Characterization of two safe Enterococcus strains producing enterocins isolated from Egyptian dairy products.

Five bacterial cocci isolates were selected from a wide pool of 503 isolates collected from traditional Egyptian dairy products on the basis of their inhibitory activities against Lactobacillus brevis F145, Lactobacillus bulgaricus 340, Enterococcus faecium HKLHS, Listeria ivanovii ATCC, Listeria innocua CIP 80.11 and Listeria monocytogenes EGDe 107776. These 5 isolates were identified as E. faecium TX1330 and E. faecium E980 by 16S rDNA amplification and sequencing. The antibacterial activity of the two strains was not affected by treatment of the cell free culture supernatant with catalase but their activities disappeared completely when digested with protease K, α-chymotrypsin and trypsin. The antimicrobial substance was stable over a wide range of pH (2-10) and was active after heating at 100 °C for 10 min. Bacteriocin yield in two strains reached a maximum (1,600 AU/ml) at the end of the exponential phase (6 h) and remained stable until the end of 24 h-incubation period when the medium reached pH 5.5. Maximal production of bacteriocin was obtained when growing the bacterial cells at temperatures ranging between 30 and 37 °C. Bacteriocin production was unaffected when the bacterial cells grew under severe conditions of pH (9.6) and in high salt (6.5% NaCl). Thanks to PCR gene amplification the bacteriocins produced by E. faecium TX1330 could be identified as enterocins A and B structural genes, while the bacteriocins produced by E. faecium E980 could be identified as enterocins P and L50A structural genes, which can be classified into two enterocin subclasses (IIa and IIc), respectively. PCR amplification demonstrated that the two studied strains did not contain virulence factors asal, cyl A and B, ace, efaAfs and espfm. These two strains were sensitive to most of the tested antibiotics but were resistant to tetracycline. E. faecium E980 was also resistant to chloramphenicol.

Endometrial Nd-YAG laser ablation by hysterofibroscopy: long-term results of 137 cases.

OBJECTIVE: In our gynecology department, we have been performing endometrial laser ablation (ELA) under video control using a flexible hysteroscope since 1989. The aim of this study is to evaluate the long term results of our experience. STUDY DESIGN: We went back to the files of 137 patients treated between 1989 and 1993. These women (mean age 42 years) exhibited menorrhagia unamenable to medical treatments which had been developing for 28 months. Mean hysterometry was 9.8 cm. A hysteroscopy with ELA was performed. Our procedure lasts 19 min on average and uses 0.9 1 of glycocol. There were no perforations. Six patients presented a fever above 38 degrees C within the next 48 h; only one developed a true endometritis necessitating antibiotherapy. One patient who had received several GnRH agonist courses had a coagulation of the uterus and had to be hysterectomised. RESULTS: Nine patients were lost to follow-up; for the others, mean follow-up was 32 months. Seventeen women (13.3%) were hysterectomised, including the patient with a coagulation necrosis of the myometrium. In most cases, this was for undetected adenomyosis or fibromas evolving after hysteroscopy. Bleeding recurred in two other patients; they refused hysterectomy but should be counted as failures of this method. Among the 109 patients (85.1%) considered a success, 35 have had menopause since the procedure. CONCLUSION: ELA is a simple quick procedure which significantly reduces the number of hysterectomies. In addition, the economic value of ELA is beginning to be assessed in the literature. This long-term study should allow the indications to be better defined by eliminating patients with a high risk of failure and should lead to improved results.

[Antibiotic prophylaxis in a priori cesarean sections without a high risk of infection. Experiences of a Tunisian maternity department]. / L'antibioprophylaxie dans les césariennes a priori sans "haut risque infectieux". Expérience d'une maternité tunisienne.

OBJECTIVE: This study was conducted to evaluate the effect of antibiotic prophylaxy on decreasing the frequency of postoperative infections after cesarean sections performed in cases with no prior indication of a high risk of infection. METHODS: A prospective randomized study included 269 cesarean sections without a high risk of infection performed in the Maternity and Neonatology Ward of the Sousse Hospital from February 1991 to July 1991. The patients were randomly divided into two groups. One group received an antibiotic prophylactic treatment including cephapirine, gentamicin and metronidazole) and the second group was given no treatment. RESULTS: Antibiotic prophylactic therapy led to a reduction of infectious morbidity after cesarean section in patients without high risk o infection from 33% to 11%. A 66% rate of efficacy was observed. In addition, antibiotics given in this context led to substantial cost reduction both by reducing the cost of antibiotics prescribed in the postoperative period and by reducing the number of days of hospitalization, and thus total cost. CONCLUSION: This study demonstrated the effectiveness of antibiotic prophylaxy for cesarean sections in patients without a high risk of infection. Nevertheless, a reevaluation of the antibiotic protocols and a rigorous operative procedure are essential.