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Introduction: Saprochete capitata is unusual etiologic agent in immunocompromised patients, particularly in those with hematologic malignancy and severe neutropenia. Most often, infections of the oral cavity are manifested clinically as oral candidiasis. Invasive forms are rarely described. Observation: a 63-year-old man consulted for pseudomembranous lesions associated with ulcero perforating lesion of the tongue and palatal region ulcerations. All evolving in a context of profound physical deterioration and severe neutropenia. Mycological examination showed Saprochaete capitata. The evolution was favorable with oral voriconazole. Comment: Saprochaete capitata invasive fungal infections have become an important cause of morbidity and mortality, particularly in hematology-oncology patients. Invasive or non-invasive, oropharyngeal involvement with this pathogen should not be underestimated in the neutropenic patient. They are the main starting point for fongemia of this pathogen, which is often fatal. Conclusion: Saprochete capitata is now recognized emerging etiologic agent in patients with hematological malignancy and severe neutropenia. Early detection and diagnosis of these fungal infections could lead to reduced morbidity and mortality, particularly in locally invasive infection.

From 123 clinical and environmental Pseudomonas aeruginosa isolates, 24 strains were selected for their similar antibioresistance, virulence and biofilm formation profiles, to examine their diversity and occurrence of clones within two hospitals and different natural sites in Meknes (Morocco). Pulsed-field gel electrophoresis, using DraI enzyme, didn’t reveal a close relationship between clinical and environmental isolates nor between strains of the two hospitals. 19 genotypes were obtained, including two virulent environmental clones and three clinical clones virulent and resistant to antibiotics. Intra-hospital transmission of high-risk clones detected, in and between wards, constitutes a great public health concern.

Increased prevalence of latent tuberculosis infection (LTBI) has been observed among high-risk populations such as healthcare workers (HCWs). The results may depend on the method of LTBI assessment, interferon-gamma release assay (IGRA) and/or tuberculin skin test (TST). Here, we investigated the prevalence and risk factors for LTBI assessed by both IGRAs and TST in HCWs living in Morocco, a country with intermediate tuberculosis (TB) endemicity and high BCG vaccination coverage. HCWs were recruited in two Moroccan hospitals, Rabat and Meknes. All the participants underwent testing for LTBI by both IGRA (QuantiFERON-TB Gold In-Tube, QFT-GIT) and TST. Different combinations of IGRA and TST results defined the LTBI status. Risk factors associated with LTBI were investigated using a mixed-effect logistic regression model. The prevalence of LTBI among 631 HCWs (age range 18-60 years) varied from 40.7% (95%CI 36.9-44.5%) with QFT-GIT to 52% (95%CI 48.2-56.0%) with TST using a 10 mm cut-off. The highest agreement between QFT-GIT and TST (κ = 0.50; 95%CI 0.43-0.56) was observed with the 10 mm cut-off for a positive TST. For a definition of LTBI status using a double positive result for both QFT-GIT and TST, significant associations were found with the following risk factors: being male (OR = 2.21; 95%CI 1.40-3.49; p = 0.0007), belonging to age groups 35-44 years (OR = 2.43; 95%CI 1.45-4.06; p = 0.0007) and even more 45-60 years (OR = 4.81; 95%CI 2.72-8.52; p = 7.10-8), having a family history of TB (OR = 6.62; 95%CI 2.59-16.94; p = 8.10-5), and working at a pulmonology unit (OR = 3.64; 95%CI 1.44-9.23; p = 0.006). Smoking was associated with LTBI status when defined by a positive QFT-GIT result (OR = 1.89; 95%CI 1.12-3.21; p = 0.02). A high prevalence of LTBI was observed among HCWs in two Moroccan hospitals. Male gender, increased age, family history of TB, and working at a pulmonology unit were consistent risk factors associated with LTBI.

The aim of this study is to assess the prevalence and molecular characterization of uropathogenic extended spectrum β-lactamases (ESBLs) producing Enterobacteriaceae (E-ESBL) isolated from the external consultants of the two big hospitals of Meknes, Moulay Ismail military hospital and Mohamed V regional hospital. During 3 years (2012–2014), 787 uropathogenic Enterobacteriaceae strains were isolated. These Enterobacteriaceae isolates were examined phenotypically for ESBL production. ESBL strains were subjected to antimicrobial susceptibility testing and were investigated for the presence of plasmid mediated quinolone resistance genes by using conventional PCR and DNA sequencing. The genetic transfer of the plasmids was carried out by conjugation. The overall prevalence of E-ESBL was 7.37%. The blaCTX-M-15 (76.78%) was the most frequently detected in ESBL isolates, followed by blaTEM-1 and the blaSHV-1 and blaSHV-11 variants respectively. Identification of plasmid mediated quinolone resistance genes showed that 23.59% of E-ESBL isolate is carrying the qnrB gene and 7.86% carrying the qnrS gene. The variant aac(6′)-Ib-cr was found in 82.02% of ESBLs. Bacterial conjugation tests have shown the existence of high molecular weight conjugative plasmids carrying the blaCTX-M-15, blaTEM, blaSHV genes. Community dissemination of EESBLs could pose a public health problem. Thus, a policy of surveillance of the resistance seems necessary.

Carbapenem-resistant Acinetobacter baumannii has recently been defined by the World Health Organization as a critical pathogen. The aim of this study was to compare clonal diversity and carbapenemase-encoding genes of A. baumannii isolates collected from colonized or infected patients and hospital environment in two intensive care units (ICUs) in Morocco. The patient and environmental sampling was carried out in the medical and surgical ICUs of Mohammed V Military teaching hospital from March to August 2015. All A. baumannii isolates recovered from clinical and environmental samples, were identified using routine microbiological techniques and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed using disc diffusion method. The carbapenemase-encoding genes were screened for by PCR. Clonal relatedness was analyzed by digestion of the DNA with low frequency restriction enzymes and pulsed field gel electrophoresis (PFGE) and the multi locus sequence typing (MLST) was performed on two selected isolates from two major pulsotypes. A total of 83 multidrug-resistant A. baumannii isolates were collected: 47 clinical isolates and 36 environmental isolates. All isolates were positive for the bla OXA51-like and bla OXA23-like genes. The coexistence of bla NDM-1 /bla OXA-23-like and bla OXA 24-like /bla OXA-23-like were detected in 27 (32.5%) and 2 (2.4%) of A. baumannii isolates, respectively. The environmental samples and the fecally-colonized patients were significantly identified (p

Introduction: This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods: This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Results: During the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n=6352) and 9.6% of Gram negative rods (n=4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p

Samples sources, collection dates, wards, OXA-type carbapenemases and PFGE of A. baumannii isolates. (DOCX 19 kb)

Samples sources, collection dates, wards, OXA-type carbapenemases and PFGE of A. baumannii isolates. (DOCX 19 kb)