IntroductionThe colonization of patients by carbapenemase-producing Enterobacterales (CPE) has been associated with heightened mortality, especially in vulnerable individuals within intensive care units (ICUs). Our study aimed to comprehensively assess CPE prevalence among ICU patients across the Mediterranean region pre-COVID-19, conducting a multicenter prevalence study in the first quarter of 2019.MethodsWe collected clinical data and rectal or fecal samples from 256 ICU patients for CPE testing. Additionally, we performed whole-genome sequencing on 40 representative CPE strains to document their molecular characteristics.ResultsAmong the 256 patients, CPE was detected in 73 samples (28.5%), with prevalence varying from 3.3 to 69.0% across participating centers. We observed 13 colistin-resistant CPE strains, affecting three ICUs. Genetic analysis revealed highly diverse E. coli and K. pneumoniae strains, predominantly from international high-risk clones. Notably, blaOXA-48 and blaNDM-1 were the most prevalent carbapenemase genes. Molecular typing uncovered potential patient clusters in six centers. Significantly, longer hospital stays were associated with increased CPE carriage (p < 0.001). Nine centers across Morocco, Tunisia, Egypt, and Lebanon voluntarily participated.DiscussionOur study provides CPE prevalence in Mediterranean ICUs and reaffirms established CPE presence in this setting but also provides updates on the molecular diversity of CPE strains. These findings highlight the imperative of reinforcing infection control measures in the participating ICUs to curtail escalated mortality rates, and of strictly applying isolation measures around patients originating from the Mediterranean region when transferred to other healthcare institutions.

Introduction La bronchiolite aiguë du nourrisson est une infection respiratoire aiguë virale qui sévit par épidémies annuelles essentiellement à l’automne et en hivers. Le principal virus en cause est le virus respiratoire syncytial (VRS). Le diagnostic virologique des bronchiolites virales repose sur l’analyse d’un prélèvement respiratoire par des techniques qui détectent un large panel de virus. Objectifs Ce travail a pour objectif d’identifier les virus responsables des bronchiolites aiguës dans notre contexte et d’analyser la corrélation entre le type de virus et la sévérité du tableau clinique. Patients et méthode Il s’agit d’une étude prospective de 4 ans et 9 mois portant sur 107 nourrissons atteints de bronchiolite virale qui ont pu bénéficier de l’étude virologique. Nous avons exclu de cette étude les nourrissons ayant une maladie pulmonaire chronique du prématuré, une maladie cardiaque congénitale, une maladie génétique, une immunodéficience congénitale ou acquise ou des troubles neuromusculaires. Résultats L’âge moyen était de 7 mois avec des extrêmes allant d’un mois à 24 mois. La symptomatologie clinique était dominée par la polypnée (93 %), la toux sèche (92 %), la rhinorrhée (71 %). L’auscultation pulmonaire a objectivé des râles sibilants chez tous les patients. Dans cette série, 28 patients soit 26,1 % cas ont présenté une forme clinique sévère de bronchiolite virale. La confirmation virologique a été réalisée par la PCR multiplex chez 84 patients, le test rapide par immunochromatographie (grippe/VRS) dans 9 cas et la PCR SARS-Cov-2 chez 14 nourrissons. Six virus ont été détectés en mono-infection chez 83 patients (76,1 %). Le VRS dominait largement chez ces nourrissons hospitalisés (44,5 %) suivi par le Human Rhinovirus/entérovirus (16,8 %), le SARS-CoV-2 (16,8 %), l’Influenza A H1N1 (13,2 %), le para-influenza type 3 (6 %) et le métapneumovirus (2,4 %). Vingt-trois patients (21,4 %) avaient une co-infection virale à deux virus. Le VRS a été détecté en co-infection dans 18 cas. Un seul patient avait une co-infection à 3 virus. Dans cette série, le VRS est responsable de bronchiolites modérées (p<0,001) et le rhinovirus seul ou associé au VRS est responsable de bronchiolites sévères (p<0,001). Conclusion Ces résultats contribueront à une meilleure compréhension de l’épidémiologie des bronchiolites virales afin de contrôler leur diffusion notamment dans les collectivités des nourrissons. Ceci grâce au développement de stratégies de prévention efficaces et d’approches thérapeutiques ciblées.

Background Carbapenem-resistant Pseudomonas aeruginosa are being increasingly described worldwide. Here, we investigated the molecular mechanisms underlying carbapenem resistance in an extremely drug-resistant P. aeruginosa isolate from a neonatal intensive care unit in Morocco.Materials and methods P. aeruginosa strain O82J1 was identified using MALDI-TOF-MS. Carba NP, immunochromatographic assay NG Carba5 and antimicrobial susceptibility testing using disc diffusion and microbroth were performed. Whole-genome sequencing using the Illumina and MinION technologies and different software packages available at the Center of Genomic Epidemiology were used to predict the resistome, sequence type and plasmid types.Results P. aeruginosa O82J1 co-expressed two metallo-beta-lactamases, blaNDM-1 and blaVIM-2, and was susceptible to colistin and apramycin only. It belonged to ST773 that is frequently reported worldwide as a high-risk P. aeruginosa clone. The blaVIM-2 gene was integron-borne on a IncP-2 465-kb plasmid, whereas the blaNDM-1 gene was chromosomally encoded and embedded in an integrative conjugative element, probably at the origin of its acquisition. A total of 23 antimicrobial resistance genes were detected including a blaPER-1 ESBL gene, and an 16S-rRNA methyltransferase gene rmtB.Conclusions The isolation of XDR P. aeruginosa isolates expressing several carbapenemases in a neonatal intensive care unit is of great concern due to the reduced treatment options, relying only on colistin, but not recommended in neonates, and apramycin, not yet approved for human therapy. Concerns were further elevated due to the resistance to cefiderocol and ATM/AVI, two novel and last-resort antibiotics recommended to treat infections caused by Gram-negative bacteria, particularly XDR P. aeruginosa in adults.

Background: During the COVID-19 pandemic, healthcare professionals experienced an increased workload, which may have affected infection prevention and control (IPC) programs and consequently healthcare- associated infection (HAI) rates. The objective of this study was to estimate the prevalence of HAI in Ibn Rochd University Hospital Center (IRUHC) and identify associated factors. Methods: A survey was conducted on November 30, 2021 at IRUHC, including all patients hospitalized for at least 48 hours. Data was collected using a questionnaire, and analyzed using SPSS IBM software version 16. The significance level was set at 0.05. Results: Among 887 patients, the prevalence of HAI was 9.7% (7.7%; 11.6%). The highest prevalence was observed in intensive care units (ICUs) (44.2%). Nosocomial pneumonia was the most common site (26.8%). The main isolated microorganisms were Acinetobacter baumannii (18.0%) and Escherichia coli (16.0%). All Acinetobacter baumannii isolated strains were imipenem-resistant. The presence of HAI was significantly associated with the presence of an invasive medical device (p<0.001), a higher physical status score of American Society of Anesthesiologists (ASA) (p<0.001), and a longer hospital stay (p<0.001). Conclusion : The emergence of imipenem-resistant Acinetobacter baumannii (IRAB) represents a serious therapeutic and epidemiological problem requiring the establishment of a system for monitoring the microbial environment and the application of strict hygiene measures.

Introduction:the laboratory diagnosis of meningococcal meningitis relies on conventional techniques. This study aims to evaluate the correlation between the reduced sensitivity to penicillin G of Neisseria meningitidis (N.m) strains and the expression of the altered PBP 2 gene.Methods:out of 190 strains of N.m isolated between 2010 and 2021 at the bacteriology laboratories of Ibn Rochd University Hospital Centre (IR-UHC) in Casablanca and the UHC Mohammed VI in Marrakech, 23 isolates were part of our study. We first determined their state of sensitivity to penicillin G by E-Test strips and searched for the expression of the penA gene by PCR followed by Sanger sequencing.Results:of all the confirmed cases of N.m, 93.15% (n=177) are of serogroup B, 75.2% (n = 143) are sensitive to penicillin G and 24.73% (n = 47) are of intermediate sensitivity. No resistance to penicillin G was observed. Reduced sensitivity to penicillin G in N.m is characterized by mutations namely F504 L, A510 V, I515 V, G541 N and I566 V located in the C-terminal region of the penA gene encoding the penicillin-binding protein 2 (PBP2) (mosaic gene).Conclusion:our study presents useful data for the phenotypic and genotypic monitoring of resistance to penicillin G in N.m and can contribute to the analysis of genetic exchanges between different Neisseria species.

Community-acquired urinary tract infections (UTIs) represent a significant public health issue, primarily due to the increasing antibiotic resistance among uropathogens. This study assesses the resistance status of uropathogenic community Enterobacterales to various antibiotics, particularly aminoglycosides, and determines the prevalence of aminoglycoside-modifying enzyme (AME) genes, while investigating the coexistence of 16S rRNA methylating enzymes. We analyzed 628 clinical isolates of Enterobacterales obtained from 4282 cytobacteriological urine examinations at the Pasteur Institute Casablanca, Morocco, collected from October 2018 to December 2021. Identification and antibiotic susceptibility testing were conducted using the VITEK 2® COMPACT system, following CA-SFM guidelines. DNA extraction utilized the heat shock method, and subsequent PCR was performed. Gram-negative bacteria accounted for 85% of isolates, with Enterobacterales representing 91% of this group. E. coli (73%) and Klebsiella pneumoniae (20%) were the most common species among Enterobacterales. Resistance was particularly high for ampicillin (76.7%) and amoxicillin-clavulanate (58%). Among aminoglycosides, gentamicin and tobramycin resistance rates were 33.5% and 35%, respectively, while amikacin resistance was observed in 21.3% of isolates. High frequencies of AME genes were detected, with AAC(3′)-IIa (27.7%) and AAC(6′)-Ib (25.9%) being the most prevalent. Notably, no 16S rRNA methylation genes (rmtA, rmtB, rmtC, rmtD) were found. All tested strains exhibited biofilm-forming capacity, with K. pneumoniae demonstrating intense biofilm production. The study highlights a concerning trend of antibiotic resistance among uropathogenic Enterobacterales in the community setting, correlating genotype with resistance phenotype and emphasizing the need for enhanced surveillance and targeted treatment strategies.

BACKGROUND:Streptococcus pneumoniae, a major contributor to global morbidity and mortality, disproportionately affects children, the elderly, and immunocompromised individuals. Despite vaccination efforts, the challenge of serotype replacement highlights the ongoing struggle against invasive pneumococcal diseases (IPD) in Morocco, emphasizing the need for updated public health strategies and vaccine efficacy assessments. METHODS:This study was conducted at the Ibn Rochd University Hospital Center and the Mohammed VI University Hospital Center from 2019 to 2022, focusing on hospitalized children. It involved the analysis of 74 strains of IPD, assessing the distribution of pneumococcal serotypes and their antibiotic sensitivity in the post-vaccination era. RESULTS:The prevalence of meningitis or meningo-encephalitis was found to be 66% among the study subjects, with the most frequent serotypes being 3, 19A, 6B, 14, and 11. These serotypes varied significantly by age and location. Coverage rates for the pneumococcal conjugate vaccines, PCV-10 and PCV-13, were 20.27% and 56.75%, respectively. Notably, 43% of the strains were non-vaccine serotypes, with serotypes 3 and 19 accounting for 36% of the infections in children, indicating a lack of vaccine efficacy against these types. Additionally, 31.3% of the strains were Penicillin non-susceptible Streptococcus pneumoniae (PNSP), with 81.25% associated with non-vaccine serotypes. CONCLUSIONS:This study highlights the persistence of IPD in Moroccan children, revealing significant challenges despite vaccination efforts. With the reintroduction of PCV-13, concerns about the efficacy against non-vaccine serotypes, particularly 3 and 19A, remain. Continuous surveillance and adaptable vaccination strategies are essential to combat these serotype replacements and ensure the effectiveness of future preventive measures.

Pertussis is a real public health problem due to high neonatal morbidity rates and resurgence despite high vaccination coverage. The purpose of this study is to analyze the epidemiological profile of pertussis in infants hospitalized from 2012 to 2019. We conducted a retrospective, descriptive study over a 7-year and 8-month period from January 2012 to July 2019. It involved 500 infants admitted with clinical suspicion of pertussis. The average age of infants was 72 days, ranging from 28 days to 18 months; 75% of infants were less than 3 months old. The peak incidence was registered in 2012 and 2016, with a summer predominance (32%); 460 infants (92%) were not or incompletely vaccinated, 42.2% of whom were too young to be vaccinated. A probable contaminant in the entourage was found in 43,6% of cases. Whooping cough and cyanosis were the main reason for hospitalization (77.6%). Chest radiography objectified bronchial disease (25,4%) and alveolar foci (22.7%). Blood count performed in 410 infants showed hyperlymphocytosis in 67.5% of cases. Polymerase chain reaction (PCR) on nasopharyngeal sample collected from 206 infants was positive for Bordetella pertussis in 64% of cases; 118 PCR performed in mothers were positive in 47.7% of cases. All infants received Clarithromycin. Pertussis is a major cause of morbidity in infants in Casablanca. The prevention strategy is based on vaccination of family members of infants. However, vaccination of pregnant women appears to be more effective.

The discovery of antibiotics has been an important medical advance that has improved the prognosis of bacterial infections. Recent trends in hospital antimicrobial resistance show a high prevalence of extended-spectrum-beta-lactamase-producing Enterobacterales (ESBL-PE) [ [1] Lucet J.C. Bouadma L. Épidémiologie française de l'infection acquise en réanimation. Réanimation. 2015 May; 24: 221-223 Crossref Scopus (2) Google Scholar , [2] Nordmann P. Carbapenemase-producing Enterobacteriaceae: overview of a major public health challenge. Med Mal Infect. 2014 Feb; 44: 51-56 Crossref PubMed Scopus (186) Google Scholar ]. Enterobacterales are distinguished by their capacity to survive and spread in the community and in hospitals, especially in intensive care units [ [3] MacVane S.H. Antimicrobial resistance in the intensive care unit: a focus on Gram-negative bacterial infections. J Intens Care Med. 2017 Jan; 32: 25-37 Crossref PubMed Scopus (118) Google Scholar ]. Colonization is a risk factor for ESBL-PE infections which are associated with increased morbidity, mortality, hospital costs and length of stay [ [4] Marchaim D. Gottesman T. Schwartz O. Korem M. Maor Y. Rahav G. et al. National multicenter study of predictors and outcomes of bacteremia upon hospital admission caused by Enterobacteriaceae producing extended-spectrum β-lactamases. Antimicrob Agents Chemother. 2010 Dec 1; 54: 5099-5104 Crossref PubMed Scopus (115) Google Scholar ].

Background Streptococcus pneumoniae (S. pneumoniae) , remains a major cause of mortality and morbidity worldwide. The objective of this study was to determine the trends of invasive pneumococcal diseases (IPD) in adult and elderly population in Casablanca (Morocco) before and after introduction of pneumococcal conjugate vaccine (PCV) by determining the distribution of pneumococcal serotypes and antibiotic resistance profile of isolated strains. Method The proposed study is a retrospective laboratory-based surveillance of IPD in hospitalized adult (15–59 years old) and elderly (≥ 60 years old) patients in Ibn Rochd University Hospital Centre from 2007 to 2019 (13 years). All the 250 non-duplicate clinical invasive isolates from adult and elderly patients, confirmed as S. pneumoniae according to the laboratory standard identification procedures, are included in this study. Results A significant decrease of the overall incidence in IPD was observed only in adults from 0.71 to 0.54/100000 populations ( P = 0.02) and to 0.47/100000 populations ( P = 0.0137) in the early and mature post-vaccine period respectively compared to the pre-vaccine period. Our results also showed a significant reduction in the overall prevalence of vaccine serotypes from 28.17 to 6.90% ( P = 0.0021) for the PCV-10 serotypes, and from 46.48 to 25.86% ( P = 0.0164) for the PCV-13 serotypes only in the mature post-vaccine period (2015–2019). In parallel, the rate of non-vaccine serotypes did not significantly change in the early post-vaccine period (2011–2014) while it increased considerably from 54 to 74.14% ( P = 0.0189) during the mature post-vaccine period. The rate of penicillin non-susceptible pneumococcal isolates decreased significantly from 23.94 to 8.77% ( P = 0.02) in adult patients, and the rate of cotrimoxazole non-susceptible pneumococcal isolates significantly decreased from 29.58 to 8.77% in the early post-vaccine period ( P = 0.003) and to 7.24% in the mature post-vaccine period ( P = 0.0007). Conclusion Although childhood vaccination has considerably reduced the incidence of IPD in adult population through the herd effect, IPD remain a real public health problem due to the alarming increase in non-vaccine serotypes (NVS) and the lack of herd effect among elderly population. The rate of antibiotic resistance was relatively low. Nevertheless, resistance constitutes a serious problem to the therapeutic arsenal due to the known capacity for genetic dissemination in the pneumococcus.

Introduction: Serratia rubidaea is a gram-negative bacillus. it is an opportunistic pathogen bacterium rarely isolated in humans, usually found in the respiratory tract, bile , stools or wounds, but also in the blood. Case report: 40-years-old patient followed for a currently relapsing lymphoma, hospitalized to receive a salvage treatment. The patient had an arterial catheter in place two weeks previously. Four blood cultures were positive for S. rubidaea within the first 48 hours. The clinical and biological evolution were favorable after the establishment of adequate antibiotic therapy according to the results of the antibiogram. Discussion and conclusion: S. rubidaea infections are exceptional. the bacteraemic form is rarely described. This bacterium is most often isolated from the respiratory tract. Adequate antibiotic therapy after carrying out an antibiogram allowed a favorable evolution of the patient then a better support.Introduction: Serratia rubidaea is a gram-negative bacillus. it is an opportunistic pathogen bacterium rarely isolated in humans, usually found in the respiratory tract, bile , stools or wounds, but also in the blood. Case report: 40-years-old patient followed for a currently relapsing lymphoma, hospitalized to receive a salvage treatment. The patient had an arterial catheter in place two weeks previously. Four blood cultures were positive for S. rubidaea within the first 48 hours. The clinical and biological evolution were favorable after the establishment of adequate antibiotic therapy according to the results of the antibiogram. Discussion and conclusion: S. rubidaea infections are exceptional. the bacteraemic form is rarely described. This bacterium is most often isolated from the respiratory tract. Adequate antibiotic therapy after carrying out an antibiogram allowed a favorable evolution of the patient then a better support.

Introduction antimicrobial resistance in gram-negative bacilli is one of the major concerns in public health. We aimed to evaluate gram-negative bacilli epidemiology, antimicrobial profiles, and the resistance´s mechanism for Enterobacteriaceae isolated from specimens of hospitalized patients in wards of University Hospital Center Ibn Rochd of Casablanca, Morocco. Methods a prospective study of the patient's specimens, collected from December 2016 to 31st March 2017. Isolation and identification were performed using conventional biochemical tests. According to the European Committee on Antimicrobial Susceptibility Testing guidelines, antibiotic susceptibility was determined. Polymerase Chain Reaction (PCR) was used to detect β-lactamase and carabapenemase genes: CTX-M, SHV, TEM, OXA-48, NDM, and VIM among the Enterobacteriaceae. Results according to inclusion criteria, 38 Enterobacteriaceae, 25 Acinetobacter baumannii (A. baumannii), and 10 Pseudomonas aeruginosa (P. aeruginosa) were included during the study period; these bacteria were mainly responsible for bacteremia. Fifty-five percent of enterobacteria were extended-spectrum β-lactamase (ESBL), 42% EBSL and carbapenemase, and 3% carbapenemase, with high coresistances. Eighty-four percent of A. baumannii were XDR. All P. aeruginosa were MDR; amikacin showed the best activity (70% susceptibility). The genotypic approach revealed the presence of blaCTX-M, blaSHV, blaTEM in 68%, 22%, and 11% respectively. Of the 22 carbapenemase-producers, 41% were blaOXA-48 and 18% blaNDM; none had blaVIM. Furthermore, various genes coexistence were detected: blaCTX-M+blaOXA-48; blaCTX-M+blaNDM; blaCTX-M+blaSHV+blaOXA-48; and blaSHV+blaOXA-48. Conclusion findings revealed highly resistance rate among isolates. This raises the need to control antibiotics and regular screening to identify dynamics promoting resistance. Thus, we recommend developing antimicrobial stewardship programs and improving hygiene systems to prevent the nosocomial spreading of these phenotypes in our center.

BACKGROUND:The aim of this study is to determine the in vitro activity of ceftazidime-avibactam (CZA) on Entero-bacteriaceae and P. aeruginosa strains isolated in the bacteriology-virology laboratory of the Ibn Rochd University of Casablanca.METHODS:This is a prospective descriptive longitudinal study conducted from May 28 through June 25, 2022, on Enterobacteriaceae and P. aeruginosa isolated from diagnostic samples received at the Bacteriology-Virology and Hospital Hygiene Laboratory of the Ibn Rochd University Hospital of Casablanca. The isolation and identification of the strains were carried out using standard bacteriological techniques. The study of sensitivity to ceftazidime-avibactam was done by diffusion susceptibility testing on agar medium according to EUCAST 2022 recommendations.RESULTS:During the study period, 271 strains of Enterobacteriaceae were isolated. The sensitivity rate to ceftazidime-avibactam was 91% vs. 74% for ceftazidime alone. R. terrigena was the most resistant strain to CZA with a rate of 69%, followed by E. cloacae (14%), then K. pneumoniae (6%), and finally E. coli (5%). Among the strains isolated, 24% (n = 66) produced ESBL, of which 29% (n = 19) were resistant to CZA, and 10.7% (n = 29) were re-sistant to imipenem, including 44, 8% (n = 13) that were resistant to imipenem and CZA. Regarding P. aeruginosa, 92 strains were isolated. The CZA resistance rate was 33.6% (n = 31). Among the strains isolated, 30.4% (n = 29) were resistant to imipenem, of which 82.7% (n = 24) were resistant to CZA.CONCLUSIONS:The in vitro evaluation of the ceftazidime-avibactam activity on the strains isolated, mainly: E. Coli, K. Pneumoniae, and E. Cloacae, showed a good inhibitory activity of this molecule which can constitute a therapeutic alternative for the treatment of infections due to these microorganisms.

Objective: The purpose of this study was to investigate the emergence of Raoultella terrigena, a rarely found opportunistic pathogen, co-producing NDM and OXA-48 carbapenemases in isolates recovered from various clinical specimens in our institution. Methods: From April 2020 to November 2021, we focused on strains of Enterobacteriaceae with reduced sensitivity to ertapenem giving rise to suspicion of the production of carbapenemases according to the CASFM-EUCAST criteria. These strains were isolated from samples for diagnostic purposes and identified in the microbiology laboratory of our institution. Only non-duplicate clinical and surveillance isolates obtained from patients were included. Results: Out of 159 Enterobacteriaceae suspected, 53 strains of Raoultella terrigena producing carbapenemases were isolated. Among these isolates, 64%(n=34) were NDM producers, 4% (n=2) were OXA-48 producers and 32% (n=17) had both the NDM and OXA-48. The co-existence of NDM and OXA-48 carbapenemases was found more often in Raoultella terrigena than Klebsiella pneumoniae. Among the seventeen isolates of Raoultella terrigena, all were multidrug-resistant. Conclusion: This study reported for the first time the emergence of NDM and OXA-48 carbapenemases co-existence in Raoultella terrigena isolates in our country which is starting to limit treatment options.

Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance (MDR) of S. pneumoniae strains isolated from healthy children throughout the years 2020-2022. Antimicrobial susceptibility testing of S. pneumoniae strains in selected antimicrobials was performed using disk diffusion and E-test methods on bloodMueller-Hinton agar. The antimicrobials tested included oxacillin, amoxicillin, ceftriaxone, norfloxacin, gentamicin, vancomycin, erythromycin, clindamycin, pristinamycin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole. A total of 201 S. pneumoniae strains were isolated from the nasopharynx of healthy children in Marrakesh, Morocco. The highest rate of resistance of S. pneumoniae was found in penicillin (57.2%), followed by tetracycline (20.9%), and erythromycin (17.9%). The rates of resistance to clindamycin, trimethoprim-sulfamethoxazole, and chloramphenicol were 14.9%, 4%, and 1.5%, respectively. All isolates were susceptible to norfloxacin, gentamicin, vancomycin, and pristinamycin. Approximately 17% of all S. pneumoniae strains were resistant to at least three different antibiotic families. This study showed a low rate of antibiotics resistance among nasopharyngeal S. pneumoniae strains, and it is thus essential to monitor S. pneumoniae susceptibility in healthy children.

Pertussis is a real public health problem due to high neonatal morbidity rates and resurgence despite high vaccination coverage. The purpose of this study is to analyze the epidemiological profile of pertussis in infants hospitalized from 2012 to 2019. We conducted a retrospective, descriptive study over a 7-year and 8-month period from January 2012 to July 2019. It involved 500 infants admitted with clinical suspicion of pertussis. The average age of infants was 72 days, ranging from 28 daysto 18 months;75% of infants were less than 3 months old. The peak incidence was registered in 2012 and 2016, with a summer predominance (32%); 460 infants (92%) were not or incompletely vaccinated, 42.2%of whom were too young to be vaccinated. A probable contaminant in the entourage was found in 43,6% of cases. Whooping cough and cyanosis werethe main reason for hospitalization (77.6%).Chest radiography objectified bronchial disease (25,4%) and alveolar foci (22.7%).Blood count performed in 410 infants showed hyperlymphocytosis in 67.5% of cases. Polymerase chain reaction (PCR)on nasopharyngeal sample collected from 206 infants was positive for Bordetella pertussis in64% of cases; 118 PCR performed in mothers were positive in 47.7%of cases. All infants received Clarithromycin. Pertussis is a major cause of morbidityin infants in Casablanca. The prevention strategy is based on vaccination of family members of infants. However, vaccination of pregnantwomen appears to be more effective.

BACKGROUND:In order to determine domains with the most difficulties and plan a relevant training, the aim of this study was to assess training needs of medical biology residents at the Ibn Rochd University Hospital of Casablanca, concerning antibiograms interpretation.METHODS:A descriptive and comparative study was carried out in February 2022, with two resident groups. The first one included all residents in training in the bacteriology-virology laboratory and having spent at least 2 months. The 2nd one included residents who had validated their course (9 months). Data were collected from collective interviews and a self-administered questionnaire with a qualitative and quantitative grid analysis.RESULTS:Residents expressed needs in the three learning domains (knowledge, know-how, interpersonal skills) but they were low to moderate (scores from 0.2/4 to 2.4/4). Priority topics for training were: interpretation of observed phenotypes (5.85/8), followed by interpretative reading according to EUCAST recommendations (5.05/8). The two groups' responses were similar, except for the know-how domain of natural resistance mechanisms where the needs were greater in G1 (p = 0.008).CONCLUSIONS:In the light of these results, additional training with relevant aims should be planned.

Aims The aim of our work is to study the association of genetic polymorphisms in the cagA and vacA genes with the risk of developing gastric lesions.

Background: The aim is to determine the prevalence of bacterial nosocomial infections (NI) and its associated factors in COVID-19 ICU. Methods: A descriptive retrospective study, from April to August 2020, was carried on patients with respiratory distress following SARS-Cov-2 infection presenting a sign of bacterial infection. Results: A total of 29 patients (33% of hospitalized patients) contracted a NI, their age was 65 years +/- 13.90 and sex-ratio M/F was 2.62. All patients had an invasive device: central line (65%), bladder catheter (72%), and mechanical ventilation (76%). The time of NI occurring was 5 to 8 days. Charlson comorbidity index was 4 - 6 in 18 patients (62%). Of the 35 samples taken, 45 bacteria were isolated: multi drug resistant A. baumannii and P. aeruginosa accounted for 24.4%. Of all, 16 deaths were recorded (55, 17%). Conclusions: NI is common in COVID-19 ICU and can be predicted by risk factors that should be managed.

Background H. pylori infection induce atrophic gastritis (AG) and intestinal metaplasia (IM) that can lead to gastric cancer (GC). The severity of gastric lesions is related to H. pylori genetic diversity. The oncogenic potential of H. pylori cagA virulence factor is linked to its high polymorphic EPIYA motifs. Objectives Our aim was to evaluate the association of EPIYA motifs with the risk of AG and IM in Casablanca population. Methods A total of 210 patients suffering from gastric lesions (chronic gastritis, AG, and IM) was enrolled. H. pylori infection and the type of lesions were diagnosed by ureC PCR and histological examination, respectively. Detection of the cagA gene, and the type of EPIYA motifs, were carried out by PCR Results The prevalence of H. pylori and cagA gene was 95% and 37%, respectively. CagA-positive strains were associated with the risk of IM. The EPIYA motifs detected were: EPIYA-ABC (58%), EPIYA-ABCC (22%), and EPIYA-AB (20%). The EPIYA-ABCC motif was associated with the risk of IM (p-value = 0.007), compared to AG (p-value = 0.28). Conclusion The EPIYA-ABCC motif might be a useful marker for the identification of patients at high risk of developing IM that can lead to GC.