Macrolide and tetracycline resistance in clinical strains of Streptococcus agalactiae isolated in Tunisia.

Between 2007 and 2009, 226 clinical strains of Streptococcus agalactiae, recovered from female genital specimens and from gastric fluid or ear specimens from infected newborns, were isolated at the Laboratory of Microbiology of Charles Nicolle Hospital of Tunis. They were investigated to determine the prevalence of antibiotic resistance and to characterize the mechanisms of resistance to macrolide and tetracycline. All strains were susceptible to penicillin, ampicillin and quinupristin-dalfopristin.

Nosocomial outbreak of imipenem-resistant Pseudomonas aeruginosa producing VIM-2 metallo-β-lactamase in a kidney transplantation unit.

Background: Twenty four non replicate imipenem resistant P. aeruginosa were isolated between January and November 2008, in the kidney transplantation unit of Charles Nicolle Hospital of Tunis (Tunisia). This study was conducted in order to establish epidemiological relationship among them and to identify the enzymatic mechanism involved in imipenem resistance.

Virulence determinants, phylogenetic groups and fluoroquinolone resistance in Escherichia coli isolated from cystitis and pyelonephritis.

Aim Of The Study: The aim of this study is to assess the relation between virulence genotype, phylogenetic group and susceptibility to fluoroquinolones and the urinary tract infection type including pyelonephritis and cystitis due to Escherichia coli.

Materials And Methods: Between 2006 and 2007, 129 non-duplicate E. coli isolates from pyelonephritis (n=56) and cystitis (n=73) were prospectively collected.

Characterization and molecular epidemiology of extended spectrum beta-lactamase producing Enterobacter cloacae isolated from a Tunisian hospital.

In 2009, out of the 66 nonrepetitive Enterobacter cloacae collected at Charles Nicolle hospital in Tunisia, 44 were extended spectrum β-lactamase (ESBL) producers. The aim of the current study was to detect and characterize the genes encoding the ESBLs including blaTEM, blaSHV, and blaCTX-M groups by polymerase chain reaction and sequencing. Pulsed-field gel electrophoresis (PFGE) analysis was used to determine the genetic relatedness between isolates.

Carbapenem-resistant Acinetobacter baumannii producing the carbapenemase OXA-23 in Tunisia.

Aim: To analyze the mechanisms of resistance to carbapenems among imipenem resistant A. baumannii recovered from different wards at Charles Nicolle Hospital.

Methods: From January to December 2007, 50 carbapenem-resistant A.

Molecular mechanisms of tetracycline and macrolide resistance and emm characterization of Streptococcus pyogenes isolates in Tunisia.

Streptococcus pyogenes or group A Streptococcus, a major human pathogen, remains susceptible to beta-lactams, but resistance to other antibiotics is becoming more common. The purpose of this study was to characterize both phenotypic and genotypic epidemiological markers of group A Streptococcus and to identify the mechanisms of resistance to macrolides and tetracyclines. A total of 103 strains, isolated at Charles Nicolle University Hospital of Tunis, were investigated.

[Bacteriological profile of urinary tract infections in women in Aziza Othmana Hospital: 495 cases].

Background: Urinary infection is a frequent pathology in the community as well as at the hospital.

Aim: To analyze the profile of bacteria isolated from urinary tract infectious in women and their antimicrobial resistance.

Methods: During two year period (1 January 2005 to 31 December 2006), 4536 urinary specimens were analyzed at the Laboratory of Aziza Othmana Hospital.

[Questionnaire evaluation of hand hygiene by the healthcare staff of Charles Nicolle Hospital of Tunis].

Background: Known to be reservoir of bacteria, hands are implicated in bacteria cross-transmission which enhances nosocomial-acquired infection rates (NI) and outbreaks. Hand washing is then considered the first mean with authentic efficiency to prevent NI.

Aim: To describe the situation of the hand hygiene at Charles Nicolle hospital of Tunis in order to identify problems that can oppose to the good execution of this practice.

Clinical isolates of Pantone-Valentine leucocidin- and gamma-haemolysin-producing Staphylococcus aureus: prevalence and association with clinical infections.

Pantone-Valentine leucocidin (PVL) and gAMMA-haemolysin (Hlg) are members of the synergohymenotropic toxin family produced by Staphylococcus aureus and encoded by pvl and hlg genes, respectively. Many reports describe an association between PVL toxin and necrotic lesions involving skin and mucosa. The aim of this study was to determine the prevalence of S.

Corynebacterium propinquum isolated from a pus collection in a patient with an osteosynthesis of the elbow.

Background: Although non- diphtherial corynebacteria are ubiquitous in nature and commonly colonize the skin and mucous membranes of humans, they rarely account for clinical infections.

Aim: we report a case of infection due to non- diphtherial corynebacteria, Corynebacterium propinquum.

Case: A Tunisian male patient of 67 years old was admitted to orthopedic surgery and traumatology ward of Charles Nicolle university hospital of Tunis (Tunisia) for a left elbow trauma.

Hospital acquired outbreak of methicillin-resistant Staphylococcus aureus infection initiated by a health care worker.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly important pathogen leading to hospital acquired infections.

Aim: This study was done to confirm an outbreak of MRSA suspected at Charles Nicolle Hospital.

Methods: From 26 April to 11 June 2002, six patients hospitalized in the dermatologic ward at Charles Nicolle hospital of Tunisia have developed infections caused by MRSA.

Epidemiological markers of Streptococcus pyogenes strains in Tunisia.

To further understand the epidemiology of Streptococcus pyogenes or group A streptococcus (GAS) infections in Tunisia, phenotypic and genomic markers of GAS isolates, including antibiotic susceptibility, biotypes, T and emm types and toxin gene profiles, have been characterized. A total of 103 isolates, collected between 2000 and 2006, were investigated; 47 were recovered from invasive infections, and 56 from non-invasive infections. Rates of resistance to tetracycline, erythromycin, clindamycin and rifampin were 70.

Antimicrobial resistance of respiratory pathogens in North African countries.

This study reports the antimicrobial resistance of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes isolated from patients in Algeria, Morocco and Tunisia. 672 non-duplicate isolates were recovered from May 2006 to May 2007. The minimum inhibitory concentrations (MICs) were determined using the E-test and interpreted according to EUCAST guidelines.

High rates of macrolide resistance among clinical isolates of Streptococcus agalactiae in Tunisia.

One hundred sixty non duplicate erythromycin resistant Streptococcus agalactiae isolates were collected in Tunisia from January 2005 to December 2007 They were investigated to determine their resistance level to different macrolides and the mechanisms involved. Most erythromycin resistant S. agalactiae isolates were isolated from urinary specimens (38.

Antibiotic consumption as a driver for resistance in Staphylococcus aureus and Escherichia coli within a developing region.

Background: This study aimed to provide insight into possible antibiotic drivers of methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli resistant to third-generation cephalosporins (3GCREC) in southern and eastern Mediterranean institutions.

Methods: MRSA and 3GCREC susceptibility proportions from 19 regional hospitals, previously published by the ARMed project, were correlated with antibiotic use data from the same institutions.

Results: Hospitals reporting below-median MRSA proportions had significantly lower total antibiotic use.

Molecular epidemiology and genetic environment of acquired bla ACC-1 in Salmonella enterica serotype Livingstone causing a large nosocomial outbreak in Tunisia.

Eighty-four isolates of Salmonella enterica serovar Livingstone were collected from patients hospitalized in a pediatric ward in Sfax Hospital (South Tunisia). These isolates were responsible for two nosocomial outbreaks in 2000 and 2002. Twenty-eight clinical isolates of S.

Health care worker perceptions of hand hygiene practices and obstacles in a developing region.

A structured self-assessment questionnaire was distributed to 8 southern and eastern Mediterranean hospitals to identify perceived obstacles to hand hygiene (HH). An insufficient number of sinks and alcohol handrub stations was rated by the vast majority of respondents as the most critical impediment, whereas improved availability of HH products was deemed the key intervention to increase compliance. The least importance and relevance were given to HH auditing and collegial reminders.

Diversity in VIM-2-encoding class 1 integrons and occasional blaSHV2a carriage in isolates of a persistent, multidrug-resistant Pseudomonas aeruginosa clone from Tunis.

From 2002 to 2006, 35 of 73 multidrug-resistant Pseudomonas aeruginosa isolates from different wards at Charles Nicolle hospital of Tunis were positive for class B carbapenemase (using the imipenem-EDTA test), owing to a bla(VIM-2) gene cassette in a class 1 integron. Twenty-three isolates additionally produced the extended-spectrum beta-lactamase SHV2a. DNA sequences immediately surrounding bla(SHV2a) shared extensive identity with a Klebsiella pneumoniae plasmid sequence.

Spread of multidrug resistant Acinetobacter baumannii in a teaching hospital.

Background: A. baumannii is an important opportunistic pathogen widely distributed in the hospital environment and responsible for a variety of nosocomial infections especially in patients from intensive care units.

Aim: We describe an outbreak of Acinetobacter baumannii (16 stains) in 3 intensive care units (I, II, III) at Charles Nicolle hospital of Tunis over a 5 month period (March to July 2005).

[Community-acquired pneumonia due to Panton-Valentine producing Staphylococcus aureus: first description in Tunisia].

Background: Community-acquired pneumonia due to Panton-Valentine producing S.aureus is a serious infection recently described. Many cases have been reported worldwide.

[Methicillin resistant Staphylococcus aureus: phenotypic and genotypic studies].

Background: Staphylococcus aureus is a human opportunistic pathogen. Its important pathogenicity and the increasingly rate of resistance to methicillin are the main causes of morbidity and mortality.

Aim: In order to evaluate the epidemiologic situation of Methicillin Resistant S.

Clonal spread of carbapenem resistant Pseudomonas aeruginosa in an university hospital.

Aim: We examined 14 Pseudomonas aeruginosa clinical isolates collected in 2000 from patients hospitalised in different wards at Charle Nicolle hospital from Tunisia.

Methods: Analysis includes serotyping, antimicrobial susceptibility profile, beta-lactamase detection, randomly amplified polymorphic DNA and pulsed field gel electrophoresis. All Pseudomonas aeruginosa strains belonged to serotype O12 and they demonstrated a high level of resistance to all antibiotioc tested.

[Implementation of antimicrobial resistance surveillance and antibiotic consumption in an intensive care burn department].

Background: The increasing consumption of antibiotics in hospitals and the economic implications of this increase lead to survey this consumption in the various hospital units.

Aim: Our study proposes to measure the annual antibiotic use and antimicrobial resistance in an intensive care Burn department in order to manage the control measures.

Methods: The study was conducted during a 5 year period (1 January 2000 to 31 December 2004).

Self-protection as a driver for hand hygiene among healthcare workers.

A total of 2,725 healthcare workers in 8 Mediterranean countries replied to a self-assessment questionnaire that assessed their perceptions on hand hygiene. Responses revealed that rates of hand hygiene compliance before patient contact were significantly less than rates after patient contact (P < .001) and that use of soap and water was preferred over use of alcohol-based hand rub.