Etiology of acute diarrhea in tunisian children with emphasis on diarrheagenic escherichia coli: prevalence and identification of E.coli virulence markers

Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age. Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens. In diarrheagenic children, 107 pathogenic bacteria were isolated [12 Salmonella spp. [9.7%] and 95 diarrheagenic Escherichia coli strains [76.6%]: 29 enteroaggregative E.coli [EAEC] [23.4%], 15 enteroinvasive E.coli [EIEC] [12.1%], 17 enteropathogenic E.coli [EPEC] [13.7%], 26 enterotoxigenic E.coli [ETEC] [21%] and 2 enterohemoragic E.coli [EHEC] [1.6%]. However, in the control group, 23 pathogenic E.coli strains were isolated [42.6%] 8 EAEC [14.8%], 12 EIEC [22.2%] and 3 EPEC [5.5%]. Among diarrheagenic E.coli [DEC], only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls [P < 0.0003]. Group A rotavirus was identified in 33.9% [n=42] of diarrheagenic children and in 11.1% among the control group [n=6]. Concerning norovirus, 8.9% [n=11] of the samples collected from diarrheagenic children and 9.2% [n=5] from the control group were positive. The prevalence of rotaviruses and Salmonella spp were also significantly higher in patients with diarrhea than in controls [P = 0.002 and P < 0.019, respectively]. Finally, enteropathogenic parasites [Entamoeba coli and cryptosporidium Oocystes] were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively. These results provide baseline data about the relative importance of different enteropathogens in Tunisian children

Particularites bacteriologiques des infections urinaires chez l'enfant dans la region de Sousse, Tunisie

Urinary tract infection [UTI] is frequent in childhood. Our purpose is to determine the bacterioiogic profile of UT1 in children through a retrospective study of 1281 urinary specimens analysed in the Laboratory of Microbiology of F. Hached University hospital of Sousse between 1 997 and 2002 [2000 except]. The most Frequent pathogens recovered were E. coli [71%], K. pneumoniae [10%] P. mirabilis [8%], Staphylococcus [1,6%], P, aeruginosa [1%] and others [2%]. E. coli susceptibility to antibiotics was characterised by the high resistance percentage to amoxicillin [60%], to amoxicilline- acid clavulanic [54%] and catrimoxazole [40%]. The resistance percentage to third generation cepha-losporins, to aminoglycosides and to nitrofurane remained very low, respectively of 1,5%, 1% and 1%. High resistance rates among K. pneumoniae strains towards to amoxicillin -acid clavulanic and Cefotaxim, respectively of 63 and 39% were noticed. The resistance percentages to amikacin and cotrimoxazole were respectively of 17 and 65%, but only of 4% to nitrofurane. 70% of P. mirabilis strains were resistant to amoxicillin, 63% of them remained susceptible to amoxicillin acid clovulonic. No resistance was shown to amikacin against 31% towards cotrimoxozole