Introduction: Quinolones have a powerful antimicrobial activity and are frequently prescribed in general medicine. This study aims to evaluate the emergence of plasmid mediated quinolone resistance «PMQR» genes among enterobacterial isolates from Morocco. Material and methods: 237 enterobacterial strains were isolated from community setting. Resistance to antibiotics and the detection of extended-spectrum β-lactamases (ESBL) were conducted according to the recommendations of the French Society of Microbiology; PMQR, ESBL (TEM, SHV and CTX- M) and AmpC genes were screened by PCR. The aac(6')-Ib-cr gene was identified by PCR-RFLP. All PCR products were sequenced. Conjugation experiments were done using the sodium azide-resistant strain E. coli K12J5. Results: 26.3% of the strains are resistant to at least 5 antibiotics; 7 strains (3%) show an ESBL phenotype. The prevalence of «PMQR» genes is 11.10%: the qnr gene was found in 6 isolates with a rate of 1.7% for qnrS1 and 0.9% for qnrB (B5, B6). The aac(6')-Ib-cr gene was detected in 8.5% of the strains. The qnrA and qepA genes were not found. Conjugation experiments showed that the genes qnrS1, aac(6')-Ib-cr and CTX-M-15 have been co-transfered together and that these genes are carried on conjugative plasmids of high molecular weight. Conclusion: This study confirms the dissemination of qnr and aac(6')-Ib-cr in Moroccan community setting. However, the high level of antibiotic resistance concerns a high risk of transmission of multidrug-resistant bacteria and challenges the authorities for surveillance of resistance policy.
In this article, we focus our work on the modeling of genetic risk factors on ischemic strokes occurred. To do this, logistic regression was widespread in our study. We proceeded in two stages: the first, we modeled the probability of the occurrence of ischemic stroke in an individual (i) based on genetic risk factors. Our sample consisted of 330 individuals aged at least 40 years, divided into 165 patients who had an ischemic stroke and 165 controls. We applied the Wald test for all variables in the model one by one and we concluded to Reject H0, since the coefficients of our variables are not all zero. In a second step, we studied the effects of these variables on the risk factors and then the effect of variables on Ischemic stroke to present the model equation. We set a prediction threshold after specification test, that allows us to ensure the quality of the fit of the model and its degree of prediction, the proportion of people who have ischemic stroke is (50%). The results showed that 128 of 156 people with Ischemic stroke allowed a positive predictive value of 82%. We conclude that the prediction rate and the success rate of our model is 80.30 %, the results obtained with the «XLSTAT» software show a very good model with (sensitivity 78% and specificity 83%).