Antibiotic resistance patterns of carbapenemase-producing Enterobacterales in Mohammed VI University Hospital of Marrakech, Morocco.

OBJECTIVES: The emergence and spread of Carbapenem-Resistant Enterobacterales (CRE) has become a growing concern for health services, internationally, nationally, and regionally. In Morocco, the situation is more worrisome as studies on CRE are scarce and/or scattered and/or outdated. As a result, we carried out the present study to determine and update CRE prevalence at Mohammed VI University Hospital of Marrakech, Morocco. PATIENTS AND METHODS: A cross-sectional prospective study was carried out from March 2018 to March 2020 on 41161 clinical specimens of 23,469 patients suspected of bacterial infections. Enterobacterales strains were isolated following standard bacteriological procedures. Bacterial strains were identified using BD-Phoenix and MALDI-TOF-MS. Antibiotic susceptibility was determined for 14 antibiotics. Carbapenemase production and phenotypic detection were characterized using modified carbapenem inactivation phenotypic and immunochromatographic methods. RESULTS: All in all, 484 Enterobaterales resistant to at least one carbapenem were recovered. The majority was isolated from the neonatal unit (14%), followed by the urology-nephrology (11%), and plastic surgery departments (10%). K. pneumoniae (n=232) was the most isolated, followed by E. cloacae (n=148), E. coli (n=56), and S. marcescens (n=17). Antibiotic susceptibility profile showed high rates of resistance to ciprofloxacin (75.21%), gentamicin (84.50%), and cotrimoxazole (88.42%). Out of 484 CRE positive cultures, 388 (80.16%) were Carbapenemase-positive. Out of the latter, 170 were metallo-beta-lactamase producers (NDM), 162 OXA-48-like, and 56 both. CONCLUSION: These findings emphasize the urgent need for control precautions and strict measures to contain and mitigate this issue.

Streptococcus pneumoniae carriage among febrile children at the time of PCV-10 immunization in pediatric emergencies at Mohammed VI University Hospital Centre in Marrakesh (Morocco).

OBJECTIVES: In Morocco, 13-valent pneumococcal conjugated vaccine (PCV) was introduced in the childhood immunization program in October 2010 and changed to PCV-10 in July 2012. The purpose of this study was firstly to determine the prevalence of pneumococcus carriage in a population of febrile infants in Marrakesh and secondly, to investigate the risk factors for carriage and the distribution of circulating serotypes. MATERIAL AND METHODS: This prospective study was conducted from February to June 2017, in the pediatric emergency department of the Mother and Child Hospital of Mohammed VI University Hospital Centre (UHC) in Marrakesh. At total of 183febrile infants, aged 2-18months, were enrolled in this study and were swabbed for nasopharyngeal carriage. Pneumococci were cultured, identified, serotyped, and tested for penicillin susceptibility. Demographic data and risk factors for carriage were collected. The statistical analyses performed were the following: the analysis of the risk factors using logistic regression, the estimation of serotype diversity with the Simpson index, and the Chi2 test to compare serotype distribution in the prevaccination (a cohort of 660 healthy children, less than 2years old, in the Marrakesh region, in 2008-2009) and postvaccination periods. RESULTS: The prevalence of Streptococcus pneumoniae carriage was 68.3%. Of the 183infants enrolled in this study, 111 had received at least one dose of PCV-10. Colonization by vaccine serotype among febrile children was related to incomplete vaccination status. In total, vaccine serotypes accounted for 6.4% (n=8): 19F (n=2), 1 (n=2) and one strain for each of the following serotypes: 14, 23F, 6B, and 9V. Non-vaccine and nontypeable strains presented 63.2% and 23.2%, respectively, with dominance of serotypes 6A (6.4%), 15A/15F (5.6%), 20, 22F/22A, 23B, and 11A/11D with a prevalence of 3.2%. The rate of pneumococcus strains with reduced susceptibility to penicillin was 33.6%, of which 90.2% were non-vaccine serotypes and nontypeable strains. Serotype diversity increased in the postvaccination period and the effectiveness of PCV-10 against vaccine serotypes was estimated at 89.6%. CONCLUSION: An important change in the distribution of vaccine and non-vaccine serotypes was observed after the introduction of the PCVs. In fact, the prevalence of vaccine serotypes decreased significantly while non-vaccine serotypes emerged. These results underscore the importance of maintaining close and prolonged surveillance of serotype distribution to monitor the dynamics of nasopharyngeal pneumococcal carriage.

Streptomyces thinghirensis sp. nov., isolated from rhizosphere soil of Vitis vinifera.

A novel actinomycete, strain S10(T), was isolated from rhizosphere soil of wild Vitis vinifera in Thinghir, Ouarzazate Province, Southern Morocco. The taxonomic status of this strain was established using a polyphasic approach. Strain S10(T) had white-grey aerial mycelium with long, spiral spore chains bearing smooth surfaced spores and produced a yellow diffusible pigment. Chemotaxonomic analyses showed that the cell wall of strain S10(T) contained ll-diaminopimelic acid and glycine. Phylogenetic analysis based on the almost complete 16S rRNA gene sequence indicated that strain S10(T) belonged to the Group I streptomycetes, branching off next to Streptomyces marokkonensis LMG 23016(T) from the Streptomyces violaceoruber group. DNA-DNA relatedness and phenotypic data distinguished strain S10(T) from the phylogenetically closest related type strains. It is therefore proposed that strain S10(T) (=CCMM B35(T)=DSM 41919(T)) represents the type strain of a novel species of the genus Streptomyces, for which the name Streptomyces thinghirensis sp. nov. is proposed.

Streptomyces marokkonensis sp. nov., isolated from rhizosphere soil of Argania spinosa L.

The novel actinomycete strain Ap1(T) was isolated from rhizosphere soil of the argan tree (Argania spinosa L.) in the south of Morocco. Strain Ap1(T) has been reported as a novel producer of the pentaene polyene macrolide isochainin, which strongly inhibits the growth of pathogenic yeasts and phytopathogenic fungi. Strain Ap1(T) shows a greyish-white aerial mycelium with chains of smooth-surfaced spores of the Spiralis type and a cell wall containing ll-diaminopimelic acid. Based on chemotaxonomy and morphological features, strain Ap1(T) was identified as a member of the genus Streptomyces. 16S rRNA gene sequence similarities based on almost-complete 16S rRNA gene sequences showed that strain Ap1(T) is closely associated with members of the Streptomyces violaceoruber species group (S. violaceoruber, S. coelescens, S. violaceorubidus, 'S. caesius', 'S. lividans', S. violaceolatus and S. humiferus) and others (Streptomyces aurantiogriseus, S. lienomycini, S. chattanoogensis, S. rubrogriseus and S. tendae). However, protein profiling, DNA-DNA hybridization and BOX-PCR fingerprinting proved a relationship above the species level. In addition, the phenotype also allowed for the differentiation of strain Ap1(T) from its closest neighbours. As a result of this polyphasic approach, we conclude that strain Ap1(T) represents a novel species of the genus Streptomyces, for which the name Streptomyces marokkonensis sp. nov. is proposed. The type strain is Ap1(T) (=R-22003(T) =LMG 23016(T) =DSM 41918(T)).