Ibn Rochd University Hospital Research Articles

Surgical treatment of Trapezo-metacarpal luxation

Introduction: Trapeziometacarpal dislocation, often resulting from violent trauma in young people, is generally diagnosed clinically and by imaging. It can cause instability of the first column and promote the development of rhizarthrosis . The treatment of fresh dislocations gives rise to debates between orthopedic and surgical approaches. This series reports a number of cases rarely exceeding fifteen. Material and method: This is a retrospective series of five cases of trapezio -metacarpal dislocation collected between January 2017 and October 2022 in the trauma-orthopedics department of Wing 4 of the Ibn Rochd University Hospital in Casablanca. Results: The patients were mainly men with an average age of 34 years, with lesions mainly located on the right side and caused by road accidents or falls. The diagnosis was confirmed by radiographs, mainly revealing isolated trapeziometacarpal dislocations. Treatment consisted of percutaneous metacarpo - trapezius pinning , with good short-term results for all patients. Discussion: Trapeziometacarpal dislocation is a rare pathology. Its diagnosis is based on radiological examinations and therapeutic approaches such as trapeziometacarpal pinning. Conclusion: Treatment by reduction followed by pin stabilization seems to offer satisfactory results for trapeziometacarpal dislocation.

Morbidity and Postoperative Mortality of Colorectal Tumors

Colorectal cancer, by its frequency and severity, represents a serious public health problem worldwide. In Morocco, the incidence of colorectal cancer is constantly increasing. Post-operative morbidity and mortality is an event whose evaluation and analysis are necessary to improve surgical results and optimize patient care. Thus, knowledge of the causes and risk factors of morbidity and mortality will contribute not only to a better evaluation of patients candidates for colorectal surgery, but also to reveal new avenues of research to improve the post-operative prognosis of these patients. The objective of this retrospective work is to carry out an epidemiological study of the morbidity and mortality of patients admitted during the postoperative period of colorectal surgery to the surgical intensive care unit of the Ibn Rochd University Hospital in Casablanca; as well as the search for potential predictive factors associated with it.

Invasive Pneumococcal Infections Among Moroccan Children: Pneumococcal Vaccination Challenges in the Mature Vaccine Era.

Streptococcus pneumoniae, a major contributor to global morbidity and mortality, disproportionately affects children, the elderly, and immunocompromised individuals. Despite vaccination efforts, the challenge of serotype replacement highlights the ongoing struggle against invasive pneumococcal diseases (IPD) in Morocco, emphasizing the need for updated public health strategies and vaccine efficacy assessments. This study was conducted at the Ibn Rochd University Hospital Center and the Mohammed VI University Hospital Center from 2019 to 2022, focusing on hospitalized children. It involved the analysis of 74 strains of IPD, assessing the distribution of pneumococcal serotypes and their antibiotic sensitivity in the post-vaccination era. The prevalence of meningitis or meningo-encephalitis was found to be 66% among the study subjects, with the most frequent serotypes being 3, 19A, 6B, 14, and 11. These serotypes varied significantly by age and location. Coverage rates for the pneumococcal conjugate vaccines, PCV-10 and PCV-13, were 20.27% and 56.75%, respectively. Notably, 43% of the strains were non-vaccine serotypes, with serotypes 3 and 19 accounting for 36% of the infections in children, indicating a lack of vaccine efficacy against these types. Additionally, 31.3% of the strains were Penicillin non-susceptible Streptococcus pneumoniae (PNSP), with 81.25% associated with non-vaccine serotypes. This study highlights the persistence of IPD in Moroccan children, revealing significant challenges despite vaccination efforts. With the reintroduction of PCV-13, concerns about the efficacy against non-vaccine serotypes, particularly 3 and 19A, remain. Continuous surveillance and adaptable vaccination strategies are essential to combat these serotype replacements and ensure the effectiveness of future preventive measures.

Obstetric Renal Failure: Causes, Prognosis, and Evolution

The incidence of obstetric acute renal failure remains significant in developing countries. The aim of our study is to define the risk factors involved in the occurrence of ARF during pregnancy or during the immediate postpartum period and to evaluate its evolutionary profile in terms of epidemiology, etiopathogenesis, and therapeutic management over the years in Morocco. This is a retrospective study conducted in the maternal-infant resuscitation service of the Ibn Rochd University Hospital of Casablanca, over the period from January 2020 to August 2023, including 95 patients. The current incidence in our series over this period was 22.2%. The mean age of our population was 33 ± 7.74 years [18-43 years], 67.3% of patients were in the gestational period, compared to 33.7% in the immediate postpartum period. Fourteen patients were primiparous (8.6%), 27.4% had a history of miscarriage, and 10.7% had a history of pre-eclampsia. Oligo-anuria was initially identified in 24 patients. The most frequent etiology was pre-eclampsia (56.7%), followed by hemorrhage (27%) and sepsis (19.3%). The evolution was marked by recourse to hemodialysis in 62% of cases, with a maternal mortality of 26%. The existence of heart disease, the context of pre-eclampsia, and the use of diuretics and vasoactive drugs were significantly correlated with maternal survival. No factor was correlated with secondary recovery from ARF. The development of health structures and the optimization of screening strategies are the keywords for prevention.

Prevalence of Healthcare-Associated Infections in a Tertiary Hospital in Casablanca, Morocco, 2021.

During the COVID-19 pandemic, healthcare professionals experienced an increased workload, which may have affected infection prevention and control (IPC) programs and consequently healthcare-associated infection (HAI) rates. The objective of this study was to estimate the prevalence of HAI in Ibn Rochd University Hospital Center (IRUHC) and identify associated factors. A survey was conducted on November 30, 2021 at IRUHC, including all patients hospitalized for at least 48 hours. Data was collected using a questionnaire, and analyzed using SPSS IBM software version 16. The significance level was set at 0.05. Among 887 patients, the prevalence of HAI was 9.7% (7.7%; 11.6%). The highest prevalence was observed in intensive care units (ICUs) (44.2%). Nosocomial pneumonia was the most common site (26.8%). The main isolated microorganisms were Acinetobacter baumannii (18.0%) and Escherichia coli (16.0%). All Acinetobacter baumannii isolated strains were imipenem-resistant. The presence of HAI was significantly associated with the presence of an invasive medical device (p<0.001), a higher physical status score of American Society of Anesthesiologists (ASA) (p<0.001), and a longer hospital stay (p<0.001). Conclusion: The emergence of imipenem-resistant Acinetobacter baumannii(IRAB) represents a serious therapeutic and epidemiological problem requiring the establishment of a system for monitoring the microbial environment and the application of strict hygiene measures.

Oral and Dental Status in Children with Congenital Heart Disease in Ibn Rochd University Hospital of Casablanca Morocco

Objective: A case-control survey was conducted to assess the oral status of children with congenital heart disease in the cardiothoracic department at the CHU Ibn Rochd in Casablanca.

The value of arthroscopy in joint fractures of the lower limb

Introduction: Lower extremity joint fractures are common and require precise management to avoid complications. Arthroscopy offers advantages in terms of precise control, detection of associated lesions and minimally invasive surgery, thus improving post-operative outcomes. Material and methods: The retrospective study focused on 51 cases of joint fractures of the lower limb treated by arthroscopy at the Ibn Rochd University Hospital over a period of four years including : 30 ankle fractures, 20 knee fractures and a single case of hip joint fracture. The pathological study was carried out on a radiological analysis and the fractures were then classified according to the appropriate classification. Results: In the first case, a 16-year-old adolescent victim of a road accident suffered a postero-superior dislocation of the left hip, requiring emergency reduction followed by arthroscopy to remove three intra-articular foreign bodies. For the second case, knee joint fractures were observed in adults aged 20 to 55 years, mainly men, following road accidents. Surgical treatment included fracture reduction and internal fixation, with satisfactory postoperative results. Finally, in the third case, ankle joint fractures were observed in young and active adults, with a male predominance. Surgical treatment, carried out on average four days after the accident, also consisted of reduction of the fractures followed by osteosynthesis. Postoperative results were very positive, with rapid functional recovery and no complications reported. Discussion: Joint fractures of the lower limb include those of the hip, tibial plateaus and ankle. For hip fractures, more common in young adults, reduction of dislocations is crucial, often carried out under general anesthesia. Tibial plateau fractures, observed mainly in young men, require precise detection of associated lesions, which are often difficult to identify initially. As for ankle fractures, common in active adults, precise imaging, such as CT, is recommended to guide treatment, including arthroscopic screw fixation in cases of syndesmosis damage. Conclusion: Joint fractures of the lower limb are complex and require careful evaluation. Arthroscopy has revolutionized their treatment by providing precise assessment, direct reduction and treatment of associated lesions allowing rapid recovery and reduced post-operative risks compared to conventional surgery.

Exploring Silico-tuberculosis: A Detailed Investigation of 45 Cases in Occupational Settings

Objective: Silicosis is a lung disease caused by inhaling crystalline silica dust, leading to inflammation and scarring of lung tissue. This retrospective study investigates the association between silicosis and tuberculosis (TB) in occupational settings, analyzing 45 male silicosis patients at Ibn Rochd University Hospital in Casablanca from June 2003 to December 2023. Cases: The average duration of occupational exposure was 18 years, primarily in well-digging, stone crushing, mining, and masonry. Clinical symptoms included dyspnea (89%), persistent bronchial syndrome (83%), and hemoptysis (54%). Imaging typically revealed pseudo-tumoral opacities, often with associated mediastinal lymphadenopathy and micronodular or excavated opacities. TB diagnosis was confirmed by GeneXpert (23% in sputum, 70% in bronchial aspirate fluid) and culture (7%). Conclusion: Anti-tuberculous treatment led to clinical improvement in most cases, but there were two deaths from acute respiratory failure and one case of TB relapse. The findings underscore the importance of screening and chemoprophylaxis for TB in managing silicosis. Preventive measures and worker health protections are crucial to reduce the incidence of silicosis and its complications.

Wounds from sharp objects of the upper limb (About 504 Cases)

Introduction: Assaults by stabbing constitute a growing problem, leading to serious trauma to the upper limb. This study examines the characteristics, management and consequences of upper limb wounds caused by such attacks. Material and methods: This is a retrospective study of 504 cases of wounds of the upper limb caused by stabbing, collected over four years at the IBN ROCHD University Hospital in Casablanca. Data were collected from medical records and included information on injuries, surgical management, complications, and functional outcomes. Results: The lesions predominated on the left upper limb, mainly affecting the hand, wrist, and forearm. The injuries were varied, often involving tendons, nerves, muscles, bones, and vessels. Surgical management was carried out according to established principles, with specific repair techniques. Postoperative complications were common, including sensorimotor disorders, infections, and joint stiffness. Discussion: The results highlight the extent of upper limb trauma caused by stabbing attacks. The complexity of the lesions requires multidisciplinary care. Postoperative complications highlight the ongoing challenges faced by patients. In addition, the psychological consequences of aggression are significant and require special attention. Conclusion: This study highlights the importance of understanding and treating upper limb wounds caused by stabbing attacks. The results provide essential information to improve management strategies and prevent long-term complications, while highlighting the medical and psychological challenges associated with these traumas.

Self-locking tenotomy of the long head of the biceps: What is the benefit?

Tenotomy and tenodesis of the biceps are the surgical techniques used to treat pathology of the long biceps. Between the proponents of the two techniques, the superiority of one over the other is still debated. The Popeye sign is often cited to the disadvantage of tenotomy. The aim of our study is to report on our experience using a self-locking tenotomy and its impact on Popeye's sign, and to assess our functional results. This is a retrospective study of 53 shoulders treated for long biceps tendinopathy, isolated or associated with a rotator cuff tear. All patients underwent surgery at the AILE 4 orthopedic department of the Ibn Rochd University Hospital in Casablanca over a period of five years, and were reviewed at least six months later. A self-locking tenotomy was performed in all patients. The mean age at surgery was 58 years. Popeye's sign was observed in five patients and was well accepted in four patients. Constant-Murray scores improved significantly by an average of 25 points. Satisfaction was over 90%. Professional and sporting activities were resumed in all patients. We highlight the value of the self-locking tenotomy as a simple, rapid, reproducible, effective and low-cost arthroscopic technique, ensuring a tenodesis effect by reducing the rate of appearance of Popeye's sign.

The seroprevalence of COVID-19 among people living with HIV in Morocco

The association of COVID-19 and HIV infection would seem deadly in terms of prognosis and the possibilities of viral clearance given the immunodeficiency. However, a lower seroprevalence has been reported in some studies compared to that found in the non-HIV population. The objective of this study is to determine the seroprevalence of COVID-19 among people living with HIV (PLHIV) in Morocco. This is a prospective study carried out in the infectious diseases department of the Ibn Rochd University Hospital in Casablanca. We included PLHIV who consulted the Infectious Diseases Day-Hospital service between January 18, 2021 and March 10, 2021. After informed consent, patients completed a survey and had blood drawn for SARS-CoV-2 antibody testing. The determination of IgG antibodies against SARS-CoV-2 in blood was carried out using chemiluminescence microparticle immunoassay technology. We included 418 PLHIV in the study, most patients were male (50.24%), the average age was 40 years, 90.2% of patients were on antiretroviral treatment, 56.7% had a viral load &lt;20 copies/ml, and 47.37% had a CD4 count greater than 500 cells/μL. The IgG test was positive in 53 patients, representing a seroprevalence of 12.68%. None of the patients had clinical signs. Seroprevalence was higher in female patients (58.49%), aged between 30 and 40 years (41.51%), in patients with a negative viral load (64.15%) and a CD4 count greater than 500 cells/mm3 (49.6%). Our study showed that the seroprevalence of COVID-19 was higher among PLHIV compared to people without HIV infection. All the patients had asymptomatic forms which pushes us to evoke a theory, to demonstrate, of the action of antiretrovirals against SARS-CoV-2.

Exploring inflammatory markers of COVID-19 severity in Moroccans

IntroductionThe global impact of the SARS-CoV-2-induced COVID-19 pandemic has reached Morocco. Early identification of factors contributing to severity is imperative for effective management. There is, however, a notable research gap, as only a limited number of studies have systematically investigated the importance of inflammatory biomarkers in assessing COVID-19 severity in the Moroccan context. No study has included the dosage of IL-6 which represents one of the main inflammatory agents responsible for the inflammatory storm. This study attempts to fill this gap by exploring the role of inflammatory biomarkers in the severity of COVID-19 in Moroccan patients. Material and methodsThis prospective cross-sectional study was conducted at the Medical Immunology Laboratory of Ibn Rochd University Hospital in Casablanca, between November 2, 2020, and December 1, 2021. Data on demographic characteristics, underlying comorbidities, and laboratory tests were collected from medical records. The patients were divided into non-severe and severe groups. we performed an assay of il-6 using an automated chemiluminescence. technique. ResultsThe study analyzed 371 confirmed COVID-19 patients and found that lymphopenia, hyperneutrophilia, increased NLR, CRP, and IL-6 were associated with the severity of COVID-19. Significant positive correlations were found between IL-6 and other immune-inflammatory parameters, including neutrophil count, CRP, and NLR. Conclusionour study provides evidence that NLR, CRP are potential biomarkers for predicting COVID-19 severity in Moroccans. This finding could help with the early identification of severe cases, which can lead to better management and outcomes.

Erectile Dysfunction: Epidemiological and Clinical Case Series Profile at the Ibn Rochd University Hospital in Casablanca

Erectile Dysfunction: Epidemiological and Clinical Case Series Profile at the Ibn Rochd University Hospital in Casablanca

Interest of toxicological analysis in patients admitted to a pediatric emergency department

Objective: Evaluate the interest of toxicology screening in the management of patients in a pediatric emergency department, by assessing its diagnostic utility. Patients and Methods: This is a retrospective cross-sectional study conducted over two years in the Emergency Department of the Abderrahim Harouchi Mother and Child Hospital, of the Ibn Rochd University Hospital in Casablanca, Morocco. We included all children who underwent qualitative toxicological screening by Gas Chromatography coupled with Mass Spectrometry (GC/MS). A descriptive analysis was conducted on the clinical and toxicological characteristics of the patients. The contingency test allowed us to compare the context of the toxicological screening request and its diagnostic utility. Results: Eighty-seven children were included, with a Male-to Female sex ratio of 1.2. The age of the patients ranged from 1 month to 14 years, with a median of three years. Among the included population, 119 screenings were performed. Drugs were implicated in 27 cases, while 4 pesticide intoxications were found, including carbofuron, chloralose, methomyl and terbucarb, along with 2 cannabis intoxications. A proportion of 88% of screening requests, made in the absence of clinical guidance, turned out to be positive, accounting for 31% (24 cases out of 77) (p&lt;0.001). Conclusion: Toxicological analysis is a valuable tool to assist the clinician in managing intoxications by confirming or excluding the toxic hypothesis. However, toxicological analysis can only be useful and effective, avoiding analytical pitfalls, in the presence of dialogue between the clinician and the analyst.

Clinicopathological characteristics and tumor infiltrating immune cells associations of PD-L1 tumor expression in non-small cell lung cancer patients.

Our study aimed to perform on Moroccan patients' non-small cell lung carcinoma (NSCLC) concerning the relationship between PD-L1 tumor expression, clinicopathological features and tumor infiltrating immune cells (ICs). This is a retrospective study (2019 to 2021) conducted on samples from Moroccan patients with NSCLC at the Pathological Anatomy Laboratory of Ibn Rochd University Hospital in Casablanca. Eligible participants for our study had to meet the following predefined criteria: age ≥18 years, histologically confirmed NSCLC, no prior therapeutic interventions, availability of clinical and pathological data, and a usable tumor sample for determining PD-L1 status. Exclusion criteria applied to patients with other types of lung cancer and unusable tumor samples. The evaluation of tumor and immune expression of PD-L1 was performed using immunohistochemistry (IHC), with the 22C3 clone on the Dako Autostainer Link 48 platform. Tumor PD-L1 expression was categorized into 3 levels: TPS <1% (negative expression), TPS 1-49% (low expression), and TPS ≥50% (high expression). ICs infiltrating the tumor expressing PD-L1 were considered positive when more than 1% of positive ICs were present. Among the 316 analyzed samples, 56.6% showed a negative expression of PD-L1, 16.8% displayed a low expression of PD-L1, and 26.6% exhibited a strong expression. Regarding the histological type, among patients with TPS ≥ 50%, 25.8% had adenocarcinoma. Among patients with TPS ≥ 50%, 24.81% were smokers. PD-L1 was also strongly expressed in the lung (28.2%) and bronchi (26.5%). PD-L1 expression (TPS ≥ 50%) was observed in 35.29% of early-stage patients. Concerning tumor cells (TCs), 27.5% of tumors infiltrated by ICs had TPS ≥ 50%. Furthermore, coexpression of PD-L1 on both TCs and ICs infiltrating the tumor was found in 27.8% of tumors. Statistical analysis demonstrated a significant association between tumor PD-L1 expression and smoking status (P=0.019). However, no significant difference was observed between PD-L1 expression and the presence of ICs infiltrating the tumor (P=0.652), as well as the IHC expression of PD-L1 on ICs (P=0.259). Our results demonstrate a significant association between PD-L1 expression and smoking status. However, no significant association was observed between PD-L1 expression and the presence of infiltrating ICs, nor with the IHC expression of PD-L1 on ICs. Our data underscore the importance of participating in the study of specific factors influencing PD-L1 expression in patients with NSCLC.

LED Treatment for Chronic Leg Ulcers

Introduction Chronic leg ulcers impact patients' quality of life and pose a therapeutic challenge for dermatologists. The aim of this study was to evaluate the efficacy of LED monotherapy on healing and pain in the treatment of chronic leg ulcers. Materials and Methods his prospective descriptive study was conducted at the Laser Unit of the Dermatology and Venereology Department at Ibn Rochd University Hospital in Casablanca from July 2021 to May 2023. Inclusion criteria were the presence of a leg ulcer and age &gt; 18 years. Exclusion criteria included uncontrolled diabetes and pregnancy. We used a polychromatic LED device combining five colors: violet (415nm), blue (465nm), yellow (590nm), red (630nm), and infrared (850nm), in continuous mode with total fluences of 48J/cm2 and 64J/cm2. Results 23 patients were recruited, with 78.3% being male and a male-to-female ratio of 3.6. The average age was 44.5 years (19-70 years). Vascular etiology was found in 65.2% of cases. Enzyme deficiency was observed in 17.4%: prolidase deficiency and protein C deficiency. Leg ulceration related to a systemic disease was noted in 17.4%. Hematological etiology was identified in 8.7%: sickle cell disease and thalassemia. At the end of treatment, pain regression was noted in 72% of cases. Healing was complete in 26.1% of cases and partial in 73.9%. Conclusion Chronic ulcers represent debilitating conditions with challenging healing. LED therapy using a combination of colors (violet, blue, yellow, red, infrared) accelerated the healing of chronic leg ulcers of various etiologies and reduced pain. Further largescale comparative studies are needed to assess the effectiveness of LED therapy with color combinations in the healing of chronic leg ulcers and to establish practical usage recommendations.

A Rare Case of Angio-Behcet Revealed by Hemoptysis of Great Abundance

Behçet's disease (BD) is a chronic, relapsing vasculitis of unknown etiology that is characterized by mucocutaneous, ocular, articular, vascular, gastrointestinal, and central nervous system.It mainly affects young subjects, generally 20 to 30 years old with a predominance of men. Thoracic involvement of Behcet's disease is unusual but serious. It is related to the well known vascular tropism of the disease. It may involve the superior vena cava, pulmonary arteries, aorta and subclavian vessels. These vascular attacks can be arterial or venous thrombosis, aneurysms or pseudo-aneurysms .In Behçet's disease, pulmonary artery aneurysms are considered exceptional. these aneurysms manifest themselves by recurrent hemoptysis as is the case with our patient who consulted in pneumolgy department 20 august 1953 at the university hospital Ibn Rochd Casablanca, for a moderate to great abundance hemoptysis revealing an angio-behcet. This is a negative element in patients with BD. it is a diagnostic and therapeutic emergency.The treatment of BD is not well codified but it depends on the severity of the systemic manifestations. Regarding vascular involvement, surgical treatment of an aneurysm with all its risks in patients with Behçet's disease frequently results in aneurysm recurrence. The arterial aneurysms have a poor prognosis, especially pulmonary aneurysms.

Prevalence of metronidazole resistance and Helicobacter pylori infection in Moroccan children: a cross-sectional study.

the prevalence of Helicobacter pylori (H. pylori) infection in children is very high in Morocco. Eradication rates of H. pylori infection decrease due to the emergence of resistance to antibiotics. Data on the antimicrobial susceptibility of H. pylori in Moroccan children are not available. This study aims to assess the prevalence of H. pylori infection and the metronidazole resistance rate of H. pylori in Moroccan pediatric patients, and their association with epidemiologic factors. a cross-sectional study was conducted on 132 pediatric patients who had an indication for upper gastrointestinal endoscopy and attended pediatric hospital Abderrahim Harouchi of the University Hospital Ibn Rochd, Casablanca, Morocco. Detection of H. pylori infection and the susceptibility to metronidazole was performed by classic PCR. Statistical analysis was performed using R Studio software. the overall prevalence of H. pylori infection was 80.3%. vomiting was significantly associated with H. pylori infection (p-value=0.01). Regarding the resistance rate of metronidazole, we found that the prevalence of H. pylori resistance to metronidazole was high (70.8%) and it significantly increased, especially in pediatric patients living in urban areas (p-value=0.01). the prevalence of H. pylori infection and resistance rate of metronidazole were very high in Moroccan children. Therefore, triple therapy with metronidazole must be preceded by a study of the bacterium's susceptibility to the prescribed antibiotics, in particular to metronidazole.

Epidemiology and Mode of Emergency Diversion of Obstructive Renal Failure of Malignant Cause Retrospective Report

Objective: Obstructive uropathy and its surgical management. Methods: Retrospective cross-sectional study carried out in the urology department of Ibn Rochd University Hospital in Casablanca over a 12-month period (April 2019-March 2020). It included 63 cases of patients hospitalized for obstructive renal failure. We included all patients with renal failure due to a documented malignant pathology. Results: Most of the patients were men (n = 45, 71.4%). The mean age was 60.2 years, with the most affected age group between 51 and 60 years. Forty-three patients (68.3%) were being treated for cancer. The clinical symptoms were diverse, dominated by low back pain. The bladder was the first organ affected by a tumor process. Renal function was impaired in all patients. Twenty patients (31.7%) (n=20) underwent dialysis prior to any bypass. The percutaneous nephrostomy (PCN) was inserted in 56 patients (88.9%) (n=56), the double J catheter in 5 patients (7.9%) (n=5), and 2 patients (3.2%) (n=2) had a percutaneous nephrostomy and a double J catheter inserted contralaterally. Conclusions: In this cohort, bladder tumor was the main cause of obstructive renal failure. Percutaneous nephrostomy was the main mode of diversion used in our center. This choice was dictated by epidemiology and center experience not having a success rate of double J ureteral catheter placement in obstructive renal failure secondary to bladder tumor.

Neisseria meningitidis with decreased susceptibility to penicillin G and molecular characterization of the penA gene in strains isolated at University Hospital Centers of Casablanca and Marrakech (Morocco).

the laboratory diagnosis of meningococcal meningitis relies on conventional techniques. This study aims to evaluate the correlation between the reduced sensitivity to penicillin G of Neisseria meningitidis (N.m) strains and the expression of the altered PBP 2 gene. out of 190 strains of N.m isolated between 2010 and 2021 at the bacteriology laboratories of Ibn Rochd University Hospital Centre (IR-UHC) in Casablanca and the UHC Mohammed VI in Marrakech, 23 isolates were part of our study. We first determined their state of sensitivity to penicillin G by E-Test strips and searched for the expression of the penA gene by PCR followed by Sanger sequencing. of all the confirmed cases of N.m, 93.15% (n=177) are of serogroup B, 75.2% (n = 143) are sensitive to penicillin G and 24.73% (n = 47) are of intermediate sensitivity. No resistance to penicillin G was observed. Reduced sensitivity to penicillin G in N.m is characterized by mutations namely F504 L, A510 V, I515 V, G541 N and I566 V located in the C-terminal region of the penA gene encoding the penicillin-binding protein 2 (PBP2) (mosaic gene). our study presents useful data for the phenotypic and genotypic monitoring of resistance to penicillin G in N.m and can contribute to the analysis of genetic exchanges between different Neisseria species.