[Listeriosis in Tunis: seven cases reports]. / Les infections à Listeria monocytogenes à Tunis: à propos de sept cas.

Listeria monocytogenesis a Gram positive facultative intracellular bacterium that can be responsible for severe infections, affecting essentially pregnant women, immunocompromised patients at the early and later stages of life. In Tunisia, invasive L. monocytogenes infections are thought to be exceptional and limited data are available about listeriosis. We reported seven cases (five newborn children and two infants) of human listeriosis that occurred in Tunis from 2000 to 2008. The newborn children were hospitalized for suspicion of maternofoetal infections. The two infants were hospitalized for fever associated with digestive signs in one case and neurological signs in the other. L. monocytogenes-was isolated from culture of cerebrospinal fluid in four cases, peripheral samples in two cases and from blood culture in one case. Isolates identification was based on conventional methods. Antimicrobial susceptibility was realized according to the recommendation of the "Comité de l'antibiogramme de la Société française de microbiologie". All L. monocytogenes isolates were sensitive to amoxicillin and aminoside but resistant to 3rd generation cephalosporins. Investigations of the immune system were realized for the two infants including phenotypic analysis of peripheral blood cells by flow cytometry, lymphocyte proliferation assays, phagocytic cell functions and measurement of immunoglobulins as well as complement. All these explorations were normal for both infants. The outcome was fatal in only one case (a newborn child), and all the other patients recovered after adapted antibiotic treatment. In conclusion, our study shows that listeriosis is not exceptional in Tunis. Thus, it is necessary to know how to evoke this diagnosis, at any age, in order to establish an early and adapted antibiotic treatment and to avoid fatal outcome.

Prevalence of autoantibodies in a Tunisian cohort of hepatitis C virus infected dialysis patients.

The hepatitis C virus (HCV) is the principal agent of viral chronic hepatitis. Cirrhosis and hepatocellular carcinoma are the major complications of this chronic infection. In haemodialysis, HCV infection remains a very frequent problem. Several autoimmune phenomena have been described during this infection. Two hundred haemodialysis patients, all of them anti-HCV (+), were included in this study to evaluate the frequency of Anti-Nuclear Autoantibodies (ANA), anti-cardiolipine antibodies (ACL), anti-smooth muscle antibodies (ASMA), anti-mitochondria antibodies (AMA), anti-thyroperoxydase antibodies (ATPO) and Rheumatoid Factor (RF) comparing them to healthy controls. Sixty eight serums (34%) patients were positive to at least one of the auto-antibodies tested. The difference between patients and controls was statistically significant. These markers were dominated by RF of the IgM isotype and ACL of the IgG isotype. Nevertheless, the positivity of ANA, ASMA, AMA and ATPO was not statistically different comparing to the controls. In addition, an association between the presence of the auto-antibodies and the viral replication was found suggesting that HCV is responsible for inducing these autoimmune phenomena.