Dissemination of carbapenem-resistant strains carrying the , and in Morocco.

Background: is a microorganism which has been classified by the World Health Organization in the list of the bacterial strains that pose the biggest danger to human health. This study was performed to determine the susceptibility profile to carbapenems and to detect carbapenemases production in 111 isolates. Among these 30 are environmental isolates and 81 are from the three major hospitals in Morocco.

Methods: All strains of were tested against diverse antimicrobial agents (13 antibiotic drugs) by the agar diffusion test. Minimum inhibitory concentration (MIC) of imipenem on carbapenem-resistant strains (CRAB) was determined by the E-test technique. Simple phenotypic tests were used to detect carbapenemases and metallo-β-lactamases (MBLs) production including the modified Hodge test, EDTA test, and the cloxacillin test. The presence of carbapenemases-encoding resistance genes of CRAB strains was examined using polymerase chain reaction (PCR).

Results: Carbapenem resistance was observed in 23 clinical isolates showing dissemination of the multiresistance profile. Molecular biology techniques indicated that all these strains encoded the naturally occurring gene and were proved as The gene was detected in 16 strains (69.6%). The metallo-β-lactamase gene was detected in five isolates (21.7%). GES-type carbapenemases were found in 15 strains, the existence of three classes of carbapenemases ( , , and ) was detected in three strains, while none of the CRAB isolates contained the , , , or encoding genes.

Conclusions: This study established baseline proof of three classes of carbapenemases producing in Morocco, showing the important role of surveillance in controlling their spread.