Hakima Kabbaj

Respiratory syncytial virus (RSV) imposes a substantial burden of severe acute respiratory infection (SARI), especially in young children and the elderly. Methods: We describe RSV epidemiology among hospitalized SARI patients at the Ibn Sina University Hospital Center (Rabat, Morocco) from 1 January 2021, to 31 December 2025, using multiplex PCR (BioFire^® RP2.1plus or Xpert^® SARS-CoV-2/Flu/RSV). Results: Among 4604SARI samples, RSV prevalence was 16.1% (739/4604), predominantly pediatric (88.6%, p < 0.001), with peak burden in infants p < 0.001). Pediatric prevalence was 28.3% (655/2316) vs. 3.8% (84/2204) in adults (p < 0.001), with predominance in the elderly ≥60 years (51/1041, 4.9%). Co-infections occurred in 46.7% (310/665) of FilmArray-tested positives (total = 665), led by rhinovirus/enterovirus (198/310, 63.9%), and were significantly higher in children (48.5%, p < 0.001). RSV peaked in winter (51.6%), except for summer dominance in 2021 (52.5%), reflecting COVID-19 non-pharmaceutical intervention effects. Conclusions: These data establish Morocco’s first comprehensive RSV surveillance baseline, highlighting post-pandemic epidemiological shifts. As maternal vaccines and monoclonal antibodies emerge, these data inform optimal implementation in low- and middle-income countries (LMICs).

Enterovirus can cause central nervous system (CNS) infections ranging from meningitis to severe encephalitis. The aims of our study were to describe and develop the current epidemiological, biological, and clinical aspects of these infections as well as to enrich Moroccan data. This is a retrospective study conducted from January 2021 to March 2023, which included all patients admitted to the hospitals of Ibn Sina University Hospital Center in Rabat (Morocco) with clinical suspicion of CNS infection and positive cerebrospinal fluid (CSF) for enterovirus detected by BioFire® FilmArray® panel meningitis/encephalitis. 1479 CSF were analyzed by multiplex PCR. Enterovirus was detected in 19 patients (1.28%) with a median age of 5 years, predominantly affecting male patients (73.7%) and children (94.7%), especially those aged 2 years and older (68.4%). Fever was the most common symptom (77.8%), followed by headache (66.7%). The seasonal peak of enterovirus detection was also observed. For most patients, the CSF was predominantly lymphocytic (88.2%) with normal glycorrhachia (84.2%) and proteinorachia (73.7%). A notable proportion (10.5%) had a normal CSF cytology. Hyperproteinorachia was found in 26.3% of cases and hypoglycorrhachia in 5.3%. Blood analysis revealed a normal WBC count in 55.6% of cases, hyperleukocytosis in 33.3%, and leukopenia in 11.1%. CRP was elevated in 72.2% of cases. CNS enterovirus infections were particularly present among the pediatric population in this study. The lack of specificity in clinical and biological manifestations may sometimes suggest bacterial etiology. The widespread use of multiplex PCR can therefore provide a reliable and rapid method of detection and diagnosis.

Respiratory viruses are the most involved pathogens in acute respiratory infections. During the COVID-19 pandemic, new elements have been brought to this topic, especially at the diagnostic and therapeutic level. The objective of this work is to describe the epidemiology of respiratory viruses in patients admitted to the Ibn Sina University Hospital of Rabat during a period characterized by the emergence and spread of SARS-CoV-2. We conducted a retrospective study from January 1 to December 31. We included all patients treated for acute respiratory infection and for whom a multiplex respiratory panel PCR was requested. Virus detection was performed using a FilmArray RP 2.1 plus BioFire multiplex respiratory panel. The study population was relatively adults with a mean age of 39years. The sex ratio M/F was 1.20. The survey revealed a high prevalence of 42.3 of patients hospitalized in the adult intensive care unit whose respiratory distress was the most common reason for hospitalization (58). The positivity rate was 48.1. This rate was higher in the pediatric population 83.13 compared to adults 29.7. Monoinfection was found in 36.4 of cases, and codetection in 11.7 of cases. This survey revealed that a total of 322 viruses were detected, HRV being the most incriminated virus (48.7), followed by RSV in 13.8 of patients. Considering the five most detected viruses in our study (HRV, RSV, PIV3, ADV, and hMPV), we found that the incidence was significantly higher in the pediatric population. SARS-CoV-2 was detected only in adults population. In our study, we found that influenza A and B viruses, PIV2, MERS, and all bacteria were not detected by this kit during the study period. Regarding the seasonal distribution, RSV and hMPV showed a significantly high incidence during autumn and summer and SARS-CoV-2 and CoV OC43 showed a high peak during winter. In this study, we found a lack of detection of influenza virus and a shift in the usual winter peak of RSV to the summer, while the detection of ADV and HRV was less affected. This difference in detection could be due on the one hand to the difference in stability between enveloped and nonenveloped viruses and on the other hand to the escape of certain viruses to the different sanitary measures introduced after the declaration of the COVID-19 pandemic. These same measures were effective against enveloped viruses such as RSV and influenza viruses. The emergence of SARS-CoV-2 has modified the epidemiology of other respiratory viruses, either directly by viral interference or indirectly by the preventive measures taken.

Objectives The aim of the present research is to update data on the seroprevalence of rubella and to identify the associated risk factors among pregnant women in the Rabat region of Morocco in order to take immediate action to monitor the virus. Design A cross-sectional study. Setting The study was conducted at Ibn Sina University Hospital and at referral healthcare centres in the region of Rabat. Participants A total of 502 pregnant women (mean age 29.7±6.3 years, range 17–44 years) attending the maternity department during 8 months were selected for serological testing. Outcome measures A structured questionnaire was used to obtain sociodemographic, reproductive and clinical characteristics after obtaining written informed consent. Venous blood samples were collected to determine rubella-specific IgG antibodies using an automated chemiluminescent microparticle immunoassay (ARCHITECT i1000SR and i2000SR, Abbott Diagnostics). Results Antirubella IgG antibodies (≥10 IU/mL) were found in 408 (85.9%) pregnant women examined. The rate of susceptibility to rubella virus infection among pregnant women was found to be 14.1%. These protective rates were found to differ significantly between uneducated pregnant women (80.9%) and those with university-level education (95.5%) (p=0.02). Pregnant women in the 17–24, 25–34 and 35–44 years age groups accounted for 92.5%, 85.2% and 82.8%, respectively (p=0.015). Also, IgG seropositivity status was found to differ significantly between multiparous (83.3%) and primiparous (92.5%) pregnant women (p=0.01). None of the other characteristics was significantly associated with rubella infections. Conclusion Vaccination programmes need to be updated to ensure that campaigns reach their specified goals. Thus, implementing an effective, large-scale screening programme for congenital rubella infection in different regions of Morocco is highly recommended. On the other hand, seronegative pregnant women should be given special preventive care and health education about rubella transmission and congenital rubella syndrome sequelae.

SARS-CoV-2 is a major public health problem worldwide. Since its emergence, several diagnostic kits have been developed to ensure rapid patient management. The aim of our study is to check the performance of the new Moroccan SARS-CoV-2 detection kit: MAScIR SARS-CoV-2 M 2.0. The following parameters were studied: repeatability, reproducibility, analytical specificity, analytical sensitivity, and comparison with the GeneFinder COVID-19 Plus RealAmp Kit. In addition, an external quality evaluation comprising five specimens was carried out as part of an international program for the external quality evaluation of sublaboratories of the WHO and the Laboratory Office of the National Institute of Hygiene of Morocco. The results of all parameters studied showed an analytical performance that complied with the requirements of the method verification/validation protocol adopted by the Central Laboratory of Virology and met the recommendations of COFRAC (French Accreditation Committee). During the current study, the sequencing of some randomly selected positive samples was performed, among which the carriers of the Alpha variant, the Delta variant, and the Omicron variant were detected. These results allowed us to deduce that this kit was valid for detecting these three variants.

Background. RT-PCR is the gold standard for COVID-19 diagnosis, but the lack of standardization of assays, whose diagnostic performance may widely vary, complicates the interpretation of the discrepancies that may be encountered. Study design. We conducted a retrospective study over a ten-month period at the Central Laboratory of Virology of Ibn Sina University Hospital of Rabat. We included nasopharyngeal swabs, positive and negative for SARS-CoV-2 on FilmArray BioFire® Respiratory Panel 2.1 Plus, which were subjected to our laboratorys reference test, MAScIR SARS-CoV-2 M kit 2.0, initially or after a freeze-thaw cycle. The results were compared, and each discrepant sample with sufficient volume underwent the third test, using ARGENE® SARS-CoV-2 R-GENE kit. Results. Of 80 SARS-CoV-2 negative samples on FilmArray, there were no discordant results, whereas of 80 SARS-CoV-2 positive samples on FilmArray, 21 had discordant results on MAScIR, and only 11 could be tested on ARGENE, revealing positive results in 6 cases. 12.7 and 76.5 correspond to the discordance rates for MAScIR (with one or both targets detected on FilmArray), while 14.3 and 100 correspond to those of ARGENE. As the estimated sensitivity and specificity of FilmArray, compared with MAScIR, were 100 and 79.2, respectively, its lower limit of detection, and ARGENE assay results, made it difficult to distinguish between false positives on FilmArray and false negatives on MAScIR without further investigations. Conclusion. The implementation of a new assay in our laboratory revealed discrepancies suggesting a lack of sensitivity of our laboratorys reference test, leading us consequently to retain the SARS-CoV-2 positive result of these discordant samples on FilmArray, regardless of the detection of one or both targets. Our study, which is, to our knowledge, the first comparing FilmArray RP2.1 and MAScIR 2.0 assays for SARS-CoV-2 detection, highlights the urgent need to standardize RT-PCR assays for COVID-19 diagnosis.

Purpose: Despite the use of antiviral prophylaxis with valacyclovir, cytomegalovirus infection (CMV) can still occur in seropositive kidney transplant recipients. In this study, we aimed to assess the incidence of CMV DNAemia and its risk factors in Moroccan transplant recipients. Patients and Methods: Sixty kidney recipients with positive cytomegalovirus serostatus, receiving post-transplant prophylaxis were enrolled between 2013 and 2017. In total, 455 plasma samples were collected and tested for CMV DNAemia using PCR-based Abbott RealTime assays. Results: The incidence of CMV infection in seropositive patients was 63%. In patients with quantifiable DNAemia, the duration of CMV infection was significantly shorter than in those with detectable DNAemia (141.5 ± 96.9 vs 294.1 ± 112.6 days, P < 0.001). During prophylactic treatment, 14 of 30 patients (47.0%) experienced active replication with quantifiable DNAemia, whereas none of eight patients with detectable DNAemia did (P = 0.017). Patients with symptomatic DNAemia were significantly younger than those without symptoms (28.8 ± 5.12 vs 38.1 ± 12.34 years, P = 0.007). The peak viral loads were significantly associated with viral disease (odds ratio: 3.39, 95% confidence interval: 1.21– 9.53, P = 0.02). The duration of DNAemia (21.2 vs 13.4 days, P = 0.028) was significantly longer in symptomatic patients. Significantly higher rates of acute rejection were exclusively observed in recipients with disease (4/8, 50% vs 0/22, 0%, P = 0.003). Conclusion: Patients with high-level DNAemia were at an increased risk of progression to disease and acute rejection. Monitoring the viral load during the first year post-transplantation is essential, to support current preventive strategies.

The early detection and genotyping of the hepatitis C virus (HCV) are important in the management of this infection. The genotype is the major factor influencing treatment decisions. That's why it is necessary to use fast and accurate methods in its determination. This study reports, over a period of 3 years (from May 2012 to July 2015), the percentage of indeterminate genotypes by the Abbott RealTime HCV Genotype II test and their results using a sequencing technique. Of 309 samples of 309 patients tested, 11 were indeterminate (4.4%). There were three cases of cross‐reactivity (1b/4 in one case, 2/5 in two cases) and a possible co‐infection 1 + 4. Among those indeterminate genotypes, cross‐reactivities and co‐infections, ten samples were tested by sequencing. The results were for four of them a 1d subtype, five were a 2i subtype and one was a 2l subtype. These results support the thesis of complementarity between the two methods: genotyping for the detection of mixed reactions and sequencing for resolving indeterminate cases by genotyping.

Objective. To determine the prevalence of metallo beta-lactamases (MBL) among carbapenem resistant strains ofAcinetobacter baumanniiin our hospital.Methodology. During a period of 12 months (January–December 2010), 47 isolates ofAcinetobacter baumanniiwere collected from different clinical specimens of in-patients. Antimicrobial susceptibility was determined and interpreted using the disk diffusion method according to the Antibiogram Committee of the French Society for Microbiology guidelines. Imipenem nonsusceptible isolates were further screened for production of MBL.Results. AllAcinetobacter baumannii’ isolates were resistant to ticarcillin, ticarcilline/clavulanate, piperacillin, piperacillin/tazobactam, gentamicin, tobramycin, and ciprofloxacin, except an isolate that was sensitive to ceftazidime and cefepime. In addition to that, amikacin and trimethoprim/sulfamethoxazole were, respectively, sensitive by 59.5% and 53%. Among 57,4% (27/47) imipenem non-susceptible isolates ofAcinetobacter baumannii, 74% (20/27) were found to be MBL producers.Conclusion. Although the rate of imipenem non-susceptible isolates ofAcinetobacter baumanniseems to remain stable in 2005 (57%) and 2010 (57,5%), the prevalence of MBL producer strain is increasing (38% in 2005 versus 75% in 2010). The findings strongly suggest that there is a need to track the detection of MBL producers; moreover, a judicious use of carbapenems is necessary to prevent further spread of these organisms.