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Background: Equipment and hospital surfaces constitute a microbial reservoir that can contaminate hospital users and thus create an infectious risk. The aim of this work, which was carried out for the first time at a hospital in Meknes (regional hospital in the center of Morocco), is to evaluate the microbiological quality of surfaces and equipment in three potential risk areas (burn unit, operating room, and sterilization service)., Methods: This study was carried out over a period of 4 months (February-May 2017). A total of 60 samples were taken by swabbing according to the standard (ISO/DIS 14698-1 (2004)) in an environment of dry area and equipment after biocleaning. Isolation and identification were performed according to conventional bacteriological methods and by microscopic observation for fungi., Results: The study showed that 40% of surface samples were contaminated after biocleaning. The burn unit recorded a percentage of 70% contamination ( p value <0.001), 13% for the sterilization service, and 7% for the operating room. 89% of the isolates were identified as Gram-positive bacteria against 11% for fungi ( p value <0.001). Bacterial identification showed coagulase-negative staphylococci (32%), Bacillus spp. (16%), Corynebacterium (8%), and oxidase-negative Gram-positive bacillus (40%) while fungal identification showed Aspergillus niger ( n  = 2) and Aspergillus nidulans ( n  = 1)., Conclusion: To control the infectious risk related to equipment and hospital surfaces, it would be necessary to evaluate the disinfection protocol applied in these units., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Samira Jaouhar et al.)

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.

The emergence and the rapid spread of Pseudomonas aeruginosa carrying carbapenemases represent a serious threat to public health due to their delicate therapy. This work was performed to establish the resistance profile and to detect carbapenemases producing in 123 P. aeruginosa isolates. Among these 55 are environmental isolates and 68 are from the two major hospitals of Meknes-Tafilalet region in Morocco. All strains were tested against 14 antipseudomonal drugs by disc diffusion method. On carbapenem resistant strains minimum inhibitory concentrations of imipenem were determined by the E-test method. The modified Hodge test and EDTA tests were used for the detection of carbapenemases and metallo-β-lactamases (MBLs), respectively. PCR and DNA sequencing were conducted to detect carbapenemase-encoding genes and the enzyme types. 12% of isolates was susceptible to all antibiotics tested and Carbapenem resistance was observed in 33 P. aeruginosa isolates, 33.3% of them were multi-drug resistant. Among carbapenem resistant strains only two (6.1%) were positive for carbapenemases and also for MBLs. In addition to their resistance to almost all β-lactams tested, the MBLs producing strains were resistant to aminoglycosides. Molecular biology techniques confirmed the phenotypic results obtained for the two strains carbapenemase producers and demonstrated that each one of them carried blaVIM-2. The present study reports the first isolation of blaVIM genes in clinical isolates of P. aeruginosa in Morocco. Such isolates represent a serious emerging threat requiring strict hygiene measures to better control their spread., (Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Background: The production of metallo-beta-lactamases (MBL) such as VIM (Verona integron-encoded metallo-ß-lactamase), IMP (Imipenem-resistant Pseudomonas) and NDM (New Delhi metallo-ß-lactamase) in Gram-negative bacilli (GNB) resistant to carbapenems is a real concern for clinicians, given the therapeutic impasses involved. However, the existence of resistance genes encoding these enzymes is virtually undocumented in Burkina Faso. Aim: To genotypically demonstrate carbapenem resistance through the production of VIM-type carbapenemases in GNB strains collected at the Centre Hospitalier Universitaire de Tengandogo (CHU-T) and the Hôpital Saint Camille de Ouagadougou (HOSCO) in Burkina Faso. Methods: In this study, the resistance profile of 158 strains of GNB to imipenem, meropenem, ertapenem, doripenem and aztreonam was determined using the disc diffusion method. Resistant strains were analyzed by conventional PCR to detect blaVIM using specific primers. Results: Of 158 GNB strains collected, 91 (57.6%) were resistant to at least one of the carbapenems and/or aztreonam. The highest prevalence of resistant strains was observed in Escherichia coli (E. coli) 45.1% (n=41) and Klebsiella pneumoniae (K. pneumonia) 26.5% (n=24), which are the majority species. The blaVIM gene was detected in only 7 resistant strains (7.7%), including 3.3% (n=3/91) of E. coli, and 1.1% (n=1/91) of each of the species Pseudomonas aeruginosa (P. aeruginosa), Klebsiella oxytoca (K. oxytoca), Proteus mirabilis (P. mirabilis) and Serratia marcescens (S. marcescens). Conclusion: This study established the existence of blaVIM gene, which is involved in the resistance of GNB to carbapenems through the production of VIM-type enzymes at CHU-T and HOSCO in Burkina Faso. [ABSTRACT FROM AUTHOR]

This review explores our understanding of Cryptosporidium species and Giardia duodenalis distribution in Middle East and North African (MENA) water resources. Results emphasize that Cryptosporidium species (sp.) and G. duodenalis (oo)cysts are present in distinct categories of water in ten MENA countries. Cryptosporidium sp. proportional prevalence in the MENA region was 24.5% (95% CI 16.3-33.8), while G . duodenalis prevalence was 37.7% (95% CI 21.9-55.1). Raw wastewater and surface water were the water categories most significantly impacted. Both parasites were reported in the various types of MENA drinking waters. The most frequent species/genotypes reported were C. hominis , C. parvum , and G. duodenalis assemblage A. Despite the high prevalence of (oo)cysts reported, we should consider the absence of waterborne outbreaks. This indicates significant underestimation and underreporting of both parasites in MENA. Stakeholders should apply water contamination legislation to eradicate Cryptosporidium sp. and G. duodenalis (oo)cysts from water resources/categories., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

In Morocco, the scarcity of rainfall is linked to global warming and to the overexploitation of groundwater due to demographic and socio-economic pressures, which generates a major problem, namely a significant decline of the piezometric level. The goal of this study is to assess the piezometric and rainfall levels of the groundwater in the Angads aquifer, which is one of the most important in the Eastern part of Morocco. To do so, graphs were drawn from the piezometric data of three piezometers, namely AP1, AP2, and AP3 located respectively in the Eastern, Central, and Western part of the country, and from the rainfall data of the Oujda station during the period from 1985 to 2015. The main results revealed a fluctuation in rainfall over time, with an increase recorded in 2009. Indeed, the results of the variation of piezometric levels over the years generally showed a downward trend, especially in the area between the aquifer outlet and the Maghnia plain in Algeria, while the results of the assessment of the piezometric land rainfall levels over time generally show a downward trend. In the face of this decline, effective strategies need to be considered to protect these resources from depletion, including artificial recharge of the aquifer, wastewater reuse which aims to restore an aquifer overexploited by excessive pumping, whose drawdown is detrimental, and multi-purpose water storage. [ABSTRACT FROM AUTHOR]

The assessment of the bacterial quality of groundwater is a critical step in ensuring safe drinking water. A total of nine (9) water samples were obtained from wells located within the study area, during the wet and dry seasons between December 2020 and December 2021. The parameters measured in this study include total germs at 22 °C (TG-22 °C) and 37 °C (TG-37 °C), total coliforms (TC), fecal coliforms (FC), fecal streptococci (FS), and the sulfito-reductor clostruim (SRC). The results show that the contamination levels vary widely between the different wells and between seasons. The highest levels of contamination were found in W6, with the highest values of all parameters measured except for TC. W1 and W7 were the only wells that were protected, and they had lower levels of contamination compared to unprotected wells. The sources of pollution were mainly related to agricultural activities, such as animal waste and metal waste. The findings of this study suggest the need for improved management practices to reduce contamination and protect the groundwater resources in the study area. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Good health and a safe environment are essential for sustainable development, including the appropriate management of healthcare wastes. The study intends to assess the generation rate and management methods of healthcare waste in the regional hospital center and a private clinic in Tangier, Morocco, with a focus on potential risks to health workers from infectious diseases. METHODS: The study collected data on healthcare waste generation over a period of two months by measuring and analyzing general and hazardous waste using an electronic scale. The data was presented as averages in kilograms per bed per day and as percentages. A questionnaire was provided to 100 healthcare workers. It included questions on their sociodemographic characteristics and their knowledge and attitudes regarding healthcare waste management. FINDINGS: The case study revealed that the healthcare waste production in the two institutions varied, with the private clinic producing 0.76 kilograms per day per bed and the regional hospital center producing 1.84 kilograms per day per bed. The survey also discovered that the hazardous fraction of waste generated in the regional hospital center was 40 percent, which was much higher than the World Health Organization's estimation. The daily amount of hazardous waste generated increased from 260.49 kilograms to 436.81 kilograms post-COVID-19. The survey found gaps in knowledge, attitudes, and daily challenges in waste management practices among the health workers in both facilities. CONCLUSION: The survey findings suggest that the healthcare waste management methods in Tangier are unsafe and may endanger the health workers and patients. The study found that the lack of monitoring and control contributed significantly to noncompliance with good practices. These findings can be used by the regional divisions of the Ministry of Health to develop specific protocols for managing sanitary emergencies and perform routine observation and training at all levels in the two facilities studied. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis, the most common form of leishmaniasis, causes long-term skin lesions on exposed areas of the skin. It is caused by a protozoan parasite belonging to the genus Leishmania and is transmitted via infected phlebotomine sand flies. In North Africa, particularly Algeria, the disease represents a major public health problem. This retrospective study, which focuses on the agropastoral region of Djelfa (central Algeria) during a period of 16 years, from 2006 to 2021, is part of the surveillance of cutaneous leishmaniasis to identify the key factors favouring its probable spread. The analyzed data reveal that this disease is more prevalent in male patients (53.60%) and is highly widespread in this vast area of 66,415 km2 with a total of 3864 CL cases, reaching a peak of 1407 cases in 2006. Statistically, the Pearson correlation validated by the p-value shows, in an original and sometimes unexpected way, that certain factors, such as temperature linked to climate change, are playing a significant role in the probable spread of the disease in Djelfa and its surrounding regions. The concentration of the population in some specific rural areas with limited or nonexistent access to public health services is another potential factor in disease transmission. The results were highlighted by a significant correlation coefficient ( r = 0.66 ) with a p-value less than 0.01. While there is currently no vaccine or prophylactic drug available, our research represents a preliminary approach that addresses various epidemiological aspects of the disease. This paves the way for a proactive preventive strategy involving the control of vector-borne diseases. [ABSTRACT FROM AUTHOR]

Objective: Pseudomonas aeruginosa is a common cause of nosocomial infections worldwide. Increasing in the emergence and spread of multidrug-resistant (MDR) strains is a serious health concern. The aim of the present study was to determine the antibiotic resistance pattern of P. aeruginosa isolated from clinical samples. Materials and Methods: The current retrospective cross-sectional study was conducted at a tertiary-care hospital in Oman. The data of P. aeruginosa isolates identified during 2015-2019 at Sohar Hospital were retrieved from Al-Shifa computerized data system. The data were systematically analyzed using SPSS 22 software system, IBM Chicago. Descriptive statistics were applied to find frequencies and percentages. Trends were analyzed using a one-sample Chi-square test. Results: A total of 5865 P. aeruginosa strains identified in clinical samples of 4024 patients were studied. The frequency of isolation of P. aeruginosa was more among people aged >60 years (33%). The rate of isolation was significantly high (47%) in pus/wound swabs. The overall resistance of P. aeruginosa was low to moderate (10%-30%) to commonly used anti-pseudomonal drugs. Among, 10% were MDR strains. The lowest resistance (10%) was observed to piperacillin-tazobactam (TAZP), while significantly high resistance (29%-30%) was exhibited by carbapenems. Furthermore, strains isolated from respiratory secretions and urine samples have shown a significantly high percentage of resistance compared to others. Conclusions: Piperacillin-tazobactam is recommended as the drug of choice for treating especially severe Pseudomonas infections. Moderate resistance to carbapenems is an alarming sign. This pattern of resistance suggests the probable overuse of drugs. Therefore, it emphasizes strict antibiotic policy, rapid detection, and continuous monitoring of drug-resistant strains, and timely dissemination of the resistant report to clinicians. [ABSTRACT FROM AUTHOR]

Leishmaniasis is an infectious disease transmitted to humans by the bite of a female sandfly. In Morocco, leishmaniasis is considered a real health concern. The aims of this study were to analyze the epidemiological situation and identify localities at risk of transmission of leishmaniasis in the province of Moulay Yaâcoub. The study was a retrospective analysis of leishmaniasis cases reported over a period of 11 years from 2005 to 2015 in Moulay Yaâcoub Province. The data were collected from the registries of the Prefectural Cell of the Moulay Yaâcoub Province Medical Delegation, Regional Directorate of Health, Fez-Meknes, and analyzed statistically. The results showed that leishmaniasis was present, with an annual average of 18.63 cases. A total of 205 cases of leishmaniasis were recorded, with 53% cutaneous leishmaniasis and 47% visceral leishmaniasis. Females were the most affected, at 53.7%, mainly by cutaneous leishmaniasis, although the difference was not statistically significant (χ² = 0.7, pvalue = 0.79). Cutaneous leishmaniasis affected all age groups, whereas visceral leishmaniasis affected only young people under 30. The communes most affected were Ain Chkef and Ain Kansara, and the difference between the proportions of cases detected in the different sites was statistically significant (χ² = 96.03, p-value < 0.05). To the best of our knowledge, this is the first time such a study has been conducted in Moulay Yaâcoub Province. [ABSTRACT FROM AUTHOR]

Urinary tract infection is one of the most common infectious diseases worldwide. This study aimed to determine the frequency of Urinary tract infections, identify the microorganisms involved, and determine the antibiotic resistance pattern of Escherichia coli. Conventional biochemical techniques identified isolates. The antibiogram was produced using the Muller-Hinton agar disc diffusion method according to the recommendations of the Antibiotic Committee of the French Microbiology Society. During the study period, 21. 4% of the samples were identified as positive. The microorganisms isolated were: Escherichia coli (47%), Klebsiella pneumoniae (19%) followed by Trichomonas vaginalis (9%), Candida albicans, and Pseudomonas sp (8%). Finally, Staphylococcus aureus and Proteus rettgeri represent 4% of isolates. The dominant resistance of E.coli was to amoxicillin and ticarcillin (55%) followed by cefalotine (39%). Resistance to fluoroquinolones was 27% (norfloxacin). The amikacin and gentamicin resistance rates were 12.5%, and 10.5% respectively. The resistance to the third-generation cephalosporins (ceftazidime, cefotaxime) was 10.5%. E. coli were resistant to nitrofurantoin and fosfomycin with percentages of 10.5%, and 6.6% respectively. However, the resistance to imipenem does not exceed 2%. Increasing rates of E.coli antibiotic resistance indicate that careful monitoring of their use is necessary. [ABSTRACT FROM AUTHOR]

Pulmonary tuberculosis is an airborne disease when people with tuberculosis cough up tuberculosis bacilli into the air. It is a serious public health problem in developing countries. In Morocco, the clinical management of pulmonary tuberculosis is often ambulatory, and hospitalization is indicated only for severe or complicated cases. This study aims to investigate the risk factors associated with pulmonary tuberculosis in patients hospitalized. A retrospective study was conducted on patients with pulmonary tuberculosis hospitalized in the pulmonology department from January 1, 2019 to June 1, 2021. Data were extracted from tuberculosis patients' records and statically analyzed using SPSS software. A total of 140 cases of pulmonary tuberculosis were identified with a predominance of the male gender (90.71%). The age category between 15 and 34 years was the most affected by the disease (p=0.017). The bivariate analysis showed that there are apparent risk factors for the disease. Most of the patients who developed the disease were smokers (p=0.035) of the male gender (p=0.003). There was a significant association between the disease and HIV-positive status (p=0.001). In addition, diabetic patients were also predisposed to develop the disease (p=0.002). In conclusion, young and male patients were more likely to be affected by the disease. Smoking, contact with a person with tuberculosis, and comorbidity with the disease were found to be risk factors for developing lung disease. This calls for intensified screening activities for tuberculosis in active patients. [ABSTRACT FROM AUTHOR]

The increase in dental healthcare facilities and the use of single-use equipment have increased the production of healthcare waste. Their mismanagement exposes healthcare workers, waste managers, and the population to an infectious risk and negatively impacts the environment. Therefore, a correct management procedure has to be adopted from separation through storage to disposal. This study aimed to investigate dentists' knowledge, attitudes, and practices regarding managing infectious healthcare waste in private dental offices. A descriptive and analytical cross-sectional survey was conducted between December 2020 and March 2021 among private dentists registered at the Moroccan National Council of Dentists in the Rabat-Salé-Kénitra region. A questionnaire was developed to assess waste management in dental offices. Of the 500 questionnaires distributed, 190 completed and exploitable questionnaires were collected. Only 27.3% of healthcare waste managers in dental practices received training, 21,5% of practitioners assimilated the used gloves into household waste, 71.5% disposed of the waste generated by their offices directly into public bins, and 86.4% were unaware of Moroccan law 28-00 on waste management and disposal. This study highlights dentists' apparent lack of knowledge regarding healthcare waste management, and significant gaps were identified between actual practices and recommended regulations. To address these issues, developing a comprehensive medical waste management plan is crucial to encourage the practical cooperation of all stakeholders in this sector. [ABSTRACT FROM AUTHOR]

Waterborne diseases, including infection by viral hepatitis, represents a significant public health problem in many parts of the world, particularly in Morocco. They are sensitive to environmental conditions. Some or all are likely to be affected by climate change, which could alter their risk. The objective of this work is to study the impact of rainfall on the evolution of viral hepatitis in the prefecture of Meknes during the 2010-2014period. The number of cases of water-borne viral hepatitis between 2010 and 2014 were obtained from prefectural epidemiology unit of Meknes, while the climatic variables were obtained from the meteorological station of the Agropolis agribusiness and research center of the region of Meknes. The epidemiological situation of viral hepatitis in the study area shows that the prefecture of Meknes was still affected by this epidemic during all the years of the study with a rate which reached 95 cases in 2012. In addition, this study shows that the years of heavy rainfall have seen a decrease in viral hepatitis cases. Climatic factors can therefore affect public health. In fact, heavy rainfall can reduce the risk of the appearance of diseases, in particular viral hepatitis, by reducing water pollution by dilution. Hence the need to encourage studies to improve knowledge and scientific evidence of the association between health and climate, and to integrate climatic factors into epidemic surveillance systems. [ABSTRACT FROM AUTHOR]

Urban areas may affect the richness of avian species. The abundance and diversity of urban landscapes offer breeding habitats and nesting resources for urban-adapted species. In our study, we investigated the breeding birds in urban landscapes of Fez's historical city (Morocco). We used line-transects to search for nests of breeding species, populations, and habitats counting breeding sites and predicting factors (foraging, nesting resources, and urbanization). Furthermore, four habitats counting green gardens, old city walls, urban farms, and urban forests were prospected to search for nests of breeding birds. Among 13 breeding species including 12 resident-breeders, and one breeding migrant, a total of 109 nests were documented. Five species counting Turdus merula, Sylvia atricapilla, Spilopelia senegalensis, Columba livia, and Coloeus monedula were encountered in green gardens; four species counting Athene noctua, Sturnus unicolor, Passer domesticus, and Tachymarptis melba were observed in old city walls. Falco tinnunculus, Fringilla coelebs, and Accipiter nisus occurred in urban forests; and Streptopelia decaocto in urban farms. The recorded nests were divided between cavities (50 nests) and trees (59 nests). In green spaces, nests were distributed among Olea europaea (17), Citrus aurantium (15), Bambusa vulgaris (11), and Eucalyptus globulus (7). In contrast, Olea oleaster and Cupressus sp. hosted only tree nests each, while Populus sp. and Washingtonia filifera hosted only one nest each. Most nests were recorded in habitats rich in nesting trees and close to water sources. On the contrary, the number of nests decreased as the surface and distance of the habitat to the urban center increased. Our data revealed the diversity, habitat use, and nesting substrates of urban breeding bird communities in Morocco and the Southern slope of the Western Palearctic. Future urban plans must integrate measures to provide suitable breeding resources such as cavities of old walls and a high diversity of urban green spaces for birds to enhance their breeding performances, thus promoting the well-being of the population via increasing biodiversity. [ABSTRACT FROM AUTHOR]

We assessed the spatial variability in the size structure of phytoplankton, community composition, primary production and carbon fluxes through the planktonic food web of the Gulf of Gabès (GG; Southeastern Mediterranean Sea) in the fall of 2017 during the MERMEX-MERITE cruise. High concentrations in nutrients, chlorophyll a (~ 2–6 µg L−1) and primary production (1816–3674 mg C m−2 d−1) revealed an eutrophic status of the studied stations in the GG. In accordance with hydrodynamic features, inorganic nutrients showed increases in concentrations from North to South and from coast to offshore, these nutrient gradients impacting the spatial distribution of phytoplankton community. Size-fractioned phytoplankton biomass and production were the lowest in the northernmost zone where they were mainly sustained by pico-sized fraction. Concomitantly, in this area, small aloricate ciliates were dominant leading to a high microbivory. Conversely, higher biomass and production were measured towards the South and offshore with prevalence of larger phytoplankton (nano- and/or micro-sized fractions) supported by diatoms. The herbivorous protozooplankton and metazooplankton were more abundant in these zones, resulting in an increase of the herbivory. The vertical particulate organic carbon flux followed also a north–south and coast-offshore increasing gradient, with a higher contribution of phytoplankton, and zooplankton fecal pellets to the sinking organic matter in the southernmost area. Our results suggest that even in nutrient-rich and highly productive waters, a continuum of trophic pathways, ranging from microbial to multivorous and herbivorous food webs, may exist, which implies different efficiencies in carbon export and carrying capacity within the ecosystem. [ABSTRACT FROM AUTHOR]

Sandflies are small insects belonging to the order Diptera, which make up the Phlebotominae subfamily within the Psychodidae family. In the fight against leishmaniasis in the prefecture of Meknes, Morocco, a study of the phlebotomist population was carried out during the period of activity of sandflies while studying the link between the abundance of these insects and climatic factors, namely, temperature, moisture, rainfall, and wind speed. A total of 958 phlebotomus were captured, 73% of which belong to Phlebotomus sergenti, a vector of Leishmania species causing human cutaneous leishmaniasis. This study also showed the existence of two months of risk in July and September with a positive correlation between temperature and abundance of sandflies and a negative correlation between abundance of sandflies and rainfall and moisture. Indeed, it is necessary to strengthen the means to fight this disease during periods of activity and to use medium-term climatological forecasts to develop an alert system for leishmaniasis. [ABSTRACT FROM AUTHOR]

Leishmaniasis is a major health problem caused by a protozoan of the genus Leishmania, most commonly transmitted by infected female sand flies. Intersectoral collaboration is essential for the implementation of integrated vector management control with community participation. The present study aims to evaluate the knowledge, attitude and practices of the population toward leishmaniasis in central Morocco. A quantitative cross-sectional study was conducted using an administered questionnaire assisted by health professionals, on 750 people in the Marrakech Safi, endemic region of cutaneous leishmaniasis (CL). Of those, 702 agreed to be recruited for our study, of which 63,5% were women, 48,1% were aged between 18 and 40 years, and more than half of the participants (60%) were from rural areas. Overall, the knowledge, attitude and practices (KAPs) for leishmaniasis are too poor for more than 85% of the population in the study area. Basic knowledge and perceptions of leishmaniasis were good for 14,6% of respondents. While, 4,5% of the members had good knowledge of CL, only 0,7% had good level of knowledge about vesciral leishmaniasis (VL). Furthermore 3,7% of those polled have favorable attitudes and preventive practices. No association was found between knowledge and age, province or occupation. However, rural residents were four times more likely than urbain residents to have good basic knowledge (ORA = 4,74; CI95%: 1,04 -22,05). In addition, the female gender also has the chance to possess good basic knowledge and perceptions 3 times more than the men (ORA = 3,18; CI95%: 1,16 -8,69). The low level of KAPs regarding leishmaniasis proves the lack of community participation in the fight against leishmaniasis in central Morocco. [ABSTRACT FROM AUTHOR]

Caused by the Leishmania parasite and transmitted by the bite of sand flies, leishmaniasis is a multi-factor disease which causes a big health problem. Anarchic, accelerated, and unplanned urbanization, as well as inadequate environmental hygiene and important human migratory flows constitute risk factors for Leishmaniasis. From this point of view and through the present study, the risk factors of leishmaniasis that represent the impact of the population, urbanization, and poverty on the distribution of the disease in the study area have been evaluated. The health data for this study were obtained from the registers of the prefectural of epidemiology unit. However, the socio-economic data were obtained from the High Commissioner's Office of Morocco. The statistical analysis was carried out using SPSS software. The evolution of the annual number of leishmaniasis cases reported during the study period shows that the provinces most affected by this epidemic are the provinces of Taza and Taounate with 25%, as well as Boulemane (18%) and Sefrou (16%). In addition, the study of the risk factors of this epidemic shows a positive correlation between leishmaniasis cases reported and urbanization (R = 0, 51) and a weak correlation between demographic weight and leishmaniasis cases reported (R = 0, 27). However, there is no relationship between the distribution of leishmaniasis and poverty. These results show the impact of socioeconomic factors on the distribution of leishmaniasis in the Fez-Meknes region. Indeed, actors should take these results into consideration when determining risk areas in order to develop a leishmaniasis alert system. [ABSTRACT FROM AUTHOR]

Background: In North African countries, zoonotic cutaneous leishmaniasis (ZCL) is a seasonal disease linked to Phlebotomus papatasi, Scopoli, 1786, the primary proven vector of L. major dynamics. Even if the disease is of public health importance, studies of P. papatasi seasonal dynamics are often local and dispersed in space and time. Therefore, a detailed picture of the biology and behavior of the vector linked with climatic factors and the framework of ZCL outbreaks is still lacking at the North African countries' level. Our study aims to fill this gap via a systematic review and meta-analysis of the seasonal incidence of ZCL and the activity of P. papatasi in North African countries. We address the relationship between the seasonal number of declared ZCL cases, the seasonal dynamic of P. papatasi, and climatic variables at the North African region scale. Methods: We selected 585 publications, dissertations, and archives data published from 1990 to July 2022. The monthly incidence data of ZCL were extracted from 15 documents and those on the seasonal dynamic of P. papatasi from 11 publications from four North African countries. Results: Our analysis disclosed that for most studied sites, the highest ZCL incidence is recorded from October to February (the hibernal season of the vector), while the P. papatasi density peaks primarily during the hot season of June to September. Overall, at the North African region scale, two to four months laps are present before the apparition of the scars reminiscent of infection by L. major. Conclusions: Such analysis is of interest to regional decision-makers for planning control of ZCL in North African countries. They can also be a rationale on which future field studies combining ZCL disease incidence, vector activity, and climatic data can be built. [ABSTRACT FROM AUTHOR]

This study aims to verify the relevance of Brachidontes pharaonis to assess the ecotoxicological status of polluted sites. For this, the levels of some heavy metals (i.e. Zn, Cu, Pb, and Cd) and a battery of biomarkers including metallothionein (MT), malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) were assessed in mussels collected from the harbor of Rades (North), and the harbor of Zarzis (South). Moreover, abiotic parameters including temperature, salinity, pH, and dissolved oxygen were assessed. Results from the ICP-OES showed that the southern population exhibited a higher metal pollution index with significantly higher Zn, Cu, and Pb concentrations. Moreover, the specimens from Zarzis displayed significantly higher levels of MDA, MT, GSH, GPx, SOD, and CAT reflecting higher levels of oxidative and chemical stress. These results emphasize the potential utility of B. pharaonis for the monitoring of heavily impacted sites. [ABSTRACT FROM AUTHOR]

Background and Aims: Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis that causes skin lesions on exposed parts of the body. It is endemic in over 170 districts and highly prevalent in the northern and southern parts of Ethiopia. Thus, the aim of this study was to assess the determinants of CL among students of Wegeltena secondary school in Delanta district, Northeast Ethiopia. Methods: This unmatched case–control study was conducted from January 4 to 20, 2021 at Wegeltena secondary school. Cases were students who had an active lesion of CL and controls were students who had never been infected with CL (no active lesions). A simple random sampling technique was utilized to select participants in the control group. Data were collected by using a pretested, interviewer‐administered structured questionnaire. Bivariable and multivariable logistic regression analyses were performed and variables were declared determinants of CL at a p value of <0.05. Results: A total of 225 students (58 cases and 167 controls) participated in the study. The mean age of cases and controls was 18.6 (SD ± 0.99 years) and 18.5 years (SD ± 1.17 years), respectively. In this study, 74.1% of cases and 51.5% of controls have been living in rural areas. Furthermore, being male (adjusted odds ratio [AOR] = 4.11; 95% confidence interval [CI]: 1.94–8.69), rural residents (AOR = 2.95; 95% CI: 1.33–6.52), living in areas where caves (AOR = 3.63; 95% CI: 1.24–10.59), nearby forest (AOR = 4.04; 95% CI: 1.42–11.51), and hyrax available (AOR = 2.43; 95% CI: 1.16–5.08) were significantly associated with CL. Conclusion: In our study, sociodemographic and environmental factors were found to be determinants of CL. Therefore, reducing outdoor activities, wearing protective clothes, use of insecticide‐treated nets, and destruction of sand fly breeding sites shall be implemented targeting the rural population that resides in areas where forests, caves, and hyraxes are prominent. [ABSTRACT FROM AUTHOR]

Leishmaniasis is endemic in Morocco where both cutaneous and visceral forms coexist. To date, anthroponotic cutaneous leishmaniasis (ACL) determinants remain poorly investigated in Morocco. However, the disease risk factors identification is vital to determine the specific preventive process. In this aim, a case-control study was conducted in the main active ACL foci in central Morocco. Epidemiological data were extracted from bulletins, registers and annual reports of the regional direction of Health offices. The socioeconomic and environmental data were collected from epidemiological surveys, completed by a questionnaire intended for accessible positive population and control people selected from the cases' entourage. The study included 258 cases and 395 controls. Our results showed that many socioeconomic factors were associated with ACL in Morocco such as the rural habitation (OR = 4.163; 95% CI: 2.91–5.96), movement to endemic area (OR = 4.53; 95% CI: 3.03–6.77), provenance from leishmaniasis foci (in Essaouira focus OR = 5.34; 95% CI: 1.19–24.03) and poverty. In addition, environmental factors like proximity of vegetation (OR = 2.45; 95% CI: 1.14–5.25), poor domestic hygiene, particularly the absence of sewage system/waste management (OR = 1.63; 95% CI: 1.35–1.96), and presence of animals (OR = 2.67; 95% CI: 1.14–5.25) increase the risk of ACL in Morocco. Except for Matrimonial status (married people, OR = 4.11; 95% CI: 1.80–9.41), there is however no significant association of the disease with the other socio-demographic factors in the study area (p>0.05). These several risk factors must be taken in consideration to prevent this disease through multidisciplinary collaboration and community participation. [ABSTRACT FROM AUTHOR]

Background. Multidrug resistance (MDR) and extensively drug-resistant (XDR) are now the biggest threats to human beings. Alternative antimicrobial regimens to conventional antibiotic paradigms are extensively searched. Although Cistus extracts have long been used for infections in traditional folk medicines around the world, their efficacy against resistant bacteria still needs to be elucidated. We aim to investigate the antibiotic susceptibility profiles of clinical strains Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae (acronym "ESKAPE"), and their resistance mechanisms by PCR, as well as their sensitivity to C. monspeliensis (CM) and C. salviifolius (CS) methanol extracts and their fractions. Methods. Antibiotic susceptibility profile and resistance mechanism were done by antibiogram and PCR. Fractions of CM and CS were obtained using maceration and Soxhlet; their antibacterial activities were evaluated by determining inhibition zone diameter (IZD), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). Results. Results revealed that all strains were XDR except S. aureus, which was MDR. The PCR indicates the presence of gene-mediated resistance (blaCTX-M, blaSHV, blaOXA-48, blaNDM, blaOXA-51, blaOXA-58, blaIMP, blaVIM, and blamecA). Also, maceration was slightly better for bioactivity preservation. Overall, the extracts of CM (IZD = 20 mm, MIC = 0.01 mg/mL) were more active than those of CS. All extracts inhibited MRSA (methicillin-resistant Staphylococcus aureus) and ERV (Enterococcus faecium Vancomycin-Resistant) with interesting MICs. The ethyl acetate fraction manifested great efficacy against all strains. Monoterpene hydrocarbons and sesquiterpenes oxygenated were the chemical classes of compounds dominating the analyzed fractions. Viridiflorol was the major compound in ethyl acetate fractions of 59.84% and 70.77% for CM and CS, respectively. Conclusions. The superior activity of extracts to conventional antibiotics was seen for the first time in the pathogens group, and their bactericidal effect could be a promising alternative for developing clinical antibacterial agents against MDR and XDR ESKAPE bacteria. [ABSTRACT FROM AUTHOR]

Background: Cutaneous leishmaniasis is a neglected tropical disease caused by Leishmania spp. and transmitted by female sandflies. Terrorism and counter-insurgency military operations in Federally Administered Tribal Areas (FATA) lead to a large-scale migration of internally displaced persons (IDPs) in Khyber Pakhtunkhwa and thus, new outbreaks of several infectious diseases such as cutaneous leishmaniasis occurred. This study intended to find the prevalence of cutaneous leishmaniasis in people with cutaneous lesions suspected of having cutaneous leishmaniasis in four remote districts of Khyber Pakhtunkhwa and to assess the participant's knowledge, attitude, and practices about the infection and its control. Methods: A cross-sectional study was carried out in four remote districts of Khyber Pakhtunkhwa including Karak, Lakki Marwat, Tank, and Dera Ismail Khan (D. I. Khan) and a total of 1,674 participants were recruited using a convenience sampling technique. Results: The prevalence of cutaneous leishmaniasis among the participants with cutaneous lesions was 50.4% and the infection was comparatively more prevalent in district Karak. Among participants, 56.8% were male and mostly, 53.8% were under the age of 16 years with 52.8% living in kutcha houses and were from rural areas. Multiple skin lesions were more common, and the face was frequently affected body part. The ratio of participants with lesions older than a month was higher and the majority confronted infections with blood protozoan parasites for the first time. Most participants were unaware of the signs/symptoms of the disease, basic knowledge of the vectors, anthroponotic spread, preventive measures, secondary infections, and reservoir hosts. The use of wood/animal dung as fuel, closeness with reservoir animals, and no use of insect repellents were some of the notable risk factors. Conclusion: Cutaneous leishmaniasis is highly prevalent in the study area and a very low level of awareness was reported among the participants. This study necessitates the planning and execution of regulations and preventive programs, public health education, awareness campaigns, and disease management practices to overcome future incidence of cutaneous leishmaniasis. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) due to Leishmania tropica is a neglected tropical disease characterized by a wide geographical distribution in the Mediterranean basin and is endemic in several of its countries. In addition, the vector Phlebotomus sergenti is abundantly present all around the basin. Its transmission cycle is still subject to debate. In some countries, the presence of an animal reservoir has been confirmed. In Morocco, CL due to L. tropica has risen since the 1980s and has spread widely to become the most abundant form of leishmaniasis in the territory. However, the anthroponotic transmission is so far the only recognized mode, despite recordings of L. tropica infection in animal hosts. In this review article, we assess the situation of CL due to L. tropica in the Mediterranean basin with a focus on Morocco and gather knowledge about any potential zoonotic transmission in the country. A concomitant zoonotic transmission could explain the persistence of the disease in areas where human protective measures combined with vector management did not help reduce the disease burden. Author summary: Cutaneous leishmaniasis (CL) due to Leishmania tropica is a neglected tropical disease still considered to be anthroponotic in Morocco despite evidence of zoonotic transmission in other endemic countries of the Mediterranean basin. Its high incidence in the country makes it necessary to investigate whether or not a potential concomitant zoonotic transmission exists alongside the anthroponotic one. Moreover, several reports of natural animal infection have been noted in the country. In this paper, we review how CL due to L. tropica is present around the Mediterranean basin, with a particular focus on the Moroccan foci, and try to unveil the existence of a zoonotic transmission in the area. A deep understanding of the transmission patterns of L. tropica in the region is necessary for the implementation of effective control measures and a better assessment of the disease burden. In addition, the complexity of this neglected disease requires more fundamental and applied research to unveil potential factors involved in its spread. [ABSTRACT FROM AUTHOR]

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The emphasis upon livestock health requires regular assessment of livestock drinking water quality. The results of this study are based on 12 months of water quality survey over 18 sites in Upper Ganga Canal (UGC) in Roorkee City, India, covering a command area of nearly 450 km2. Conventionally, the water of the UGC provides irrigation to agricultural land, and also it is used as a source of livestock drinking water. In this study, special attention was paid to quantify the major metallic contaminants such as aluminum, arsenic, cadmium, chromium, cobalt, copper, iron, lead, manganese, mercury, and zinc. Subsequently, a suitability analysis was performed by comparing the observed concentrations of heavy metals with the existing water quality guidelines proposed by regulatory agencies, such as the Australian and New Zealand Environment and Conservation Council (ANZECC, 2000), Canadian Council of Ministers of the Environment (CCME, 2008), Department of Water Affairs and Forestry, South Africa (DWAF, 1996), and Food and Agricultural Organization (FAO, 1985). The arithmetic weightage-based heavy metal pollution index (HPI) was also computed considering all the metals together to evaluate the pollution status of the UGC canal. Results of water quality analysis indicate that the levels of mercury and manganese were considerably higher than their permissible limit in water. Concentrations of heavy metals viz., lead, arsenic, chromium, cobalt, cadmium, and copper, along with aluminum, were found to be mostly within their recommended limits. HPI of water in UGC, Roorkee, was found to be suitable for livestock drinking, excluding three sites. [ABSTRACT FROM AUTHOR]

Algeria, like other arid and semi-arid African countries, is confronted by problems related to rapid population growth and water stress (water shortage). This stress fosters raw wastewater reuse in market gardening and horticulture. The advantages of this wastewater consist of their nutrients whose organic materials contribute to soils enrichment with humus, as well as their availability in large quantities. However, raw wastewater reuse entails a potential risk of environmental and water resources pollution. The purpose of this work was to evaluate the parasite load of raw wastewater from the city of Biskra's discharge outfalls (Biskra valley and Z'mor valley), while considering the demographic and socio-economic profile of populations connected to these outfalls. Our results revealed a variety of parasites in the form of helminths eggs at the following average concentrations: Ascaris sp. (33.66 eggs/L,), Trichuris sp. (22 eggs/L), Enterobius vermicularis (19.58 eggs/L), Ancylostoma sp. (17.41 eggs/L), Nematodirus sp. 17.83 (eggs/L), Hymenolepis nana (21.66 eggs/L), Moniezia expansa (16.5 eggs/L), Taenia sp. (18.5 eggs/L), Fasciola hepatica (0.58 eggs/L) and Strongyloides spp (17.11 eggs/L). The parasitic helminths eggs distribution varies according to the size of urban areas and the socio-economic level of populations connected to each outfall. This study also highlighted the qualitative and quantitative seasonal variations of helminths eggs in wastewater from Biskra's two outfalls. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is not an uncommon tropical disease. Cutaneous leishmaniasis is its most common form. The objectives of our study were to determine the distribution of cutaneous leishmaniasis by sex, age groups and residence in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from January 1, 2021 to January 23, 2021. The data for cutaneous leishmaniasis was retrieved from District Health Office, D.I.Khan for year 2020. A sample size of 419 was calculated from population at risk of 1,750,000 with 0.1034% margin of error, 95% confidence level and 0.01164% assumed prevalence of cutaneous leishmaniasis. Sex, age groups and residence were our three nominal variables. Distribution was analyzed by count and percentage with 95% confidence intervals. Three hypotheses for distribution were testified by chi-square goodness of Fit test. Results: Out of 419 positive cases of cutaneous leishmaniasis, 269 (64.20%) were men and 150 (35.80%) women, 254 (60.62%) were in age group up to 19 years, 101 (24.11%) in age group 20-39 years and 64 (15.27%) in age group =40 years, and 113 (26.97%) were urban and 306 (73.03%) rural. Our distribution by sex (p=0.01327), age groups (p=<0.0001) and residence (p=<0.0001) were not similar to expected. Conclusions: The prevalence of cutaneous leishmaniasis in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan was higher in men than women, highest in age group up to 19 years than age groups 20-39 and =40 years, and higher in rural than urban. The prevalence for men was higher than expected for men and prevalence for women was lower than expected for women. The prevalence for age group up to 19 years was highest than expected for this age group than age groups 20-39 and =40 years. The prevalence for rural was higher than expected for rural and the prevalence for urban was lower than expected for urban. [ABSTRACT FROM AUTHOR]

The impact of climate factors on the epidemiology of diseases in general and leishmaniasis in particular continues to be a subject of research and analysis. Changes in climatic parameters contribute to the creation of ecological conditions favorable to the multiplication of the vectors of certain diseases. With this in mind, this study presents an entomological survey conducted in Meknes prefecture and the study of the link between the abundance of sandflies, an indicator of the risk of leishmaniasis in a given area, and the climatic factors. Monthly trapping of this fauna was carried out during a year from March 2016 until April 2017 using adhesive traps. Climatic data from the region were used to determine the effect of climate on the distribution of sandflies. A total of 941 leishmaniasis vector specimens were captured. The dominant species is Ph. sergenti (73.32), followed by Ph. longicuspis (8.25%), then Ph. perniciosus (7.94%) and Ph. papatasi (6.31%). The sex ratio study showed that males are more abundant than females for all species. The seasonal fluctuation is bimodal with two peaks, the first in July and the second in September. The results show a positive correlation between temperature and abundance of sandflies (r = 0.99) and a negative correlation with humidity and precipitation with a correlation coefficient of r = −0.87 and r = −0.72. Indeed, the medium-term climatological forecasts are essential tools to develop a warning system for leishmaniasis. [ABSTRACT FROM AUTHOR]

Background. The microbiological risk of the hospital environment, including inert surfaces, medical devices, and equipment, represents a real problem. Objective. This study is aimed at demonstrating and assessing the antibacterial activity of three synthetic disinfectants classified as quaternary ammoniums on different bacterial strains (Gram-negative and Gram-positive like Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus) isolated from the hospital environment. The reference strains included Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, and Pseudomonas aeruginosa ATCC 27853 used as negative control strains. Method. Three quaternary ammonium disinfectants were tested: DDN9® (0.5%) which contains didecylmethylpolyoxyethylammonium propionate as an active substance, spray (0.4%) containing quaternary ammonium compounds, and Phagosurf ND® (0.4%) with didecyldimethylammonium chloride. Their effect was evaluated using the disk diffusion technique and the broth dilution methods, allowing the Minimum Inhibitory Concentration (MIC) and then the Minimum Bactericidal Concentration (MBC). Result. Only the growth of Gram-positive bacteria and some strains of Gram-negative bacteria were inhibited by the three synthetic disinfectants. NDD9® demonstrated an antibacterial effect only against the Gram-positive strains (S. aureus and S. aureus ATCC 29213) with a MIC of 0.25 mg/ml. The disinfectant spray showed effect against all four strains including E. coli (9), S. aureus, E. coli ATCC 25922, and P. aeruginosa ATCC 27853 with an inhibitory concentration of 4 mg/ml, while the growth of S. aureus ATCC 29213 was inhibited at 2 mg/ml. The third disinfectant, Phagosurf ND®, inhibited only the growth of S. aureus ATCC 29213 at a MIC of 4 mg/ml. Conclusion. This study is the first here in Morocco to evaluate the bacterial activity of products intended for the control of the healthcare environment. The results obtained on the three disinfectants tested reveal an ineffectiveness against some isolated strains from the hospital environment. [ABSTRACT FROM AUTHOR]

Background: Carbapenem antibiotics consider the primary treatment choice for serious Pseudomonas aeruginosa infection. Hence, the evolution of carbapenem resistance mediated by acquiring genes encoding class b enzymes is of global concern. The purpose of this article research is to explore the prevalence, drug resistance profiles, and metallo-β-lactamases (MβLs) production in extensively drug-resistant carbapenem-resistant P. aeruginosa (XDR-CRPA). Methods: P. aeruginosa isolates were collected and identified according to conventional methods. Antibiotic resistance patterns were determined by single disk diffusion. Minimum inhibitory concentrations (MICs) of (imipenem, meropenem, ceftazidime, piperacillin/tazobactam, levofloxacin, and gentamicin) were determined for CRPA. A subset of the isolates collection consisting of the XDR-CRPA with the highest MICs to imipenem and meropenem were selected for the phenotypic screening of carbapenemases and MβLs production capability using the modified carbapenem inactivation (mCIM) and imipenem-EDTA combined disk (MβL-CD) methods, respectively. Then, molecular analysis, including identification by the specific primer of 16S rRNA and detection of MβL genes using polymerase chain reaction (PCR) was performed to the XDR selected isolates. Results: Among 100 P. aeruginosa isolated throughout this period, 59% exhibited reduced susceptibility rates to carbapenems. A total of 20.3% and 57% of CRPA isolates were MDR and XDR, respectively. MIC values of the CRPA revealed that these isolates exhibited high MIC50 and MIC90 to the six selected antibiotics. The findings of the (mCIM) assay displayed identical concordance results with the MβL-CD. Molecular investigation technique assured that 10 (90.9%) and 2 (18.1%) of the 11 XDR selected isolates are positive for blaNDM-1 and blaVIM-1 genes, respectively. Polymyxin B and colistin followed by aztreonam were the most effective antibiotics used for curing infections caused by XDR Pseudomonas aeruginosa. Conclusion: The prevalence of high XDR-CRPA in our study is a critical problem. Our present study found that the blaNDM-1 was present at a significant frequency among the selected XDR isolates, highlighting the need for establishing strict antimicrobial policies to avoid the prompt spread of these isolates. [ABSTRACT FROM AUTHOR]

Background. Leishmaniases are vector-borne diseases with health risks. They cause a big health problem. These parasitic diseases are transmitted by the parasite of the genus Leishmania through sandflies. Objective. The aim of this work is to study the distribution of the incidence of cutaneous leishmaniasis (CL) cases and the impact of urbanization and socioeconomic factors and their effects as leishmaniasis risk factors. Methods. We conducted a retrospective study of CL cases collected at the level of Sefrou Province during the period from 2007 to 2011. The data was collected from registers of the Medical Delegation of Sefrou Province. The socioeconomic data, namely, the poverty rate, the popular density, and the type of environment (urban/rural) of Sefrou Province, were obtained from the High Commission for Planning. Statistical analysis was performed by SPSS software (version 20). The data were registered in a Microsoft Excel 2010 file. Statistical analysis was based on one-way analysis of variance (ANOVA), and then a correlation study was carried out (Pearson correlation). The results were considered significant when p was less than 0.05. The database was analyzed by QGIS 2.18, which is open source software. Results. A total of 349 cases of CL were collected at Sefrou Province from 2007 to 2011. A percentage of 49% of the cases come from urban areas, while 51% of the cases come from rural areas. In the statistical analysis, the division of the incidence of CL cases was found to be significantly associated only with urbanization. For the other factors, the number of people or the poverty rate is not taken into account in the incidence dynamics. Conclusion. This study may be useful for the implementation of future adequate measures and controls. Getting rid of leishmaniasis requires a comprehensive approach by acting on the sources of contamination through good continuous surveillance, appropriate management, effective vector control, and awareness-raising strategies. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is an opportunistic pathogen associated with a broad spectrum of infections in humans. However, the pathogenicity of environmental P. aeruginosa strains, especially isolates from museums and conservation laboratories, is not widely recognized. In this study, the virulence attributes of P. aeruginosa isolated from pre-Columbian textiles were compared to those of a clinical strain. Both genetically identified environmental strains (KP842564 and KP842565) exhibited a high ability to form biofilms on abiotic surfaces and high hemolytic activity. In addition, strain KP842564 was a moderate pyocyanin producer and showed proteolytic properties toward bovine serum albumin, fibrinogen, mucin, and casein. In contrast to the clinical isolate, the environmental strains were susceptible to all the tested antimicrobial agents. The strains also showed high bioadhesion and colonization capacity on archeological textile samples, in which wool fibers were the only source of nutrients, as confirmed by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDX) analysis. This study highlights the need to identify microorganisms which inhabit historic objects, in order to avoid exposure to occupational hazards. Although the strain KP842565 exhibited only some of the examined virulence-related features, given that the production of pyocyanin and hemolysins as well as the formation of biofilm are important virulence factors of P. aeruginosa, the results indicate that these strains may present a potential health risk for humans. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a bacteria which can live in freshwater, soil and plants. It is a commensal of the digestive tube, slightly abundant in human body. Its presence in wells water is a result of current anthropogenic activity and pollution loads. It is an important nosocomial pathogenic agent characterized by an intrinsic resistance to multiple antimicrobial agents which can develop high-level multidrug resistance. To assess the contamination of these well waters by this pathogenic germ, two hundred samples were collected for four seasonal campaigns between March 2017 and May 2018 with a rate of forty three (43) samples per season in an irrigated zone. The samples were analysed to identify P. aeruginosa, then the isolated serotypes were determined by slid agglutination test using four pools and 20 monovalent Antisera. The detected P. aeruginosa were tested for susceptibility to 18 antibiotics. A total of (n=85/139) isolated strains were identified as P. aeruginosa representing 61.15 % of prevalence among Pseudomonas spp. Antimicrobial resistance revealed that 68% of them are multidrug resistant, while15.09 % of strains resist at least to 7 antibiotics, 30.19% resist at least to 11 antibiotics, 13.21% resist at least to 12 antibiotics, 5.66% resist at least to 13 antibiotics, and 3.77% resist at least to 14 antibiotics. The high level resistance of P. aeruginosa is observed with piperacillin tazobactam (100/10µg) (84.91%), ciprofloxacin (5µg) (79.25%), imipenem (10µg) and ceftazidime (30μg) (37.58%). The resistance of phenotypes of P. aeruginosa strains allowed to identify (n=20/85) ESBL, (n=31/85) oxacillinase broad spectrum ES-OXA, (n=5/85) phenotype of impermeability to imipenem, (n=12/85) cephalosporinase AMPC, and (n=17/85) wild type. The results showed the high antibiotic resistance levels of P. aeruginosa strains from well water samples against antibiotics. Furthermore, based on the results, these well waters can be a source of P. aeruginosa and human and animal susceptibility to other opportunistic pathogens. [ABSTRACT FROM AUTHOR]

Original article Objective(s): Resistance to carbapenems is the principal reason for the continuing utilization of colistin as a last resort choice for treating the infections resulted from multidrug carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates. The assessment of antimicrobial resistance pattern, the prevalence of carbapenem-resistance determinants, and molecular epidemiology of colistin-resistant isolates among CRPA strains were the aims of the present research. Materials and Methods: The current cross-sectional research was conducted on 269 CRPA isolates collected from various clinical samples from 2013 to 2016. After performing identification tests, disk diffusion as well as MIC methods were used for testing sensitivity to the antibiotics. Modified Hodge Test (MHT) was utilized to produce carbapenemase. PCR technique identified beta-lactamase classes A, B, and D genes. Results: In total, from 269 CRPA, five isolates (1.3%) were resistant to colistin. It was found that blaNDM-1, blaIMP-1, blaVIM-2, and blaOXA-10 genes were present in 40%, 40%, 20%, and 100% of colistin-resistant isolates, respectively. DLST type 25-11 is a significant cluster of colistin-resistant P. aeruginosa isolates. Conclusion: The appearance of colistin-resistant isolates in CRPA carrying blaNDM-1 with multiple carbapenem-resistant genes shows the great problem in the treatment of P. aeruginosa infections. [ABSTRACT FROM AUTHOR]

The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) represent a major clinical problem and raise serious health concerns. The present study aimed to investigate and ascertain the occurrence of CRE among hospitalized patients of Mohamed VI University Hospital, Marrakech, Morocco. Biological samples were collected over a one-year period (2018). The bacterial isolates were identified by MALDI-TOF-MS. Antibiotic susceptibility testing was performed using disc diffusion and Etest. The modified Hodge test and combined disc diffusion test were used for phenotypic detection. CRE hydrolyzing enzyme encoding genes: blaOXA-48, blaKPC, blaIMP, blaVIM, and blaNDM were characterized by PCR and DNA sequencing. In total, 131 non-duplicate CRE clinical strains resistant to Ertapenem were isolated out of 1603 initial Enterobacteriaceae. Klebsiella pneumoniae was the most common species (59%), followed by Enterobacter cloacae (24%), E. coli (10%), Citrobacter freundii (3%), Klebsiellaoxycota (2%), Serratia marcescens (1%), and Citrobacter braakii (1%). Of these, 56.49%, 21.37%, 15.27%, 3.38%, and 3.05% were collected from blood, urine, pus, catheters and respiratory samples, respectively. Approximately 85.5% (112/131) of the isolates were carbapenemase producers (40 blaOXA-48, 27 blaNDM, 38 blaOXA-48 + blaNDM and 7 blaVIM). All metallo-β-lactamases isolates were NDM-1 and VIM-1 producers. This is the first documentation of blaOXA-48 genes from C. freundii and C. braakii in Morocco. [ABSTRACT FROM AUTHOR]

The production of diverse and extended spectrum β-lactamases among Escherichia coli and ESKAPE pathogens is a growing threat to clinicians and public health. We aim to provide a comprehensive analysis of evolving trends of antimicrobial resistance and β-lactamases among E. coli and ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acine to bacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) in the Arabian region. A systematic review was conducted in Medline PubMed on papers published between January 2000 and February 2020 on countries in the Arab region showing different antibiotic resistance among E. coli and ESKAPE pathogens. A total of n = 119,144 clinical isolates were evaluated for antimicrobial resistance in 19 Arab countries. Among these clinical isolates, 74,039 belonged to E. coli and ESKAPE pathogen. Distribution of antibiotic resistance among E. coli and ESKAPE pathogens indicated that E. coli (n = 32,038) was the predominant pathogen followed by K. pneumoniae (n = 17,128), P. aeruginosa (n = 11,074), methicillin-resistant S. aureus (MRSA, n = 4370), A. baumannii (n = 3485) and Enterobacter spp. (n = 1574). There were no reports demonstrating Enterococcus faecium producing β-lactamase. Analyses revealed 19 out of 22 countries reported occurrence of ESBL (Extended-Spectrum β-Lactamase) producing E. coli and ESKAPE pathogens. The present study showed significantly increased resistance rates to various antimicrobial agents over the last 20 years; for instance, cephalosporin resistance increased from 37 to 89.5%, fluoroquinolones from 46.8 to 70.3%, aminoglycosides from 40.2 to 64.4%, mono-bactams from 30.6 to 73.6% and carbapenems from 30.5 to 64.4%. An average of 36.9% of the total isolates were reported to have ESBL phenotype during 2000 to 2020. Molecular analyses showed that among ESBLs and Class A and Class D β-lactamases, blaCTX-M and blaOXA have higher prevalence rates of 57% and 52.7%, respectively. Among Class B β-lactamases, few incidences of blaVIM 27.7% and blaNDM 26.3% were encountered in the Arab region. Conclusion: This review highlights a significant increase in resistance to various classes of antibiotics, including cephalosporins, β-lactam and β-lactamase inhibitor combinations, carbapenems, aminoglycosides and quinolones among E. coli and ESKAPE pathogens in the Arab region. [ABSTRACT FROM AUTHOR]