Epidemiology and risk factors for staphylococcal urinary tract infections in the Moroccan Casablanca area.

PURPOSE: This study aimed to ascertain the prevalence and risk factors for developing staphylococcal urinary tract infections (UTIs) in the Casablanca area of Morocco. METHODS: In Casablanca, Morocco, a retrospective evaluation of 772 UTIs patients was conducted between January 2020 and December 2022. The research included two groups of patients: those with staphylococcal UTIs and those without. Sex, age, chronic illnesses, antibiotic exposure, urinary catheterization, urological surgery, and UTIs history were the risk variables assessed. We employed a logistic regression model to identify the characteristics that were predictive of staphylococcal UTIs. RESULTS: Eight staphylococcal species were responsible for 16.84% of UTIs in 772 non-repeating individuals. Patients infected with S. saprophyticus (35.38%) were the most common, followed by those infected with S. epidermidis (24.61%), S. aureus (13.85%), and S. hemolyticus (10.78%). Multivariate logistic regression analysis revealed that male sex (95% CI: 0.261-0.563), immunosuppression and immunosuppressive treatments (95% CI: 0.0068-0.64), chronic diseases (95% CI: 0.407-0.965), previous UTIs (95% CI: 0.031-0.228), frequency of urination more than 8 times a day (95% CI:1.04-3.29), frequency of urination once or twice a day (95% CI: 1.05-2.39), and urinary catheterization (95% CI: 0.02-0.22) were the most likely predictors of staphylococcal UTIs. In addition, a larger proportion of patients with staphylococcal UTIs were made aware of the risk factors associated with staphylococcal UTIs (52.31%, χ2 = 4.82, = 0.014). CONCLUSIONS: This is the first global study to evaluate the predictive factors for acquiring UTIs caused by staphylococci. Monitoring these factors will enable medical authorities to devise effective strategies for managing UTIs and combating antibiotic resistance.

Prevalence and antibacterial resistance patterns of uropathogenic staphylococci in Casablanca, Morocco.

INTRODUCTION: The purpose of this research is to evaluate the resistance profile of uropathogenic staphylococci bacteria in Casablanca, Morocco. METHODOLOGY: In this retrospective cross-sectional research carried out from January 2017 to December 2020, isolation and identification were carried out according to the usual techniques in medical microbiology. Staphylococcus aureus isolates were confirmed by polymerase chain reaction (PCR) amplification of the nuc gene, and the antibiogram was performed according to the guidelines of the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2021). The susceptibility of uropathogenic staphylococci to vancomycin was determined with broth microdilution following the recommendations of the Clinical and Laboratory Standards Institute. The mecA gene was tested on phenotypically cefoxitin-resistant S. aureus isolates by PCR. RESULTS: The prevalence of urinary tract infections (UTIs) was 18% (772/4374). UTIs were more common in females (n = 483, 63%) than males (n = 289, 37%). Among the Gram-positive bacteria isolated (198, 25.65%), the prevalence of staphylococci was (130/198, 65.66%). Among staphylococcal species identified, coagulase-negative staphylococci (CoNS) were more prevalent (112/130, 86.15%), and Staphylococcus saprophyticus was the most frequently isolated CoNS (46/112, 41.07%). Additionally, there were several S. aureus strains (18/130, 13.85%). Forty-four percent of S. aureus isolates (n = 8) were resistant to cefoxitin and also harboured the mecA gene. All S. aureus isolates were susceptible to linezolid, cotrimoxazole and vancomycin. CONCLUSIONS: The prevalence and antibacterial resistance patterns of uropathogenic staphylococci in this study, with a high percentage of methicillin resistance, require careful consideration of antimicrobial therapy for staphylococcal UTIs.