Multidrug-resistant (MDR) bacteria represent a major public health challenge, contributing to therapeutic failure, increased healthcare costs, prolonged hospital stays, and higher mortality rates. This study aimed to investigate the epidemiology and resistance mechanisms of MDR bacteria in Northern Morocco in order to provide baseline data to support infection prevention and control strategies. This cross-sectional study was conducted throughout 2024 and included a wide range of clinical specimens processed in the microbiology laboratory of a tertiary-care university hospital. Bacterial identification was performed using matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry. Antimicrobial susceptibility testing (AST) was carried out using automated minimum inhibitory concentration (MIC) determination with the BD Phoenix™ M50 system and disk diffusion, with interpretation according to the 2021 CA-SFM/EUCAST guidelines. Carbapenemase genes were detected using multiplex PCR with the GeneXpert® Xpert Carba-R system (Cepheid, Sunnyvale, CA, USA). A total of 4561 clinical samples were analyzed, of which 286 (6.27%; N = 286/4561) yielded MDR isolates. Nearly half of these isolates originated from intensive care units (48.3%; N = 138/286). The most frequent MDR-related infections were bloodstream infections (34.6%; N = 99/286), urinary tract infections (19.2%; N = 55/286), and pneumonia (17.5%; N = 50/286). The predominant MDR pathogens were extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (42.3%; N = 121/286) and multidrug-resistant Acinetobacter baumannii (21.7%; N = 62/286), followed by carbapenemase-producing Enterobacterales (CPE) (13.3%; N = 38/286) and multidrug-resistant Pseudomonas aeruginosa (11.5%; N = 33/286). Methicillin-resistant Staphylococcus aureus (MRSA) (9.8%; N = 28/286) and vancomycin-resistant Enterococcus faecium/faecalis (VRE) (1.4%; N = 4/286) were also identified. Among CPE isolates, NDM (57.9%; N = 22/38) and OXA-48 (21.1%; N = 8/38) were the predominant carbapenemase genes, while (21.1%; N = 8/38) co-harbored both. No IMP, VIM, or KPC genes were detected. MDR organisms represent a substantial burden of nosocomial infections in this tertiary-care hospital setting, with limited therapeutic options. These findings highlight the importance of sustained antimicrobial stewardship, infection prevention measures, and robust surveillance systems to optimize patient management and limit the impact of antimicrobial resistance. Not applicable.
Harrak et al. (Sat,) studied this question.