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Ben Ayed N, Ktari S, Jdidi J, Gargouri O, Smaoui F, Hachicha H, Ksibi B, Mezghani S, Mnif B, Mahjoubi F, Hammami A. Nasopharyngeal Carriage of Streptococcus pneumoniae in Tunisian Healthy under-Five Children during a Three-Year Survey Period (2020 to 2022). Vaccines (Basel) 2024; 12:393. [PMID: 38675775 PMCID: PMC11054273 DOI: 10.3390/vaccines12040393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
We aimed to assess the prevalence of nasopharyngeal pneumococcal carriage and to determine serotype distribution, antibiotic susceptibility patterns, and evolutionary dynamics of Streptococcus pneumoniae isolates in healthy under-five children. Nasopharyngeal swabs were collected from healthy children over three survey periods between 2020 and 2022. All pneumococcal isolates were serotyped and tested for antimicrobial susceptibility. A total of 309 S. pneumoniae isolates were collected, with an overall prevalence of nasopharyngeal pneumococcal carriage of 24.4% (CI95%: [22-26.8%]). These isolates were classified into 25 different serotypes. The most common serotypes were 14 (14.9%), 19F (12%), 6B (10.4%), and 23F (7.4%), which are covered by the PCV10 vaccine, as well as 19A (8.4%) and 6A (7.8%), which are covered by the PCV13 vaccine. A significant decrease in the proportion of serotype 19F (p = 0.001) and an increase in serotypes 19A (p = 0.034) and 6A (p = 0.029) were observed between the three survey periods. Multidrug resistance (MDR) was noted for 56.6% of the isolates. A significant association with antimicrobial resistance was observed for the most frequent serotypes, mainly serotype 19A. In conclusion, one-quarter of healthy under-five children in Tunisia carried S. pneumoniae in their nasopharynx. A dominance of vaccine serotypes significantly associated with antimicrobial resistance was recorded.
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Affiliation(s)
- Nourelhouda Ben Ayed
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Sonia Ktari
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Jihen Jdidi
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax 3029, Tunisia
| | - Omar Gargouri
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Fahmi Smaoui
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
| | - Haifa Hachicha
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Boutheina Ksibi
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Sonda Mezghani
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Basma Mnif
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Faouzia Mahjoubi
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
| | - Adnene Hammami
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease LR03SP03, Habib Bourguiba University Hospital, University of Sfax, Sfax 3029, Tunisia; (S.K.); (O.G.); (F.S.); (H.H.); (B.K.); (S.M.); (B.M.); (F.M.); (A.H.)
- Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia;
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Toumi A, Ben Brahim H, Berriche A, Hachfi W, Marrakchi C, Ammari L, Ben Lasfar N, Koubaa M, Aoun K, Neji S, Ben Abdallah R, Bouchekoua M, Mhalla S, Naïja H, Gargouri S, Hannachi N, Thabet L, Mnif B, Achour W, Marzouk M, Boutiba I, Chippaux JP. [32nd National STPI Congress 2nd French-speaking Congress of Infectious Pathology and Clinical Microbiology 5 to 7 May 2023, Hammamet, Tunisia]. Med Trop Sante Int 2023; 3:mtsi.v3i4.2023.432. [PMID: 38390017 PMCID: PMC10879895 DOI: 10.48327/mtsi.v3i4.2023.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/08/2023] [Indexed: 02/24/2024]
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Louati K, Maalej A, Kolsi F, Kallel R, Gdoura Y, Borni M, Hakim LS, Zribi R, Choura S, Sayadi S, Chamkha M, Mnif B, Khemakhem Z, Boudawara TS, Boudawara MZ, Safta F. Shotgun Proteomic-Based Approach with a Q-Exactive Hybrid Quadrupole-Orbitrap High-Resolution Mass Spectrometer for Protein Adductomics on a 3D Human Brain Tumor Neurospheroid Culture Model: The Identification of Adduct Formation in Calmodulin-Dependent Protein Kinase-2 and Annexin-A1 Induced by Pesticide Mixture. J Proteome Res 2023; 22:3811-3832. [PMID: 37906427 PMCID: PMC10696604 DOI: 10.1021/acs.jproteome.3c00484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/27/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
Pesticides are increasingly used in combinations in crop protection, resulting in enhanced toxicities for various organisms. Although protein adductomics is challenging, it remains a powerful bioanalytical tool to check environmental exposure and characterize xenobiotic adducts as putative toxicity biomarkers with high accuracy, facilitated by recent advances in proteomic methodologies and a mass spectrometry high-throughput technique. The present study aims to predict the potential neurotoxicity effect of imidacloprid and λ-cyhalothrin insecticides on human neural cells. Our protocol consisted first of 3D in vitro developing neurospheroids derived from human brain tumors and then treatment by pesticide mixture. Furthermore, we adopted a bottom-up proteomic-based approach using nanoflow ultraperformance liquid chromatography coupled with a high-resolution mass spectrometer for protein-adduct analysis with prediction of altered sites. Two proteins were selected, namely, calcium-calmodulin-dependent protein kinase-II (CaMK2) and annexin-A1 (ANXA1), as key targets endowed with primordial roles. De novo sequencing revealed several adduct formations in the active site of 82-ANXA1 and 228-CaMK2 as a result of neurotoxicity, predicted by the added mass shifts for the structure of electrophilic precursors. To the best of our knowledge, our study is the first to adopt a proteomic-based approach to investigate in depth pesticide molecular interactions and their potential to adduct proteins which play a crucial role in the neurotoxicity mechanism.
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Affiliation(s)
- Kaouthar Louati
- Faculty
of Pharmacy, Laboratory of Pharmacology, Analytics & Galenic Drug
Development-LR12ES09, University of Monastir, Road Avicenne, Monastir 5000, Tunisia
| | - Amina Maalej
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, Sfax 3018, Tunisia
| | - Fatma Kolsi
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Rim Kallel
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Yassine Gdoura
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Mahdi Borni
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Leila Sellami Hakim
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
| | - Rania Zribi
- Higher
Institute of Applied Studies to Humanities of Tunis (ISEAHT), University of Tunis, 11 Road of Jebel Lakdhar, Tunis 1005, Tunisia
| | - Sirine Choura
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, Sfax 3018, Tunisia
| | - Sami Sayadi
- Biotechnology
Program, Center for Sustainable Development, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
| | - Mohamed Chamkha
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, Sfax 3018, Tunisia
| | - Basma Mnif
- Department
of Bacteriology, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Zouheir Khemakhem
- Legal Medicine
Department, Habib Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Tahya Sellami Boudawara
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Mohamed Zaher Boudawara
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, Sfax 3089, Tunisia
- Faculty
of Medicine, Avenue of Majida Boulila, University
of sfax, Sfax 3029, Tunisia
| | - Fathi Safta
- Faculty
of Pharmacy, Laboratory of Pharmacology, Analytics & Galenic Drug
Development-LR12ES09, University of Monastir, Road Avicenne, Monastir 5000, Tunisia
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Louati K, Maalej A, Kolsi F, Kallel R, Gdoura Y, Borni M, Hakim LS, Zribi R, Choura S, Sayadi S, Chamkha M, Mnif B, Khemakhem Z, Boudawara TS, Boudawara MZ, Safta F. Differential Proteome Profiling Analysis under Pesticide Stress by the Use of a Nano-UHPLC-MS/MS Untargeted Proteomic-Based Approach on a 3D-Developed Neurospheroid Model: Identification of Protein Interactions, Prognostic Biomarkers, and Potential Therapeutic Targets in Human IDH Mutant High-Grade Gliomas. J Proteome Res 2023; 22:3534-3558. [PMID: 37651309 PMCID: PMC10629271 DOI: 10.1021/acs.jproteome.3c00395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Indexed: 09/02/2023]
Abstract
High-grade gliomas represent the most common group of infiltrative primary brain tumors in adults associated with high invasiveness, agressivity, and resistance to therapy, which highlights the need to develop potent drugs with novel mechanisms of action. The aim of this study is to reveal changes in proteome profiles under stressful conditions to identify prognostic biomarkers and altered apoptogenic pathways involved in the anticancer action of human isocitrate dehydrogenase (IDH) mutant high-grade gliomas. Our protocol consists first of a 3D in vitro developing neurospheroid model and then treatment by a pesticide mixture at relevant concentrations. Furthermore, we adopted an untargeted proteomic-based approach with high-resolution mass spectrometry for a comparative analysis of the differentially expressed proteins between treated and nontreated spheroids. Our analysis revealed that the majority of altered proteins were key members in glioma pathogenesis, implicated in the cellular metabolism, biological regulation, binding, and catalytic and structural activity and linked to many cascading regulatory pathways. Our finding revealed that grade-IV astrocytomas promote the downstream of the mitogen-activated-protein-kinases/extracellular-signal-regulated kinase (MAPK1/ERK2) pathway involving massive calcium influx. The gonadotrophin-releasing-hormone signaling enhances MAKP activity and may serve as a negative feedback compensating regulator. Thus, our study can pave the way for effective new therapeutic and diagnostic strategies to improve the overall survival.
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Affiliation(s)
- Kaouthar Louati
- Laboratory
of Pharmacology, Analytics and Galenic Drug Development- LR12ES09,
Faculty of Pharmacy, University of Monastir, Road Avicenne, 5000 Monastir, Tunisia
| | - Amina Maalej
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Fatma Kolsi
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Rim Kallel
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Yassine Gdoura
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Mahdi Borni
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Leila Sellami Hakim
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
| | - Rania Zribi
- Higher Institute
of Applied Studies to Humanities of Tunis (ISEAHT), University of Tunis, 11 Road of Jebel Lakdhar, 1005 Tunis, Tunisia
| | - Sirine Choura
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Sami Sayadi
- Biotechnology
Program, Center for Sustainable Development, College of Arts and Sciences, Qatar University, 2713 Doha, Qatar
| | - Mohamed Chamkha
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Basma Mnif
- Department
of Bacteriology, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Zouheir Khemakhem
- Legal Medicine
Department, Habib Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Tahya Sellami Boudawara
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Mohamed Zaher Boudawara
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty of
Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Fathi Safta
- Laboratory
of Pharmacology, Analytics and Galenic Drug Development- LR12ES09,
Faculty of Pharmacy, University of Monastir, Road Avicenne, 5000 Monastir, Tunisia
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Louati K, Kolsi F, Kallel R, Gdoura Y, Borni M, Hakim LS, Zribi R, Choura S, Maalej A, Sayadi S, Chamkha M, Mnif B, Khemakhem Z, Boudawara TS, Boudawara MZ, Safta F. Research of Pesticide Metabolites in Human Brain Tumor Tissues by Chemometrics-Based Gas Chromatography-Mass Spectrometry Analysis for a Hypothetical Correlation between Pesticide Exposure and Risk Factor of Central Nervous System Tumors. ACS Omega 2023; 8:29812-29835. [PMID: 37599976 PMCID: PMC10433342 DOI: 10.1021/acsomega.3c04592] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023]
Abstract
Pesticides are widely used, resulting in continuing human exposure with potential health impacts. Some exposures related to agricultural works have been associated with neurological disorders. Since the 2000s, the hypothesis of the role of pesticides in the occurrence of central nervous system (CNS) tumors has been better documented in the literature. However, the etiology of childhood brain cancers still remains largely unknown. The major objective of this work was to assess the potential role of pesticide exposure as a risk factor for CNS tumors based on questionnaires and statistical analysis of information collected from patients hospitalized in the Neurosurgery Department of the Habib Bourguiba Hospital Medium in Sfax, Tunisia, during the period from January 1, 2022, to May 31, 2023. It also aimed to develop a simple and rapid analytical method by the gas chromatography-mass spectrometry technique for the research traces of pesticide metabolites in some collected human brain tumor tissues in order to more emphasize our hypothesis for such a correlation between pesticide exposure and brain tumor development. Patients with a history of high-risk exposure were selected to conduct further analysis. Chemometric methods were adapted to discern intrinsic variation between pathological and control groups and ascertain effective separation with the identification of differentially expressed metabolites accountable for such variations. Three samples revealed traces of pesticide metabolites that were mostly detected at an early age. The histopathological diagnosis was medulloblastoma for a 10-year-old child and high-grade gliomas for 27- and 35-year-old adults. The bivariate analyses (odds ratio >1 and P value <5%) confirmed the great probability of developing cancer by an exposure case. The Cox proportional hazards model revealed the risk of carcinogenicity beyond the age of 50 as a long-term effect of pesticide toxicity. Our study supports the correlation between pesticide exposure and the risk of development of human brain tumors, suggesting that preconception pesticide exposure, and possibly exposure during pregnancy, is associated with an increased childhood brain tumor risk. This hypothesis was enhanced in identifying traces of metabolites from the carbamate insecticide class known for their neurotoxicity and others from pyridazinone, organochlorines (OCs), triazole fungicide, and N-nitroso compounds known for their carcinogenicity. The 2D-OXYBLOT analysis confirmed the neurotoxicity effect of insecticides to induce oxidative damage in CNS cells. Aldicarb was implicated in brain carcinogenicity confirmed by the identification of oxime metabolites in a stress degradation study. Revealing "aziridine" metabolites from the OC class may better emphasize the theory of detecting traces of pesticide metabolites at an early age. Overall, our findings lead to the recommendation of limiting the residential use of pesticides and the support of public health policies serving this objective that we need to be vigilant in the postmarketing surveillance of human health impacts.
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Affiliation(s)
- Kaouthar Louati
- Faculty
of Pharmacy, Laboratory of Pharmacology, Analytics and Galenic Drug
Development, LR12ES09, University of Monastir, Road Avicenne, 5000 Monastir, Tunisia
| | - Fatma Kolsi
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Rim Kallel
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Yassine Gdoura
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Mahdi Borni
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Leila Sellami Hakim
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Rania Zribi
- Higher Institute
of Applied Studies to Humanities of Tunis (ISEAHT), University of Tunis, 11 Road of Jebel Lakdhar, 1005 Tunis, Tunisia
| | - Sirine Choura
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Amina Maalej
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Sami Sayadi
- Biotechnology
Program, Center for Sustainable Development, College of Arts and Sciences, Qatar University, 2713 Doha, Qatar
| | - Mohamed Chamkha
- Laboratory
of Environmental Bioprocesses, Centre of
Biotechnology of Sfax, Road of Sidi-Mansour, P.O. Box 1177, 3018 Sfax, Tunisia
| | - Basma Mnif
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Zouheir Khemakhem
- Legal
Medicine Department, Habib Bourguiba University
Hospital, Road El Ain
km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Tahya Sellami Boudawara
- Laboratory
of Pathological Anatomy and Cytology, Habib
Bourguiba University Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Mohamed Zaher Boudawara
- Department
of Neurosurgery, Habib Bourguiba University
Hospital, Road El Ain km 1.5, Avenue of Ferdaous, 3089 Sfax, Tunisia
- Faculty
of Medicine, University of Sfax, Avenue of Majida Boulila, 3029 Sfax, Tunisia
| | - Fathi Safta
- Faculty
of Pharmacy, Laboratory of Pharmacology, Analytics and Galenic Drug
Development, LR12ES09, University of Monastir, Road Avicenne, 5000 Monastir, Tunisia
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Ktari S, Ben Ayed N, Ben Rbeh I, Garbi N, Maalej S, Mnif B, Rhimi F, Hammami A. Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018. BMC Microbiol 2023; 23:36. [PMID: 36739390 PMCID: PMC9898894 DOI: 10.1186/s12866-023-02784-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/25/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide. In this study, we sought to analyze serotype distributions, antibiotic resistance, and genetic relationships of 106 clinical invasive pneumococcal isolates recovered in Tunisia between 2012 and 2018, prior to the routine use of pneumococcal conjugate vaccines (PCV). METHODS We used multiplex PCR, the disk diffusion method and/or E-test, and multi-locus sequence typing (MLST). RESULTS The most frequent serotypes were 14 (17%), 19F (14.2%), and 3 (11.3%). Of the 106 S. pneumoniae isolates, 67.9% were penicillin non-susceptible (29.4% were resistant), 45.3% were amoxicillin non-susceptible (17% were resistant), and 16% were cefotaxime non-susceptible. For antibiotics other than β-lactams, resistance rates to erythromycin, tetracycline, cotrimoxazole, and chloramphenicol were 62.3, 33, 22.6, and 4.7%, respectively. Two isolates were non-susceptible to levofloxacin. Among 66 erythromycin-resistant pneumococci, 77.3% exhibited the cMLSB phenotype, and 87.9% carried ermB gene. All tetracycline-resistant strains harbored the tetM gene. The potential coverage by 7-, 10-, and 13-valent pneumococcal conjugate vaccines were 55.7, 57.5, and 81.1%, respectively. A multilocus sequence typing analysis revealed great diversity. Fifty different sequence types (STs) were identified. These STs were assigned to 10 clonal complexes and 32 singletons. The most common STs were 179, 2918, 386, and 3772 - related mainly to 19F, 14, 6B/C, and 19A serotypes, respectively. CONCLUSIONS This study demonstrated that the majority of the serotypes of invasive pneumococci in the Tunisian population were 14, 19F, and 3. Moreover, we noted a high degree of genetic diversity among invasive S. pneumoniae isolates. The highest proportions of antibiotic non-susceptible isolates were for penicillin, erythromycin, and tetracycline. Further molecular characteristics are required to monitor the genetic variations and to follow the emergence of resistant pneumococci for the post-vaccination era in Tunisia.
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Affiliation(s)
- Sonia Ktari
- Laboratory of Microbiology, Faculty of Medicine Sfax, University of Sfax-Tunisia, Avenue Majida Boulila, 3027, Sfax, Tunisia. .,Research Laboratory Microorganisms and Human Disease "MPH LR03SP03", Sfax, Tunisia.
| | - Nourelhouda Ben Ayed
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Imen Ben Rbeh
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia
| | - Nourhène Garbi
- Medical Genetic Department, HediChaker Hospital, Sfax, Tunisia
| | - Sonda Maalej
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Basma Mnif
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Faouzia Rhimi
- Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Adnene Hammami
- grid.412124.00000 0001 2323 5644Laboratory of Microbiology, Faculty of Medicine Sfax, University of Sfax-Tunisia, Avenue Majida Boulila, 3027 Sfax, Tunisia ,Research Laboratory Microorganisms and Human Disease “MPH LR03SP03”, Sfax, Tunisia ,grid.413497.cLaboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
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Chtourou L, Moalla M, Mnif B, Smaoui H, Gdoura H, Boudabous M, Mnif L, Amouri A, Hammami A, Tahri N. Prevalence of Helicobacter pylori resistance to clarithromycin in Tunisia. J Med Microbiol 2022; 71. [PMID: 36006691 DOI: 10.1099/jmm.0.001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Helicobacter pylori (H. pylori) resistance to clarithromycin is increasing worldwide. Data on the prevalence of H. pylori resistance are limited in Tunisia.Gap statement. Given that H. pylori resistance to clarithromycin has not been studied in Tunisia since 2010, there was a need to determinate its prevalence and the principal mutations implicated in this resistance.Aim. The aims were to define the prevalence of H. pylori infection among symptomatic patients and to determinate the level of clarithromycin resistance among these patients and the main mutations conferring this resistance.Methods. We conducted a cross-sectional study from March 2017 to February 2020 in the Hepato-Gastroenterology Department of Hedi Chaker University Hospital in Sfax that included 124 Tunisian patients who underwent gastroduodenal endoscopy with biopsies. Mutations conferring resistance to clarithromycin were detected using the Allplex H. pylori and ClariR PCR Assay.Results. Out of 124 biopsies, 101 (81.5 2 %) were PCR-positive for H. pylori. Mutations conferring resistance to clarithromycin were detected in 30/95 (31.6 %) of patients. The rate of primary resistance was 25.3 % and of secondary resistance 62.5 %. The most frequently detected mutation was A2143G (86, 90%) followed by A2142G (11, 36%). Seven patients had a double mutation A2143G-A2142G. The factors independently associated with resistance to clarithromycin were diabetes, high blood pressure, the presence of a bulbar ulcer on endoscopy and the presence of gastric atrophy on histology.Conclusion. Detection of more than 25 % of strains with clarithromycin resistance mutations makes the H. pylori first-line treatment with clarithromycin questionable in our setting, and a review of empirical treatment of H. pylori is urgently needed.
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Affiliation(s)
- Lassaad Chtourou
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Manel Moalla
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Basma Mnif
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hend Smaoui
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Hela Gdoura
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mona Boudabous
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Leila Mnif
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Ali Amouri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nabil Tahri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
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Sallem N, Hammami A, Mnif B. Trends in human intestinal carriage of ESBL- and carbapenemase-producing Enterobacterales among food handlers in Tunisia: emergence of C1-M27-ST131 subclades, blaOXA-48 and blaNDM. J Antimicrob Chemother 2022; 77:2142-2152. [PMID: 35640660 DOI: 10.1093/jac/dkac167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/06/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To determine the prevalence of community intestinal carriage of ESBL-producing Enterobacterales (ESBL-E), acquired-AmpC-producing Enterobacterales (aAmpC-E) and carbapenemase-producing Enterobacterales (CPE) in Tunisia. METHODS From November 2012 to September 2017, stool samples from food handlers in Sfax, Tunisia, were screened for ESBL-E, AmpC-E and CPE using antibiotic-containing media. The genes encoding these β-lactamases were characterized by PCR, sequencing, and transfer assays. ST131 clonal groups were detected by PCR and characterized for antibiotic resistance, virulence genes and PFGE patterns. RESULTS Of 2135 participants, ESBL-E, aAmpC-E, and CPE carriage were detected in 419 (19.63%), 35 (1.63%) and 7 (0.33%) participants, respectively. CTX-M-15 (60%), CTX-M-1 (16.8%) and CTX-M-27 (12.8%) were the most common ESBL determinants. The ESBL-E carriage was significantly higher in summer (33%) and autumn (25.7%) than in winter (12.1%) and spring (11.4%). ST131 was detected in 50 (13.2%) of the 378 ESBL-producing Escherichia coli isolates; most of them (35; 70%) belonged to subclade C1 (cluster C1-M27: 23 isolates, 46%; cluster C1-non-M27: 12 isolates, 24%) followed by those belonging to subclade C2 (11; 22%). Although subclade C2 isolates, all harbouring blaCTX-M-15, had the highest resistance rates and virulence factor and addiction system scores, the subclade C1 isolates, mainly harbouring blaCTX-M-27 (94%), were predominant since 2015. The most frequently detected carbapenemase-encoding gene was blaOXA-48-like (85%) and acquired AmpC-encoding genes were blaDHA-1 (54%) and blaCMY-2 (46%). CONCLUSIONS This is the first large Tunisian study to reveal a high faecal ESBL carriage rate, a low CPE carriage rate, and the predominance of CTX-M-27-producing subclade C1 among faecal ESBL-ST131 isolates in the Tunisian community.
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Affiliation(s)
- Nesrine Sallem
- Habib Bourguiba University Hospital, Research Laboratory Microorganisms and Human Disease, University of Sfax, Route El Ain Km 0.5, 3029, Sfax, Tunisia
| | - Adnene Hammami
- Habib Bourguiba University Hospital, Research Laboratory Microorganisms and Human Disease, University of Sfax, Route El Ain Km 0.5, 3029, Sfax, Tunisia.,Faculty of Medicine Sfax, Laboratory of Microbiology, University of Sfax, Avenue Majida Boulila, 3027, Sfax, Tunisia
| | - Basma Mnif
- Habib Bourguiba University Hospital, Research Laboratory Microorganisms and Human Disease, University of Sfax, Route El Ain Km 0.5, 3029, Sfax, Tunisia.,Faculty of Medicine Sfax, Laboratory of Microbiology, University of Sfax, Avenue Majida Boulila, 3027, Sfax, Tunisia
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Ksibi B, Ktari S, Ghedira K, Othman H, Maalej S, Mnif B, Fabre L, Rhimi F, Hello SL, Hammami A. Antimicrobial resistance genes, virulence markers and prophage sequences in Salmonella enterica serovar Enteritidis isolated in Tunisia using whole genome sequencing. Current Research in Microbial Sciences 2022; 3:100151. [PMID: 35909609 PMCID: PMC9325895 DOI: 10.1016/j.crmicr.2022.100151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Antimcrobial resistance genes, virulence factors and prophage sequences were studied in WGS of 45 Salmonella Enteritidis from different sources. WGS is most powerful tool for determining genomic variation in S. Enteritidis. Two major lineages of S. Enteritidis were detected in Tunisia. Missense mutations identified in virulence genes were mostly detected in lineage B. Salmon118970_sal3 and RE_2010 phages were detected in lineage A and lineage B, respectively.
Salmonella Enteritidis causes a major public health problem in the world. Whole genome sequencing can give us a lot of information not only about the phylogenetic relatedness of these bacteria but also in antimicrobial resistance and virulence gene predictions. In this study, we analyzed the whole genome data of 45 S. Enteritidis isolates recovered in Tunisia from different origins, human, animal, and foodborne samples. Two major lineages (A and B) were detected based on 802 SNPs differences. Among these SNPs, 493 missense SNPs were identified. A total of 349 orthologue genes mutated by one or two missense SNPs were classified in 22 functional groups with the prevalence of carbohydrate transport and metabolism group. A good correlation between genotypic antibiotic resistance profiles and phenotypic analysis were observed. Only resistant isolates carried the respective molecular resistant determinants. The investigation of virulence markers showed the distribution of 11 Salmonella pathogenicity islands (SPI) out of 23 previously described. The SPI-1 and SPI-2 genes encoding type III secretion systems were highly conserved in all isolates except one. In addition, the virulence plasmid genes were present in all isolates except two. We showed the presence of two fimbrial operons sef and ste previously considered to be specific for typhoidal Salmonella. Our collection of S. Enteritidis reveal a diversity among prophage profiles. SNPs analysis showed that missense mutations identified in fimbriae and in SPI-1 and SPI-2 genes were mostly detected in lineage B. In conclusion, WGS is a powerful application to study functional genomic determinants of S. Enteritidis such as antimicrobial resistance genes, virulence markers and prophage sequences. Further studies are needed to predict the impact of the missenses SNPs that can affect the protein functions associated with pathogenicity.
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Ben Ayed N, Ktari S, Mezghani S, Mnif B, Mahjoubi F, Hammami A. Relationship Between Serotypes and Antimicrobial Nonsusceptibility of Streptococcus pneumoniae Clinical Isolates in Tunisia. Microb Drug Resist 2021; 28:370-377. [PMID: 34918966 DOI: 10.1089/mdr.2021.0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Streptococcus pneumoniae remains a significant cause of morbidity and mortality worldwide despite the overall success of the vaccine programs. In Tunisia, pneumococcal conjugate vaccines (PCV)10 was introduced in the national immunization program in April 2019. We sought to determine the relationship between serotypes and antimicrobial nonsusceptibility of S. pneumoniae isolates recovered from clinical samples in the prevaccination period in the south of Tunisia. A total of 504 nonduplicate S. pneumoniae isolates collected between 2012 and 2018 were tested for antimicrobial susceptibility, among them 439 (87.1%) were serotyped. The most common serotypes were 19F (17.8%), 14 (15.3%), 3 (9.1%), 19A (8.2%), and 23F (7.3%). The proportions of isolates with serotypes covered by PCV7, PCV10, and PCV13 were 55.4%, 56.3%, and 77.9%, respectively. Three-quarters (74.4%) of pneumococcal isolates were nonsusceptible to penicillin, and about half (54.8%) were multidrug resistant. Penicillin nonsusceptibility was observed for all 19A and 23F isolates, and was significantly associated with serotypes 19F (odds ratio [OR]: 33.7) and 14 (OR: 8.7). A significant association with multidrug resistance was noted for serotypes 19A (OR: 10), 19F (OR: 9.4), 23F (OR: 8.6), and 6B (OR: 5.2). The alarming rates of pneumococcal antimicrobial nonsusceptibility and the strong association with the most prevalent serotypes compel microbiologists to monitor the impact of the PCV10 introduced recently in our national immunization program.
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Affiliation(s)
- Nourelhouda Ben Ayed
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Ktari
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonda Mezghani
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Basma Mnif
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Faouzia Mahjoubi
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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Jemaa MB, Trigui M, Zribi W, Elleuch E, Abid A, Koubaa M, Mnif B, Ellouze Z, Ayedi K, Hammemi A, Jemaa MB, Zribi M, Keskes H. [Acute osteomyelitis caused by community-acquired methicillin-resistant Staphylococcus aureus in children: about 15 cases]. Pan Afr Med J 2021; 39:84. [PMID: 34466186 PMCID: PMC8379408 DOI: 10.11604/pamj.2021.39.84.12560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/06/2018] [Indexed: 11/11/2022] Open
Abstract
La prise en charge de l´ostéomyélite aiguë devient plus délicate depuis l´émergence du Staphylocoque aureus résistant à la méthicilline d´origine communautaire. Nous avons recueilli les cas d´ostéomyélite aiguë dues à ce germe sur une période de 21 ans (Janvier 1995-Décembre 2016) et nous avons essayé d´analyser les particularités de cette entité pathologique. Notre série comporte 15 enfants, d´âge moyen 9 ans. Le membre inférieur était atteint dans tous les cas. Une notion de traumatisme local a été signalée dans 8 cas et une porte d´entrée cutanée a été trouvée dans 4 cas. Le mode de début était aigu dans 12 cas avec un tableau de pseudo-paralysie du membre atteint. Une staphylococcie pulmonaire avec des signes septico-pyohémiques ont été notés dans un cas. L´hémoculture était positive dans 8 cas. La recherche par PCR de la leucocidine de Panton et Valentine était pratiquée dans 1 cas avec un résultat positif. Tous ces patients ont eu un débridement chirurgical et une antibiothérapie empirique secondairement adaptée. L´évolution était bonne dans 8 cas et mauvaise dans les autres cas avec passage à la chronicité dans 6 cas et un cas de décès. Une fracture pathologique a été signalée dans 3 cas. La survenue d´une ostéomyélite à Staphylocoque aureus résistant à la méthicilline d´origine communautaire est péjorative. Connaitre ces infections en se basant sur des arguments cliniques et paracliniques est un enjeu important pour une prise en charge thérapeutique spécifique et rapide.
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Affiliation(s)
- Mohamed Ben Jemaa
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Moez Trigui
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Wassim Zribi
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Emna Elleuch
- Service des Maladies Infectieuses CHU Hédi Chaker de Sfax, Sfax, Tunisie
| | - Ameur Abid
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Makram Koubaa
- Service des Maladies Infectieuses CHU Hédi Chaker de Sfax, Sfax, Tunisie
| | - Basma Mnif
- Laboratoire de Microbiologie, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Zoubayer Ellouze
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Kamel Ayedi
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Adnène Hammemi
- Laboratoire de Microbiologie, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Mounir Ben Jemaa
- Service des Maladies Infectieuses CHU Hédi Chaker de Sfax, Sfax, Tunisie
| | - Mohamed Zribi
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
| | - Hassib Keskes
- Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie
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Ktari S, Ben Ayed NEH, Maalej S, Mnif B, Rhimi F, Hammami A. Clinical optochin resistant Streptococcus pneumoniae and Streptococcus pseudopneumoniae strains in Tunisia. J Infect Dev Ctries 2021; 15:672-677. [PMID: 34106891 DOI: 10.3855/jidc.13106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/15/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Streptococcus pneumoniae can be responsible for severe human infections. Optochin resistance has been a potential cause of misidentification of pneumococcus and other members of the mitis group. Hence, rapid and easy optochin resistant (Optr) S. pneumoniae identification is essential. METHODOLOGY Atypical pneumococci were characterized using optochin susceptibility, bile solubility based on spectrophotometric reading, serotyping, pulsed field gel electrophoresis (PFGE), 16S rRNA sequencing and PCR-based assays targeting pneumococcal genes lytA, ply, pspA, cpsA, Spn9802 and Spn9828. RESULTS Optical density values for the bile solubility test suggest the identification of four Optr S. pneumoniae and one Streptococcus pseudopneumoniae. All Optr pneumococci harbored cpsA, lytA, ply, Spn9802, Spn9828 and pspA genes. Only ply, spn9802 and Spn9828 genes were detected in S. pseudopneumoniae. The 16S rRNA sequencing differentiates between these two species. Optr S. pneumoniae strains belonged to different genotypes and serotypes (14, 19A, 3 and 9V). Three Optr S. pneumoniae isolates were typed as pspA family 2, while one belonged to pspA family 1. Sequencing of the atpA and atpC gene of the Optr variants revealed three mutations in the ATPase a-subunit (L99I, M23V and V52I) and one mutation in ATPase c-subunit (V48I). CONCLUSIONS Our data indicate that bile OD-values provides an accurate, fast and easy method to discriminate between Optr S. pneumoniae and other Streptococcus mitis group. Moreover molecular techniques, confirming the bile test, can be used in order to prevent these atypical pneumococci and alert clinical microbiologists of the presence of these strains in the community.
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Affiliation(s)
- Sonia Ktari
- Laboratory of Microbiology, Medical School of Sfax, Tunisia.
| | | | - Sonda Maalej
- Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Basma Mnif
- Habib Bourguiba University Hospital, Sfax, Tunisia
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Mnif B, Sallem N, Triki Z, Hammami A. A report on the first outbreak of emm89 group A streptococcus invasive infections in a burns unit in Tunisia. J Med Microbiol 2019; 68:1540-1543. [PMID: 31483245 DOI: 10.1099/jmm.0.001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Four group A streptococcus (GAS) bacteraemia occurred in a small burn unit within 2 weeks. The GAS patient isolates, characterized as emm89, shared the same PFGE pulsotype with two other strains isolated 2 months later. The outbreak investigation revealed that a nurse was the most likely source of GAS transmission, as she was confirmed to carry the same outbreak strain in her throat and had direct and regular contact with the six outbreak patients in the unit. The outbreak was controlled after the nurse had undergone eradication treatment. This report highlights the emergence of the emm89 clone and its capacity to elicit invasive GAS outbreaks.
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Affiliation(s)
- Basma Mnif
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Nesrine Sallem
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Zied Triki
- Burns unit, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Adnene Hammami
- Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
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Ktari S, Ben Ayed NEH, Jmal I, Mnif B, Mezghani S, Rhimi F, Hammami A. Clinical levofloxacin-resistant Streptococcus pneumoniae isolates in North Africa. J Glob Antimicrob Resist 2018; 12:181-182. [PMID: 29425693 DOI: 10.1016/j.jgar.2018.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
Affiliation(s)
- Sonia Ktari
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Nour El Houda Ben Ayed
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Ikram Jmal
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Basma Mnif
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Sonda Mezghani
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Faouzia Rhimi
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
| | - Adnene Hammami
- University of Sfax, Faculty of Medicine of Sfax, Sfax, Tunisia; Laboratory of Microbiology, Habib Bourguiba University Hospital, Sfax, MPH LR03SP03, Tunisia.
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Ktari S, Jmal I, Mroua M, Maalej S, Ben Ayed NE, Mnif B, Rhimi F, Hammami A. Serotype distribution and antibiotic susceptibility of Streptococcus pneumoniae strains in the south of Tunisia: A five-year study (2012–2016) of pediatric and adult populations. Int J Infect Dis 2017; 65:110-115. [DOI: 10.1016/j.ijid.2017.10.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022] Open
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Regaieg K, Bahloul M, Turki O, Mnif B, Bouaziz M. [The efficacy of the tigecycline-colistin association in the treatment of multi-resistant Acinetobacter baumannii meningitis]. Med Mal Infect 2017; 47:175-177. [PMID: 28215823 DOI: 10.1016/j.medmal.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/18/2017] [Indexed: 02/07/2023]
Affiliation(s)
- K Regaieg
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bahloul
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie.
| | - O Turki
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
| | - B Mnif
- Laboratoire de microbiologie, CHU Habib Bourguiba, Sfax, Tunisie
| | - M Bouaziz
- Service de réanimation polyvalente, CHU Habib Bourguiba, Sfax, Tunisie
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Regaieg K, Chtara K, Bahloul M, Mnif B, Hammami A, Bouaziz M. [Guillain-Barré syndrome complicating Shigella flexneri infection]. Presse Med 2016; 46:244-245. [PMID: 28024833 DOI: 10.1016/j.lpm.2016.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/24/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Kais Regaieg
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Kamilia Chtara
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Mabrouk Bahloul
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie.
| | - Basma Mnif
- Hôpital Habib Bourguiba, service de microbiologie, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Adnène Hammami
- Hôpital Habib Bourguiba, service de microbiologie, route El Ain Km 1, 3029 Sfax, Tunisie
| | - Mounir Bouaziz
- Hôpital Habib Bourguiba, service de réanimation médicale, route El Ain Km 1, 3029 Sfax, Tunisie
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Ktari S, Ksibi B, Gharsallah H, Mnif B, Maalej S, Rhimi F, Hammami A. Molecular epidemiological characteristics ofSalmonella entericaserovars Enteritidis, Typhimurium and Livingstone strains isolated in a Tunisian university hospital. APMIS 2015; 124:194-200. [DOI: 10.1111/apm.12484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/22/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Sonia Ktari
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Boutheina Ksibi
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Houda Gharsallah
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Basma Mnif
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Sonda Maalej
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Fouzia Rhimi
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
| | - Adnene Hammami
- Laboratory of Microbiology; Faculté de Medecine Sfax; Centre Hospitalier Universitaire Habib Bourguiba; Sfax Tunisia
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Ktari S, Le Hello S, Ksibi B, Courdavault L, Mnif B, Maalej S, Fabre L, Hammami A, Weill FX. Carbapenemase-producing Salmonella enterica serotype Kentucky ST198, North Africa. J Antimicrob Chemother 2015; 70:3405-7. [PMID: 26377865 DOI: 10.1093/jac/dkv276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sonia Ktari
- Faculté de médecine de Sfax, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia
| | - Simon Le Hello
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Paris, France
| | - Boutheina Ksibi
- Faculté de médecine de Sfax, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia
| | | | - Basma Mnif
- Faculté de médecine de Sfax, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia
| | - Sonda Maalej
- Faculté de médecine de Sfax, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia
| | - Laetitia Fabre
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Paris, France
| | - Adnene Hammami
- Faculté de médecine de Sfax, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisia
| | - François-Xavier Weill
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Paris, France
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Chaari A, Pham T, Mnif B, Chtara K, Medhioub F, Baccouche N, Bahloul M, Hammami A, Bouaziz M. Colistin–tigecycline versus colistin–imipenem–cilastatin combinations for the treatment of Acinetobacter baumannii ventilator-acquired pneumonia: a prognosis study. Intensive Care Med 2015; 41:2018-9. [DOI: 10.1007/s00134-015-4010-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 10/23/2022]
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Mnif B, Mahjoubi F, Frikha I, Hammami A. Multidrug‐resistant OXA‐48‐producing Klebsiella pneumoniae mediastinitis treated safely and effectively with imipenem and colistin. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Basma Mnif
- Laboratoire de Microbiologie, Centre Hospitalo‐universitaire Habib Bourguiba, Sfax, Tunisia
| | - Faouzia Mahjoubi
- Laboratoire de Microbiologie, Centre Hospitalo‐universitaire Habib Bourguiba, Sfax, Tunisia
| | - Imed Frikha
- Service de chirurgie cardiovasculaire, Centre Hospitalo‐universitaire Habib Bourguiba, Sfax, Tunisia
| | - Adnane Hammami
- Laboratoire de Microbiologie, Centre Hospitalo‐universitaire Habib Bourguiba, Sfax, Tunisia
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Chaari A, Mnif B, Bahloul M, Mahjoubi F, Chtara K, Turki O, Gharbi N, Chelly H, Hammami A, Bouaziz M. Acinetobacter baumannii ventilator-associated pneumonia: epidemiology, clinical characteristics, and prognosis factors. Int J Infect Dis 2013; 17:e1225-8. [DOI: 10.1016/j.ijid.2013.07.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 06/27/2013] [Accepted: 07/19/2013] [Indexed: 01/31/2023] Open
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Mnif B, Harhour H, Jdidi J, Mahjoubi F, Genel N, Arlet G, Hammami A. Molecular epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli in Tunisia and characterization of their virulence factors and plasmid addiction systems. BMC Microbiol 2013; 13:147. [PMID: 23800277 PMCID: PMC3701463 DOI: 10.1186/1471-2180-13-147] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 05/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extended-spectrum β-lactamases (ESBLs), particularly CTX-M- type ESBLs, are among the most important resistance determinants spreading worldwide in Enterobacteriaceae. The aim of this study was to characterize a collection of 163 ESBL-producing Escherichia coli collected in Tunisia, their ESBL-encoding plasmids and plasmid associated addiction systems. RESULTS The collection comprised 163 ESBL producers collected from two university hospitals of Sfax between 1989 and 2009. 118 isolates harbored blaCTX-M gene (101 blaCTX-M-15 gene and 17 blaCTX-M-14 gene). 49 isolates carried blaSHV-12 gene, 9 blaSHV-2a gene and only 3 blaTEM-26 gene. 16 isolates produced both CTX-M and SHV-12. The 101 CTX-M-15-producing isolates were significantly associated to phylogroup B2 and exhibiting a high number of virulence factors. 24 (23.7%) of the group B2 isolates belonged to clonal complex ST131. Pulsed-field gel electrophoresis (PFGE) typing revealed a genetic diversity of the isolates. 144 ESBL determinants were transferable mostly by conjugation. The majority of plasmid carrying blaCTX-M-15 genes (72/88) were assigned to various single replicon or multireplicon IncF types and had significantly a higher frequency of addiction systems, notably the VagCD module. CONCLUSION This study demonstrates that the dissemination of CTX-M-15 producing E. coli in our setting was due to the spread of various IncF-type plasmids harboring multiple addiction systems, into related clones with high frequency of virulence determinants.
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Affiliation(s)
- Basma Mnif
- Laboratoire de Microbiologie, Hôpital Habib Bourguiba, Sfax, Tunisie.
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Abstract
We characterized 67 Escherichia coli isolates with reduced susceptibility to cefotaxime obtained from 136 samples of healthy broilers housed in 36 Tunisian farms. All these isolates harboured blaCTX-M-1 and/or blaCMY-2 genes located mostly on self-conjugative IncI1 plasmids. qnrS1, qnrA6 and aac(6')-Ib-cr were detected in six isolates. Considerable genetic diversity was detected among isolates from different farms. To our knowledge, this is the first detailed documentation of a high occurrence of blaCTX-M-1 and blaCMY-2 in E. coli at the poultry farm level in Tunisia as well as the first description of plasmid-mediated quinolone resistance in food animals in Tunisia which may contribute to the dissemination of these genes throughout Tunisia.
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Affiliation(s)
- B Mnif
- Laboratory of Microbiology, University Hospital Center of Habib Bourguiba, Sfax, Tunisia
| | - S Ktari
- Laboratory of Microbiology, University Hospital Center of Habib Bourguiba, Sfax, Tunisia
| | - F M Rhimi
- Laboratory of Microbiology, University Hospital Center of Habib Bourguiba, Sfax, Tunisia
| | - A Hammami
- Laboratory of Microbiology, University Hospital Center of Habib Bourguiba, Sfax, Tunisia
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Mnif B, Ktari S, Chaari A, Medhioub F, Rhimi F, Bouaziz M, Hammami A. Nosocomial dissemination of Providencia stuartii isolates carrying bla OXA-48, bla PER-1, bla CMY-4 and qnrA6 in a Tunisian hospital. J Antimicrob Chemother 2012; 68:329-32. [PMID: 23014719 DOI: 10.1093/jac/dks386] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To report an outbreak due to Providencia stuartii isolates carrying bla(OXA-48), bla(PER-1), bla(CMY-4) and qnrA6 in a Tunisian hospital in 2011. METHODS Eight intensive care unit (ICU) patients infected/colonized by extended-spectrum β-lactamase (ESBL)-producing P. stuartii between March and May 2011 were included. Molecular epidemiology was studied by PFGE. Antibiotic resistance genes were analysed by PCR and sequencing and the plasmid incompatibility group by a PCR-based replicon typing scheme. RESULTS Eight patients were colonized with ESBL-producing P. stuartii isolates. All these isolates were clonally related and found to carry bla(OXA-48), bla(PER-1), bla(CMY-4), qnrA6 and aac-6'-Ib genes on the same self-conjugative IncA/C plasmid. The same strain was also cultured from environmental samples in the ICU. All these isolates were susceptible to carbapenems. Only one colonized patient developed P. stuartii pleurisy and was effectively treated with imipenem alone. CONCLUSIONS This is the first report of an outbreak due to P. stuartii isolates carrying bla(OXA-48) in Tunisia. The simultaneous expression of various resistance genes (bla(OXA-48), bla(CMY-4), bla(PER-1), qnrA and aac-6'-Ib) by P. stuartii isolates is alarming.
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Affiliation(s)
- Basma Mnif
- Laboratory of Microbiology, University Hospital Center of Habib Bourguiba, Sfax, Tunisia.
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Ktari S, Mnif B, Koubaa M, Mahjoubi F, Ben Jemaa M, Mhiri MN, Hammami A. Nosocomial outbreak of Myroides odoratimimus urinary tract infection in a Tunisian hospital. J Hosp Infect 2011; 80:77-81. [PMID: 22099498 DOI: 10.1016/j.jhin.2011.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 09/25/2011] [Indexed: 10/15/2022]
Abstract
We report a nosocomial outbreak of urinary tract infection caused by Myroides odoratimimus, previously called Flavobacterium odoratum, in the urology unit of a Tunisian hospital. From May to November 2010, seven isolates of M. odoratimimus were recovered from urine. Pulsed-field gel electrophoresis clearly differentiated these isolates into two possibly related clones from two different periods. All patients but one had urinary calculi and underwent endourological surgery. All Myroides isolates were resistant to all antibiotics tested. Three patients were successfully treated with ciprofloxacin and rifampicin. Clinicians should be aware that M. odoratimimus may induce serious and prolonged nosocomial outbreaks of urinary tract infections.
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Affiliation(s)
- S Ktari
- Laboratoire de Microbiologie, CHU Habib Bourguiba, Sfax, Tunisia
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Ktari S, Mnif B, Louati F, Rekik S, Mezghani S, Mahjoubi F, Hammami A. Spread of Klebsiella pneumoniae isolates producing OXA-48 -lactamase in a Tunisian university hospital. J Antimicrob Chemother 2011; 66:1644-6. [DOI: 10.1093/jac/dkr181] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ktari S, Mnif B, Znazen A, Rekik M, Mezghani S, Mahjoubi-Rhimi F, Hammami A. Diversity of β-Lactamases inPseudomonas aeruginosaIsolates Producing Metallo-β-Lactamase in Two Tunisian Hospitals. Microb Drug Resist 2011; 17:25-30. [DOI: 10.1089/mdr.2010.0104] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sonia Ktari
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Basma Mnif
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Abir Znazen
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Manel Rekik
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Sonda Mezghani
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Fouzia Mahjoubi-Rhimi
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
| | - Adnane Hammami
- Laboratory of Microbiology, University Hospital Center (CHU) of Habib Bourguiba, Sfax, Tunisia
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Ktari S, Mahjoubi F, Mnif B, Kallel H, Bouaziz M, Hammami A. [Investigation of three nosocomial outbreaks of Serratia marcescens in an intensive care unit in Sfax-Tunisia]. Tunis Med 2010; 88:501-506. [PMID: 20582888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED THE AIM of the study was to type Serratia marcescens responsible for nosocomial outbreaks in an intensive care unit in Sfax -Tunisia. METHODS The relatedness between S. marcescens isolates was studied by Pulsed field gel electrophoresis (PFGE). We included 56 strains of Serratia marcescens isolated from patients hospitalized in the intensive care unit during 2003 and 2004. Seven epidemiological unrelated strains of Serratia marcescens were also tested. Samples from environment and hands of the nursing and medical staff were collected and cultured to identify the source of contamination. RESULTS All strains showed a wild type of antimicrobial susceptibility. PFGE typing revealed that three different clones were present. None of the cultures taken from hands of unit staff and from environmental samples yielded positive results for S. marcescens. CONCLUSION We have confirmed the presence of three consecutive outbreaks caused by three genetically unrelated bacterial clones of Serratia marcescens in the intensive care unit ward. These outbreaks are closely related to the frequent use of colistin and the lack of measures of hygiene in this ward.
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Affiliation(s)
- Sania Ktari
- Service de Microbiolgie, Habib Bourguiba de Sfax-Tunisie
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Mnif B, Vimont S, Boyd A, Bourit E, Picard B, Branger C, Denamur E, Arlet G. Molecular characterization of addiction systems of plasmids encoding extended-spectrum beta-lactamases in Escherichia coli. J Antimicrob Chemother 2010; 65:1599-603. [PMID: 20507859 DOI: 10.1093/jac/dkq181] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Escherichia coli producing CTX-M-type extended-spectrum beta-lactamases (ESBLs) are spreading worldwide. The aim of this work was to investigate the addiction systems carried by the replicons involved in the emergence and spread of ESBLs in relation to ESBL and replicon types. METHODS A collection of 125 TEM, SHV and CTX-M ESBL-producing E. coli isolates and their 125 transconjugants or transformants was analysed. Five plasmid protein antitoxin-regulated systems and three plasmid antisense RNA-regulated systems were sought by PCR. RESULTS Two hundred and ninety-eight plasmid addiction systems were detected in the parental strains (mean 2.38, range 0-6 per strain) and 86 were detected in the recipient strains (mean 0.69, range 0-5 per strain). PemKI, CcdAB, Hok-Sok and VagCD were the most frequently represented systems in both recipient and parental strains. The parental SHV and CTX-M ESBL-producing strains had more addiction systems than the TEM ESBL producers. In the recipient strains, the frequency of addiction systems was significantly higher in IncF plasmids. Among the IncF replicons carrying CTX-M-type enzymes, the frequency of addiction systems was significantly higher in IncF plasmids carrying CTX-M-15 (mean 3.5) or CTX-M-9 (mean 4) than in those carrying CTX-M-14 (mean 0.6). CONCLUSIONS In E. coli producing CTX-M-15 or CTX-M-9 ESBLs, plasmids bearing the bla(CTX-M) gene have multiple addiction systems that could contribute to their maintenance in host strains.
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Affiliation(s)
- Basma Mnif
- Université Pierre et Marie Curie-Paris-6, Faculté de Médecine, Site Saint-Antoine, Laboratoire de Bactériologie, ER8 Paris, France
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Vimont S, Mnif B, Fevre C, Brisse S. Comparison of PFGE and multilocus sequence typing for analysis of Klebsiella pneumoniae isolates. J Med Microbiol 2008; 57:1308-1310. [PMID: 18809566 DOI: 10.1099/jmm.0.2008/003798-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sophie Vimont
- Service de Bactériologie-Hygiène, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75970 Paris Cedex 20, France
| | - Basma Mnif
- Service de Bactériologie-Hygiène, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75970 Paris Cedex 20, France
| | - Cindy Fevre
- Institut Pasteur, Genotyping of Pathogens and Public Health, 28 Rue du Dr Roux, 75724 Paris Cedex 15, France
| | - Sylvain Brisse
- Institut Pasteur, Genotyping of Pathogens and Public Health, 28 Rue du Dr Roux, 75724 Paris Cedex 15, France
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Ktari S, Arlet G, Mnif B, Gautier V, Mahjoubi F, Ben Jmeaa M, Bouaziz M, Hammami A. Emergence of multidrug-resistant Klebsiella pneumoniae isolates producing VIM-4 metallo-beta-lactamase, CTX-M-15 extended-spectrum beta-lactamase, and CMY-4 AmpC beta-lactamase in a Tunisian university hospital. Antimicrob Agents Chemother 2006; 50:4198-201. [PMID: 17015633 PMCID: PMC1694011 DOI: 10.1128/aac.00663-06] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Klebsiella pneumoniae clinical isolates resistant to carbapenems were recovered from 11 patients in the hospital of Sfax, Tunisia. The isolates were closely related as shown by pulsed-field gel electrophoresis, and they produced VIM-4 metallo-enzyme, CTX-M-15 extended-spectrum beta-lactamase, and CMY-4 AmpC enzyme. The bla(VIM-4) gene is part of a class 1 integron.
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Affiliation(s)
- Sonia Ktari
- Laboratoire de Microbiologie, CHU Habib Bourguiba, Sfax, Tunisie
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Mnif B, Boujelbène I, Mahjoubi F, Gdoura R, Trabelsi I, Moalla S, Frikha I, Kammoun S, Hammami A. Endocarditis due to Kytococcus schroeteri: case report and review of the literature. J Clin Microbiol 2006; 44:1187-9. [PMID: 16517928 PMCID: PMC1393139 DOI: 10.1128/jcm.44.3.1187-1189.2006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report the third case of endocarditis caused by the newly described micrococcal species Kytococcus schroeteri. A 49-year-old woman was admitted to the hospital with suspected prosthetic valve endocarditis. Five blood cultures and prosthetic valve cultures grew the same type of organism, initially identified as Micrococcus sp. Assignment to the genus Kytococcus was suggested by the arginine dihydrolase activity and resistance to oxacillin. After sequencing of the 16S rRNA genes, the isolate was recognized as K. schroeteri. The patient was treated first with vancomycin combined with gentamicin and later with pristinamycin and rifampin. Three cases of K. schroeteri endocarditis described within a short period of time might indicate a specific pathogenicity of this new species. The isolation of kytococci from normally sterile sites should not be overlooked.
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Affiliation(s)
- Basma Mnif
- Laboratoire de Microbiologie, CHU Habib Bourguiba, Sfax, Tunisia
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