BackgroundEscherichia 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.MethodsDuring 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.ResultsA 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.ConclusionsOur 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.
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 < 0.01). 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.
Background: The resistance to antimicrobial among patients with late Ventilator-associated pneumonia (VAP) has become increasingly more common in many ICUs in Morocco. There are scarce studies assessing VAP importance in Morocco.
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