Emergence of NDM and OXA-48-like producing Enterobacterales in Northern Morocco

Authors

  • Majda El-Hassouni Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco https://orcid.org/0009-0004-7870-7839
  • Asmae Hazzaz Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco https://orcid.org/0009-0007-6302-4973
  • Reda A Souhli Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco https://orcid.org/0009-0008-3070-8751
  • El Mehdi El Ghorba Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco https://orcid.org/0009-0006-6002-6749
  • Hanaa El Mamouny Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco
  • Kawtar El Harrak Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco
  • Nouhaila Chahid Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco
  • Youssra Amekran Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco
  • Karima Rissoul Microbiology-Virology Laboratory, Mohammed VI University Hospital Center, Tangier, Morocco

DOI:

https://doi.org/10.3855/jidc.22277

Keywords:

antimicrobial resistance, carbapenemase, Enterobacteriaceae, NDM, OXA 48, Morocco

Abstract

Introduction: Carbapenemase-producing Enterobacterales (CPE) have widely emerged as a global health threat due to the spread of resistance genes such as New Delhi metallo-β-lactamase (blaNDM) and oxacillinase-48-like β-lactamases (blaOXA-48-like). Data on the molecular epidemiology of CPE in northern Morocco remain limited. Hence, this study aimed to report the epidemiological profile of carbapenem-resistant Enterobacterales and their molecular analysis.

Methodology: A prospective study was conducted from July 2024 to July 2025 at Mohammed VI University Hospital, Tangier. Ninety-two non-duplicate Enterobacterales isolates were collected across different departments. Species were identified via the matrix-assisted laser desorption/ionization - time-of-flight (MALDI-TOF MS) technique and antimicrobial susceptibility testing was performed according to the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Carbapenemase production was screened using GeneXpert® Carba-R (Cepheid, Sunnyvale, USA). Associations between clinical, microbiological, and molecular data were assessed using Chi square or Fisher’s exact tests.

Results: Klebsiella pneumoniae dominated across all isolates (75/92; 81.5%), followed by Escherichia. coli (8/92; 8.7%). BlaNDM was found in 65/92 (70.6%), blaOXA-48-like in 17/92 (18.5%), and both in 10/92 (10.9%). Most cases occurred in neonatal (38%) and intensive care units (31.5%). Resistance exceeded 70% for several major antibiotics; 29.3% were colistin-resistant. Mortality was 46.7%. Diabetes (p < 0.01) and severe burns (p < 0.01) were significantly associated with carbapenemase carriage.

Conclusions: CPE, especially NDM-producing Klebsiella pneumoniae, represent a major threat in northern Morocco, notably in neonatal and critical care units. Their high resistance and mortality highlight the urgent need for reinforced infection control, molecular surveillance, and rapid diagnostics.

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Published

2026-08-31

How to Cite

1.
El-Hassouni M, Hazzaz A, Souhli RA, El Ghorba EM, El Mamouny H, El Harrak K, Chahid N, Amekran Y, Rissoul K (2026) Emergence of NDM and OXA-48-like producing Enterobacterales in Northern Morocco. J Infect Dev Ctries 20:1179–1186. doi: 10.3855/jidc.22277

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Section

Original Articles