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Resume Introduction Par son incidence, son polymorphisme clinique, sa gravite et la frequence des anomalies urologiques sous-jacentes, l’infection du tractus urinaire (ITU) est un probleme important en pediatrie. Les objectifs de notre travail etaient d’etablir le profil bacteriologique des ITUs chez les enfants au CHU Mohammed VI d’Oujda (Maroc), puis d’etudier la sensibilite des souches bacteriennes isolees aux antibiotiques. Methodes C’est une etude retrospective de 25 mois (mai 2016 a juin 2018) incluant les echantillons urinaires emanant d’enfants âges d’un jour a 16 ans et adresses au laboratoire de microbiologie pour ECBU. Les urines etaient traitees conformement aux recommandations du referentiel en microbiologie medicale (REMIC). Resultats Nous avons collige 3314 demandes d’ECBU. Les services des urgences etaient en tete de liste des services demandeurs d’ECBU (59,75 %). Dans 54,73 % des cas l’ECBU etait realise apres demarrage de l’antibiotherapie. La plupart des urines etaient recueillies au milieu du jet (67,38 %). Les infections du tractus urinaire representaient 6,91 % des cas. Elle predominait chez les filles (69,86 %). E. joli etait la bacterie la plus isolee (73,38 %). Les taux de resistances au trimethoprime-sulfamethoxazole, amoxicilline-acide clavulanique, ceftriaxone, ciprofloxacine et amikacine etaient respectivement : 45,8 %, 41,18 %, 16,39 %, 12,18 % et 3,78 %. Conclusions Les taux de resistances des bacteries isolees aux antibiotiques doivent nous inciter a une amelioration de nos conditions de diagnostic des infections urinaires afin d’eviter les traitements inutiles, a appliquer les recommandations de prise en charge des ITUs en vigueur et a appliquer rigoureusement les mesures d’hygiene chez les patients infectes ou porteurs de bacteries multiresistantes aux antibiotiques.

The cytobacteriological examination of urine (CBEU) is the most prescribed test in a microbiology laboratory. The objectives of this work were to present our experience in carrying out the CBEU and to share one of the means that we consider very useful in the daily practice of this crucial analysis. This is a 28-month prospective study (March 2016 to June 2018). The CBEU was carried out in accordance with the recommendations of the medical microbiology referential (REMIC). Antibiotic susceptibility was studied in accordance with the recommendations of the l'European committee on antimicrobial susceptibility testing (EUCAST). Cultures were positive for urinary tract infection in 5.09% (n=769) of cases and for colonization in 4.88% (n=737) of cases. E. coli alone accounted for 57.8% (n=850) of all isolates. In our experience, the display of the interpretation flowchart at the bench level, as well as the availability of clinical information and cytology results when examining urocultures, allows our technicians to decide, independently, what action to take for each CBEU according to the particular context of the patient for whom it has been prescribed. Similarly, this flowchart allows the unique microbiologist in the laboratory to contextually interpret each CBEU.

Disseminated cryptococcosis is a rare fungal infection, which mainly occurs in immunocompromised patients, and the diagnosis is difficult. Therefore, it is less likely to be considered in immunocompetent patients. Here, we present a case of fatal cryptococcal infection of the pleural fluid and ascites in a patient seronegative for HIV. The patient was a 45-year old man who was followed for Crohn's disease and treated with steroids and an immunosuppressant (azathioprine). The culture of pleural and ascites fluids showed the presence of yeasts colonies identified as Cryptococcus neoformans. Bacteriological examination of the blood culture or cerebrospinal fluid (CSF) was not prescribed. The HIV serology was negative. At the fourth day of treatment, the patient died because of the deterioration of neurological and hepatocellular functions. The main diagnostic problems that led to this fatal outcome were non-suspicion of an at-risk patient, lack of microbiological analysis of the blood or CSF, and inadequate antifungal therapy.

Background and Purpose:The presence of yeasts in the urine is not synonymous with urinary tract infectionsinceit can result insimple colonization or contamination. Regarding this, it is required to further clarify the epidemiological profile of funguria. Accordingly, the present study was conducted to establish the epidemiology of funguriainthe Mohammed VI Teaching Hospital of Oujda, Morocco. Materials and Methods:This retrospective studywas conducted onall urine samples sent for cytobacteriological examination to amicrobiology laboratoryover a period of 28 months(i.e., from March 2016 to June 2018). After the removal of duplicates, the urinesampleswere treated according to the recommendations of the medical microbiology standards. Results:A total of15,165 urine sampleswerecollected. Urinary colonization accounted for 4.94% (n=749) of cases. The infections of the urinary tract accounted for 5.35% (n=811) of cases. Microbial isolates (n=1,669) in colonization and urinary tract infections were dominated by bacteria (93.47%, n=1,560). Furthermore, the yeasts accounted for 6.53% (n=109) of the isolates. Candidaalbicanswas isolated from56.88% (n=62) of funguriacases. Theriskfactors forfunguriain our series wereessentially old age, admission tointensive care unit, and broad-spectrum antibiotic therapy. Conclusion:The current level of knowledge about the clinical situations leading to funguria with the improvement and popularization of efficient identification techniques for yeasts other than C. albicans should redress the epidemiology of funguria.This should allow the knowledgeable societies to establish the rules of interpreting the cytobacteriological examination of the urine in case of funguria, as for bacteriuria.

Introduction:l´infertilité du couple est devenue ces dernières années un problème de santé publique, dont l´origine peut être féminine, masculine ou mixte. L´origine masculine est incriminée dans 40% des cas. Au Maroc, la plupart des publications ont été axées sur les étiologies et les facteurs de risque de l´infertilité masculine. L´objectif de notre étude est l´évaluation de la prévalence de l´infertilité masculine et le profil des paramètres spermatiques chez les hommes infertiles ou à risque d´infertilité au sein d´un hôpital tertiaire à Rabat. Méthodes:analyse de 482 patients adressés pour bilan d´infertilité du couple ou dans le cadre du bilan préopératoire d´une varicocèle ou d´une ectopie testiculaire. Les données démographiques, les facteurs de risque d´infertilité, le caractère primaire ou secondaire de l´infertilité ont été enregistrées pour chaque patient. Les paramètres spermatiques ont été étudiés et interprétés selon les normes actualisées de l´OMS en 2010 avec études des facteurs associés à leur perturbation. Résultats:l´âge moyen des patients était de 35,35±8,81 ans. L´infertilité était primaire dans 61,8%. Les facteurs de risque d´infertilité les plus fréquemment retrouvés sont le tabac suivi par la varicocèle et l´infection. Le spermogramme était perturbé dans 53,1%. L´anomalie la plus fréquente était la perturbation de la vitalité (36,9%) suivie par la concentration spermatique (29,7%) et la morphologie (29,3%). L´âge était le seul facteur ayant un impact significatif sur le spermogramme (p=0,002). Les anomalies de la mobilité se voient à partir de 31 ans, la vitalité est perturbée à 34 ans, la morphologie à 35 ans et la concentration à 37 ans. L´azoospermie a été retrouvée dans 16,4% essentiellement associée à l´infertilité primaire. L´oligo-asthéno-tératospermie était l´association la plus représentée (26,2%). Conclusion:l´infertilité masculine est fréquente dans notre contexte, l´âge étant son principal facteur de risque. La mobilité est le paramètre le plus précocement atteint.

Introduction l´infertilité du couple est devenue ces dernières années un problème de santé publique, dont l´origine peut être féminine, masculine ou mixte. L´origine masculine est incriminée dans 40% des cas. Au Maroc, la plupart des publications ont été axées sur les étiologies et les facteurs de risque de l´infertilité masculine. L´objectif de notre étude est l´évaluation de la prévalence de l´infertilité masculine et le profil des paramètres spermatiques chez les hommes infertiles ou à risque d´infertilité au sein d´un hôpital tertiaire à Rabat. Méthodes analyse de 482 patients adressés pour bilan d´infertilité du couple ou dans le cadre du bilan préopératoire d´une varicocèle ou d´une ectopie testiculaire. Les données démographiques, les facteurs de risque d´infertilité, le caractère primaire ou secondaire de l´infertilité ont été enregistrées pour chaque patient. Les paramètres spermatiques ont été étudiés et interprétés selon les normes actualisées de l´OMS en 2010 avec études des facteurs associés à leur perturbation. Résultats l´âge moyen des patients était de 35,35±8,81 ans. L´infertilité était primaire dans 61,8%. Les facteurs de risque d´infertilité les plus fréquemment retrouvés sont le tabac suivi par la varicocèle et l´infection. Le spermogramme était perturbé dans 53,1%. L´anomalie la plus fréquente était la perturbation de la vitalité (36,9%) suivie par la concentration spermatique (29,7%) et la morphologie (29,3%). L´âge était le seul facteur ayant un impact significatif sur le spermogramme (p=0,002). Les anomalies de la mobilité se voient à partir de 31 ans, la vitalité est perturbée à 34 ans, la morphologie à 35 ans et la concentration à 37 ans. L´azoospermie a été retrouvée dans 16,4% essentiellement associée à l´infertilité primaire. L´oligo-asthéno-tératospermie était l´association la plus représentée (26,2%). Conclusion l´infertilité masculine est fréquente dans notre contexte, l´âge étant son principal facteur de risque. La mobilité est le paramètre le plus précocement atteint.

The pre-analytical step of the cytobacteriological examination of urine (CBEU) is one of the most critical in microbiology. The objectives of our study were to determine the rate of urinary contamination and to analyze the factors that would facilitate this in order to propose solutions to this problem. METHOD This is a 26-month descriptive study including all CBEU requests to our laboratory. Urine was treated in accordance with the recommendations of the medical microbiology recommendations. Urine was considered contaminated in the case of polymorphic culture with at least three different types of germs with a count from 103 CFU/mL. RESULTS We collected 16,412 CBEU requests. Urine was contaminated in 4,830 cases (29.43%). Of the contaminated urine, 39.23% (n=1,895) was from emergency departments, 79.44% (n=3,837) was collected in the middle of the stream, 69.83% (n=3,373) was from a female patient and 16.34% (n=789) was from children under the age of 5. DISCUSSION AND CONCLUSION To reduce urine contamination, quality instructions describing sampling procedures should be available and samples in the middle of the stream and through the collection adhesive bags should be replaced by sus-pubic puncture samples in children, whenever the profit/risk ratio of this method is favourable.

We evaluated the body fluid module on Sysmex UF-1000i (UF-1000i-BF) for analysis of white blood cell (WBC) and red blood cell (RBC) in cerebrospinal fluid. We collected 93 cerebrospinal fluid samples and compared the results of the UF-1000i-BF mode with the Fast-Read 102 disposable counting cell. Results shows a good correlation between the UF-1000i and the microscopic examination. The concordance percentage is 99.06% for white blood cells and 85.18% for red blood cells. The UF-1000i-BF mode offers rapid and reliable total WBC and RBC counts for initial screening of cerebrospinal fluid, and can improve the workflow in a routine laboratory.

Resume But L’objectif principal de cette etude etait d’etablir l’epidemiologie microbienne des ecoulements vaginaux, puis etudier la sensibilite des souches isolees aux antibiotiques. L’objectif secondaire etait de pouvoir orienter l’antibiotherapie probabiliste. Methodes Il s’agit d’une etude prospective de six mois, incluant toutes les patientes ayant beneficie d’un prelevement genital pour etude cytobacteriologique. Nous avons etabli l’epidemiologie microbienne des ecoulements vaginaux puis etudie la sensibilite des isolats aux antibiotiques. L’isolement et l’identification des bacteries ont ete realises par les techniques bacteriologiques classiques (examen microscopique direct, culture et caracteres biochimiques). L’etude de la sensibilite aux antibiotiques a ete realisee conformement aux recommandations du comite de l’antibiogramme de la Societe francaise de microbiologie. Resultats Nous avons collige 412 patientes avec ecoulements vaginaux d’origine infectieuse. Les infections mixtes representaient 25,97 % [IC 95 %] (107/412) des cas. Nous avons identifie 392 germes dont 42,6 % [IC 95 %] (167/392) des agents des candidoses, 39,03 % [IC 95 %] (153/392) des agents des vaginites et 15,81 % [IC 95 %] (62/392) des agents des vaginoses. Les isolats de Streptococcus agalactiae etaient sensibles au betalactamines. Conclusion Les ecoulements vaginaux dans notre serie sont souvent des candidoses et des vaginites bacteriennes. Les germes responsables sont tres varies et sont presque tous non sexuellement transmissibles. Leur sensibilite aux antibiotiques n’est pas alarmante.

Pasteurella multocida can cause serious infections after dog or cat bite. We report here a rare case of hand infection caused by P. multocida consecutive to an injury by a thorn of the prickly pear. It caused an amputation of the distal phalanx of the thumb in a trisomic patient. It is about a 27-year-old man who was admitted to the hospital with swelling and intense pain of the left hand. He reported a sting by a thorn of prickly pear 15 days before. The patient was admitted to proceed with operative irrigation and debridement. The pus was collected for microbiological examination. Microscopic examination after Gram staining revealed small Gram-negative coccobacilli, associated to polymorphonuclear reaction. Culture have objectivated Pasteurella multocida. The isolated strain was susceptible to betalactamins. Patient was treated with ampicillin. Well-conducted antibiotics and repetitive local cares have not prevented local lesions from progressing to necrosis of the soft parts of the thumb and osteitis of the distal phalanx of the thumb. The patient underwent a necrosectomy and an amputation of the distal phalanx. Ampicillin was replaced by amoxicillin/clavulanic acid and after 15 days, progression was clinically and microbiologically favorable. In the case we report, since the patient does not report any exposure or contact with animals, the thorn prick is the source of infection. It was contaminated from the animal reservoir. Taking into account the monomicrobism of the infection, treatment with aminopenicillins was sufficient. Our propositus came to the hospital 15 days after the inoculation of the bacterium. This duration appears to be very late in relation to the acute character of pasteurellosis. This was probably the main reason why the local infection evolved towards osteoarticular complications. That's why, we should consider Pasteurella multocida in case of infection by inoculation, even in the absence of contact with the animals.

Resume L’objectif de ce travail etait de verifier les performances de l’automate de cytologie urinaire Sysmex UF1000i annoncees par le fabriquant. La verification des performances avait pour but d’evaluer la repetabilite, la reproductibilite, le seuil de detection, la limite de quantification, la linearite, et la contamination inter-echantillons pour les leucocytes, les hematies, les bacteries, les cylindres et/ou les cellules epitheliales. Tous les tests ont ete realises dans les conditions de temperature ambiante et d’humidite relative preconisees par le fabriquant. Nous avons commence l’etude par la calibration de l’automate UF-1000i, et la verification de ses performances telles qu’annoncees par le fabriquant. Les resultats de verification des performances de l’automate etaient tous acceptables et en accord avec les valeurs annoncees par le fabriquant. L’automatisation permet de rendre des resultats rapides, d’offrir une meilleure tracabilite, de diminuer le risque d’erreur et d’optimiser le temps technicien. Les performances de UF-1000i que nous avons demontrees n’empechent pas que l’automate presente quelques limites. En effet, l’identification des types de cristaux, de cylindres et de levures n’est possible qu’apres examen microscopique. Les donnees obtenues encouragent a utiliser l’automate UF-1000i comme outil diagnostique de routine dans notre laboratoire, d’autant plus que ces resultats concordent parfaitement avec la clinique et sont plus rapides a obtenir.

Background The aim of this study is to establish the bacterial epidemiology of chronic osteoarticular infections in adults, to study the susceptibility of the isolated strains to antibiotics and to demonstrate the influence of osteosynthesis material thereon. Patients and methods This is a retrospective study of 78 months, from January 2006 to June 2012, providing bacteriological samples from patients with osteitis and osteoarthritis in the Mohammed V military teaching hospital of Rabat. Isolation and identification of bacteria were made by bacteriological classical techniques. The antimicrobial susceptibility testing of the isolates was performed by disk diffusion agar method, as recommended by the Committee of the susceptibility of the French Society for Microbiology (CA-SFM). Results We collected 234 cases, 53% (n = 124) of patients without osteosynthesis material (group A) and 47% (n = 110) patients with osteosynthesis material (group B).We isolated 371 bacteria which 51.49 (n = 191) in group A and 48.51% (n = 180) in group B. Gram-positive cocci were the most frequent (n = 234), followed by the Gram-negative bacilli (n = 114) and the Gram-positive bacilli (n = 19). Our study shows that the rate of resistance to antibiotics in strains obtained from patients with osteosynthesis material is higher compared to those obtained from patients without osteosynthesis material. Conclusions Chronic OA infection in adults is difficult to diagnose and treat. Its good management must be multidisciplinary.

Resume Saccharomyces cerevisiae est une levure cosmopolite, largement utilisee dans l’industrie agroalimentaire et pharmaceutique. Son incidence en pathologie humaine est rare, mais reste probablement sous-estimee par rapport a la vraie situation. Cette levure est consideree actuellement comme pathogene emergent et opportuniste. Les facteurs de risque sont l’immunodepression et le port de dispositif intravasculaire. Les fongemies sont les formes cliniques les plus frequentes. Nous rapportons le premier cas d’infection invasive a S. cerevisiae decrit au Maroc puis proposons une revue de la litterature des cas decrits dans le monde. Il s’agit d’un patient âge de 77 ans sans antecedents pathologiques notables, qui etait hospitalise pour une stenose digestive haute secondaire a une tumeur gastrique infranchissable metastatique. Son histoire etait marquee par la survenue d’un etat de choc septique dont le bilan etiologique a permis l’isolement de S. cerevisiae dans ses urines et son sang, avec comme arguments de confirmation du caractere invasif : presence de plusieurs facteurs de risque chez le patient, examen microbiologique direct positif, culture abondante et exclusive de S. cerevisiae a partir des prelevements. L’identification d’espece a ete confirmee par l’etude des caracteres biochimiques de la levure isolee. La confirmation d’infection a S. cerevisiae necessite une suspicion clinique chez le patient presentant des facteurs de risque, mais aussi un diagnostic microbiologique correct.

Objectives.We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco).Methods.The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance.Results.During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases withAcinetobacter baumanniibeing the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapenemase inAcinetobacter baumannii. The antibiotherapy introduced in the first 24 hours was adequate in 72% of the cases.Conclusions.Bloodstream infections in ICU occur most often in patients over 55 years, with hypertension and diabetes. The bacteria involved are mainly Gram negative bacteria multiresistant to antibiotics. Early administration of antibiotics significantly reduces patients mortality.

Background Post cardiac surgery mediastinitis is the major infectious complication, despite the development of surgical techniques and the application of strict preventive measures. The Haemophilus influenzae mediastinitis is very rare. The mediastinitis caused by the association between Haemophilus influenzae and Aggregatibacter aphrophilus has never been described to our knowledge. Case presentation We report the case of an exceptional combination of Haemophilus influenzae and Aggregatibacter aphrophilus in a patient operated for single bypass which is complicated by mediastinitis the 10th day after the surgical act. Conclusion The conclusion to be drawn from this work is to think in unusual seeds in case of mediastinitis post cardiac surgery for the elaboration of recommendations for antibiotic prophylaxis.

The aim of this cross-sectional study is to assess the epidemiological profile and antibiotic susceptibility of bacteria isolates in burn patients hospitalized from 2007 to 2015 in a Moroccan hospital.Of 627 samples, 451 wounds, 126 blood cultures, and 50 catheter samples were analyzed. A total of 610 microorganisms were isolated from a total of 108 patients.The most prevalent isolates were Pseudomonas aeruginosa (18.5%), Acinetobacter baumannii (14.7%), and Staphylococcus aureus (14.5%); a high prevalence (31.1%) of methicillin-resistant S aureus also was found. Imipenem followed by piperacillin/tazobactam performed best against P aeruginosa. A baumannii isolates showed a very high resistance to imipenem and all beta-lactams antibiotics but were sensitive to colistin.The profile of this bacterial ecology shows there are resistant species requiring frequent use of second-line antibiotics and strengthening of aseptic procedures in burn treatments.

Tuberculosis is a contagious disease that usually attacks the lungs but sometimes attacks other parts of the body, such as the kidneys, glands, and bones. It is an endemic and major public health problem in Morocco. Tuberculosis is transmitted through the airways via the inhalation of microdroplets containing Mycobacterium tuberculosis . We present here the whole-genome shotgun sequences of three multidrug-resistant M. tuberculosis strains isolated from Morocco.

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

Brucellosis is the most frequent bacteria zoonosis in the world, with more than half a million new cases each year [1] . It is also the most significant zoonos in the edge of the Mediterranean Sea [2] . This zoonosis is capable of affecting humans and cause polymorphic clinical manifestations. In Morocco, the southern regions are the main affected areas [3] . We are reporting the observation of a 17-year-old male patient, who presented a febrile meningeal syndrome for 9 months without sensitivo-motor deficit. Tuberculosis is frequently evoked in such clinical presentations because Morocco is an endemic country, brucellosis is therefore often forgotten. The results of lumbar puncture, magnetic resonance imaging (MRI) and especially serology aided to conclude to a neuro-brucellosis. The outcome was favourable with antibiotic therapy.

This report describes the whole-genome shotgun sequences of two multidrug-resistant Acinetobacter baumannii strains, ABE8_07 and ABE12_M, isolated from a Moroccan hospital floor. These two genome sequences will initiate the study and characterization of the Acinetobacter baumannii genome in Morocco.

This report describes the whole-genome shotgun sequences of two multidrug-resistant Acinetobacter baumannii strains, ABE8_07 and ABE12_M, isolated from a Moroccan hospital floor. These two genome sequences will initiate the study and characterization of the Acinetobacter baumannii genome in Morocco.

Background This study aims to assess the susceptibility of Acinetobacter baumannii isolates to the antiseptics and disinfectants commonly used, and to the non-approved product. Methods This is a prospective study carried out from February to August 2015, in the Bacteriology department of Mohammed V Military Teaching hospital of Rabat on A.baumannii isolates collected from colonized and/or infected patients and environmental samples. The antiseptics and disinfectants susceptibility testing was assessed using the micromethod validated in our department. The antiseptics and disinfectants studied were: 70% ethyl alcohol, chlorhexidine, povidone-iodine, didecyldimethylammonium chloride and a commercial product which was presented as a hospital disinfectant (non-registered product). Results Povidone-iodine, 0.5% chlorhexidine digluconate, 70% ethyl alcohol and didecyl dimethyl ammonium chloride in combination with N- (3-aminopropyl) -N-dodecylpropane-1, 3-diamine were effective against all the 81 A.baumannii isolates tested, and their logarithmic reduction ≥ 5 were observed in 100% of the isolates in their undiluted form. The strains isolated from patients were more resistant than environmental strains: at a dilution of ½ for 70% ethyl alcohol (37.77% vs 11.11%, p = 0.007) and at a dilution of 1/10 (100% vs 69.44%, p

Here, we describe the annotated genome sequence of Mycobacterium tuberculosis MTB13_M. The organism was isolated from a sputum sample in Morocco.

Tuberculosis (TB) is a global public health problem endemic to Morocco. While extrapulmonary TB uncommonly presents in osteoarticular anatomic locations, tarsal or metatarsal osteitis can occur when TB presents in the tarsal bones. Clinical symptoms are often insidious causing a delay in diagnosis that may lead to bone destruction. While diagnosis can be guided by X-ray imaging, bacteriologic and histologic examination of the tissue allows for pathogen isolation, identification of the bacillus and strain sensitivity to antibacillary treatment.We report a rare case of navicular osteitis associated with tarso-metatarsal arthritis caused by tuberculosis in a 68-year-old man. This case illustrates an exceptional location of osteoarticular TB and support diagnostic difficulties encountered: (i) imaging is not specific; (ii) lesions are paucibacillary which reduces conventional microbiological methods sensitivity and (iii) the peripheral location of the Koch bacillus within the lesion dictates surgical biopsy than percutaneous puncture. We recommend testing for tuberculosis in any case of chronic osteolysis and/or arthritis of the foot, especially in TB endemic countries.

L’Arcanobactérium haemolyticum (A.haemolyticum) est un bacille à Gram positif. L’homme en est le principal réservoir. C’est un pathogène opportuniste essentiellement chez l’immunodéprimé, et qui peut être responsable d’infection au niveau de la peau et du pharynx chez les sujets sains, surtout chez les enfants et les adolescents. Il peut causer des surinfections des ulcères chroniques, et occasionnellement des infections invasives. Sa détection au niveau des cultures reste toujours difficile car il simule de nombreuses bactéries auxquelles il est souvent associé dans les produits pathologiques. Et Il n’existe pas de recommandations concernant l’étude sa sensibilité aux antibiotiques. Les bactériémies àArcanobactérium sont rares, à notre connaissance, seize cas ont été décrits dans la littérature. Nous rapportons, un autre cas de bactériémie à A.haemolyticum, secondaire à une surinfection d’escarres fessières.The Pan African Medical Journal 2016;25

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

The objective of this work is to describe the microbiology of diabetic foot infections (DFIs).The authors included all samples of infected diabetic foot ulcers between January 2009 and June 2014 at the Mohammed Vth Military Teaching Hospital of Rabat, Morocco.The researchers collected 199 samples corresponding to 157 patients. The mean age of the patients was 59 years ± 12 years. Of the collected samples, deep samples represented 41% and swab samples 59%. Direct examination indicated anaerobic infection in 32% of the cases. There were 307 bacteria isolates from both deep and swab samples. There was no statistically significant association between the sampling method and isolate species (P = 0.237). Enterobacteriaceae, Staphylococcus aureus, Streptococcus sp, nonfermenting gram-negative bacilli (NFGNB), and Enterococcus sp represented 31.8%, 12.6 %, 12.3%, 11.7%, and 8.7% of the isolates, respectively. Methicillin-resistant S. aureus represented 4.7% of S. aureus isolates. Enterobacteriaceae and NFGNB-producing extended spectrum β-lactamases represented 14.1% and 5.1%, respectively, with isolates producing carabapenemase representing 3.8% and 38.5%. Piperacillin-tazobactam, imipenem, and ciprofloxacin resistance concerned 7.5%, 4.7%, and 25.5%, respectively, of isolated Enterobacteriaceae, and 35.9%, 30.7%, and 35.9% of NFGNB. Low susceptibility to β-lactams was found in 4.9% of Streptococcus sp isolates and 4.9% of Streptococcus sp isolates were resistant to moxifloxacin.Gram-negative bacilli are responsible for 43% of DFIs, and multidrug-resistant GNB is a challenging issue in DFI management. The sampling method doesn't seem to impact the bacteriological profile; however, this finding must be confirmed with further study.

Treatment of Acinetobacter baumannii meningitis is an important challenge due to the accumulation of resistance of this bacteria and low meningeal diffusion of several antimicrobial requiring use of an antimicrobial effective combination to eradicate these species. We report a case of Acinetobacter baumannii multidrug-resistant nosocomial meningitis which was successfully treated with intravenous and intrathecal colistin associated with rifampicin.

Background Escherichia coli (E. coli) is the most commonly isolated bacteria in human pathology. In Morocco the data concerning the nature and the rates of antibiotic resistance of E. coli in both hospitals and city environment remains relatively poor and needs further investigations. Methods During a 16 months period, E. coli isolates were collected from different culture specimens received in the Bacteriology Department of the Military teaching Hospital Mohammed-V-Rabat for routine diagnostic purposes. E. coli isolates were identified and their antimicrobial susceptibility pattern was determined. Results A total of 1369 E. coli isolates comprising 33 % (1369/4110) of culture-positive samples were consecutively collected. Isolates of E. coli were, in 40.5 % (554/1369) of cases from hospitalized patients and in 59.5 % (815/1369) of cases from outpatients. Urine isolates represented 82 % (1123/1369) of the cases. High rates of resistance were found for amoxicillin (42.5 %), cefalotin (30.4 %), norfoloxacin (29.9 %) and sulfamethoxazole (37.7 %). The detection rate of ESBL was 6.1 % (85/1369). In hospitalized patients 11.9 % of the isolates of E. coli (66/554) had an ESBL phenotype while in outpatients cases only 2.3 % of isolates of E. coli (19/815) had this phenotype. Conclusions Our findings suggest that more judicious use of antibiotics is needed especially in probabilistic treatment. The emergence of ESBL in the Moroccan cities is an indicator of the severity of this problem that is not limited to health care facilities.

Corynedbacterium striatum (CS) is a Gram-positive coryneform bacillus that is part of mucous and skin flora. It has been considered as a causative agent of many infections in intensive care, neurology, traumatology and urology, but was never implicated in non-gonococcal urethritis. We report the case of a nosocomial urethritis due to Corynebacterium striatum following resection of an intrameatus condyloma.

We report a rare case of Corynebacterium bovis septicemia about a 65 year old man who received prolonged antibiotic treatment with colistin, imipenem and fosfomycin. We discuss in this work the circumstances of emergence of C. bovis infection through a literature review.

Objective. To study the sensitivity level of extended spectrum beta-lactamase-producing Enterobacteriaceae to Carbapenems (Imipenem, Ertapenem) marketed in Morocco and discusses the place of Ertapenem in the treatment of extended spectrum-beta-lactamase-producing. Materials and Methods. A retrospective study of 110 extended spectrum beta-lactamase-producing Enterobacteriaceae. Isolates obtained from blood cultures, superficial and deep pus, and catheters were conducted. The minimum inhibitory concentrations of Imipenem and Ertapenem were done by the E-test. The modified Hodge test was conducted for resistant or intermediate strains. Results. 99.1% of isolates were susceptible to Imipenem. For Ertapenem, 4 were resistant and 4 intermediate. The modified Hodge test was positive for all 08 isolates. A minimum inhibitory concentration comparison of K. pneumoniae, E. cloacae, and E. coli for Imipenem has noted a significant difference between E. cloacae on one hand and E. coli, K. pneumoniae on the other hand ( 𝑃 < 0 . 0 1 ). No significant difference was noted for minimum inhibitory concentration of Ertapenem. Conclusion. Our results confirm in vitro effectiveness of Ertapenem against extended spectrum beta-lactamase-producing Enterobacteriaceae as reported elsewhere. However, the emergence of resistance to Carbapenems revealed by production of carbapenemases in this study confirmed a necessary bacteriological documented infection before using Ertapenem.