Iranian journal of microbiology · 2026
Evaluation of susceptibility to colistin, fosfomycin and mecillinam in carbapenemase-producing Enterobacterales isolated in Marrakech in 2023.
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Nordine Wissal, Ame Ayoub El, Benhoumich Taoufik, Hanchi Asmaa Lamrani, Soraa Nabila
Аннотация
BACKGROUND AND OBJECTIVES: Carbapenemase-producing Enterobacterales (CPE) constitute a critical public health concern due to multidrug resistance and limited available treatment options. This study aimed to assess the in vitro susceptibility of CPE isolates to colistin, fosfomycin, and mecillinam.
MATERIALS AND METHODS: Prospective study was conducted in 2023 at Mohammed VI University Hospital, Marrakech. A total sample of 180 non-duplicate CPE isolates were collected and identified by standard microbiological methods. Antimicrobial susceptibility testing was performed following recommended guidelines.
RESULTS: Among the isolates, Klebsiella pneumoniae (60%) and Escherichia coli (14%) predominated. The most common carbapenemase was NDM (62%), followed by OXA-48 (26%) and co-producers (11%). Most isolates were obtained from intensive care (32%), plastic surgery (13%), and neonatology (12%) units. Skin and soft tissue (43%) and bloodstream (21%) were the predominant infected sites. Resistance rates were 25% for colistin, 48% for fosfomycin, and 64% for mecillinam, with frequent co-resistance to fluoroquinolones, aminoglycosides, and cotrimoxazole.
CONCLUSION: The high prevalence of NDM-producing Klebsiella pneumoniae and significant resistance to last-line agents suggest the urgent need for antimicrobial stewardship, optimized therapeutic strategies, and strengthened regional surveillance.
MATERIALS AND METHODS: Prospective study was conducted in 2023 at Mohammed VI University Hospital, Marrakech. A total sample of 180 non-duplicate CPE isolates were collected and identified by standard microbiological methods. Antimicrobial susceptibility testing was performed following recommended guidelines.
RESULTS: Among the isolates, Klebsiella pneumoniae (60%) and Escherichia coli (14%) predominated. The most common carbapenemase was NDM (62%), followed by OXA-48 (26%) and co-producers (11%). Most isolates were obtained from intensive care (32%), plastic surgery (13%), and neonatology (12%) units. Skin and soft tissue (43%) and bloodstream (21%) were the predominant infected sites. Resistance rates were 25% for colistin, 48% for fosfomycin, and 64% for mecillinam, with frequent co-resistance to fluoroquinolones, aminoglycosides, and cotrimoxazole.
CONCLUSION: The high prevalence of NDM-producing Klebsiella pneumoniae and significant resistance to last-line agents suggest the urgent need for antimicrobial stewardship, optimized therapeutic strategies, and strengthened regional surveillance.