Molecular characterization of mutations associated with resistance to second line drugs in Mycobacterium tuberculosis patients from Casablanca, Morocco.

The emergence and spread of extensively drug-resistant tuberculosis (XDR-TB) is a serious threat to global health. Therefore, its rapid diagnosis is crucial. The present study aimed to characterize mutations conferring resistance to second line drugs (SLDs) within multidrug Mycobacterium tuberculosis (MDR-MTB) isolates and to estimate the occurrence of XDR-TB in Casablanca, Morocco. A panel of 200 MDR-TB isolates was collected at the Pasteur Institute between 2015-2018. Samples were subjected to drug susceptibility testing to Ofloxacin (OFX), Kanamycin (KAN) and Amikacin (AMK). The mutational status of gyrA, gyrB, rrs, tlyA and eis was assessed by sequencing these target genes. Drug susceptibility testing for SLDs showed that among the 200 MDR strains, 20% were resistant to OFX, 2.5% to KAN and 1.5% to AMK. Overall, 14.5% of MDR strains harbored mutations in gyrA, gyrB, rrs and tlyA genes. From the 40 OFXR isolates, 67.5% had mutations in QRDR of gyrA and gyrB genes, the most frequent one being Ala90Val in gyrA gene. Of note, none of the isolates harbored simultaneously mutations in gyrA and gyrB genes. In eight out of the 200 MDR-TB isolates resistant either to KAN or AMK, only 25% had A1401G or Lys89Glu change in rrs and tlyA genes respectively. This study is very informative and provides data on the alarming rate of fluoroquinolone resistance which warrants the need to implement appropriate drug regimens to prevent the emergence and spread of more severe forms of Mycobacterium tuberculosis drug resistance.

Medicinal and Aromatic Plants Used in Traditional Treatment of the Oral Pathology: The Ethnobotanical Survey in the Economic Capital Casablanca, Morocco (North Africa).

In order to identify the medicinal and aromatic plants most requested for the treatment of the most common oral pathology, an ethnobotanical survey was carried out in the economic capital Casablanca, Morocco. The data basis was obtained draw selected traditional herbalists based on the semi-structured questionnaire. Quantitative indices such as use value (UV), family UV (FUV), fidelity level and informant consensus factor (ICF) were intended to evaluate the importance of plant species. A total of 46 plants species belonging to 22 families that were used. Juglandaceae family showed the highest significance (FUV = 0.75). We identified 40 species used for gum disease (gingivitis, periodontal abscess), 15 for dental pain (toothache, tooth sensitivity), 14 for halitosis, 12 for oral ulcers (aphtous, mouth ulcers and herpes), 3 for dental stain (teeth cleaning, sparkling and bleaching) and only 2 for tooth decay. The used plants are mainly prepared as decoction (80.4%). Syzygium aromaticum (UV = 0.94) was the specie most commonly prescribed by local herbalists. The higher ICF (0.75) was registered for the use gum disease.