Primary resistance to clarithromycin, metronidazole and amoxicillin of Helicobacter pylori isolated from Tunisian patients with peptic ulcers and gastritis: a prospective multicentre study

<p>Abstract</p> <p>Background</p> <p>The frequency of primary resistance to antibiotics in H. pylori isolates is increasing worldwide. In Tunisia, there are limited data regarding the pattern of H. pylori antibiotic primary resistance.</p> <p>Aim</p> <p>To evaluate the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and to detect the mutations involved in clarithromycin resistance.</p> <p>Materials and methods</p> <p>273 strains isolated from adults and children were enrolled. The primary resistance to clarithromycin, metronidazole and amoxicillin was evaluated by means of E-test minimal inhibitory concentration (MIC). The real-time PCR using Scorpion primers was performed in all cases to assess clarithromycin primary resistance and point mutations involved.</p> <p>Results</p> <p>No resistance to amoxicillin was detected. For adults, resistance to clarithromycin and metronidazole was found respectively in 14.6% and 56.8%, and respectively in 18.8% and 25% in children. Overall, the rates of global primary resistance to clarithromycin and metronidazole in Tunisia were respectively determined in 15.4% and 51.3%.</p> <p>By the use of Scorpion PCR, the A2143G was the most frequent point mutation observed (88.1%), followed by the A2142G (11.9%); the A2142C was not found and 18 of 42 patients (42.8%) were infected by both the resistant and the susceptible genotype.</p> <p>The association of clarithromycin resistance with gender was not statistically significant, but metronidazole resistant strains were isolated more frequently in females (67.8%) than in males (32.2%) and the difference was significant. As for gastroduodenal diseases, the difference between strains isolated from patients with peptic ulceration and those with non peptic ulceration was not statistically significant. When about the distribution of resistant strains to clarithromycin and metronidazole between the three Tunisian cities (Tunis, Menzel Bourguiba and Mahdia), the difference was not statistically significant.</p> <p>Conclusion</p> <p>Local data regarding the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and the main genetic mutation involved in clarithromycin resistance in vivo (A2143G) are necessary to prove a clear need for a periodic evaluation of antibiotic consumption and new therapeutic strategies in Tunisia in order to avoid the emergence of resistant strains.</p

Implementation of the One Health approach to fight arbovirus infections in the Mediterranean and Black Sea Region: Assessing integrated surveillance in Serbia, Tunisia and Georgia

Background In the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter-sectoral collaboration; however, no standardized methodology exists to study One Health surveillance. Methods We designed a situation analysis study to document how integration of laboratory/clinical human, animal and entomological surveillance of arboviruses was being implemented in the Region. We applied a framework designed to assess three levels of integration: policy/institutional, data collection/data analysis and dissemination. We tested the use of Business Process Modelling Notation (BPMN) to graphically present evidence of inter-sectoral integration. Results Serbia, Tunisia and Georgia participated in the study. West Nile Virus surveillance was analysed in Serbia and Tunisia, Crimea-Congo Haemorrhagic Fever surveillance in Georgia. Our framework enabled a standardized analysis of One Health surveillance integration, and BPMN was easily understandable and conducive to detailed discussions among different actors/institutions. In all countries, we observed integration across sectors and levels except in data collection and data analysis. Data collection was interoperable only in Georgia without integrated analysis. In all countries, surveillance was mainly oriented towards outbreak response, triggered by an index human case. Discussion The three surveillance systems we observed prove that integrated surveillance can be operationalized with a diverse spectrum of options. However, in all countries, the integrated use of data for early warning and inter-sectoral priority setting is pioneeristic. We also noted that early warning before human case occurrence is recurrently not operationally prioritized

Additional file 2: of Relevance of the Mann Whitney Wilcoxon test in the survival analysis of newly established companies in Tunisia (Case of the sfax region)

Questionnaire about the survival factors of newly created companies in Tunisia (Case of the Sfax Region). (DOCX 16 kb

French wine - a historical, social and economic phenomenon

The thesis aims to gather the information from various sources- the historic, specialized sources-books, from the Internet or from my personal consultations as well. The topic has been chosen because the wine stands for France; it has been an inseparable part of the French history and cultural traditions. In other words, it is a phenomenon which along with a language has been developing the identity of the nation. The thesis does not seek to cover the whole representation of the French wine but it provides to look into the world of the French winegrowing. The end of the thesis deals with the wine from an economic point of view. So far, the wine has largely been participant in a prosperous state economy. However, as socalled new wines are placed on the market, France is loosing its original standing is receding from its authentic positions. Powered by TCPDF (www.tcpdf.org

Secretion of cyclodextrin glucanotransferase in <i>E. coli</i> using <i>Bacillus subtilis</i> lipase signal peptide and optimization of culture medium

72-79The cyclodextrin glycosyltransferase (CGTase) of Paenibacillus pabuli US132 was fused to the secretive lipase signal peptide of B. subtilis. This leads to an efficient secretion of the recombinant enzyme into the culture medium of E. coli as an active and soluble form contrasting with the native construction leading to a periplasmic production. In order to enhance the yield of CGTase production, an experimental design methodology was applied for the optimization of the culture composition. Hence, the media components were submitted to preliminary screening using a Plakett-Burman design. The concentrations of the major operating ones were then optimized to enhance the secretion of CGTase using response surface methodology. The findings revealed that concentrations of 0.5% potato starch, 3% yeast extract, 3% tryptone, 1.5% casein hydrolysate, 0.5% NaCl, 0.2% KH2PO4, and 0.02% MgSO4 were the optimal conditions for CGTase production. The experimental value (9.43 U/ml) obtained for CGTase activity was very close to the predicted value (9.27 U/ml)

Wild grown red and yellow hawthorn fruits from Tunisia as source of antioxidants

© 2014 The Authors. Hawthorn fruits (Crataegus spp.), may be a good source of antioxidants if is consumed as fresh fruit since we know that it produce a numerous beneficial effects for human health. In this study, two species of hawthorn fruit, Crataegus monogyna and Crataegus azarolus were analyzed by HPLC-DAD-MS and compared with respect to their phytochemical composition. Phenolic profiles of studied fruits showed some similarities and differences in terms of polyphenols between the two species. Twenty phenolics compounds distributed into four subclasses were identified: four phenolic acids including three hydroxycinnamic acids and one hydroxybenzoic acid, eight flavonoids representing the most abundant subclass including six glucosylated flavonols and two flavones, two anthocyanins are present as glycosides of cyanidin, with cyanidin-3-. O-glucoside is the most abundant, only in monogyna peel fraction and four flavanols divided into a monomer (-)-epicatechin identified in all fruit parts of both species, a dimer B2 and two trimers (C1 and C2). These phenolic compounds are concentrated especially in peel fraction. These results indicate that hawthorn fruits should be recommended in dietary habits as a potential source of antioxidant and anticarcinogenic phenolic compounds.Peer Reviewe

Improvement of Left Ventricular Mass Following Balloon Angioplasty of Native Coarctation of the Aorta: Midterm follow-up in Cairo University, Children's Hospital

Objectives: We evaluated mid-term results of balloon angioplasty (BAP) of native coarctation of the aorta (CoA) in children. There is paucity of data on left ventricular hypertrophy (LVH) and left ventricular mass (LVM) post balloon dilatation of native CoA, hence we also assessed LVM regression. Study Design: Thirteen children were included (11 boys, 2 girls) with median age at intervention of 16 months (4-96 months) and all underwent BAP for native CoA. Patients were followed-up by transthoracic echocardiography assessment of left ventricular function, LVM, recoarctation, and other complications. Follow-up period ranged from 9– 36 months (mean±SD, 24.38±8.22 months). Results: The mean peak systolic gradient decreased to ≤20 mmHg in 11 patients (84.6%), mean peak systolic gradient decreased from 61.15±12.44 mmHg before to 18.85±13.72 mmHg and 15.38±6.27 mmHg immediately after angioplasty and at last follow-up, respectively (P=0.00). There was recurrence of mean pressure gradient in two patients; the first patient was 4 months old and had a successful balloon angioplasty six months later and surgery was performed in the second patient. Ventricular function improved in all patients, mean left ventricular mass index (LVMI) during diastole significantly decreased from 142.27±131.22 before angioplasty to 69.55±54.38 g/cm2 at last follow-up (P=0.038). None of the patients developed aneurysms or any other complications at last follow-up. Conclusion: Considering its mid-term outcome, BAP is a successful and reliable procedure in the treatment of CoA. Follow-up by LVMI can be a noninvasive tool to assess mid and long term improvement

The contact maps of AmyA and AmyB.

<p>The black dots show the common contacts, the pink dots show the contacts which are unique to the native structure and the green for the contacts unique to the truncated enzyme structure.</p