[Upper urinary tract infections in adults: about 261 episodes]

Upper urinary tract infections are frequent. Escherichia coli is the main pathogen identified from community acquired infections. We aim to study epidemiologic, clinical and bacterial features of this infection. We identified 261 episodes that occurred in241 patients. They were 213 females and 48 males aged of 48, 75 years. Enterobacteriaceae were the main pathogens isolated in 93,5%: E. coli in 73,3% and Klebsiella pneumoniae in 15,3%. E.coli sensitivity was of 30% for amoxicillin, 98% for cefotaxim, 96% for gentamicin, 90% for ciprofloxaine and 56% for co-trimoxazole. Anterior antibiotic use was associated with low E. coli sensitivity mainly with fluoroquinolones [96 vs 77%] and co-trimoxazole [62 vs 43%]. This enhances the role of antibiotic pressure on the resistance emergence. The reasonable use of antibiotics is necessary to limit resistance extent

Evaluating the therapeutic care of HIV infection in Tunisia

Our aim is to determine different therapeutic response profiles in Tunisian HIV- 1 infected patients, to identify those with therapeutic failure and to compare the results of the genotypic resistance test used in Tunisia [INNO LiPA Test] with those of automatic sequencing to evaluate its efficacy. The retrospective survey concerns 392 infected patients enrolled from January 2001 to December 2006. Evaluation of HIV INNO LiPA test was performed by comparing these test results with those of automatic sequencing in 36 plasmatic samples for 13 infected patients with therapeutic failure. on the basis of the HIV viral load evolution, 57.55% of patients present a good therapeutic response and 42.44% a bad one. Patients with therapeutic failure require genotypic resistance test. A comparison of HIV INNO LiPA test and direct sequencing showed a strong concordance between the two tests results either for reverse transcriptase gene or protease gene. However, the uninterruptible results obtained by INNO LiPA test [8.79% of analysed codons] and the limited number of analysed codons were the defaults of INNO LiPA technique .the contribution of INNO LiPA technique in the knowledge of the epidemiological HIV resistance profiles of virus strains of HIV infected individuals failing therapy was considerable. However, due to INNO LiPA technique limitations, sequence analysis must be considered a more complete assay for the monitoring of antiretroviral resistance of HIV infected patients

[Mucormycosis: four case reports]

Mucormycosis is a rare and invasive fungal infection, but frequently fatal when it occurs. It commonly affects patients with diabetes mellitus. The aim of this study is to assess the clinical presentation, radiological findings, management and prognosis of mucormycosis. This retrospective study was conducted in the department of infectious diseases of Rabta hospital between January 1988 and December 2004 and included patients hospitalized for mucormycosis confirmed by mycological and/or histological findings. The study is about four diabetic patients with mucormycosis [3 men and a woman]. Three of them had diabetic ketoacidosis at the time of diagnosis. The infection was sinusal in 2 cases and rhinocerebral in the other two cases. Treatment consisted in systemic amphotericin B combined with surgical debridement in 3 cases. A fatal outcome was noted in 2 cases. Mucormycosis remains a severe infectious disease in diabetic patients. Early diagnosis and treatment is mandatory for a successful management of this infection