[Antimicrobial susceptibilities of emterobacteriaceae isolated from urinary tract infections in the area of Monastir]

The aim of this study is to determinate the local epidemiology of urinary tract infections in the university hospital of Monastir and to evaluate antimicrobial susceptibility of most incriminated Enterobacteriaceae strains since 2002 to 2005. Identification of strains was based on conventional bacteriological features. Susceptibility to antibiotics was studied according to the Antibiogram Committee of the French Microbiology Society recommendations. In total, 8505 Enterobacteriaceae strains were isolated including Escherichia coli [76%] followed by Klebsiella spp. [10.5%] and Proteus mirabilis [4%]. For E. coli and P. mirabilis, resistances rates were respectively 61% and 71% to amoxicillin, 46.4% and 45.5% to the combination amoxicillin-clavulanic acid, and 39.6% and 26% to cotrimoxazole. Strains of Klebsiella spp. were resistant to cefotaxim and amoxicillin + clavulanic acid in respectively 42% and 20% of cases. Finally, from 2002 to 2005, a significant increase in Enterobacteriaceae resistance was observed for ofloxacin, from 11.9% to 17.6% and ciprofloxacin, from 9.1% to 14.5%. The emergence of antimicrobial resistance justifies that empiric treatment of urinary tract infections should be revised regularly

Azathioprine for prevention of postoperative recurrence in crohn's disease

Crohn's disease is a chronic inflammatory bowel disease that can involve any portion of the gastrointestinal tract. Up to 74% of patients require surgery. However, although respective surgery improves the clinical situation, relapses is frequent in most cases. The aim of this clinical trial was to evaluate the profile of patient who received AZA after surgical treatment in order to prevent postoperative recurrence. This was a retrospective study including 17 patients with severe Crohn's disease attending our gastrointestinal unit from September 1998 to June 2004. Patients were eligible if they have severe Crohn's disease, undergoing curative surgical treatment and received azathioprine for the first time after surgery to prevent postoperative recurrence. The study population comprised 17 patients with Crohn's disease [10 men and 7 women; mean age, 27 years]. The Crohn's disease was ileo-colic in 10 cases with perineal manifestations for 2 patients and ileal in 7 cases. The indications for surgery were stenosis in 10 cases, fistula in 5 cases, perforation in 1 case and corticosteroid-resistance in 1 case. The median folio wing-up period was 40 months [9-80 months]. During this period, only 1 patient reported severe adverse event and discontinued treatment due to acute pancreatitis. 1 patient was lost to follow-up and 3 patients had moderate clinical relapse. Maintained remission was obtained for 12 patients. None of our patients had surgical relapse. The result of this study shows the effect of Azathioprine in preventing both clinical and surgical relapses in patients with Crohn's disease who have undergone surgery