Evaluation of susceptibility to colistin, fosfomycin and mecillinam in carbapenemase-producing Enterobacterales isolated in Marrakech in 2023.

IF 1.9 Q4 MICROBIOLOGY

Iranian Journal of Microbiology Pub Date : 2026-06-01 DOI:10.18502/ijm.v18i3.21657

Wissal Nordine, Ayoub El Ame, Taoufik Benhoumich, Asmaa Lamrani Hanchi, Nabila Soraa

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Abstract

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.

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马拉喀什2023年产碳青霉烯酶肠杆菌对粘菌素、磷霉素和美西林的敏感性评价

背景和目的：产碳青霉烯酶肠杆菌（CPE）由于多药耐药和现有治疗方案有限，构成了一个重要的公共卫生问题。本研究旨在评估CPE分离株对粘菌素、磷霉素和美西林的体外敏感性。材料和方法：前瞻性研究于2023年在马拉喀什穆罕默德六世大学医院进行。采用标准微生物学方法对180株非重复CPE分离株进行鉴定。按照推荐的指导方针进行抗菌药物敏感性试验。结果：以肺炎克雷伯菌（60%）和大肠埃希菌（14%）为主。最常见的碳青霉烯酶是NDM(62%)，其次是OXA-48（26%）和联合生产者（11%）。大多数分离株来自重症监护病房（32%）、整形外科病房（13%）和新生儿病房（12%）。皮肤和软组织（43%）和血流（21%）是主要的感染部位。粘菌素的耐药率为25%，磷霉素的耐药率为48%，美西林的耐药率为64%，对氟喹诺酮类药物、氨基糖苷类药物和复方新诺明的耐药率常见。结论：产ndm肺炎克雷伯菌的高流行率和对最后一线药物的显著耐药性表明迫切需要进行抗菌药物管理，优化治疗策略，加强区域监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Iranian Journal of Microbiology MICROBIOLOGY-

CiteScore

2.40

自引率

7.10%

发文量

审稿时长

12 weeks

期刊介绍： The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.