High levels multi-resistance to antibiotics among extended- spectrum β-lactamases-producing Enterobacteriaceae from Northwest Morocco

Infections provoked by extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae are increased worldwide and are often associated with amplified morbidity and mortality. Identification and antibiotic susceptibility analyses are mean contributors to successful treatment. Few data have been reported on the prevalence of ESBL producing strains in Morocco but this is the first report investigating on this subject in Northwest Morocco (Tangier-Tetouan), which is an important transit region between Europe and Africa. A subsite of 111 Enterobacteriaceae isolates derived from clinical specimens was collected from March to June 2012 and analyzed. Resistance profiles were determined by testing susceptibility to 14 antibiotics belonging to different families using Muller Hinton agar diffusion. Investigation of ESBL strains was performed by the synergies or double disc assays. The studies demonstrated that the most requested analysis concerns the urine samples (66.66 %), following by pus (28.82 %) and vaginal samples (04.50 %). E. coli is the most incriminate infectious agent with 70.27 % in urine and 46.87 % in pus followed by K. pneumonia with 37.50 % and 20.27 % in urine and pus respectively. Susceptibility test showed high resistance rates touching major antibiotic families. β-lactam groups are most concerned with values over 60% for penicillin, 45% for early generation cephalosporins and 36% for extended-spectrum cephalosporins. Carbapenems seems to maintain high activity against Enterobacteriaceae with only 4.5% resistance rate. We noted resistance rates of about 34% for fluoroquinolones and 22% for aminoglycosides except amikacin, which exhibited the lowest resistance rate with less than 1%. Prevalence of ESBLs strains was relatively high and represents about 20 % in the analyzed bacterial group. Antibiotics are precious compounds to treat bacterial infection diseases. Being broad-spectrum antibiotics, β-lactam and flouroquinolones are the most prescribed worldwide. Their extensive and inappropriate use has contributed to emergence of multi-drogue resistance bacteria, especially among Enterobacteriaceae, and increasing loss of activity over time.