Antibiotic resistance patterns of carbapenemase-producing Enterobacterales in Mohammed VI University Hospital of Marrakech, Morocco

• Published in: Infectious diseases now (Online) 2022-09, Vol.52 (6), p.334-340
• Main Authors: Ilham, Dilagui, Souad, Loqman, Asmae, Lamrani Hanchi, Nabila, Soraa
• Format: Article
• Language: English
• Subjects: carbapenem-resistant; Enterobacterales; Metallo-beta-lactamase; OXA-48 Like; phenotypic
• ISSN: 2666-9919; 2666-9919
• DOI: 10.1016/j.idnow.2022.06.001

•The emergence and spread of Carbapenem-Resistant Enterobacterales (CREs) has become a major clinical problem and raises serious health concerns.•All in all, 484 Enterobaterales (out of 4800 initial isolates) resistant to at least one carbapenem were recovered (between 2018 and 2020) from patients admitted to Mohammed VI University Hospital of Marrakech, central Morocco.•Over 80.16% (388/484) of isolates were Carbapenemase producers.•The first records of the emergence of carbapenem resistance among E. aerogenes, E. hormaechei, M. morganii, S. fonticola, P. mirabilis, K. ozaenae, P. stuartii, R. ornithinolytica and K. ascorbate in Marrakech hospitals are reported.•Our findings highlight the urgent need for control precautions and strict measures of containment. Objectives: The emergence and spread of Carbapenem-Resistant Enterobacterales (CRE) has become a growing concern for health services, internationally, nationally, and regionally. In Morocco, the situation is more worrisome as studies on CRE are scarce and/or scattered and/or outdated. As a result, we carried out the present study to determine and update CRE prevalence at Mohammed VI University Hospital of Marrakech, Morocco. Patients and methods: A cross-sectional prospective study was carried out from March 2018 to March 2020 on 41161 clinical specimens of 23469 patients suspected of bacterial infections. Enterobacterales strains were isolated following standard bacteriological procedures. Bacterial strains were identified using BD-Phoenix and MALDI-TOF-MS. Antibiotic susceptibility was determined for 14 antibiotics. Carbapenemase production and phenotypic detection were characterized using modified carbapenem inactivation phenotypic and immunochromatographic methods. Results: All in all, 484 Enterobaterales resistant to at least one carbapenem were recovered. The majority were isolated from the neonatal unit (14%), followed by the urology-nephrology (11%), and plastic surgery departmens (10%)... K. pneumoniae (n = 232) was the most isolated, followed by E. cloacae (n = 148), E. coli (n = 56), and S. marcescens (n = 17). Antibiotic susceptibility profile showed high rates of resistance to ciprofloxacin (75.21%), gentamicin (84.50%), and cotrimoxazole (88.42%). Out of 484 CRE positive cultures, 388 (80.16%) were Carbapenemase-positive. Out of the latter, 170 were metallo-beta-lactamase producers (NDM), 162 OXA-48-like, and 56 both. Conclusion: These findings emphasize the urgent need for control prec