RESUMO
BACKGROUND: The spread of MRSA strains at hospitals as well as in the community are of great concern worldwide. We characterized the MRSA clones isolated at Tunisian hospitals and in the community by comparing them to those isolated in other countries. RESULTS: We characterized 69 MRSA strains isolated from two Tunisian university hospitals between the years 2004-2008. Twenty-two of 28 (79%) community-associated MRSA (CA-MRSA) strains and 21 of 41 (51%) healthcare-associated MRSA (HA-MRSA) strains were PVL-positive. The PVL-positive strains belonged to predicted founder group (FG) 80 in MLST and carried either type IVc SCCmec or nontypeable SCCmec that harbours the class B mec gene complex. In contrast, very diverse clones were identified in PVL-negative strains: three FGs (5, 15, and 22) for HA-MRSA strains and four FGs (5, 15, 45, and 80) for CA-MRSA strains; and these strains carried the SCCmec element of either type I, III, IVc or was nontypeable. The nucleotide sequencing of phi7401PVL lysogenized in a CA-MRSA strain JCSC7401, revealed that the phage was highly homologous to phiSA2mw, with nucleotide identities of more than 95%. Furthermore, all PVL positive strains were found to carry the same PVL phage, since these strains were positive in two PCR studies, identifying gene linkage between lukS and mtp (major tail protein) and the lysogeny region, both of which are in common with phi7401PVL and phiSa2mw. CONCLUSIONS: Our experiments suggest that FG80 S. aureus strains have changed to be more virulent by acquiring phi7401PVL, and to be resistant to ß-lactams by acquiring SCCmec elements. These novel clones might have disseminated in the Tunisian community as well as at the Tunisian hospitals by taking over existing MRSA clones.
Assuntos
Toxinas Bacterianas/genética , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Exotoxinas/genética , Leucocidinas/genética , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecção Hospitalar/epidemiologia , DNA Bacteriano/química , DNA Bacteriano/genética , Genótipo , Hospitais Universitários , Humanos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Epidemiologia Molecular , Dados de Sequência Molecular , Tipagem de Sequências Multilocus , Prófagos/genética , Homologia de Sequência do Ácido Nucleico , Infecções Estafilocócicas/epidemiologia , Tunísia/epidemiologia , Virulência , Fatores de Virulência/genética , Resistência beta-LactâmicaRESUMO
The prevalence of plasmid-mediated quinolone resistance (PMQR) determinants was investigated in a Tunisian collection of 300 uropathogenic Escherichia coli. PMQR genes were detected in 68 isolates (22.7%) as follows: aac(6')-Ib-cr (n=66), qnrB1 (n=3), qnrA6 (n=1), and qnrS1 (n=1). Three isolates carried the 2 determinants aac(6')-Ib-cr and qnrB1. aac(6')-Ib-cr was usually carried on IncF-type plasmids (n=47/60) and frequently associated with blaCTX-M-15 (n=60). Substitutions in gyrA and parC genes were detected in 57.5% of strains. A major cluster including 29 isolates was individualized, 28 of them belonged to the virulent ST131 clone. In our hospital, the high prevalence of PMQR in E. coli isolates was due to horizontal transfer but also to the spread of ST131 clone.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/epidemiologia , Quinolonas/farmacologia , Escherichia coli Uropatogênica/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Análise por Conglomerados , Infecções por Escherichia coli/microbiologia , Feminino , Genes Bacterianos , Hospitais Universitários , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Plasmídeos/análise , Prevalência , Tunísia/epidemiologia , Escherichia coli Uropatogênica/classificação , Escherichia coli Uropatogênica/genética , Escherichia coli Uropatogênica/isolamento & purificação , Fatores de Virulência/genética , Adulto JovemRESUMO
Introduction: Identifying the infecting bacterial flora is one of the main rules to be followed to ensure the success of antibiotherapy in the treatment of the infected diabetic foot
The aim of the work was to define the bacteriological profile of the bacteria causing the infection of the diabetic foot at the surgery unit B of Charles Nicolle's hospital in Tunis and determine the prognostic factors of this condition
Methods: It was an open prospective study. It concerned 100 diabetic patients operated on for diabetic foot infection. All patients had bacteriological samples taken through deep scraping and swabing carried out in the operating room
Results: The average age of patients was 59,5 +/- 11 years, with a sex-ratio of 2,4. The foot infection was represented in 82 % of cases by a wet gangrene. The enterobacteria were the most frequently isolated bacteria [73%], followed by streptococcus [10%], Staphylococcus aureus [9%]. The rate of multidrug-resistant bacteria was of 9,5%. The empiric antibiotic therapy used [fusidic acid +amoxicillin/ clavulanic acid] was inactiveon 44,1% of the isolated bacteria. When we compared the group of patients with unfavourable development [who have been reoperated] and the group of patients with favourable development, we have found two poor prognosis factors: arteritis [p=0,018 ; OR=23,7] and presence of multidrug-resistant bacteria [p=0,027 ; OR=5,8]
Conclusion: The enterobacteria were the main bacteria causing the infection of diabetic foot. The prognostic factors found, arteritis and isolation of multidrug-resistant bacteria, outpoint the importance of multidisciplinary care
RESUMO
Methicillin-resistant Staphylococcus aureus [MRSA] has become an increasingly important pathogen leading to hospital acquired infections. This study was done to confirm an outbreak of MRSA suspected at Charles Nicolle Hospital. 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. An investigation of the outbreak has been detected a nasal carriage nurse. This carrier received topical mupirocin treatment to decolonize the anterior nares and the outbreak was stopped without further incident. Typing of the MRSA strains by pulsed field gel electrophoresis demonstrated the same pulsotype shared by all isolates showing that MRSA isolates belonged to a single clonal type responsible of outbreak. Colonized nurse was the source of MRSA dissemination. This report illustrates the risk of nosocomial outbreak linked to cares delivered by the staff personnel. More sensibilisation and the respect of strict hygienic measures should be emphasized
Assuntos
Humanos , Infecções Estafilocócicas/tratamento farmacológico , Surtos de Doenças , Hospitais , Pessoal de Saúde , Portador Sadio , Nariz , Eletroforese em Gel de Campo PulsadoRESUMO
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. 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. He was treated by osteosynthesis and received an antibioprophylactic therapy with amoxicilline-clavulanate and gentamicin association. No postoperative incident was noted. When he was readmitted a month later for the osteosynthesis material removal, clinical examination found a pus collection in the operated elbow. Specimen analysis showed a Gram positive stained bacilli identified as C.propinquum. The organism was resistant only to penicillin G and sulfamethoxazole-trimethoprim association. The patient was treated with ofloxacin [2g per day for 8 days] and gentamicin [160mg per day for 5 days] with clinical improvement. According to literature, infections due to C.propinquum are rare, occurring especially in patients with medical device or immunocompromised. Thus, this pathogen should be taken in consideration in such situations
Assuntos
Humanos , Masculino , Cotovelo/lesões , Supuração , Fixação Interna de Fraturas/efeitos adversosRESUMO
Investment in Africa over the past year with regards to SARS-CoV-2 genotyping has led to a massive increase in the number of sequences, exceeding 100,000 genomes generated to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence within their own borders, coupled with a decrease in sequencing turnaround time. Findings from this genomic surveillance underscores the heterogeneous nature of the pandemic but we observe repeated dissemination of SARS-CoV-2 variants within the continent. Sustained investment for genomic surveillance in Africa is needed as the virus continues to evolve, particularly in the low vaccination landscape. These investments are very crucial for preparedness and response for future pathogen outbreaks. One-Sentence SummaryExpanding Africa SARS-CoV-2 sequencing capacity in a fast evolving pandemic.