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Fluoroquinolone-resistant (FQs-R) microorganisms causing infectious complications after ultrasound-guided needle biopsy of the prostate (TRUS-BP) have become an important challenge in healthcare settings globally, questioning the continued utility of FQ as the preferred prophylactic agent. This study aimed to characterize molecular mechanisms of resistance on FQs-R E. coli isolated from the enteric microbiota of patients undergoing (TRUS-BP) and to highlight their impact on Minimum Inhibitory Concentrations (MICs). From February 2016 to December 2018, the incidence of rectal carriage of Qs-FQs resistant Enterobacterales detected from rectal swabs of patients before undergoing (TRUS-BP) was 61.06% (80/131) all related to E. coli species. Based on the MICs range of Qs (24–256 mg/L) and FQs (0.24–128 mg/L) breakpoint by EUCAST, we categorized these E. coli isolates into three resistance profiles (I, II, and III) associated with the patterns of chromosomal mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC and the plasmid-mediated quinolone resistance encoding genes (PMQRs) detected by PCR-based assay and sequencing; MICs increase in an escalation step according to the co-occurrence of multiple molecular mechanisms. The mutation of the gyrA gene was the most frequent on codons (Ser83Leu/Thr/Tyr/Trp and Asp87Asn); mutation on the parC gene was the least on codons (Ser80Iso/Leu and Glu84 Val/Gly/Lys). PMQRs genes (4 qnrB ,7 qnrS, and one aac(6’)-Ib-cr) were determined within 15% of the isolates. Allelic variation allows us to report earliest the qnrB81 determinant in an E. coli isolate. Among isolates (35%) belonged to the notorious ST131 lineage. The phylogenetic group showed a predominance of B2 group (51, 25%), however (PFGE) revealed a high level of clonal variability. Worrying incidence of FQs-R E. coli isolates in the rectal flora of our local population showed the potential to cause post-infection. FQ resistance is a complex interplay between mutations in the QRDRs and PMQR determinants that impact MICs. The importance of intestinal microbiota as a reservoir of resistant strains and pandemic clones encourages driving mitigation challenges to characterize molecular mechanisms of antimicrobial resistance to adapt prophylactic therapy, control infection, and ensure epidemiological monitoring. [ABSTRACT FROM AUTHOR]

Introduction The coronavirus epidemic started in Tunisia in March 2020. Health personnel have been in the front line in the fight against this virus since that date. The COVID units of the hospitals and the different hospital services have been reinforced by student nurses (trainees, volunteers…). Objectives To evaluate the degree of stress perceived during the COVID-19 pandemic by student nurses. To identify coping skills during a COVID-19 pandemic. Methods Descriptive, retrospective study conducted in March 2021 on the 60 senior nursing students enrolled in the military health school. We used the Cungi (1997) stress scale and developed a self-questionnaire on coping skills used by the students. Results Our population was 54.3% male and 45.7% female. The average age was 22.6 years. The majority of the senior students (54.3%) worked in units dedicated to the care of patients with COVID-19. On the Cungi Stress Rating Scale, students had very low (13%), low (27%), and high (60%) stress levels. The main coping methods used were watching movies and listening to music (81%), playing sports (80%), praying (75%), rigorously applying social distancing measures and wearing protective gear (73%), talking with friends or psychologists (62%), doing yoga or meditation (34%), drinking herbal tea, alcohol, or taking psychotropic drugs (23%). Conclusions The COVID-19 pandemic is a time of major stress for nursing students. The coping methods used seem insufficient. Psychological support should be provided. Disclosure No significant relationships.

Introduction The coronavirus epidemic started in Tunisia on March 12, 2020. Nursing students in hospital internship are among the professional categories most exposed to the virus. Objectives To identify stressors during a COVID-19 pandemic among senior nursing students at the military health school. Methods Descriptive, retrospective study conducted in March 2021 of the 60 senior nursing students enrolled in the military health school. We developed a self-questionnaire with questions about potential stressors during a COVID-19 pandemic. Results Our population was 54.3% male and 45.7% female. The mean age was 22.6 years. Most of the senior students (54.3%) worked in units dedicated to the care of patients with COVID-19. The main stressors reported by the students were fear of seeing patients die (84%), contaminating family (81.4%), being assigned to a COVID unit (78%), lack of protective equipment (75%), catching COVID-19 (67%), contaminating colleagues (64%), delay in teaching (61%), lack of competence and making mistakes (53%). Conclusions The COVID-19 pandemic is a time of major stress for nursing students. Psychological support should be provided. Disclosure No significant relationships.

Essential oil (EO) extraction is a widespread practice generating huge amounts of solid plant by-products a potential source of bioactive compounds, on the one hand, and a detrimental risk for the environment that needs to be carefully considered on the other hand. The present study aims to valorize Myrtus communis L. leaf by-products obtained following EO extraction using a steam distillation unit through the recovery of phenolic compounds and the evaluation of their biological activities. The total phenols, flavonoids, and proanthocyanidins contents of the ethanolic extract by-product were higher than the control (leaves without extraction of EO). Their amounts increased from 69.30 to 88.06 mg GAE/g for total phenols, from 36.31 to 70.97 mg QE for flavonoids and from 19.74 to 21.49 mg CE/g of extract for proanthocyanidins. The identification of phenolic compounds by high-performance liquid-chromatography equipped with a reversed-phase (RP-HPLC) system revealed that the by-product sample includes more gallic acid, catechin, syringic acid and luteolin 7-O-glucoside but less p-coumaric acid and kaempferol than the control. Moreover, the mid-infrared spectroscopy (MIR) showed the presence of benzene ring characteristic of phenolic compounds at 756 cm−1, esters of aromatic acids and stretching vibrations of polyphenols at 1141–1234 cm−1, C=C stretching present in phenolic acids such as coumaric acid and catechin at 1604 cm−1. The assessment of antioxidant activity revealed that the ABTS+• radical scavenging activity was significantly increased, whereas the DPPH• radical inhibition activity and the ferric reduction antioxidant power were significantly decreased. The results indicated, as well, that Myrtus communis L. leaf by-products maintained a considerable antibacterial activity depending on the tested bacterial strain. Additionally, the anti-α-amylase activity was higher for the Myrtus communis L. leaf by-product extract. Therefore, Myrtus communis L. leaf by-products of EO extraction offer phenolic compounds with significant biological activities, contributing to the sustainable development and the promotion of circular economy by the recovery of valuable inputs from plant by-products. [ABSTRACT FROM AUTHOR]

Abstract Background A bilateral duplex collecting system is an unusual renal tract abnormality. Vesicoureteral reflux may be associated. We describe a rare case of bilateral duplex collecting system with bilateral vesicoureteral reflux in which the refluxing ureter on the left side drains the upper pole moiety contrary to what is often found. Case presentation A 24-year-old married Arab woman presented with ascending left-sided flank pain during micturition. She complained of recurrent urinary tract infections. A physical examination and laboratory tests were normal. Voiding cystourethrography and computed tomography scan detected bilateral duplex collecting system, grade IV vesicoureteral reflux on the left side, and grade I vesicoureteral reflux on the right. She underwent left heminephrectomy and dextranomer/hyaluronic acid injections on the right side. After a year of follow-up, a clinical examination and imaging findings were unremarkable. Conclusions A bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.

To investigate transmission of drug-resistant strains of Mycobacterium tuberculosis in Tunisia, we performed whole-genome sequencing on 46 multidrug-resistant strains isolated during 2012–2016. Core-genome multilocus sequence typing grouped 30 strains (65.2%) into 3 clusters, indicating extensive recent transmission and Haarlem clone predominance. Whole-genome sequencing might help public health services undertake appropriate control actions.

Introduction The year 2020 was marked by the COVID-19 pandemic. Health services were overwhelmed by the demands for care. Paramedics were both the main actors in the fight and the victims of this pandemic. Objectives The objective of our work was to assess paramedics’ feelings and beliefs about COVID-19. Methods Descriptive and cross-sectional study including paramedics (nurses, orderlies) from the military hospital of Tunis. Data collection was carried out by a clinical psychologist. we studied paramedics’ feelings and beliefs about COVID-19. Results A total of 161 paramedics agreed to answer our questionnaire. The average age was 37.73 years. The average number of years worked was 14.95 years. There were 85 women (52.8%) and 76 men (47.2%). The feelings about COVID-19 were anxiety in 127 (78.9%) paramedics and indifference in 34 (21.1%). The factors that could influence the spread of the pandemic were divine influence (25.5%), the organized fight against viruses (70.2%), our genetics (9.9%), mutations of the virus (6.8%), the BCG vaccine (21.7%), the Tunisian climate (5.6%), our food (13%). Conclusions The beliefs and feelings of paramedics regarding COVID-19 are many and varied. These factors must be taken into consideration because they influence the involvement of paramedics in the fight against the virus and their compliance with health and safety rules.

Introduction The year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Scientists around the world are looking for prophylactic treatment against this virus. Objectives The objective of our study was to assess the acceptability of prophylactic treatment against COVID-19 by paramedics. Methods Descriptive and cross-sectional study including paramedics (nurses, orderlies) from the military hospital of Tunis. Data collection was carried out by a clinical psychologist. We studied the acceptability of prophylactic treatment by paramedics, reasons for refusal and factors that may affect this choice. Results A total of 161 paramedics agreed to answer our questionnaire. The average age was 37.73 years. The average number of years worked was 14.95 years. There were 85 women (52.8%) and 76 men (47.2%). Only 59 (36.6%) agreed to take prophylactic treatment for COVID-19. The main reason for refusal was fear of side effects 57 (34.7%). Sufficient hindsight was the main factor that could make them change their decisions. This refusal was definitive for 55 (34.2%) paramedics. Conclusions Fear of drug side effects exceeds the fear of COVID.19. An information and communication strategy on the value of prophylactic treatments during a pandemic must be developed.

Introduction The year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Scientists around the world are looking for an effective vaccine against this virus. Objectives The objective of our study was to assess the acceptability of the COVID-19 vaccine by paramedics. Methods Descriptive and cross-sectional study including paramedics (nurses, orderlies) from the military hospital of Tunis. Data collection was carried out by a clinical psychologist. We studied the associations between the different characteristics of our population and the decision to accept or refuse vaccination against COVID-19. Results A total of 161 paramedics agreed to answer our questionnaire. The average age was 37.73 years. The average number of years worked was 14.95 years. There were 85 women (52.8%) and 76 men (47.2%). The rapid discovery of the vaccine was hoped for by 94.4%. Vaccination was considered a means of collective protection by 84.5%. However, only 52.8% agreed to be vaccinated by the COVID-19 vaccine. The main factors significantly associated with refusal of the COVID-19 vaccine were previous refusal of influenza vaccination (p = 0.006). Conclusions Apprehension about vaccination does not appear to be sparing the future COVID-19 vaccine. To achieve vaccination coverage that would protect health care workers, several awareness and communication activities must be carried out.