In Vitro Activity of Ceftazidime-Avibactam Against Enterobacteriaceae and P. aeruginosa Isolated at the Ibn Rochd University Hospital of Casablanca.

BACKGROUND: The aim of this study is to determine the in vitro activity of ceftazidime-avibactam (CZA) on Entero-bacteriaceae and P. aeruginosa strains isolated in the bacteriology-virology laboratory of the Ibn Rochd University of Casablanca. METHODS: This is a prospective descriptive longitudinal study conducted from May 28 through June 25, 2022, on Enterobacteriaceae and P. aeruginosa isolated from diagnostic samples received at the Bacteriology-Virology and Hospital Hygiene Laboratory of the Ibn Rochd University Hospital of Casablanca. The isolation and identification of the strains were carried out using standard bacteriological techniques. The study of sensitivity to ceftazidime-avibactam was done by diffusion susceptibility testing on agar medium according to EUCAST 2022 recommendations. RESULTS: During the study period, 271 strains of Enterobacteriaceae were isolated. The sensitivity rate to ceftazidime-avibactam was 91% vs. 74% for ceftazidime alone. R. terrigena was the most resistant strain to CZA with a rate of 69%, followed by E. cloacae (14%), then K. pneumoniae (6%), and finally E. coli (5%). Among the strains isolated, 24% (n = 66) produced ESBL, of which 29% (n = 19) were resistant to CZA, and 10.7% (n = 29) were re-sistant to imipenem, including 44, 8% (n = 13) that were resistant to imipenem and CZA. Regarding P. aeruginosa, 92 strains were isolated. The CZA resistance rate was 33.6% (n = 31). Among the strains isolated, 30.4% (n = 29) were resistant to imipenem, of which 82.7% (n = 24) were resistant to CZA. CONCLUSIONS: The in vitro evaluation of the ceftazidime-avibactam activity on the strains isolated, mainly: E. Coli, K. Pneumoniae, and E. Cloacae, showed a good inhibitory activity of this molecule which can constitute a therapeutic alternative for the treatment of infections due to these microorganisms.

Evaluation of Antibiograms Interpretation Training Needs of Medical Biology Residents at Ibn Rochd University Hospital.

BACKGROUND: In order to determine domains with the most difficulties and plan a relevant training, the aim of this study was to assess training needs of medical biology residents at the Ibn Rochd University Hospital of Casablanca, concerning antibiograms interpretation. METHODS: A descriptive and comparative study was carried out in February 2022, with two resident groups. The first one included all residents in training in the bacteriology-virology laboratory and having spent at least 2 months. The 2nd one included residents who had validated their course (9 months). Data were collected from collective interviews and a self-administered questionnaire with a qualitative and quantitative grid analysis. RESULTS: Residents expressed needs in the three learning domains (knowledge, know-how, interpersonal skills) but they were low to moderate (scores from 0.2/4 to 2.4/4). Priority topics for training were: interpretation of observed phenotypes (5.85/8), followed by interpretative reading according to EUCAST recommendations (5.05/8). The two groups' responses were similar, except for the know-how domain of natural resistance mechanisms where the needs were greater in G1 (p = 0.008). CONCLUSIONS: In the light of these results, additional training with relevant aims should be planned.

Nosocomial Bacterial Infections in Covid-19 ICU at Ibn Rochd University Hospital Casablanca Morocco.

BACKGROUND: The aim is to determine the prevalence of bacterial nosocomial infections (NI) and its associated factors in COVID-19 ICU. METHODS: A descriptive retrospective study, from April to August 2020, was carried on patients with respiratory distress following SARS-Cov-2 infection presenting a sign of bacterial infection. RESULTS: A total of 29 patients (33% of hospitalized patients) contracted a NI, their age was 65 years ± 13.90 and sex-ratio M/F was 2.62. All patients had an invasive device: central line (65%), bladder catheter (72%), and mechanical ventilation (76%). The time of NI occurring was 5 to 8 days. Charlson comorbidity index was 4 - 6 in 18 patients (62%). Of the 35 samples taken, 45 bacteria were isolated: multi drug resistant A. baumannii and P. aeruginosa accounted for 24.4%. Of all, 16 deaths were recorded (55, 17%). CONCLUSIONS: NI is common in COVID-19 ICU and can be predicted by risk factors that should be managed.

[Neonatal cytosteatonecrosis complicated by major hypercalcemia]. / Cytostéatonécrose néonatale compliquée d'hypercalcémie majeure.

We here report the case of a female infant with perinatal asphyxia requiring resuscitation. She was referred with sclerema neonatorum which had been observed by parents on her tenth day of life. The lesions appeared as hard erythematous nodular plaques, suggesting neonatal cytosteatonecrosis in the gluteal region. Patient's evolution was marked by progressive hypercalcemia reaching a peak of 128 mg/L (80-110 mg/L) for which re-hospitalization was required 1 month after birth. Renal ultrasound showed medullary nephrocalcinosis. Treatment was based on hyperhydration associated with diuretics, corticosteroids and abstention from vitamin D administration as well as on clinical and laboratory monitoring of serum calcium levels. A month later, cutaneous lesions were regressing and calcium levels were normalizing. The patients is still undergoing ultrasound monitoring.

[HIV co-infection in patients followed up for tuberculosis in the Division of Infectious Diseases at the Ibn Rochd University Hospital in Casablanca]. / Co-infection VIH chez les tuberculeux suivis au service des maladies infectieuses du CHU Ibn Rochd-Casablanca.

This study aims to determine the prevalence of HIV infection among patients hospitalized for tuberculosis in the Division of Infectious Diseases at the Ibn Rochd University Hospital in Casablanca and factors associated with TB-HIV co-infection. We conducted a cross-sectional retrospective study in November 2016. The database of the Division of Infectious Diseases, Laboratory of Microbiology and Immunology at the Ibn Rochd University Hospital was examined. All the patients with tuberculosis confirmed using Lowenstein Jensen culture medium and HIV Infection confirmed using Western Blot test between January 2013 and December 2015 were included. During the study period, 117 cases of tuberculosis were confirmed by culture. Fourty six (39.3%) patients had confirmed HIV infection. Thirty-four co-infected patients (73.9%) had extrapulmonary tuberculosis (this form was associated with co-infection (p=0.04)). All patients underwent TB treatment and anti-retroviral treatment according to the indication. The Evolution was favorable in 32 patients (69.6%) and 10 deaths were recorded (21.7%). Mortality rate was higher in co-infected patients than in TB patients without HIV (8.4%), (p=0.04). This study highlights a relatively high prevalence of HIV infection among tuberculosis patients. TB-HIV co-infection is associated with severe forms of tuberculosis and with an increase in mortality rate among TB patients; hence the importance of strengthening anti-co-infection joint activities.