented a hydrocephalus. Conclusion: This finding shows that clinical manifestations of neonatal pneumococcal meningitis may be atypical and/or misleading. Keywords: Streptococcus pneumoniae; neonatal meningitis; respiratory distress

Les invaginations intestinales chez l’adulte: à propos de 17 cas

L'invagination intestinale est une affection rare chez l’adulte. Elle conduit le plus souvent à la découverte d’une cause organique pouvant être tumorale. Le but de notre travail est de dégager les particularités épidémiologiques diagnostiques et thérapeutiques de cette affection; à travers une étude descriptive rétrospective, ayant portée sur 17 cas d'invagination intestinale de l'adulte opérés dans le service des Urgences Chirurgicales Viscérales du CHU Ibn Rochd de Casablanca du 1er janvier 2006 au 31 décembre 2010. La douleur abdominale était présente chez tout les patients; L'échographie abdominale pratiquée chez 12 patients; elle a montré une image en cocarde dans 9 cas, une masse abdominale dans 1 cas et un épaississement grèlique dans 5 cas. La tomodensitométrie abdominale faite chez 15 patients a objectivé l’invagination intestinale dans tous les cas. Le traitement chirurgical a été adopté chez tous les patients; il a permis de faire la résection des segments intestinaux invaginé dans tout les cas. Le résultat anatomopathologique de la pièce de résection a retrouvé une cause organique de l’invagination dans dix cas (58,8%). L’invagination intestinale chez l’adulte est souvent secondaire à une lésion organique : tumorale ou inflammatoire. Elle se caractérise par son polymorphisme clinique. Il s’agit essentiellement de phénomènes subocclusifs à répétition. Concernant le traitement de l’invagination intestinale de l’adulte, la résection du segment invaginé est toujours nécessaire car dans 80% des cas, cette affection est secondaire à une lésion organique qui doit être traitée.Pan African Medical Journal 2012; 12:1

Méningite à Streptococcus pneumoniae sérotype 7A chez un nourrisson immunisé par deux doses du vaccin pneumococcique conjugué 13-valent: à propos d’un cas

Cause majeure de morbidité et mortalité, les méningites à pneumocoque (PNO) représentent un fléau mondial. Au Maroc, le vaccin conjugué 13-valent contre le pneumocoque (PCV13) a été introduit dans le Programme National de Vaccination en octobre 2010 selon le calendrier 2 + 1 et remplacé par le PCV10 en juillet 2012, selon le même calendrier. Malgré le recours au PCV13, essentiel dans la lutte contre les maladies pneumococciques, l'émergence de nouveaux sérotypes non vaccinaux entrainent toujours des méningites chez l'enfant et engendrent de lourdes séquelles. Nous rapportons le cas d'une méningite causée par Streptococcus pneumoniae sérotype 7A chez un nourrisson immunisé avec 2 doses de PCV13. La particularité de cette observation réside dans une méningite à PNO sérotype 7A, non contenu dans le PCV13, chez un nourrisson vacciné par 2 doses du PCV13. Les auteurs insistent sur la nécessité et l'importance d'un observatoire PNO et d'une large étude épidémiologique afin de déterminer les sérotypes en circulation au Maroc depuis l'introduction du PCV13 puis PCV10

Total rupture of hydatid cyst of liver in to common bile duct: a case report

Rupture of hydatid liver cyst into biliary tree is frequent complications that involvethe common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient who presented with acute cholangitis was diagnosed as a case of totally rupture of hydatid cyst on Abdominal CT Scan. Rupture of hydatid cyst of liver into common bile duct and the gallbladder was confirmed on surgery. Treated by cholecystectomy and T-tube drainage of Common bileduct. Key words: hydatid liver cyst, Rupture, Common bile duct (CBD),jaundice

Splenic artery aneurysm revealed by digestive bleeding

Introduction : Les anévrismes de l’artère splénique sont les plus fréquents des anévrismes des artères viscérales et sont le plus souvent asymptomatiques. Un anévrisme de l’artère splénique fistulisé dans l’estomac est une cause rare mais potentiellement grave d’hémorragies digestives. Observation : Nous rapportons le cas d’un patient de 60 ans, qui a été admis pour des hématémèses, méléna et rectorragies, sans pouvoir déterminer l’origine du saignement à la fibroscopie digestive haute, puis son tableau s’est compliqué d’un abdomen aigu avec un état de choc. Le diagnostic d’un anévrisme de l’artère splénique, fistulisé en intragastrique et rompu dans l’abdomen a été révélé à la TDM abdominale. Le traitement était chirurgical avec bonne évolution. Conclusion : Bien que rare, devant la possibilité d’une hémostase spontanée retardant le diagnostic et devant l’engagement du pronostic vital, un anévrisme de l’artère splénique, fistulisé dans la lumière digestive doit être recherché en cas de saignement gastro-intestinal d’origine inconnue.Introduction: Splenic artery aneurysm is the most common visceral artery aneurysms and is often asymptomatic. A splenic artery aneurysm fistulized in the stomach is a rare but serious cause of gastrointestinal bleeding