[Enterobacteria ESBL urinary infections: epidemiology and resistance]

The enterobacteria secreting beta-lactamases extended spectrum [ESBL] isolated from various infections are a public health problem in hospitals. The aim of this study was to determine the epidemiology and the resistance to gentamicin and fluoroquinolones of this enterobacteria that was isolated of urinary infection. This is a retrospective study including the results of urine exam and their corresponding antibiograms. A study that concerne all enterobacteria isolated during a period of seven months from March 2010 to September 2010. From 6350 exam of urines, five hundred fifty-eight strains of enterobacteria was positive. The prevalence of ESLB enterobacteria represents 13.8%. The genus Klebsiella present 59.7% of ESBL isolates and is also the most secreting of the ESBL with 25% of Klebsiella strains. The resistance of enterobacteria to trimethoprim-sulfamethoxazole is generally high. The co-resistance of strains secreting ESBL to fluoroquinolones was 75%; that associated with gentamicin was 86%. Similarly; co-resistance to both gentamicin and fluoroquinolones was 72%. Analysis of the results shows a gradual increase in the frequency of ESBL-E isolated from urine in both middles hospitals and community. So therapeutic alternatives available for these multiresistant bacilli are particularly limited for patients living in fragile situation. Improving hospital hygiene and good clinical practice in using antibiotics are fundamental to fight against the spread of multi-drug resistant bacteria

[Epidemiology of ESBL enterobacteriaceae in urinary and pulmonary infections in the intensive care units]

The nosocomial infections are of a heavy diagnostic and therapeutic burden in intensive care unit [ICU]. The aim of this study is to determine the epidemiology of ESBL-E as an origin infections of urinary and pulmonary infections diagnosed in ICU. This is retrospective study conducted over a period of one year which runs from 1st March 2010 to end February 2011 analyzing the results of cellular and microbiological exams of urine and lung samples; and their corresponding antibiograms. Over three hundred and sixty two positive tests, 167 strains of Enterobacteriaceae were isolated [46%]; fifty six secretory Enterobacteriaceae ESBL producing were isolated with 33.5%. Separately, enterobacteriaceae accounted for 84% of bacteria isolated from urine samples against 31.3% producing about 59%, 44% of all klebsiella are producing ESBL. Multidrug resistance caused by ESBL-E is a universally finding. The results of this study show the gradual increase in their prevalence as important etiological agents of nosocomial infections and therefore their release into the local health environment. It is necessary again to emphasize the importance of hospital hygiene and good rules of antibiotics to limit the spread of MDR bacilli and avoid the therapeutic impasse

[ trichophyton rubrum and tinea capitis]

Tineas capitis is the most common fungal infection in children. Trichophyton rubrum is rarely reported as an etiologic agent. This study reports a diagnosed a case in a child. This case discusses a 5 year old child who had endothrix parasitism of a Trichophytic tinea capitis infection. The presence of endothrix parasitism in obtained colonies from culture tests suggests a Trichophyton rubrum infection. This diagnosis was confirmed by subculture on Lactrimel-Borelli and potato-dextrose agar medium. By discovering this case, the number of listed cases between 2003 and 2009 in the laboratory registrar became 5 cases, which represents 1.7% of all registered cases. Also a cutaneous localized infection by the same fungus was found in one case among the five registered patients. Trichophyton rubrum is rarely reported in Morocco. This epidemiological profile is the same as in many African and Western countries. The usage of special medium to subculture the fungus is fundamental to discovering this type of rare fungal infection. This fungus may also affect other cutaneous localizations other than the scalp, as it was found in one patient out of our five cases. Tinea capitis due to Trichophyton rubrum is certainly a rare disease. Its pathogenetic reaction in relation to hair is still poorly clarified. However, classifying it as a fungal affection in tinea capitis cases must be kept in mind

[Onychomycosis due to trichosporon asahii]

Trichosporon, saprophyte yeast of the skin and the digestive tract, is responsible at the man's of superficial damage whose white piedra is the most known. Occasionally, Trichosporon may affect the nail. It is reported a rare case of onychomycosis caused by Trichosporon asahii diagnosed in an immunocompetent patient. A immunocompetent 65-year-old patient presents a partial dystrophy ungueale of the big toe with an infringement under - ungueale distale less pronounced besides toenails. The mycological examinations of the material taken on 2 occasions and cultivated on 2 series of middles Sabouraud with or without actidione let push pure colonies evoking Trichosporon. On poor environments potato-carrot-bile, this yeast gave arthrospores, pseudofilaments and characteristic blasospores. The study of assimilation of sugars has concluded a Trichosporon asahii. The implication of Trichosporon asahii as causal agent of onychomycoses is difficult to confirm due to the nature of the saprophytic yeast especially in immunocompetent. However its purely repeated isolation on a series of middles associated with a positive direct examination proof of its pathogenicity. The possible bad local vascular circulatory associated with the microtraumatism and the conditions marked by humidity could explain this passage from the saprophytic to the pathogenic condition. Seen the increase of the number of saprophytes germs that acquire a possible potential pathogenic also to the immunocompetent subjects. We insist on the necessity of multiplying the prelevements and of making a rigorous interpretation of the data of the mycological examination