S. Neji - Academia.edu (original) (raw)
Papers by S. Neji
Journal de Mycologie Médicale, 2016
Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We pres... more Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed at our hospital during the last decade. The first case was of a term neonate who presented congenital heart disease (interventricular communication) and body dysmorphic disorder. He was admitted for respiratory failure and sepsis. The second case involved in a 33-year-old woman that had Hodgkinien lymphoma associated to tuberculosis. Identification was performed using commercial systems and confirmed by PCR sequencing of internal transcribed spacer, ITS1 and ITS2 regions of rDNA. Antifungal susceptibility tested by sensititre yeast revealed susceptibility to amphotericin B and resistance to fluconazole for the two strains. These cases emphasize the emerging importance of Rhodotorula sp. as a pathogen and it must be considered a potential pathogen in patients with immunosupression and with central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp. are resistant to antifungal agents, such as fluconazole.
Annales de Dermatologie et de Vénéréologie - FMC
European Psychiatry
IntroductionThe human body carries large and diverse communities of symbiotic microbes that are i... more IntroductionThe human body carries large and diverse communities of symbiotic microbes that are important for human health and development. While the impact of the bacterial microbiota, which are mostly found in the human gut, on host physiology is relatively well described, much less is known about the interactions between the mycobiota and the host and the resulting effects on human health. At the level of the nervous system, there is increasing evidence implicating the gut microbiota in a variety of neurological disorders. Similar demonstrations of a causal or supportive role of the mycobioma in neurological disorders are still rare, but several studies linking fungal dysbiosis to disease in humans suggest a contribution of symbiotic fungi to neurocognitive and behavioral disorders.ObjectivesWe aim through this review to show the role of mycobiota in neurocognitive and behavioral disorders.MethodsWe comprehensively review the scientific literature using Pubmed database and other ...
Elsevier Masson, Jun 16, 2016
![Research paper thumbnail of [Dermatomycosis due to Trichophyton verrucosum in Sfax-Tunisia]](https://attachments.academia-assets.com/99368947/thumbnails/1.jpg)
](Journal de mycologie médicale, 2011
Trichophyton verrucosum is a zoophilic dermatophyte. It can be responsible of various clinical as... more Trichophyton verrucosum is a zoophilic dermatophyte. It can be responsible of various clinical aspects especially inflammatory lesions of skin and scalp. The aim of this study was to determine the clinical and epidemiological characteristics of dermatophytosis due to T. verrucosum. It is a retrospective study realized on 35,918 patients suspected to have superficial mycoses in a 13-year-period (from 1998 to 2010). T. verrucosum was isolated in 178 patients corresponding to 1.2% of all dermatophytosis. Ochraceum variety was the most frequent (60%), followed by album variety (40%). Frequency of isolated T. verrucosum increased passing from one case in 1998 to 37 cases in 2010. The mean age was 22.7 years (range: 1.5-71 years). A percentage of 74.2 of our patients were male and 61% were from urban regions. A percentage of 32.5 could link their clinical lesions to contact with an animal (mainly cattle and sheep). Other family members were infected by tinea in 7.3% of cases. Tinea corpor...
Parasitology Research, Oct 15, 2015
Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in vari... more Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in various environmental sources. They are known to cause serious human infections. The aim of our study was to detect FLA and Acanthamoeba spp. in hospital water circuits. Eighty-four water samples were collected over a period of 4 months (September–December 2011) from different wards of the Sfax University Hospital (surgical services, intensive care unit, operating theater, and water storage tanks). FLA were detected in 53.5 % of samples as follows: surgical services (80 %), operating theater and surgical intensive care unit (13.3 %), medical intensive care unit (0 %), water storage tanks (6.6 %). The predominant morphotype was the acanthopodial (89 %). The others morphotypes were as follows: monopodial (40 %), dactylopodial (22 %), rugosa (62 %), eruptive (24 %), fan shaped (18 %), and polypodial (18 %). Acanthamoeba was found in 40 samples (47.6 %). 64.2 % of isolates were identified as Acanthamoeba spp. by PCR, using primers to amplify a region of 18S rDNA which showed variation in the product length. Sequence analysis of five PCR products identified Acanthamoeba sp. These isolates belong to T4, T10, and T11 genotypes, and to our knowledge this is the first report of the T10 and T11 genotype in Tunisia.The occurrence of potentially pathogenic FLA in the hospital environment may represent a health risk for patients, since these organisms can cause severe opportunistic illness and also can harbor pathogenic agents. Thus, increased awareness regarding these parasites and recognition of their importance, particularly in immunocompromised patients is crucial.
Journal de Mycologie Médicale, 2018
Mycopathologia, 2012
Although the arsenal of agents with anti-Aspergillus activity has expanded over the last decade, ... more Although the arsenal of agents with anti-Aspergillus activity has expanded over the last decade, mortality due to invasive aspergillosis remains unacceptably high. Resistance of the Aspergillus spp. species to antifungal drugs increased in the last 20 years with the increase in antifungal drugs use and might partially account for treatment failures. Recent advances in our understanding of mechanisms of antifungal drug action in Aspergillus, along with the standardization of in vitro susceptibility testing methods, have brought resistance testing to the forefront of clinical mycology. Recent modifications in taxonomy and understanding of the acquired resistance mechanisms of Aspergilli to drugs should support a better management of Aspergillus infections. In this paper, we review the current knowledge on epidemiology and underlying mechanisms involved in antifungal resistance in Aspergillus.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Une étude est en cours en collaboration avec le CBS et le CHU de Nancy pour apporter de plus ampl... more Une étude est en cours en collaboration avec le CBS et le CHU de Nancy pour apporter de plus amples informations sur la génétique de ces deux champignons et devrait donner lieu à un article prochainement. Dans ce travail, la présence des introns présents chez ces champignons dans les gènes ribosomiques a été étudiée et donne lieu à de nouvelles hypothèses concernant l'évolution relative des Scytalidium.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Nos données montrent que la résistance aux azolés est le résultat de plusieurs mécanismes distinc... more Nos données montrent que la résistance aux azolés est le résultat de plusieurs mécanismes distincts, reposant en particulier sur l'efflux actif de type CDR1 et/ou MDR1 dépendant. Ces mécanismes sont, comme attendu, fréquemment combinés chez un même isolat clinique. Ainsi, au moins une mutation associée à la résistance sur le gène ERG11 a pu être mise en évidence chez chacun de ces isolats cliniques. Par ailleurs, de nombreuses mutations, dont certaines jamais décrites auparavant et associées à un changement d'acide aminé ont été mises en évidence sur les facteurs de transcription TAC1, MRR1 et UPC2. De manière intéressante, nos résultats confirment l'implication des mutations T225A, E841G et G980W sur le facteur de transcription TAC1 et de G648S sur le gène UPC2 dans la surexpression constitutive de CDR1 et ERG11 respectivement et in fine dans la résistance aux azolés. Enfin, nous rapportons deux nouvelles mutations sur le gène MRR1 (R557K et K884E), potentiellement impliquées dans la surexpression de MDR1 et la résistance aux azolés.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Mycopathologia, 2010
Invasive candidiasis has emerged as an important nosocomial infection, causing significant morbid... more Invasive candidiasis has emerged as an important nosocomial infection, causing significant morbidity and mortality especially among critically ill patients. The aim of our study was to determine specie distribution and resistance profiles of Candida species isolated from blood cultures. We conducted a retrospective study of all episodes of candidemia diagnosed in our laboratory from January 2006 to May 2009. The susceptibility to antifungal agents of all Candida isolates was tested by using a Sensititre(®) YeastOne panel. A total of 130 Candida isolates were recovered from blood cultures. Candida tropicalis was the most frequent specie (37.7%), followed by C. albicans (22.3%), C. glabrata (19.2%), and C. parapsilosis (12.2%). All the isolates were inhibited by ≤1 μg/ml of amphotericin B and ≤2 μg/ml of caspofungin. For fluconazole, 7.3% of clinical isolates were resistant. It was most active against C. parapsilosis (100% susceptible), C. albicans (95.8% susceptible), and C. tropicalis (94% susceptible). All of the fluconazole-susceptible isolates were susceptible to voriconazole, as were 83.3% of the fluconazole-susceptible-dose-dependent isolates. Among fluconazole-resistant isolates, 85.7% were susceptible to voriconazole. In our institution, C. tropicalis was the most frequent specie isolated from the bloodstream. Caspofungin had an excellent in vitro activity against Candida isolates and was the drug of choice among fluconazole-resistant isolates.
European Journal of Clinical Microbiology & Infectious Diseases, 2011
We investigated six microsatellite markers to type 85 unrelated and 118 related isolates of Candi... more We investigated six microsatellite markers to type 85 unrelated and 118 related isolates of Candida glabrata from 36 patients. Three new markers were selected from the complete sequence of CBS138 and three previously described markers, RPM2, MTI and ERG3 were used. We found a genetic diversity of 0.949 by combining four of them. By applying the new microsatellite markers GLM4, GLM5 and GLM6 we were able to discriminate 29 isolates, originally identified by the more established markers, RPM2, MTI and ERG3. When epidemiologically closely related isolates from 36 patients were typed, 25 patients (72%) exhibited identical or highly related multilocus genotypes. We noted a microvariation in 4 of the patients. This minor change of one locus could be explained by a single step mutation. Since one of these patients had not received antifungal treatment; thus, the relationship between genome variation and antifungal therapy remains controversial. We can conclude from our analysis of these new microsatellite markers that they are highly selective and therefore should be considered as a useful typing system for differentiating related and unrelated isolates of C. glabrata, as well as being able to detect microvariation.
Annales de Dermatologie et de Vénéréologie, 2017
Journal de Mycologie Médicale, 2014
Fungal keratitis is responsible for a significant burden of blinding disease in the developing wo... more Fungal keratitis is responsible for a significant burden of blinding disease in the developing world. The aim of this study was to determine the etiological agents, predisposing factors and therapy of keratomycosis in our region. Retrospective study of 60 patients with clinically and cultured confirmed fungi keratitis, who were attended at department of mycology in Sfax (1995 to 2012). The mean age of patients was 47.2 years (sex ratio: 1.58). At least, one presumed predisposing factor was identified in 83.3% of cases. Corneal traumatism was established as the most common predisposing factor (61.6%) with vegetative matter (42.4%). Patients had corneal ulcer in 40% or abscess in 47.6%. All cases were positive on direct microscopy and 93% of cultures were positive. Filamentous fungi form the major etiologic agents (83%): Fusarium species (49% with F. solani [66%]), Aspergillus sp. (22%), Alternaria (5%), Scedosporium sp. (2%); and non-identified mold in (5%). Yeast were identified in 17% of cases. Topical agents were used in 97% of cases: ketoconazole 2%, amphotericin B (0.5%). Fluconazole per os was administrated for 11% of cases, itraconazole (2 cases) and voriconazole (one case). Keratoplasty was indicated for 27% of cases. The outcome was favorable in 16% of patients. Among the patients, 71% had persistent corneal deposit sequelae. Four patients lost the eyeball. Corneal traumatism was the principal risk factor for fungal keratitis in young and middle-aged farmers. Fusarium solani is the predominant cause in Sfax. Early diagnosis, coupled with appropriate treatment, is crucial for increasing the chance of complete recovery.
Journal of medical microbiology, 2021
Introduction. Trichosporon asahii has been recognized as an opportunistic agent having a limited ... more Introduction. Trichosporon asahii has been recognized as an opportunistic agent having a limited sensitivity to antifungal treatment.Hypothesis/Gap Statement. Molecular mechanisms of azole resistance have been rarely reported for Trichosproron asahii. Similar to other fungi, we hypothesized that both ERG11 gene mutation and efflux pumps genes hyper-expression were implicated.Aim. The current work aimed to study the sensitivity of clinical T. asahii isolates to different antifungal agents and to explore their resistance mechanisms by molecular methods including real-time PCR and gene sequencing.Methods. The sensitivity of T. asahii isolates to fluconazole, amphotericin B and voriconazole was estimated by the Etest method. Real-time PCR was used to measure the relative expression of Pdr11, Mdr and ERG11 genes via the ACT1 housekeeping gene. Three pairs of primers were also chosen to sequence the ERG11 gene. This exploration was followed by statistical study including the receiver oper...
Parasitology Research, 2015
Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in vari... more Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in various environmental sources. They are known to cause serious human infections. The aim of our study was to detect FLA and Acanthamoeba spp. in hospital water circuits. Eighty-four water samples were collected over a period of 4 months (September–December 2011) from different wards of the Sfax University Hospital (surgical services, intensive care unit, operating theater, and water storage tanks). FLA were detected in 53.5 % of samples as follows: surgical services (80 %), operating theater and surgical intensive care unit (13.3 %), medical intensive care unit (0 %), water storage tanks (6.6 %). The predominant morphotype was the acanthopodial (89 %). The others morphotypes were as follows: monopodial (40 %), dactylopodial (22 %), rugosa (62 %), eruptive (24 %), fan shaped (18 %), and polypodial (18 %). Acanthamoeba was found in 40 samples (47.6 %). 64.2 % of isolates were identified as Aca...
Journal de Mycologie Médicale
Medical Mycology Case Reports
Saksenaea vasiformis is a species of the order Mucorales rarely reported as a cause of human muco... more Saksenaea vasiformis is a species of the order Mucorales rarely reported as a cause of human mucormycosis. We report an unusual case of S. vasiformis otitis occurring in a diabetic woman after penetration of an insect in the right ear. Direct microscopic examination of the clinical sample showed hyaline and non septate hyphae belonging to the order Mucorales. Fungal identification was performed by sequencing the ITS region of the rDNA. To our knowledge, this is the first report of S. vasiformis infection in Tunisia.
Journal de Mycologie Médicale
Aspergillusflavus is the second leading cause of invasive and non-invasive aspergillosis. Secreti... more Aspergillusflavus is the second leading cause of invasive and non-invasive aspergillosis. Secretion of hydrolytic enzymes is considered as a virulence factor in this species. Our work aimed to study in vitro production of some virulence factors, to evaluate the biofilm production against human and avian A. flavus isolates and to investigate the antifungal susceptibility agents. Hydrolytic enzymes, biofilm production and molecular typing were studied for 62 human and 36 avian A. flavus isolates by specific solid media and six microsatellite markers. The susceptibility to antifungal agents was evaluated for 37 human isolates. All human and avian A. flavus isolates showed positive activities of extracellular hydrolase: phospholipase, protease and hemolysin. A positive elastase activity was seen in 64.51% of human A. flavus isolates and 86.1% of avian A. flavus isolates. All A. flavus in these two populations formed biofilms. Statistical significant difference was observed for the mean phospholipase activities (P=0.025) and biofilm quantification (P=0.0001) between human and avian A. flavus isolates. The in vitro susceptibility results showed a resistance in 83.7%, 81.08% and 16.21% of A. flavus isolates respectively to amphotericin B, itraconazole and posaconazole. No association was noted between all virulence factors and the genotypes of human and avian isolates. Our study allowed us to show that human strains have a higher production of extracellular hydrolases and biofilm then avian strains. These virulence factors appear to act synergistically to contribute to the virulence of A. flavus strains. Moreover, significant correlation between virulence patterns and antifungal susceptibility profiles was observed.
Journal de Mycologie Médicale, 2016
Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We pres... more Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed at our hospital during the last decade. The first case was of a term neonate who presented congenital heart disease (interventricular communication) and body dysmorphic disorder. He was admitted for respiratory failure and sepsis. The second case involved in a 33-year-old woman that had Hodgkinien lymphoma associated to tuberculosis. Identification was performed using commercial systems and confirmed by PCR sequencing of internal transcribed spacer, ITS1 and ITS2 regions of rDNA. Antifungal susceptibility tested by sensititre yeast revealed susceptibility to amphotericin B and resistance to fluconazole for the two strains. These cases emphasize the emerging importance of Rhodotorula sp. as a pathogen and it must be considered a potential pathogen in patients with immunosupression and with central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp. are resistant to antifungal agents, such as fluconazole.
Annales de Dermatologie et de Vénéréologie - FMC
European Psychiatry
IntroductionThe human body carries large and diverse communities of symbiotic microbes that are i... more IntroductionThe human body carries large and diverse communities of symbiotic microbes that are important for human health and development. While the impact of the bacterial microbiota, which are mostly found in the human gut, on host physiology is relatively well described, much less is known about the interactions between the mycobiota and the host and the resulting effects on human health. At the level of the nervous system, there is increasing evidence implicating the gut microbiota in a variety of neurological disorders. Similar demonstrations of a causal or supportive role of the mycobioma in neurological disorders are still rare, but several studies linking fungal dysbiosis to disease in humans suggest a contribution of symbiotic fungi to neurocognitive and behavioral disorders.ObjectivesWe aim through this review to show the role of mycobiota in neurocognitive and behavioral disorders.MethodsWe comprehensively review the scientific literature using Pubmed database and other ...
Elsevier Masson, Jun 16, 2016
Journal de mycologie médicale, 2011
Trichophyton verrucosum is a zoophilic dermatophyte. It can be responsible of various clinical as... more Trichophyton verrucosum is a zoophilic dermatophyte. It can be responsible of various clinical aspects especially inflammatory lesions of skin and scalp. The aim of this study was to determine the clinical and epidemiological characteristics of dermatophytosis due to T. verrucosum. It is a retrospective study realized on 35,918 patients suspected to have superficial mycoses in a 13-year-period (from 1998 to 2010). T. verrucosum was isolated in 178 patients corresponding to 1.2% of all dermatophytosis. Ochraceum variety was the most frequent (60%), followed by album variety (40%). Frequency of isolated T. verrucosum increased passing from one case in 1998 to 37 cases in 2010. The mean age was 22.7 years (range: 1.5-71 years). A percentage of 74.2 of our patients were male and 61% were from urban regions. A percentage of 32.5 could link their clinical lesions to contact with an animal (mainly cattle and sheep). Other family members were infected by tinea in 7.3% of cases. Tinea corpor...
Parasitology Research, Oct 15, 2015
Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in vari... more Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in various environmental sources. They are known to cause serious human infections. The aim of our study was to detect FLA and Acanthamoeba spp. in hospital water circuits. Eighty-four water samples were collected over a period of 4 months (September–December 2011) from different wards of the Sfax University Hospital (surgical services, intensive care unit, operating theater, and water storage tanks). FLA were detected in 53.5 % of samples as follows: surgical services (80 %), operating theater and surgical intensive care unit (13.3 %), medical intensive care unit (0 %), water storage tanks (6.6 %). The predominant morphotype was the acanthopodial (89 %). The others morphotypes were as follows: monopodial (40 %), dactylopodial (22 %), rugosa (62 %), eruptive (24 %), fan shaped (18 %), and polypodial (18 %). Acanthamoeba was found in 40 samples (47.6 %). 64.2 % of isolates were identified as Acanthamoeba spp. by PCR, using primers to amplify a region of 18S rDNA which showed variation in the product length. Sequence analysis of five PCR products identified Acanthamoeba sp. These isolates belong to T4, T10, and T11 genotypes, and to our knowledge this is the first report of the T10 and T11 genotype in Tunisia.The occurrence of potentially pathogenic FLA in the hospital environment may represent a health risk for patients, since these organisms can cause severe opportunistic illness and also can harbor pathogenic agents. Thus, increased awareness regarding these parasites and recognition of their importance, particularly in immunocompromised patients is crucial.
Journal de Mycologie Médicale, 2018
Mycopathologia, 2012
Although the arsenal of agents with anti-Aspergillus activity has expanded over the last decade, ... more Although the arsenal of agents with anti-Aspergillus activity has expanded over the last decade, mortality due to invasive aspergillosis remains unacceptably high. Resistance of the Aspergillus spp. species to antifungal drugs increased in the last 20 years with the increase in antifungal drugs use and might partially account for treatment failures. Recent advances in our understanding of mechanisms of antifungal drug action in Aspergillus, along with the standardization of in vitro susceptibility testing methods, have brought resistance testing to the forefront of clinical mycology. Recent modifications in taxonomy and understanding of the acquired resistance mechanisms of Aspergilli to drugs should support a better management of Aspergillus infections. In this paper, we review the current knowledge on epidemiology and underlying mechanisms involved in antifungal resistance in Aspergillus.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Une étude est en cours en collaboration avec le CBS et le CHU de Nancy pour apporter de plus ampl... more Une étude est en cours en collaboration avec le CBS et le CHU de Nancy pour apporter de plus amples informations sur la génétique de ces deux champignons et devrait donner lieu à un article prochainement. Dans ce travail, la présence des introns présents chez ces champignons dans les gènes ribosomiques a été étudiée et donne lieu à de nouvelles hypothèses concernant l'évolution relative des Scytalidium.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Nos données montrent que la résistance aux azolés est le résultat de plusieurs mécanismes distinc... more Nos données montrent que la résistance aux azolés est le résultat de plusieurs mécanismes distincts, reposant en particulier sur l'efflux actif de type CDR1 et/ou MDR1 dépendant. Ces mécanismes sont, comme attendu, fréquemment combinés chez un même isolat clinique. Ainsi, au moins une mutation associée à la résistance sur le gène ERG11 a pu être mise en évidence chez chacun de ces isolats cliniques. Par ailleurs, de nombreuses mutations, dont certaines jamais décrites auparavant et associées à un changement d'acide aminé ont été mises en évidence sur les facteurs de transcription TAC1, MRR1 et UPC2. De manière intéressante, nos résultats confirment l'implication des mutations T225A, E841G et G980W sur le facteur de transcription TAC1 et de G648S sur le gène UPC2 dans la surexpression constitutive de CDR1 et ERG11 respectivement et in fine dans la résistance aux azolés. Enfin, nous rapportons deux nouvelles mutations sur le gène MRR1 (R557K et K884E), potentiellement impliquées dans la surexpression de MDR1 et la résistance aux azolés.
Journal de Mycologie Médicale / Journal of Medical Mycology, 2012
Mycopathologia, 2010
Invasive candidiasis has emerged as an important nosocomial infection, causing significant morbid... more Invasive candidiasis has emerged as an important nosocomial infection, causing significant morbidity and mortality especially among critically ill patients. The aim of our study was to determine specie distribution and resistance profiles of Candida species isolated from blood cultures. We conducted a retrospective study of all episodes of candidemia diagnosed in our laboratory from January 2006 to May 2009. The susceptibility to antifungal agents of all Candida isolates was tested by using a Sensititre(®) YeastOne panel. A total of 130 Candida isolates were recovered from blood cultures. Candida tropicalis was the most frequent specie (37.7%), followed by C. albicans (22.3%), C. glabrata (19.2%), and C. parapsilosis (12.2%). All the isolates were inhibited by ≤1 μg/ml of amphotericin B and ≤2 μg/ml of caspofungin. For fluconazole, 7.3% of clinical isolates were resistant. It was most active against C. parapsilosis (100% susceptible), C. albicans (95.8% susceptible), and C. tropicalis (94% susceptible). All of the fluconazole-susceptible isolates were susceptible to voriconazole, as were 83.3% of the fluconazole-susceptible-dose-dependent isolates. Among fluconazole-resistant isolates, 85.7% were susceptible to voriconazole. In our institution, C. tropicalis was the most frequent specie isolated from the bloodstream. Caspofungin had an excellent in vitro activity against Candida isolates and was the drug of choice among fluconazole-resistant isolates.
European Journal of Clinical Microbiology & Infectious Diseases, 2011
We investigated six microsatellite markers to type 85 unrelated and 118 related isolates of Candi... more We investigated six microsatellite markers to type 85 unrelated and 118 related isolates of Candida glabrata from 36 patients. Three new markers were selected from the complete sequence of CBS138 and three previously described markers, RPM2, MTI and ERG3 were used. We found a genetic diversity of 0.949 by combining four of them. By applying the new microsatellite markers GLM4, GLM5 and GLM6 we were able to discriminate 29 isolates, originally identified by the more established markers, RPM2, MTI and ERG3. When epidemiologically closely related isolates from 36 patients were typed, 25 patients (72%) exhibited identical or highly related multilocus genotypes. We noted a microvariation in 4 of the patients. This minor change of one locus could be explained by a single step mutation. Since one of these patients had not received antifungal treatment; thus, the relationship between genome variation and antifungal therapy remains controversial. We can conclude from our analysis of these new microsatellite markers that they are highly selective and therefore should be considered as a useful typing system for differentiating related and unrelated isolates of C. glabrata, as well as being able to detect microvariation.
Annales de Dermatologie et de Vénéréologie, 2017
Journal de Mycologie Médicale, 2014
Fungal keratitis is responsible for a significant burden of blinding disease in the developing wo... more Fungal keratitis is responsible for a significant burden of blinding disease in the developing world. The aim of this study was to determine the etiological agents, predisposing factors and therapy of keratomycosis in our region. Retrospective study of 60 patients with clinically and cultured confirmed fungi keratitis, who were attended at department of mycology in Sfax (1995 to 2012). The mean age of patients was 47.2 years (sex ratio: 1.58). At least, one presumed predisposing factor was identified in 83.3% of cases. Corneal traumatism was established as the most common predisposing factor (61.6%) with vegetative matter (42.4%). Patients had corneal ulcer in 40% or abscess in 47.6%. All cases were positive on direct microscopy and 93% of cultures were positive. Filamentous fungi form the major etiologic agents (83%): Fusarium species (49% with F. solani [66%]), Aspergillus sp. (22%), Alternaria (5%), Scedosporium sp. (2%); and non-identified mold in (5%). Yeast were identified in 17% of cases. Topical agents were used in 97% of cases: ketoconazole 2%, amphotericin B (0.5%). Fluconazole per os was administrated for 11% of cases, itraconazole (2 cases) and voriconazole (one case). Keratoplasty was indicated for 27% of cases. The outcome was favorable in 16% of patients. Among the patients, 71% had persistent corneal deposit sequelae. Four patients lost the eyeball. Corneal traumatism was the principal risk factor for fungal keratitis in young and middle-aged farmers. Fusarium solani is the predominant cause in Sfax. Early diagnosis, coupled with appropriate treatment, is crucial for increasing the chance of complete recovery.
Journal of medical microbiology, 2021
Introduction. Trichosporon asahii has been recognized as an opportunistic agent having a limited ... more Introduction. Trichosporon asahii has been recognized as an opportunistic agent having a limited sensitivity to antifungal treatment.Hypothesis/Gap Statement. Molecular mechanisms of azole resistance have been rarely reported for Trichosproron asahii. Similar to other fungi, we hypothesized that both ERG11 gene mutation and efflux pumps genes hyper-expression were implicated.Aim. The current work aimed to study the sensitivity of clinical T. asahii isolates to different antifungal agents and to explore their resistance mechanisms by molecular methods including real-time PCR and gene sequencing.Methods. The sensitivity of T. asahii isolates to fluconazole, amphotericin B and voriconazole was estimated by the Etest method. Real-time PCR was used to measure the relative expression of Pdr11, Mdr and ERG11 genes via the ACT1 housekeeping gene. Three pairs of primers were also chosen to sequence the ERG11 gene. This exploration was followed by statistical study including the receiver oper...
Parasitology Research, 2015
Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in vari... more Free-living amoebae (FLA) are opportunistic and ubiquitous protozoa that are widely found in various environmental sources. They are known to cause serious human infections. The aim of our study was to detect FLA and Acanthamoeba spp. in hospital water circuits. Eighty-four water samples were collected over a period of 4 months (September–December 2011) from different wards of the Sfax University Hospital (surgical services, intensive care unit, operating theater, and water storage tanks). FLA were detected in 53.5 % of samples as follows: surgical services (80 %), operating theater and surgical intensive care unit (13.3 %), medical intensive care unit (0 %), water storage tanks (6.6 %). The predominant morphotype was the acanthopodial (89 %). The others morphotypes were as follows: monopodial (40 %), dactylopodial (22 %), rugosa (62 %), eruptive (24 %), fan shaped (18 %), and polypodial (18 %). Acanthamoeba was found in 40 samples (47.6 %). 64.2 % of isolates were identified as Aca...
Journal de Mycologie Médicale
Medical Mycology Case Reports
Saksenaea vasiformis is a species of the order Mucorales rarely reported as a cause of human muco... more Saksenaea vasiformis is a species of the order Mucorales rarely reported as a cause of human mucormycosis. We report an unusual case of S. vasiformis otitis occurring in a diabetic woman after penetration of an insect in the right ear. Direct microscopic examination of the clinical sample showed hyaline and non septate hyphae belonging to the order Mucorales. Fungal identification was performed by sequencing the ITS region of the rDNA. To our knowledge, this is the first report of S. vasiformis infection in Tunisia.
Journal de Mycologie Médicale
Aspergillusflavus is the second leading cause of invasive and non-invasive aspergillosis. Secreti... more Aspergillusflavus is the second leading cause of invasive and non-invasive aspergillosis. Secretion of hydrolytic enzymes is considered as a virulence factor in this species. Our work aimed to study in vitro production of some virulence factors, to evaluate the biofilm production against human and avian A. flavus isolates and to investigate the antifungal susceptibility agents. Hydrolytic enzymes, biofilm production and molecular typing were studied for 62 human and 36 avian A. flavus isolates by specific solid media and six microsatellite markers. The susceptibility to antifungal agents was evaluated for 37 human isolates. All human and avian A. flavus isolates showed positive activities of extracellular hydrolase: phospholipase, protease and hemolysin. A positive elastase activity was seen in 64.51% of human A. flavus isolates and 86.1% of avian A. flavus isolates. All A. flavus in these two populations formed biofilms. Statistical significant difference was observed for the mean phospholipase activities (P=0.025) and biofilm quantification (P=0.0001) between human and avian A. flavus isolates. The in vitro susceptibility results showed a resistance in 83.7%, 81.08% and 16.21% of A. flavus isolates respectively to amphotericin B, itraconazole and posaconazole. No association was noted between all virulence factors and the genotypes of human and avian isolates. Our study allowed us to show that human strains have a higher production of extracellular hydrolases and biofilm then avian strains. These virulence factors appear to act synergistically to contribute to the virulence of A. flavus strains. Moreover, significant correlation between virulence patterns and antifungal susceptibility profiles was observed.