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Fungal peritonitis is a serious complication of peritoneal dialysis (PD) leading to loss of ultrafiltration and discontinuation of PD treatment. The most frequently isolated fungi are Candida albicans and, filamentous fungi such Alternaria alternata species are found only rarely. We report the case of a 75-year-old woman who developed peritonitis due to this black fungus.

Nosocomial invasive candidiasis (IC) has emerged as a major problem in neonatal intensive care units (NICUs). We investigated herein the temporal clustering of six cases of neonatal IC due to Candida albicans in an NICU. Eighteen isolates obtained from the six neonates and two isolates from two health care workers (HCWs) working at the same unit and suffering from fingers' onychomycosis were genotyped by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA by using Sfi I (PFGE-Sfi I). PFGE-Sfi I was more effective in discriminating between temporally related isolates. It showed that (i) both HCWs had specific strains excluding them as a source of infections in neonates. (ii) Isolates collected from three neonates were identical providing evidence of their clonal origin and the occurrence of a horizontal transmission of C. albicans in the unit. (iii) The three remaining neonates had specific strains confirming that the IC cases were coincidental. (iv) Microevolution occurred in one catheter-related candidemia case. Our results illustrate the relevance of the molecular approach to investigate suspected outbreaks in hospital surveys and the effectiveness of PFGE-Sfi I for typing of epidemiologically related C. albicans isolates.

Background: Amoeba of the genus Acanthamoeba are ubiquitous free-living protozoa encountered in water and soil. They frequently cause sight-threatening keratitis., Aim: Report of the three first cases diagnosed at the laboratory of Parasitology of Sousse Hospital, (Tunisia)., Case Report: Our study concerned three lens-wearing female patients, aged 17, 20 and 29 years respectively. The patients originate from central Tunisia and presented with unilateral (2 cases) or bilateral (one case) keratitis. Diagnosis was made by demonstrating Acanthamoeba trophozoites and/or cysts on direct examination and/or culture (in agar - Escherichia coli medium) of contact lenses and/or lenses' solution. Direct examination of corneal swabs was negative in three cases but culture was positive in one. The three patients were treated with hexamidine and neomycine eye-drops for three months. Treatment led to scarring of lesions with however sequellar opacities that was minor to moderate in two cases and consisted of a central leucoma with a poor visual outcome in the last case., Conclusion: The need for systematic research of amoeba in lenses wearing patients with keratitis is emphasized.

To report the prevalence and type of intestinal parasites together with their kinetics in Sousse region. Our retrospective study concern data from the examination of 56,268 stool samples and 7552 tape tests, performed in the laboratory of parasitology of F. Hached Sousse hospital from 1st January 1987 up to 31 December 2002. We observed an overall parasite prevalence of 31.5%. Most common parasites were protozoa, Giardia lamblia, Dientamoeba fragilis and Blastocystis hominis being the most frequently encountered. Helminths consisted mainly of Enterobias vermicularis (35.86% positive tape tests) and Hymenolepis nanus. The kinetics data analysis showed an important decrease in the prevalence of Giardia lamblia, the other feco-oral transmitted flagellates and Hymenolepis nanus. In contrast, Dientamoeba fragilis and Blastocystis hominis prevalences increased. The prevalence of the amoeba showed a slight decrease. Intestinal parasites remain quite common in Sousse region, even though their epidemiological patterns are changing. Factors inducing these changes need to be investigated in order to plan efficient control measures.