Evaluation of Changes in Cariogenic Bacteria in a Young Moroccan Population with Fixed Orthodontic Appliances.

Fixed orthodontic appliances hinder the maintenance of proper oral hygiene and result in dental plaque accumulation. Many studies report that qualitative changes in the dental flora occur after initiating the orthodontic treatment, but there is a paucity of literature on the same topic among Moroccan orthodontic patients. The aim of this study was to evaluate the changes of the oral microbial flora during the orthodontic treatment period of a young Moroccan population. Materials and Methods. Dental plaque samples of 18 patients, who were randomly selected before the placement of orthodontic appliances, were collected to isolate and identify the bacterial species involved using classical bacteriological methods for species' culture and identification. The reading was recorded at T0 before placement of the device. New samples were taken again one month later and then three months afterwards, where the readings were recorded as T1 and T2, respectively. The culture was made via Columbia Agar with 5% sheep blood, Todd Hewitt Broth, and Schaedler medium containing vitamin K3. Bacterial species were identified using API-20 Strep for Streptococci and API-20 A for anaerobic bacteria. The phoenix system was used for identification. Results. After three months of orthodontic treatment, the increase in the frequency of Streptococcus sobrinus and Streptococcus mitis were significant (0.01 and 0.02, respectively) as well as for Lactobacillus (0.03). No significant difference was recorded for other bacterial species. Conclusion. There is a significant qualitative change in oral microorganisms after three months of orthodontic treatment, especially for bacteria that are incriminated in caries formation.

[Prevalence of Acinetobacter baumannii and Pseudomonas aeruginosa isolates resistant to imipenem by production of metallo-beta-lactamase]. / Prévalence des souches d'Acinetobacter baumannii et de Pseudomonas aeruginosa résistantes à l'imipénème par production de métallo-beta-lactamases.

UNLABELLED: Metallo-beta-lactamases (MBL) are enzymes produced by Gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter baumannii. These enzymes make these isolates resistant to imipenem. AIM: The aim of this study was to determine the prevalence of this resistance mechanism in Pseudomonas aeruginosa and Acinetobacter baumannii strains identified in the bacteriology laboratory of the Rabat Ibn Sina teaching hospital, Morocco. MATERIALS AND METHOD: Screening for MBL was systematic in all resistant strains and/or strains with decreased sensitivity to imipenem, according to Dongeun Yong et al.'s method, using a sterilized solution of EDTA 0.5 M pH 8. RESULTS: Eighty-five bacterial strains (48 P. aeruginosa and 37 A. baumannii) were identified 23% (11) and 57% (21) of which were respectively resistant to the imipenem. The prevalence of MbetaL producing strains was 27% for P. aeruginosa and 38% for A. baumannii. CONCLUSION: These results show that the frequency of these strains is increases in our hospital and that their emergence represents a serious therapeutic and epidemiological problem. This means that we need to implement the supervision of hospital microbial environment and strictly apply hygiene measures.

Post-transplantation diabetes mellitus.

To determine the prevalence of post-kidney transplantation diabetes (PTDM) and to assess its risk factors, we retrospectively studied 92 non-diabetic kidney transplant patients. The immunosuppressive drugs used to prevent rejection included prednisone, a calcineurin inhibitor (cyclosporine or tacrolimus) and an antimetabolite (azathioprine or mycofenolate mofetil). Diabetes was defined according to the WHO criteria and the American Diabetes Association. The mean age of our patients was 35.8 ± 10.5 years, and there was a clear male predominance (56 men and 36 women). The graft was from living related donor in 71/92 (76%) patients. The prevalence of diabetes in post-kidney transplant was 15.2%. The factors increasing the occurrence of PTDM included advanced age, high doses of steroids and cyclosporine. Management of PTDM included diet modification, oral anti-diabetic and insulin. We conclude that the prevalence of PTDM is significant in our transplant population and risk factors for its development are multiple and require aggressive multifaceted management.

Epidemiology and prevention of Staphylococcus aureus nasal carriage in hemodialyzed patients.

UNLABELLED: Nasal carriage of Staphylococcus aureus may be responsible for some serious infections among hemodialyzed patients. Its pathogenic potential and commensal nature allows for an easy transmission both in and out of hospital environment. PURPOSE: This study was to assess the prevalence of S. aureus nasal carriage, to determine its frequency and nature in hemodialyzed patients of the Rabat Ibn Sina University hospital, in Morocco. PATIENT AND METHOD: The study began in March 2008 according to the following protocol: screening of nasal carriage with five samplings, performed once a month three times, then once a month two times again after an interruption period of three months. Screening was performed weekly during the first month in hemodialyzed patients treated with mupirocin (Bactroban(®) 2%), and then monthly, to monitor the kinetics of S. aureus eradication. RESULTS: The study included 54 hemodialyzed patients with a mean 44.16±14 years of age, sex ratio of 0.54, and mean hemodialysis duration of 118.7±67 months. Permanent and intermittent S. aureus carriage was found in respectively 18.52% and 25.92% of patients. Eighty-one strains of S. aureus were identified, 14.81% of which were methicillin resistant. Eradication was sustained beyond 20 months in patients treated with mupirocin. CONCLUSION: This investigation allowed us to identify hemodialyzed patients at risk, so as to implement the rules of individual and collective hygiene, and to extend mupirocin antibiotic prophylaxis in our hemodialysis unit.