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8. Whole genomic comparative analysis of Streptococcus pneumoniae serotype 1 isolates causing invasive and non-invasive infections among children under 5 years in Casablanca, Morocco. [Open Access]

Author

NZOYIKORERA, N., DIAWARA, I., FRESIA, P., MAALOUM, F., KATFY, K., NAYME, K., MAALOUM, M., COMICK, J., CHAGUZA, C., TIMINOUNI, M., BELABESS, H., ZEROUALI, K., and ELMDAGHRI, N.

Subjects
COMPARATIVE GENOMIC ANALYSIS, STREPTOCOCCUS PNEUMONIAE, PNEUMOCCAL AFRICAN GENOME PROJECT (PAGe), SEROTYPE 1, WHOLE GENOME SEQUENCING
Abstract

Background: Streptococcus pneumoniae serotype 1 remains a leading cause of invasive pneumococcal diseases, even in countries with PCV-10/PCV-13 vaccine implementation. The main objective of this study, which is part of the Pneumococcal African Genome project (PAGe), was to determine the phylogenetic relationships of serotype 1 isolates recovered from children patients in Casablanca (Morocco), compared to these from other African countries; and to investigate the contribution of accessory genes and recombination events to the genetic diversity of this serotype.Results: The genome average size of the six-pneumococcus serotype 1 from Casablanca was 2,227,119 bp, and the average content of coding sequences was 2113, ranging from 2041 to 2161. Pangenome analysis of the 80 genomes used in this study revealed 1685 core genes and 1805 accessory genes. The phylogenetic tree based on core genes and the hierarchical bayesian clustering analysis revealed five sublineages with a phylogeographic structure by country. The Moroccan strains cluster in two different lineages, the five invasive strains clusters altogether in a divergent clade distantly related to the non-invasive strain, that cluster with all the serotype 1 genomes from Africa.Conclusions: The whole genome sequencing provides increased resolution analysis of the highly virulent serotype 1 in Casablanca, Morocco. Our results are concordant with previous works, showing that the phylogeography of S. pneumoniae serotype 1 is structured by country, and despite the small size (six isolates) of the Moroccan sample, our analysis shows the genetic cohesion of the Moroccan invasive isolates.

Published
2021

14. A mosaic tetracycline resistance gene tet(S/M) detected in an MDR pneumococcal CC230 lineage that underwent capsular switching in South Africa

Author

Lo, SW, Gladstone, RA, Van Tonder, AJ, Du Plessis, M, Cornick, JE, Hawkins, PA, Madhi, SA, Nzenze, SA, Kandasamy, R, Ravikumar, KL, Elmdaghri, N, Kwambana-Adams, B, Almeida, SCG, Skoczynska, A, Egorova, E, Titov, L, Saha, SK, Paragi, M, Everett, DB, Antonio, M, Klugman, KP, Li, Y, Metcalf, BJ, Beall, B, McGee, L, Breiman, RF, Bentley, SD, Von Gottberg, A, Brooks, AW, Corso, A, Davydov, A, Maguire, A, Pollard, AJ, Kiran, A, Moiane, B, Sigauque, B, Aanensen, D, Lehmann, D, Faccone, D, Foster-Nyarko, E, Bojang, E, Voropaeva, E, Sampane-Donkor, E, Sadowy, E, Nagaraj, G, Bigogo, G, Mucavele, H, Belabbès, H, Diawara, I, Moïsi, J, Verani, J, Keenan, J, Nair Thulasee Bhai, JN, Ndlangisa, KM, Zerouali, K, De Gouveia, L, Alaerts, M, De Cunto Brandileone, MC, Ip, M, Hasanuzzaman, M, Ali, M, Croucher, N, Wolter, N, Givon-Lavi, N, Eser, ÖK, Ho, PL, Akpaka, PE, Turner, P, Gagetti, P, Tientcheu, PE, Carter, PE, Law, P, Benisty, R, Mostowy, R, Ford, R, Henderson, R, Malaker, R, Dagan, R, Shakoor, S, Doiphode, S, Sekaran, SD, Srifuengfung, S, Obaro, S, Clarke, SC, Kastrin, T, Ochoa, TJ, Hryniewicz, W, Balaji, V, Urban, Y, Lo, SW, Gladstone, RA, Van Tonder, AJ, Du Plessis, M, Cornick, JE, Hawkins, PA, Madhi, SA, Nzenze, SA, Kandasamy, R, Ravikumar, KL, Elmdaghri, N, Kwambana-Adams, B, Almeida, SCG, Skoczynska, A, Egorova, E, Titov, L, Saha, SK, Paragi, M, Everett, DB, Antonio, M, Klugman, KP, Li, Y, Metcalf, BJ, Beall, B, McGee, L, Breiman, RF, Bentley, SD, Von Gottberg, A, Brooks, AW, Corso, A, Davydov, A, Maguire, A, Pollard, AJ, Kiran, A, Moiane, B, Sigauque, B, Aanensen, D, Lehmann, D, Faccone, D, Foster-Nyarko, E, Bojang, E, Voropaeva, E, Sampane-Donkor, E, Sadowy, E, Nagaraj, G, Bigogo, G, Mucavele, H, Belabbès, H, Diawara, I, Moïsi, J, Verani, J, Keenan, J, Nair Thulasee Bhai, JN, Ndlangisa, KM, Zerouali, K, De Gouveia, L, Alaerts, M, De Cunto Brandileone, MC, Ip, M, Hasanuzzaman, M, Ali, M, Croucher, N, Wolter, N, Givon-Lavi, N, Eser, ÖK, Ho, PL, Akpaka, PE, Turner, P, Gagetti, P, Tientcheu, PE, Carter, PE, Law, P, Benisty, R, Mostowy, R, Ford, R, Henderson, R, Malaker, R, Dagan, R, Shakoor, S, Doiphode, S, Sekaran, SD, Srifuengfung, S, Obaro, S, Clarke, SC, Kastrin, T, Ochoa, TJ, Hryniewicz, W, Balaji, V, and Urban, Y

Abstract

Objectives: We reported tet(S/M) in Streptococcus pneumoniae and investigated its temporal spread in relation to nationwide clinical interventions. Methods: We whole-genome sequenced 12 254 pneumococcal isolates from 29 countries on an Illumina HiSeq sequencer. Serotype, multilocus ST and antibiotic resistance were inferred from genomes. An SNP tree was built using Gubbins. Temporal spread was reconstructed using a birth-death model. Results: We identified tet(S/M) in 131 pneumococcal isolates and none carried other known tet genes. Tetracycline susceptibility testing results were available for 121 tet(S/M)-positive isolates and all were resistant. A majority (74%) of tet(S/M)-positive isolates were from South Africa and caused invasive diseases among young children (59% HIV positive, where HIV status was available). All but two tet(S/M)-positive isolates belonged to clonal complex (CC) 230. A global phylogeny of CC230 (n=389) revealed that tet(S/M)-positive isolates formed a sublineage predicted to exhibit resistance to penicillin, co-trimoxazole, erythromycin and tetracycline. The birth-death model detected an unrecognized outbreak of this sublineage in South Africa between 2000 and 2004 with expected secondary infections (effective reproductive number, R) of ∼2.5. R declined to ∼1.0 in 2005 and <1.0 in 2012. The declining epidemic could be related to improved access to ART in 2004 and introduction of pneumococcal conjugate vaccine (PCV) in 2009. Capsular switching from vaccine serotype 14 to non-vaccine serotype 23A was observed within the sublineage. Conclusions: The prevalence of tet(S/M) in pneumococci was low and its dissemination was due to an unrecognized outbreak of CC230 in South Africa. Capsular switching in this MDR sublineage highlighted its potential to continue to cause disease in the post-PCV13 era.

Published
2020

18. Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Author

Lo, SW, Gladstone, RA, van Tonder, AJ, Lees, JA, du Plessis, M, Benisty, R, Givon-Lavi, N, Hawkins, PA, Cornick, JE, Kwambana-Adams, B, Law, PY, Ho, PL, Antonio, M, Everett, DB, Dagan, R, von Gottberg, A, Klugman, KP, McGee, L, Breiman, RF, Bentley, SD, Brooks, AW, Corso, A, Davydov, A, Maguire, A, Pollard, A, Kiran, A, Skoczynska, A, Moiane, B, Beall, B, Sigauque, B, Aanensen, D, Lehmann, D, Faccone, D, Foster-Nyarko, E, Bojang, E, Egorova, E, Voropaeva, E, Sampane-Donkor, E, Sadowy, E, Bigogo, G, Mucavele, H, Belabbès, H, Diawara, I, Moïsi, J, Verani, J, Keenan, J, Nair Thulasee Bhai, JN, Ndlangisa, KM, Zerouali, K, Ravikumar, KL, Titov, L, De Gouveia, L, Alaerts, M, Ip, M, de Cunto Brandileone, MC, Hasanuzzaman, M, Paragi, M, Nurse-Lucas, M, Ali, M, Elmdaghri, N, Croucher, N, Wolter, N, Porat, N, Köseoglu Eser, Ö, Akpaka, PE, Turner, P, Gagetti, P, Tientcheu, PE, Carter, PE, Mostowy, R, Kandasamy, R, Ford, R, Henderson, R, Malaker, R, Shakoor, S, Grassi Almeida, SC, Saha, SK, Doiphode, S, Madhi, SA, Devi Sekaran, S, Srifuengfung, S, Obaro, S, Clarke, SC, Nzenze, SA, Kastrin, T, Ochoa, TJ, Balaji, V, Hryniewicz, W, Urban, Y, Lo, SW, Gladstone, RA, van Tonder, AJ, Lees, JA, du Plessis, M, Benisty, R, Givon-Lavi, N, Hawkins, PA, Cornick, JE, Kwambana-Adams, B, Law, PY, Ho, PL, Antonio, M, Everett, DB, Dagan, R, von Gottberg, A, Klugman, KP, McGee, L, Breiman, RF, Bentley, SD, Brooks, AW, Corso, A, Davydov, A, Maguire, A, Pollard, A, Kiran, A, Skoczynska, A, Moiane, B, Beall, B, Sigauque, B, Aanensen, D, Lehmann, D, Faccone, D, Foster-Nyarko, E, Bojang, E, Egorova, E, Voropaeva, E, Sampane-Donkor, E, Sadowy, E, Bigogo, G, Mucavele, H, Belabbès, H, Diawara, I, Moïsi, J, Verani, J, Keenan, J, Nair Thulasee Bhai, JN, Ndlangisa, KM, Zerouali, K, Ravikumar, KL, Titov, L, De Gouveia, L, Alaerts, M, Ip, M, de Cunto Brandileone, MC, Hasanuzzaman, M, Paragi, M, Nurse-Lucas, M, Ali, M, Elmdaghri, N, Croucher, N, Wolter, N, Porat, N, Köseoglu Eser, Ö, Akpaka, PE, Turner, P, Gagetti, P, Tientcheu, PE, Carter, PE, Mostowy, R, Kandasamy, R, Ford, R, Henderson, R, Malaker, R, Shakoor, S, Grassi Almeida, SC, Saha, SK, Doiphode, S, Madhi, SA, Devi Sekaran, S, Srifuengfung, S, Obaro, S, Clarke, SC, Nzenze, SA, Kastrin, T, Ochoa, TJ, Balaji, V, Hryniewicz, W, and Urban, Y

Abstract

Background: Invasive pneumococcal disease remains an important health priority owing to increasing disease incidence caused by pneumococci expressing non-vaccine serotypes. We previously defined 621 Global Pneumococcal Sequence Clusters (GPSCs) by analysing 20 027 pneumococcal isolates collected worldwide and from previously published genomic data. In this study, we aimed to investigate the pneumococcal lineages behind the predominant serotypes, the mechanism of serotype replacement in disease, as well as the major pneumococcal lineages contributing to invasive pneumococcal disease in the post-vaccine era and their antibiotic resistant traits. Methods: We whole-genome sequenced 3233 invasive pneumococcal disease isolates from laboratory-based surveillance programmes in Hong Kong (n=78), Israel (n=701), Malawi (n=226), South Africa (n=1351), The Gambia (n=203), and the USA (n=674). The genomes represented pneumococci from before and after pneumococcal conjugate vaccine (PCV) introductions and were from children younger than 3 years. We identified predominant serotypes by prevalence and their major contributing lineages in each country, and assessed any serotype replacement by comparing the incidence rate between the pre-PCV and PCV periods for Israel, South Africa, and the USA. We defined the status of a lineage as vaccine-type GPSC (≥50% 13-valent PCV [PCV13] serotypes) or non-vaccine-type GPSC (>50% non-PCV13 serotypes) on the basis of its initial serotype composition detected in the earliest vaccine period to measure their individual contribution toward serotype replacement in each country. Major pneumococcal lineages in the PCV period were identified by pooled incidence rate using a random effects model. Findings: The five most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to two or more countries. The five most prevalent serotypes in the PCV13 period varied between countries, with

Published
2019

19. Prevalence of Acinetobacter baumannii bacteremia in intensive care units of Ibn Rochd University Hospital, Casablanca

Author

El Kettani, A., Fakhreddine Maaloum, Diawara, I., Katfy, K., Harrar, N., Zerouali, K., Belabbes, H., and Elmdaghri, N.

Subjects
Acinetobacter baumannii, Bacteremi, blaOXA-23, Antibiotic resistance, bla OXA-51, lcsh:QR1-502, Original Article, blaOXA-51, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, bla OXA-23, lcsh:Microbiology
Abstract

Background and Objectives: Acinetobacter baumannii bacteremia are grave because of the multi-resistance of the organism to antibiotics. This study aimed to determine the prevalence of A. baumannii isolated from blood cultures and to describe their antibiotic resistance patterns. Materials and Methods: A retrospective longitudinal study was conducted on blood cultures between 2010 and 2014 from all Ibn Rochd University Hospital intensive care units; it was based on the exploitation of microbiology laboratory database (duplicates were excluded). Isolation and identification of A. baumannii were performed according to standard techniques of bacteriology and susceptibility testing as recommended by the CLSI. PCR was used to detect β-Lactamase genes, blaOXA-51, blaOXA-23. Results: Among the 4232 samples received at the laboratory, 2402 (56.8%) were positive. Negative coagulase Staphylococcus was isolated in 21.6% of cases followed by A. baumannii (9.2%), and K. pneumoniae (9.1%). A. baumannii strains were resistant to most antibiotics tested: imipenem (75.7%), ceftazidim (85.4%), cefotaxim (98.6%), gentamicin (78.1%), amikacin (63.5%) and ciprofloxacin (88.2%). All A. baumannii strains, resistant to carbapenem, tested were positive for blaOXA-51 genes and 87.5% expressed the blaOXA-23 genes. Conclusion: A. baumannii was the second germ frequently isolated from blood cultures in intensive care units. It was multi-resistant to antibiotics. The strengthening of hospital hygiene measures and surveillance of antibiotic resistance is needed to limit the spread of germs and to optimize the management of antibiotics.

Published
2018

30. Méningite tuberculeuse confirmée : à propos de 52 cas

Author

Dollo, I., El Fane, M., Es-sebbani, M., Chakib, A., Sodqi, M., Marih, L., Ouladlahsen, A., Bahri, L., Diraa, O., Zerouali, K., Belabbes, H., El Mdaghri, N., and El Filali, K. Marhoum

Abstract

Rapporter la prévalence de la méningite tuberculeuse confirmée et décrire les aspects cliniques, paracliniques et évolutifs.

Published
2024
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39. Meningites à streptocoque du groupe A

Author

Jouhadi, Z., primary, Sadiki, H., additional, Lehlimi, M., additional, Honsali, Z., additional, Najib, J., additional, Zerouali, K., additional, Belabess, H., additional, and Mdaghri, N., additional

Published
2012
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47. Ecthyma gangrenosum following circumcision.

Author

Hali, F., Araqi Houssaini, L., Kadiri, F., Ferram, N., Ailal, F., Zerouali, K., and Chiheb, S.

Subjects
*CIRCUMCISION, *OLDER patients, *IMMUNOCOMPROMISED patients, *INFANTS, *IMMUNE system
Abstract

Ecthyma gangrenosum (EG) is a rare, invasive cutaneous infection caused by Pseudomo- nas aeruginosa in the majority of cases. EG typically affects immunocompromised patients. The disease may affect patients of any age, although it is commonly reported in infants and elderly patients due to underdeveloped or compromised immune system. We report a case of a previously immunocompetent infant who developed extensive perineal EG complicated by Pseudomonas sepsis after circumcision. Our case is exceptional as it reports a case of ecthyma gangrenosum in a previously healthy infant with three risk factors (recent antibiotic therapy, transient neutropenia and circumcision-induced skin breach). [ABSTRACT FROM AUTHOR]

Published
2021

49. Invasive Pneumococcal Infections Among Moroccan Children: Pneumococcal Vaccination Challenges in the Mature Vaccine Era.

Author

Zerouali K, Katfy M, Kettani AE, Nzoyikorera N, Katfy K, Bousfiha AA, Gueddari W, Slaoui B, Abkari A, Chlilek A, Diawara I, Zouhair S, Asmae LH, Younous S, Mouaffak Y, Bourrous M, Lahmini W, Rada N, Draiss G, Soraa N, and Bouskraoui M

Subjects
Humans, Morocco epidemiology, Child, Preschool, Infant, Child, Male, Female, Vaccination statistics & numerical data, Adolescent, Anti-Bacterial Agents therapeutic use, Prevalence, Pneumococcal Vaccines administration & dosage, Pneumococcal Vaccines immunology, Pneumococcal Infections prevention & control, Pneumococcal Infections epidemiology, Pneumococcal Infections microbiology, Streptococcus pneumoniae immunology, Streptococcus pneumoniae classification, Streptococcus pneumoniae isolation & purification, Serogroup
Abstract

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.

Published
2024
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50. Prevalence of Healthcare-Associated Infections in a Tertiary Hospital in Casablanca, Morocco, 2021.

Author

Lyazidi S, Ouhadous M, Arai M, Zerouali K, Barrou H, and Hassoune S

Abstract

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., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Lyazidi et al.)

Published
2024
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