IJID regions · 2026
Microbiological profiles of Gram-negative bacteria isolated from respiratory samples of mechanically ventilated patients at a tertiary Moroccan hospital.
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El Ftouh Sobha, Tligui Houssain, Vila Jordi, Aberouch Larbi, Dendane Tarek, Oualili Latifa, Ssouni Oussama, Faroudy Mamoun, Zeggwagh Amine Ali, Doumiri Mouhssine, Pitart Cristina, Piquet Maria, Guiral Elisabet, Abidi Khalid
Аннотация
OBJECTIVES: To characterise the Gram-negative bacteria implicated in ventilator-associated pneumonia (VAP), focusing on their antimicrobial resistance profiles and phylogenetic relationships.
METHODS: Seventy-eight isolates were collected from protected distal samples over two years; patients were under mechanical ventilation in the three adult ICUs of a Moroccan tertiary hospital. Isolates were identified using VITEK2. PFGE and FTIR determined genetic relationships, whereas the detection of genetic resistance determinants was carried out using PCR.
RESULTS: Carbapenem-resistant Acinetobacter baumannii harbouring the bla-OXA-23 was the predominant Gram-negative bacterium. Klebsiella pneumoniae was the most prevalent among the Enterobacterales, with a high resistance rate to almost all antibiotics, due to the coexistence of (bla) CTX-M-1, TEM, SHV, and OXA-48-like genes. Escherichia coli exhibited high resistance to ciprofloxacin (86%), ceftazidime (86%), and cotrimoxazole (71%). Proteus mirabilis was highly resistant to cotrimoxazole (60%) and ticarcillin (80%). Pseudomonas aeruginosa was resistant to carbapenems in 39% of cases, in which bla NDM and bla VIM were the only metallo-beta-lactamase genes detected. In phylogenetic analysis, both FTIR and PFGE techniques underscored no epidemiological relationship among strains.
CONCLUSION: The prevalence of MDR and XDR bacteria among VAP cases in a tertiary hospital in Morocco is increasing, potentially due to the coexistence of antimicrobial resistance genes.
METHODS: Seventy-eight isolates were collected from protected distal samples over two years; patients were under mechanical ventilation in the three adult ICUs of a Moroccan tertiary hospital. Isolates were identified using VITEK2. PFGE and FTIR determined genetic relationships, whereas the detection of genetic resistance determinants was carried out using PCR.
RESULTS: Carbapenem-resistant Acinetobacter baumannii harbouring the bla-OXA-23 was the predominant Gram-negative bacterium. Klebsiella pneumoniae was the most prevalent among the Enterobacterales, with a high resistance rate to almost all antibiotics, due to the coexistence of (bla) CTX-M-1, TEM, SHV, and OXA-48-like genes. Escherichia coli exhibited high resistance to ciprofloxacin (86%), ceftazidime (86%), and cotrimoxazole (71%). Proteus mirabilis was highly resistant to cotrimoxazole (60%) and ticarcillin (80%). Pseudomonas aeruginosa was resistant to carbapenems in 39% of cases, in which bla NDM and bla VIM were the only metallo-beta-lactamase genes detected. In phylogenetic analysis, both FTIR and PFGE techniques underscored no epidemiological relationship among strains.
CONCLUSION: The prevalence of MDR and XDR bacteria among VAP cases in a tertiary hospital in Morocco is increasing, potentially due to the coexistence of antimicrobial resistance genes.