[Seroprevalence of pandemic influenza A (H1N1)pdm09 in two regions in Morocco following the 2010-2011 influenza season]. / Séroprévalence de la grippe pandémique A(H1N1)pdm09 dans deux régions du Maroc après la saison grippale 2010-2011.

PURPOSES: To study and to compare the prevalence of infection with the virus A(H1N1)pdm 2009 in the population of two regions of Morocco compared to preexisting antibody levels. PATIENTS AND METHODS: A total of 300 and 200 serum samples were collected in the region of Rabat and Meknes respectively. Samples were collected during March to April 2011. One hundred and fifty sera, collected in 2007 from blood donors, were recovered from the blood center. The research for antibodies to influenza A(H1N1)pdm09 was performed by hemagglutination inhibition assay. RESULTS: The overall prevalence of antibodies inhibiting hemagglutination at the Rabat region (67%) is significantly higher than that of Meknes (53%) while the rate of cross-reactive antibodies was 7.3%. The subjects under 25 years from the Rabat region have infection rates as high with an odds ratio of 2.45. Individuals with comorbidities have the lowest prevalence with an odds ratio of 0.61. The rate of influenza A(H1N1)pdm09 vaccination in the Rabat region is 7%. CONCLUSIONS: Immunization rates of the Moroccan population will prevent the occurrence of large outbreaks in the year 2011 to 2012 but the persistence of a naive population justifies the continuation of vaccination against A(H1N1)pdm09.

Pandemic influenza A(H1N1)2009 in Morocco: experience of the Mohammed V Military Teaching Hospital, Rabat, 12 June to 24 December 2009.

On 12 June 2009, Morocco was the first country in North Africa to report a laboratory-confirmed case of influenza A(H1N1)2009 virus infection. This study describes the epidemiological and clinical characteristics of 240 laboratory-confirmed cases among 594 outpatients with influenza-like illness at the Mohammed V Military Teaching Hospital, Rabat, from 12 June to 24 December 2009. Real-time reverse transcription-PCR was used to confirm the infection. The epidemic peaked in weeks 47 to 49 (16 November to 6 December 2009). The mean age of cases was 23 years (standard deviation: 14 years). Cough was the most common symptom in 200 cases (83%), followed by fever (≥38 °C) in 195 (81%). Diarrhoea or vomiting was reported in 12 (5%) patients. None of the cases developed any complications and no deaths occurred during the study period.

[Epidemiological features of multidrug resistant bacteria isolated from urine samples at the Mohammed V Military Teaching Hospital in Rabat, Morocco]. / Epidémiologie des bactéries multi- résistantes isolées des urines a l'Hôpital Militaire d'Lnstruction Mohammed V de Rabat (Maroc).

Hospital-acquired multidrug resistant bacteria infections are a serious public health issue causing increased morbidity, mortality and care cost. These risks underscore the need for health care institutions to maintain active panels to monitor, prevent, and manage hospital-acquired infections. The purpose of this study was to assess the epidemiology of urinary tract infection involving multidrug resistant bacteria at the Microbiology Laboratory of the Mohammed-V Military Teaching Hospital in Rabat. Study was carried out retrospectively on bacteria isolated from 10,243 urinary samples collected from January 1 to December 31, 2008. A total of 1,439 non-redundant bacteria (14.1%) meeting the criteria of urinary infection were identified. One hundred and three of the 1,439 bacteria isolated (7%) were multidrug resistant. Multidrug-resistant bacteria were more common in in-patients (63.1%). Mean patient age was 53.8 +/- 18.2 and the M/F sex ratio was 2.2. The most common multi-drug resistant bacteria were Enterobacteria producing extended spectrum bêta-lactamase (54.4% including 40.8% of Klebsiella pneumonia) and non-fermenting bacteria (45.6% including 26.2% of Pseudomonas aeruginosa. and 19.4% of Acinetobacter baumannii. These bacteria were resistant to the most commonly used antibiotics but remained highly sensitive to colistin, imipenem and amikacin.

[Epidemiology and susceptibility profile of blood culture isolates in an intensive care unit (2002-2005)]. / Epidémiologie et profil de sensibilité des isolats d'hémoculture dans un service de réanimation (2002-2005).

INTRODUCTION: The aim of our study was to determine the epidemiological profile and the antibiotics susceptibility of bacteria identified in blood culture in the intensive care unit, to improve empirical antibiotherapy. MATERIAL AND METHOD: A retrospective study was made over a four-year period (2002-2005) in the intensive care unit of the Mohammed-V Military Hospital. It included all the bacteria identified in blood culture. RESULTS: During this period, we collected 286 isolates, Gram-negative bacilli 49.3% and Gram-positive cocci 46.85%. The most frequently identified species were Acinetobacter baumannii (13.63%), Staphylococcus epidermidis (12.6%), Staphylococcus aureus (11.9%), and Pseudomonas aeruginosa (7%). Enterobacteriaceae accounted for 25.54%: Klebsiella pneumoniae 7%, and Enterobacter cloacae 7%. The rate of methicillin-resistant Staphylococcus aureus was 52.94 % and coagulase negative staphylococci 60.24%. No resistance to glycopeptides was observed. Enterobacteriaceae were resistant to third generation cephalosporins in 42.6 % and had a broad-spectrum betalactamase phenotype in 18%. The resistance rate of A. baumannii was 68.7% for ceftazidime and 31.4% for imipenem. The resistance rate of P. aeruginosa to the third generation cephalosporines and the imipenem were respectively 16.6% and 10.5%. CONCLUSION: A regular epidemiologic study of blood culture isolates and determination of susceptibility to antibiotics are necessary to improve empiric therapy.

[Serratia rubidaea bacteremia]. / Bactériémie à Serratia rubidaea.

Serratia rubidaea is an opportunist pathogenic bacterium, it is rarely identified in man, and when so, generally found in the respiratory tract, wounds, feces, bile, but also in blood. S. rubidaea can be responsible for infection, particularly in debilitated patients, receiving broad spectrum antibiotics or after undergoing extensive surgery, or invasive procedures. We report the case of a 54-year-old, nicotinic patient, with no previous medical history, admitted for complete arrhythmia due to auricular fibrillation. The patient had been carrying an arterial catheter for two weeks. Two hemocultures were positive in the first 48 hours with identification of Serratia rubidaea. S. rubidaea features inductible chromosomal betalactamase of the cephalosporinase type, resistant to ampicilline and cefalotin. The treatment combined gentamycin 160 mg/d and ciprofloxacin 400 mg/d for 10 days. The evolution was favourable.

[Pseudomonas stutzeri osteitis: A case study]. / Ostéite à Pseudomonas stutzeri à propos d'un cas.

We report a case of osteitis in a 46-year-old patient, caused by Pseudomonas stutzeri following an open fracture of the left femur. The patient was treated with 1g ceftazidime every 8 hours for two weeks combined with 160 mg/day of amikacin for 10 days. A second-line ofloxacin oral treatment at 400 mg/day was then given during 4 weeks. Surgical treatment consisted in debridement of the fracture region. Sterilization of the fracture region led to an osteosynthesis by blade plate and bone graft. The result was favorable.