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The emergence and spread of carbapenem-resistant  Enterobacteriaceae  (CRE) represent a major clinical problem and raise serious health concerns. The present study aimed to investigate and ascertain the occurrence of CRE among hospitalized patients of Mohamed VI University Hospital, Marrakech, Morocco. Biological samples were collected over a one-year period (2018). The bacterial isolates were identified by MALDI-TOF-MS. Antibiotic susceptibility testing was performed using disc diffusion and Etest. The modified Hodge test and combined disc diffusion test were used for phenotypic detection. CRE hydrolyzing enzyme encoding genes:  bla OXA-48,  bla KPC,  bla IMP,  bla VIM, and  bla NDM were characterized by PCR and DNA sequencing. In total, 131 non-duplicate CRE clinical strains resistant to Ertapenem were isolated out of 1603 initial  Enterobacteriaceae .  Klebsiella pneumoniae  was the most common species (59%), followed by  Enterobacter cloacae  (24%),  E. coli  (10%),  Citrobacter freundii  (3%),  Klebsiella   oxycota  (2%),  Serratia marcescens  (1%), and  Citrobacter braakii  (1%). Of these, 56.49%, 21.37%, 15.27%, 3.38%, and 3.05% were collected from blood, urine, pus, catheters and respiratory samples, respectively. Approximately 85.5% (112/131) of the isolates were carbapenemase producers (40  bla OXA-48, 27  bla NDM, 38  bla OXA-48 +  bla NDM and 7  bla VIM). All metallo-β-lactamases isolates were NDM-1 and VIM-1 producers. This is the first documentation of  bla OXA-48 genes from  C. freundii  and  C. braakii  in Morocco.

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Dissemination of Carbapenemases (OXA-48, NDM and VIM) Producing Enterobacteriaceae Isolated from the Mohamed VI University Hospital in Marrakech, Morocco