Characterization of invasive Neisseria meningitidis strains isolated at the Children's Hospital of Tunis, Tunisia

Neisseria meningitidis, a leading cause of bacterial meningitis and other serious infections, is responsible for approximately one-third of cases of bacterial meningitis in the Children's Hospital of Tunis. The serogroup distribution, antibiotic susceptibility and antigenic and molecular characteristics of N. meningitidis isolates were determined in patients aged 3 days-13 years between February 1998 and June 2013. In all 107 invasive strains of N. meningitidis were isolated. Reduced susceptibility to penicillin G was seen in 55.7% of isolates, with a low level of resistance in all cases; 28.4% showed a low level of resistance to amoxicillin. Serogroup B isolates were the most frequent [80.4%], followed by serogroups C [12.2%] and A [5.6%]. Isolates of serogroup A had the same antigenic formula [A:4:P1.9], the same variable regions VR1, VR2 and VR3, and belonged to the same clonal complex [CC5]. Isolates of serogroups B and C were more heterogeneous with several antigenic formulae. The most frequent clonal complex in these isolates was CC35. Serogroup B accounted for a large percentage of our isolates with marked diversity

[Invasive infections neisseria meningitidis in children in Tunis: about 79 cases]

We conducted a retrospective study of meningococcal invasive diseases [MID] contracted in children in Tunis between January 1997 and January 2006. The purpose of this study is to specify the clinical, epidemiological, therapeutic and evolutionary features of these infections and to determine antimicrobial susceptibility and the antigenic formula of N. meningitidis isolates. During the study period, we have collected 79 cases of MID arising in children aged 3 days to 11 years. The majority of children's were less than of 4 years [57.3%]. We note a frequency of the MID in winter and in spring. The most frequent clinical shape was meningitis [53%]. Twenty one patients [26.6%] had a fulminant meningococcal disease. In our series, the rate of lethality was equal to 17.7%. Among the 46 meningococcal isolates, the most frequent serogroup was the B [73%] followed by C and A. A high heterogeneousness of the antigenic formulae was observed. The most frequent phenotype was NT: NST for the group B isolates and 4:P1.13 for the group C ones. N. meningitidis with reduced susceptibility to penicillin and to amoxicillin account for 54% and 10% of all isolates respectively. The cefotaxim and the rifampin were uniformly active

[Study of the sensitivity to antibiotics and genes for macrolide resistance to streptococcus pneumoniae isolated in a pediatric tunisian setting]

Streptococcus pneumoniae is often incriminated in invasive and non invasive severe infections. Therapeutic choice becomes difficult these last years because of the spread of resistant strains worldwide, particularly pneumococci non susceptible to penicillin [PNSP]. The aim of our study was to determine the epidemiological characteristics of S. pneumoniae strains isolated in children, the antimicrobial susceptibility and the genes involved in macrolide resistance. We studied 422 none duplicated S. pneumoniae strains isolated from 2000 to 2008 in our laboratory. Invasive strains were essentially isolated from cerebrospinal fluid [50.2%] and blood culture [34.4%], whereas the majority of non invasive ones were isolated from pulmonary samples [76.5%]. Two hundred and twenty five isolates [53.3%] were with reduced susceptibility to penicillin, 12.8% of them had a high level of resistance. For the other beta-lactams, 29.6% and 15.1% of strains were with reduced susceptibility to amoxicillin and cefotaxim respectively. Erythromycin and lincomycin resistance concerned 66.6% and 59.6% respectively. Among the 66 strains studied by PCR 62 harbored ermB gene, 3 harbored mefA gene and one strain harbored both of them. PNSP strains were much more resistant to the different tested antibiotics than strains susceptible to penicillin. This fact complicates therapeutic choices and justifies the need of resorting to effective anti-pneumococcal vaccine to prevent pneumococci infections

[Neonatal infection and streptococcus pneumonae meningitis]

Streprococccus pneumoniae is a major cause of morbidity and mortality in childhood infectious disease; however, it is unusual in the neonatal infection. We report the case of a newborn, admitted in our department to manage respiratory distress. One the clinical examination, he presented hypothermia, polypnea and hypotonia. The blood and cerebrospinal fluid cultures were positive for Streptococcus pneumoniae. Brain imaging showed a hydrocephalus. He received cefotaxim and vancomycin for 56 days

[Pleural effusion with pneumonia caused by Neisseria meningitidis C: a case report]

Pleural effusion with pneumonia is an uncommon manifestation of Neisseria meningitidis infection. We report the case of a 3-year-old child who presented a one week fever and abdominal pain. Chest X ray showed pleural effusion with lung condensation. The outcome was favourable with antibiotics