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.

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.

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.

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.

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.

[Bacteriological profile and antibiotic resistance of bacteria isolates in a burn department].

Background: Nosocomial infections remain the main cause of morbidity and mortality in burn patients. Ongoing surveillance of infections in burned patients is essential to detect changes in epidemiology and to guide better empirical antibiotherapy and infection control policies. The aim of this study is to analyze the bacterial flora and the antibiotic resistance of isolates in a burn department during a two year period

Methods: From 1 January 2005 to 31 December 2006, 1268 strains were isolated from different specimens.

[Surveillance of multidrug resistant bacteria in a Tunisian hospital].

Background: Controlling antibiotic resistance of bacteria is a priority for public healthcare.

Aim: This study concerned the frequency of multidrug resistant bacteria (MDRB) in a Tunisian Hospital with the aim of establishing guidelines for MDRB prevention.

Methods: The study was conducted during two years (1 January 2005-31 December 2006).

[Evolution of 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-medication with antibiotics in the ambulatory care setting within the Euro-Mediterranean region; results from the ARMed project.

Anecdotal data from the southern and eastern Mediterranean region suggests that self-medication with antibiotics is commonly practiced in many countries. In order to provide proper information on the situation, we undertook short structured interviews in out-patients clinics or primary health centres in Cyprus, Egypt, Jordan, Lebanon, Libya, Tunisia and Turkey. A total of 2109 interviews were undertaken of which 1705 completed the full questionnaire.

Association between antibiotic use and changes in susceptibility patterns of Pseudomonas aeruginosa in an intensive care burn unit: a 5-year study, 2000-2004.

This study aimed to evaluate the relationship between antimicrobial resistance in Pseudomonas aeruginosa and annual antibiotic use in a burn unit. From 1 January 2000 to 31 December 2004, 203 non-repetitive strains of Ps. aeruginosa were recovered from various clinical specimens.

[Epidemiological profile and antibiotic susceptibility of Pseudomonas aeruginosa isolates within the burned patient hospitalized in the intensive care burn unit].

Background: Pseudomonas aeruginosa plays a predominant role as an etiological agent involved in serious infections in burned patients. Treatment of these infections is frequently complicated by antibiotic resistance, a problem that is is increasing in recent years.

Aim: The objective of this study is to analyze epidemiological profile and antibiotic susceptibility of P.

Determining the source of nosocomial transmission in hemodialysis units in Tunisia by sequencing NS5B and E2 sequences of HCV.

Hepatitis C virus infection is a significant problem in hemodialysis units. HCV is very variable genetically with six genotypes. Clinical and epidemiological investigation of a new infection requires the determination of both the genotype and the strain of the HCV involved.

[Analysis of antibiotics as a curative measure in four hospital units].

In order to analyse the methods of curative prescription of antibiotics in four units of hospitalization of the hospital Charles Nicolle of Tunis, a descriptive study of prescriptions was carried out during the first five months of year 2001. On the whole, 165 prescriptions delivered to patients were included in the study. The average age of the patients was 44 years, the sex ratio of 1.

[Detection of DNA human cytomegalovirus of a molecular methods: hybrid capture DNA CMV by immunocompromised].

Human cytomegalovirus (HCMV), a member of the beta-virus herpes family, is a ubiquitous human pathogen. After a primary infection, HCMV establishes life latency. HCMV rarely causes symptomatic disease in an immunocompetent host, however, it is a major cause of infectious morbidity and mortality in immunocompromised individuals and developing fetuses.