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Biomedical subjects

A Hammami

Publications and source records attributed to A Hammami.

At least 37 records · Page 2Linked to original sources

[Streptococcus pneumoniae of lesser sensitivity to penicillin in the Sfax region, Tunisia (1994-1995)].

In the last fifteen years, the frequency of Streptococcus pneumoniae resistance to penicillin has been regularly increasing with various degrees in different geographical zones. In order to determine the epidemiological situation in our region, we studied penicillin G susceptibility of S. pneumoniae strains isolated in our laboratory for 2 years 1994 and 1995. The S. pneumoniae strains with reduced susceptibility to penicillin G (PSDP) were detected by oxacillin screen test (using 1 microgram oxacillin disk) and completed with the determination of penicillin G MIC. We isolated 107 S. pneumoniae strains (41 in 1994 and 66 in 1995); 12 of them had reduced susceptibility to penicillin (11.2%). The study showed a difference in the percentage of penicillin susceptibility between invasive (5.1%) and non invasive strains (28.6%). The rate of strains with reduced susceptibility to penicillin increased from 7.3% in 1994 to 13.6% in 1995 with a higher degree of resistance in 1995. We concluded that our region is not spared from the problem of the decreased susceptibility to penicillin G of S. pneumoniae. These results should prompt us to survey the evolution of such resistance.

Humans↗

[Clinical, therapeutic and developmental aspects of acute bronchiolitis in Tunisia].

Fourteen infants with severe acute bronchiolitis were admitted to the Intensive Care Unit (ICU) of Tunis. This pathology represents 36% of severe bronchopulmonary infections admitted to this ICU. Their age ranged between 2 and 48 weeks (mean: 15 weeks). Eight infants had hypotrophy. Two infants had congenital heart disease and one infant had tracheo-bronchomalacia. Viruses were found in 6/11 patients. Respiratory syncytial virus (RSV) was identified in five patients and an adenovirus in one patient. Five patients had respiratory arrest at ICU admission. Ten infants had evidence of atelectasis on chest X-ray films. Thirteen patients required mechanical ventilation. One infant had inappropriate antidiuretic hormone secretion resulting in convulsions. One infant had supraventricular tachycardia. Both had RSV infection. One patient who had congenital heart disease and RSV infection died. In the other 12 patients receiving mechanical ventilation, the mean duration of ventilation was 9 days (range: 2-30 days). The second patient who had congenital heart disease and RSV infection had severe respiratory sequelae at discharge.

Bronchiolitis, Viral↗

[Viral hepatitis C in chronic hemodialyzed patients in southern Tunisia. Prevalence and risk factors].

To define, the prevalence and risk factors of hepatitis C virus (HCV) a prospective and multicentre study was performed in 235 patients undergoing haemodialysis, the anti-HCV antibodies were evaluated using an immuno-enzymatic method (wellcozyme anti-HCV). The following parameters were obtained for all patients: time on haemodialysis, blood transfusion, liver enzymes (ALT, AST), others virus markers: HBV (HBs Ag, HBs Ab, HBc Ab) and HIV. Anti-HCV was positive in 86 patients (42%). There was a significant (p < 0.05) relationship between presence of anti-HCV antibodies and duration of haemodialysis (33 +/- 24 vs 20 +/- 19 months). No statistically significant difference was found with blood transfusion and the others parameters. In conclusion, the prevalence of HCV in our center of dialysis was high. The duration of dialysis seems to be the main risk factor.

Cross Infection↗

[In vitro study of the sensitivity to antibiotics of 213 Pseudomonas aeruginosa strains isolated in an intensive care unit of the Sfax Hospital (Tunisia)].

Susceptibility of 213 strains of Pseudomonas aeruginosa isolated in a general intensive care unit during two years 1989 and 1990 was tested against 11 antibiotics: ticarcillin (TIC), ticarcillin+clavulanic acid (TCC), cefsulodin (CFS), ceftazidime (CAZ), imipenem (IMP), gentamicin (G), tobramycin (TOB), amikacin (AN), ofloxacin (OFX), norfloxacin (NOR) and ciprofloxacin (CIP). Antibiotic susceptibility testing was performed by disk agar diffusion test and by measuring minimum inhibitory concentrations (MICS using test agar dilution. 65% of strains were isolated from respiratory tract infections. Resistance frequency of this antibiotics was: TIC: 41.3%, TCC: 33.8%, CFS: 26.5%, CAZ: 23.2%, IMP: 11.6%, G: 72.5%, TOB: 46.5%, AN: 12.6%, OFX: 29.3%, NOR: 21.3%, CIP: 17.6%. We observed by measuring CMI that imipenem and amikacin were the most active antibiotics. From 1989 et 1990, the increase number of strains resistant to imipenem, amikacin and fluoroquinolones could be explained by massive use of those antibiotics. Besides their high level of resistance, strains isolated in intensive care unit ere characterized by their multiresistance: 24 strains were resistant to 8 of 11 antibiotics tested; four of them showed resistance to all antibiotics the multiresistance of those strains suggest strongly that decreased permeability could be the cause.

Aminoglycosides↗

[Encrusted pyelo-ureteritis].

The authors report a case of right encrusted pyelo-ureteritis with no other sites, either in the bladder or on the other side. They discuss possible theories of pathogenesis of the encrusted plaques, and question how far corynebacterium, group D2, could be concerned in the genesis of such lesions.

Adult↗

[Skull fracture with progressive separation. Apropos of a case].

A case of fracture of the skull with progressive separation of the fracture line in a seven-month-old is reported. The patient presented with a swelling in the right parieto-occipital area and paresis of the upper left limb; there was no clear history of trauma. The roentgenogram of the skull disclosed a large bone defect and the cerebral CT scan showed herniation of intracranial contents through this defect, confirming the diagnosis of fracture of the skull with progressive separation. In this form of skull fracture, the fracture line separates gradually and herniation of intracranial contents through the opening occurs. Clinical and roentgenographic monitoring should be routinely performed in children under three years with a skull fracture and separation of the fracture line, to detect a delayed complication. The mechanisms of this fracture are discussed in the light of data from the literature.

Humans↗

Nosocomial outbreak of acute gastroenteritis in a neonatal intensive care unit in Tunisia caused by multiply drug resistant Salmonella wien producing SHV-2 beta-lactamase.

In a Tunisian hospital 27 babies, including 12 who were premature, in a single intensive care unit suffered acute gastroenteritis in the period from January to May 1988. The mean age at the onset of gastroenteritis was 8.4 days; nine babies died. Salmonella wien was isolated from stools (all babies) and blood (4 babies). It was also isolated from the stools of one nurse and from a mattress. Twelve of the babies had received cefotaxime, which was successfully replaced by oral colimycin. The outbreak was stopped by the implementation of infection control measures. All isolates of Salmonella wien were of the same biotype, and had the same antibiotic resistance pattern (third generation cephalosporins, monobactams, aminoglycosides, chloramphenicol, trimethoprim and sulphonamides) and plasmid DNA restriction pattern. The isolates were all susceptible to a combination of cefotaxime and clavulanic acid (a beta-lactamase inhibitor), which displayed synergy, suggesting the presence of a beta-lactamase (geometric mean MICs 11.24 micrograms/ml for cefotaxime alone and 0.24 micrograms/ml in combination with 0.1 micrograms/ml potassium clavulanate). All isolates produced TEM-1 and SHV-2 beta-lactamase which was not transferable to Escherichia coli by conjugation. The presence of the SHV-2 enzyme in Salmonella wien may allow it to adapt to newer beta-lactams which is a cause for concern in this hospital.

Acute Disease↗

[Congenital sensory neuropathy with anhidrosis: type IV. Apropos of 2 new cases].

Two new cases of congenital sensory neuropathy (CSN) type IV in brothers aged 10 and 5 years are reported. Features included diffuse lack of response to pain without loss of response to touch, temperature and proprioceptive stimuli. No other neurologic anomalies were found. Both patients had complete anhidrosis. Joint destruction, which was the result of the failure to react to painful stimuli, was the most prominent feature. Nerve biopsy specimens exhibited marked reductions in numbers of amyelinic fibers with normal numbers of myelinic fibers. These two cases of CSN type IV are discussed in the light of previously reported cases and the new classification of congenital sensory neuropathies is reviewed.

Arthritis↗

Mature B-cell acute leukemia: a clinical, morphological, immunological, and cytogenetic study of nine cases.

Nine patients who presented with acute lymphoid leukemia of mature B-cell phenotype without FAB-L3 morphology are discussed. All patients were male with a median age of 69 years. All patients had extensive bone marrow involvement at presentation with lymphoid leukemic cells in the peripheral blood. Six patients had extramedullary disease and 3 developed meningeal involvement sometime during the course of their illness. The leukemic cells were negative for terminal deoxynucleotidyl transferase in all 9 cases, and monoclonal surface immunoglobulin was demonstrated in all 8 cases evaluated with a lambda light chain predominance. Clonal chromosomal abnormalities were detected in 4 of 6 cases studied with no specific pattern identified, although abnormalities involving chromosome 8 were present in all 4 cases. Despite aggressive chemotherapy, only 2 patients achieved complete remission which was of short duration (1 month) in 1 patient. Eight patients died of their disease 1 week to 20 months after diagnosis with a median survival of 5.5 months. Mature B-cell acute leukemias that are not of the FAB-L3 type have a very aggressive clinical course and poor prognosis.

Adult↗

[Brucella endocarditis on Starr aortic valve prosthesis].

The authors report the case of a 22 year old patient with brucella endocarditis on a Starr-Edwards aortic valve prosthesis implanted 5 years previously. Six blood cultures were positive for Brucella melitensis biovar I. Antibiotic therapy associating Rifampicin and Tetracycline and then Rifampicin and Ofloxacine did not prevent abscess formation and valve dehiscence. The poor haemodynamic status and persistent infection led to replacement of the valve prosthesis. Culture of the infected prosthesis grew a colony of brucella melitensis resistant to fluoro-quinolones. Valve replacement and antibiotic therapy led to clinical improvement and constant apyrexia with a 12 month follow-up. Brucella endocarditis on a valve prosthesis is a very rare occurrence. The combination of valve replacement and antibiotic therapy is usually required.

Adult↗

Non-Hodgkin's lymphoma presenting as a rectal polyp in a child.

Primary lymphoma of the rectum is extremely rare in children. We report here a 10-year-old boy with localized non-Hodgkin's lymphoma, discovered within a rectal polyp. The literature on childhood rectal lymphomas is reviewed. This case illustrates the importance of considering the possibility of malignancy with rectal polyps, even in children.

Child↗