Journal of infection in developing countries · 2026
Emergence of NDM and OXA-48-like producing Enterobacterales in Northern Morocco.
СтатьяНазвание и аннотация: Перевод в очереди
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El-Hassouni Majda, Hazzaz Asmae, Souhli Reda A, El Ghorba El Mehdi, El Mamouny Hanaa, El Harrak Kawtar, Chahid Nouhaila, Amekran Youssra, Rissoul Karima
Аннотация
INTRODUCTION: Carbapenemase-producing Enterobacterales (CPE) have widely emerged as a global health threat due to the spread of resistance genes such as New Delhi metallo-β-lactamase (blaNDM) and oxacillinase-48-like β-lactamases (blaOXA-48-like). Data on the molecular epidemiology of CPE in northern Morocco remain limited. Hence, this study aimed to report the epidemiological profile of carbapenem-resistant Enterobacterales and their molecular analysis.
METHODOLOGY: A prospective study was conducted from July 2024 to July 2025 at Mohammed VI University Hospital, Tangier. Ninety-two non-duplicate Enterobacterales isolates were collected across different departments. Species were identified via the matrix-assisted laser desorption/ionization - time-of-flight (MALDI-TOF MS) technique and antimicrobial susceptibility testing was performed according to the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Carbapenemase production was screened using GeneXpert® Carba-R (Cepheid, Sunnyvale, USA). Associations between clinical, microbiological, and molecular data were assessed using Chi square or Fisher's exact tests.
RESULTS: Klebsiella pneumoniae dominated across all isolates (75/92; 81.5%), followed by Escherichia. coli (8/92; 8.7%). BlaNDM was found in 65/92 (70.6%), blaOXA-48-like in 17/92 (18.5%), and both in 10/92 (10.9%). Most cases occurred in neonatal (38%) and intensive care units (31.5%). Resistance exceeded 70% for several major antibiotics; 29.3% were colistin-resistant. Mortality was 46.7%. Diabetes (p < 0.01) and severe burns (p < 0.01) were significantly associated with carbapenemase carriage.
CONCLUSIONS: CPE, especially NDM-producing Klebsiella pneumoniae, represent a major threat in northern Morocco, notably in neonatal and critical care units. Their high resistance and mortality highlight the urgent need for reinforced infection control, molecular surveillance, and rapid diagnostics.
METHODOLOGY: A prospective study was conducted from July 2024 to July 2025 at Mohammed VI University Hospital, Tangier. Ninety-two non-duplicate Enterobacterales isolates were collected across different departments. Species were identified via the matrix-assisted laser desorption/ionization - time-of-flight (MALDI-TOF MS) technique and antimicrobial susceptibility testing was performed according to the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Carbapenemase production was screened using GeneXpert® Carba-R (Cepheid, Sunnyvale, USA). Associations between clinical, microbiological, and molecular data were assessed using Chi square or Fisher's exact tests.
RESULTS: Klebsiella pneumoniae dominated across all isolates (75/92; 81.5%), followed by Escherichia. coli (8/92; 8.7%). BlaNDM was found in 65/92 (70.6%), blaOXA-48-like in 17/92 (18.5%), and both in 10/92 (10.9%). Most cases occurred in neonatal (38%) and intensive care units (31.5%). Resistance exceeded 70% for several major antibiotics; 29.3% were colistin-resistant. Mortality was 46.7%. Diabetes (p < 0.01) and severe burns (p < 0.01) were significantly associated with carbapenemase carriage.
CONCLUSIONS: CPE, especially NDM-producing Klebsiella pneumoniae, represent a major threat in northern Morocco, notably in neonatal and critical care units. Their high resistance and mortality highlight the urgent need for reinforced infection control, molecular surveillance, and rapid diagnostics.