Search PubMedSearch

Biomedical subjects

C Fendri

Publications and source records attributed to C Fendri.

16 recordsLinked to original sources

[Staphylococcus aureus nosocomial infections in an intensive care milieu (1985-1989) in Tunis].

221 strains of Staphylococcus aureus oxacillin resistant (MetiR) caused nosocomial infections were isolated from 1985 to 1989 in a medical intensive care unit. The survey of susceptibility to antibiotics was established according to the computerized data of disk susceptibility test. The resistance phenotypes to beta-lactams, aminoglycosides and macrolides were established for epidemiological study. S. aureus infections were mainly bacteraemia (31%) and peritonitis (12%). These isolates were resistant to oxacillin with a high level (mean MIC 386 micrograms/ml). Their resistance phenotypes were MLSBc (constitutive resistance to macrolides, lincosamine and streptogramines B) in 53% and S + KGT (resistance to streptomycin, kanamycin, gentamicin and tobramycin) in 61%. All the isolates were susceptible to pristinamycin and vancomycin (MIC 0.1 and 2 micrograms/ml). These phenotypes related to the spread of multiply drug resistant strains were responsible of nosocomial outbreaks. Strains with the same pattern of resistance were isolated among the medical staff and in the environment. Infection control measures allowed to stop these outbreaks.

Cross Infection

Prevalence of virulence markers of enteric Campylobacter in France and Tunisia.

Forty-nine strains of Campylobacter jejuni and C. coli were isolated from the stools of 49 patients clinically documented for diarrhoea and fever, and living either in the Paris metropolitan area (30) or in the Tunis area (19). The strains were identified biotyped, serotyped and studied for association with HeLa cells and the ability to elongate Chinese ovary cells (CHO). The C. jejuni biotype I was more frequent among Tunisian strains and the C. jejuni biotype II was more frequent among French strains. Twenty-four strains associated with HeLa cells (A phenotype) and 21 elongated CHO (E phenotype). These 2 phenotypes were independently distributed in individual strains and were not related to the biotypes. We defined 4 pathovars according to the presence (A and E) or absence (a and e) of these 2 markers. The prevalence of the 4 pathovars was not correlated with the origin of the strain. The lack of a virulence marker (phenotype a/e) was correlated with the lack of clinical signs of diarrhoea and fever (p = 4 x 10(-5)). We concluded that at least 1 of the 2 in vitro virulence markers is related to the pathogenicity of the strains in the humans.

Campylobacter

Species incidence and antimicrobial-agent resistance patterns of Enterobacteriaceae in Charles Nicolle Hospital, Tunis, from 1983 to 1987.

Between July 1983 and December 1987, 13,108 strains of enterobacteriaceae were isolated at Charles Nicolle Hospital in Tunis. This study reports the prevalence of different species isolated, their resistance and the evolution of bacterial resistance during that period. There appeared to be a great stability in the distribution of bacterial groups. Among the commonly sensitive species, Proteus mirabilis showed a high proportion of strains resistant to ampicillin (79.3%), carbenicillin (75.9%), cefalotin (73.8%) and gentamicin (46%). The proportions of resistant strains in P. mirabilis were much the same for each successive year from 1983 to 1987, and the percentages of resistant strains in the majority of the bacterial species were similarly stable. Amikacin and cefotaxime remained the most active antibiotics against enterobacteriaceae.

Drug Resistance, Microbial

[Beta-lactam and aminoglycoside resistant phenotypes in enterobacteria isolated in pediatrics].

Beta-lactams and aminoglycosides are widely used in the therapy of serious Gram negative infections in pediatrics. In order to survey acquired resistance, the phenotype of resistance to beta-lactams and aminoglycosides were characterized for 260 strains of enterobacteriaceae among the mainly isolated species in pediatrics. These phenotypes were established according to the results of the disk susceptibility tests for beta-lactams respectively ampicillin, ticarcillin, cefaloridin and cefotaxim, and aminoglycosides, streptomycin (S), gentamicin (G), tobryamycin (T), amikacin (A), and netilmicin (N). 49% of E. coli and 73% of P. mirabilis strains were resistant to 3 beta-lactams (RRRS). 72% of Salmonella spp. strains were resistant to 4 beta-lactams (RRRR). For the majority of strains, the mainly observed resistance phenotype to aminoglycosides was streptomycin resistance excepted for Salmonella spp., which was S + KGTNA. The high level of acquired resistance to beta-lactams and aminoglycosides among Enterobacteriaceae with the selection of multiresistant strains would be explained by the wild use of cefotaxim and amikacin in pediatrics.

Aminoglycosides

[Enzymatic resistance to cefotaxime in 56 strains of Klebsiella spp., Escherichia coli and Salmonella spp. at a Tunisian hospital (1984-1988)].

The enzymatic and plasmid-encoded resistance towards oxyimino-beta-lactams has been recently reported as related to the production of an extended-spectrum beta-lactamase (e.g. SHV-2, CTX-1 or TEM-3), in particular in our hospital since 1984. The prevalence of that resistance has been examined from January 1984 to December 1988 in function of specimen, unit and type of enzyme among 8,421 isolates of Klebsiella spp., E. coli, Salmonella spp. Each isolate showing a diameter of inhibition zone size inferior or equal to 25 mm for cefotaxime, the double disk synergy test was performed between a disk of amoxicillin and a clavulanic acid disk of cefotaxime, ceftriaxone, ceftazidime and aztreonam. In case of synergy, sonicated extracts have been prepared and examined by isoelectrofocusing with the detection of beta-lactamase activity by ceftriaxone and nitrocefin. 56 isolates (K. pneumoniae, K. oxytoca, E. coli, S. wien, S. typhimurium scored positive including 27 in pediatrics, 18 in surgery, and 8 in medicine. 41% of isolates have been obtained from blood cultures and 26.8% from urines. A majority of isolates (49/56) produced the SHV-2 type, but other types mediating the resistance phenotype CTX have been individualized initially by their isoelectric points e.g. 5.4 (TEM-20 in K. pneumoniae in July 1986), 6.4 (TEM-21 in E. coli, 1 K. pneumoniae in July 1988). The prevalence of resistance to cefotaxime from 1984 to 1988 has increased (from 0.3 to 1.4%), the highest rate being observed in pediatrics (5.6% in 1984 and 22.1% in 1988).

Cefotaxime

[Frequency and characteristics of Campylobacter jejuni-coli diarrhea in Tunisia].

Because importance of Campylobacter jejuni/coli in human disease, we studied frequency, clinical and biological symptoms of Campylobacter enteritis. Investigation has been realised on 216 cases of diarrhoea seen outside the hospital and aged from 4 days to 60 years, and 512 cases of hospitalised diarrhoea. Outside the hospital, this bacteria has the same frequency as Shigella and Salmonella (3-5%). Inside the hospital, it is rare. Outside the hospital, this bacteria is isolated in babies and children. Inside the hospital, it affects children and adults. In the hospital, clinical and biological symptoms of Campylobacter enteritis are more serious: Campylobacter predominant in stools, presence of leukocytes for all patients, and no other pathogenic organisms associated.

Adolescent

[Pseudomonas aeruginosa and beta-lactam resistance phenotypes (Tunisia 1989-1990)].

366 strains of P. aeruginosa were studied. More than half of samples were issued from urology (40%) and general surgery (21%) and samples are mostly urine specimens (46%). The phenotypes of resistance to 3 beta-lactams (respectively ticarcillin, cefotaxime and ceftazidime) showed that 73% of the strains were wild phenotype (SSS-SIS-SRS). The MIC of ticarcillin +/- clavulanic acid, azlocillin, cefoperazone, cefsulodin, cefotaxime and ceftazidime against 93 strains chosen among different phenotypes of resistance showed that ceftazidime is the most active beta-lactam, 93% of strains being inhibited by 16 micrograms/ml. These MIC and iodometric test performed on 33 strains with ticarcillin MIC > 128 mg/l showed that acquired resistance was non enzymatic in 21% of cases and was related to beta-lactamase production in 79% of cases.

Cefotaxime

[Staphylococcus aureus in the hospital milieu].

This study concern the distribution and sensibility towards some antibiotics of 318 Staphylococcus aureus strains isolated in bacteriological samples coming from la Rabta hospital units. The study of distribution shows that 75% of these strains are isolated in bacteriological samples coming from surgery and intensive care unit dermatology unit, and ear nose and throat unit. The bacteriological samples are matter, blood, and intensive care materials. The study of sensibility found a high frequency of methicillin resistant Staphylococcus aureus. These strains are also resistant towards macrolide and lincosamide. MLSB resistance is the predominant phenotypic aspect. It was also observed that all of Staphylococcus aureus gentamicin resistant strains were also resistant toward methicillin. At last is seems that pritinamicin, sulfamethoxazole-trimethoprim, and ofloxacin, are good alternatives for treatment of staphylococcus aureus infections diseases.

Anti-Bacterial Agents

[Non-groupable streptococci: identification, sensitivity to antibiotics (Charles Nicolle Hospital in Tunis)].

50 strains of viridans streptococci isolated from human material are identified by biochemical tests (bile esculin, Cl Na 6,5%, acid production from lactose, mannitol, sorbitol, inulin, arginine, esculin and starch hydrolysis; production of levan and dextran in sucrose media) Streptococcus salivarius and Streptococcus mitis are predominant species. Susceptibility to antibiotics was studied: 70% of viridans streptococci were susceptible to all antibiotics tested, high level resistance to aminoglycoside was not present. The only resistance observed were to tetracycline, macrolides and related drugs.

Aminoglycosides

[Group D streptococci and enterococci: identification, sensitivity to antibiotics and a study of the high level resistance to aminosides (Charles Nicolle Hospital in Tunis)].

197 strains of enterococcus and group D Streptococcus were isolated from human material at Charles Nicolle Hospital (Tunis) and identified by biochemical tests: 174, Enterococcus faecalis, 6 Enterococcus faecium, 2 Enterococcus durans and 15 Streptococcus bovis. The sensitivity to antibiotics was studied: all Enterococcus faecium were resistant at least to one antibiotic, 15% of Enterococcus faecalis were sensitive for all antibiotics tested the other species were frequently sensitive. High level resistance to aminoglycosides were frequent in Enterococcus faecalis 40%: among these strains high level resistance to gentamicin accounts for 12% and 18 frequently associated with resistance to kanamycin and streptomycin, this situation present therapeutic problems in case of severe infection.

Aminoglycosides