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Ghozzi K, Nakbi A, Challouf R, Dhiab RB. A review on microbial contamination cases in Tunisian coastal marine areas. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2023; 87:2142-2158. [PMID: 37186620 PMCID: wst_2023_123 DOI: 10.2166/wst.2023.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Microbial pollution in marine environments is one of the critical issues with regard to the sanitary status of recreational activities and seafood harvesting due to a potential contamination by pathogenic microorganisms. This review's objectives were to identify instances of bacterial, viral and protozoan parasite pollution in the Tunisian coastal region and to make recommendations for further research. Fecal indicators such as Escherichia coli and Salmonella spp. were detected in samples of clams and mussels. Vibrionaceae species were also recorded in seawater, sediment, fish and clams in different sites from north to south with the dominance of Vibrio alginolyticus. Bivalve mollusks collected from the Tunisian coast have been revealed to harbor viruses as well as protozoan parasites. Furthermore, the isolation of multidrug-resistant bacterial strains from Tunisian coastlines proves the significant spread and circulation of antibiotic resistance caused by the massive use of antibiotics. In conclusion, we suggest intensive monitoring and cutting-edge wastewater treatment technologies to enhance seawater quality and preserve the biodiversity of aquatic life. Rapid detection techniques for the most important pathogenic microorganisms in seafood and seawater must be also developed to reduce human health risk.
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Affiliation(s)
- Khemissa Ghozzi
- Laboratoire de Biodiversité Marine, Institut National des Sciences et Technologies de la Mer, Monastir, Tunisie E-mail:
| | - Amel Nakbi
- Laboratoire de Biodiversité Marine, Institut National des Sciences et Technologies de la Mer, Monastir, Tunisie E-mail:
| | - Rafika Challouf
- Laboratoire de Biodiversité Marine, Institut National des Sciences et Technologies de la Mer, Monastir, Tunisie E-mail:
| | - Rym Ben Dhiab
- Laboratoire de Biodiversité Marine, Institut National des Sciences et Technologies de la Mer, Monastir, Tunisie E-mail:
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Salvo M, Azambuya J, Baccardatz N, Moriondo A, Blanco R, Martinez M, Direnna M, Bertolini G, Gamazo P, Colina R, Alvareda E, Victoria M. One-Year Surveillance of SARS-CoV-2 and Rotavirus in Water Matrices from a Hot Spring Area. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:401-409. [PMID: 36181654 PMCID: PMC9525940 DOI: 10.1007/s12560-022-09537-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is still impacting not only on human health but also all economic activities, especially in those related to tourism. In this study, in order to characterize the presence of SARS-CoV-2 in a hot spring park in Uruguay, swimming pools water, wastewater, and surface water from this area were analyzed by quantitative PCR. Wastewater from Salto city located next to the hydrothermal spring area was also evaluated as well as the presence of Rotavirus (RV). Overall, SARS-CoV-2 was detected in 13% (13/102) of the analyzed samples. Moreover, this virus was not detected in any of the samples from the swimming pools water and was present in 18% (3/17) of wastewater samples from the hotels area showing the same trend between the titer of SARS-CoV-2 and the number of infected people in Salto city. SARS-CoV-2 was also detected in wastewater samples (32% (11/34)) from Salto city, detecting the first positive sample when 105 persons were positive for SARS-CoV-2. Rotavirus was detected only in 10% (2/24) of the wastewater samples analyzed in months when partial lockdown measures were taken, however, this virus was detected in nearly all wastewater samples analyzed when social distancing measures and partial lockdown were relaxed. Wastewater results confirmed the advantages of using the detection and quantification of viruses in this matrix in order to evaluate the presence of these viruses in the population, highlighting the usefulness of this approach to define and apply social distancing. This study suggests that waters from swimming pools are not a source of infection for SARS-CoV-2, although more studies are needed including infectivity assays in order to confirm this statement.
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Affiliation(s)
- M Salvo
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - J Azambuya
- Administración de Las Obras Sanitarias del Estado, Salto, Uruguay
| | - N Baccardatz
- Administración de Las Obras Sanitarias del Estado, Salto, Uruguay
| | - A Moriondo
- Ministry of Public Health, Salto, Uruguay
| | - R Blanco
- Ministry of Public Health, Salto, Uruguay
| | | | - M Direnna
- Intendencia de Salto, Salto, Uruguay
| | | | - P Gamazo
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - R Colina
- Laboratory of Molecular Virology, Centro Universitario Regional Litoral Norte, Universidad de la República, Rivera 1350, 50000, Salto, CP, Uruguay
| | - E Alvareda
- Water Department, Centro Universitario Regional Litoral Norte, Universidad de La República, Rivera 1350, 50000, Salto, CP, Uruguay.
| | - M Victoria
- Laboratory of Molecular Virology, Centro Universitario Regional Litoral Norte, Universidad de la República, Rivera 1350, 50000, Salto, CP, Uruguay.
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Baek K, Choi J, Park JT, Kwak K. Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1725-1736. [PMID: 35829753 DOI: 10.1007/s00484-022-02313-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/21/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to analyze the association between temperature and precipitation and the incidence of hepatitis A in Seoul, Korea, as meteorological factors may have different effects on specific diseases depending on the lifestyle in each region. Weekly cases of hepatitis A, weekly mean daily precipitation, and temperature data from 2016 to 2020 were analyzed. Quasi-Poisson-generalized linear models with time variable adjusted by spline function were used considering 0-6-week lags. The association of each variable and hepatitis A incidence was assessed by the single lag and the constrained distributed lag model. Multivariable distributed lag linear and non-linear models were used to develop models with significant independent variables. Weekly mean of daily mean temperature (Tmean) and maximum temperature (Tmax) were negatively associated with hepatitis A in the 6-week lag. Precipitation was negatively associated with hepatitis A in the 5- and 6-week lags. The multivariable model showed the negative association of Tmax, precipitation and hepatitis A in the 5- and 6-week lags. In the non-linear models, the incidence rate ratio (IRR) was the highest at a Tmax of 11 °C and decreased thereafter. IRR was the highest at 12 mm of precipitation and showed decrease pattern to 25 mm and then gradually increased in the 5- and 6-week lags. Identifying the impact of climate factors on hepatitis A incidence would help in the development of strategies to prevent diseases and indirectly estimate the impact of climate change on hepatitis A epidemiology.
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Affiliation(s)
- Kiook Baek
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jonghyuk Choi
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jong-Tae Park
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Kyeongmin Kwak
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
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Ayouni K, Chouikha A, Khamessi O, Touzi H, Hammemi W, Triki H. Evidence of Circulation of Several HAV Genetic Variants and Emergence of Potential Antigenic Variants in an Endemo-Epidemic Country before Vaccine Introduction. Viruses 2021; 13:v13061056. [PMID: 34204862 PMCID: PMC8227776 DOI: 10.3390/v13061056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/20/2021] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
Similar to several other countries in the world, the epidemiology of hepatitis A virus changed from high to intermediate endemicity level in Tunisia, which led to the occurrence of outbreaks. This study aimed to determine the genetic and antigenic variability of HAV strains circulating in Tunisia during the last few years. Genotyping using complete VP1 gene and VP1-2A junction confirmed the predominance of genotype IA, with co-circulation of several genetic and antigenic variants. Phylogenetic analysis including Tunisian and strains from other regions of the world showed the presence of at least two IA-variants within IA subgenotype. Amino-acid analysis showed several mutations in or close to epitope regions in the VP1-region. This study provides a baseline on the genetic and antigenic variability of HAV circulating strains before the introduction of vaccination into the national immunization schedule.
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Affiliation(s)
- Kaouther Ayouni
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1002, Tunisia; (H.T.); (W.H.); (H.T.)
- Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, El Manar, Tunis 2092, Tunisia
- Correspondence: (K.A.); (A.C.); Tel.: +216-26-199-695 (K.A.); +216-98-528-682 (A.C.)
| | - Anissa Chouikha
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1002, Tunisia; (H.T.); (W.H.); (H.T.)
- Correspondence: (K.A.); (A.C.); Tel.: +216-26-199-695 (K.A.); +216-98-528-682 (A.C.)
| | - Oussema Khamessi
- Institut Pasteur de Tunis, Université de Tunis El Manar, LR11IPT08 Venins et Biomolecules Therapeutiques, Tunis 1002, Tunisia;
| | - Henda Touzi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1002, Tunisia; (H.T.); (W.H.); (H.T.)
| | - Walid Hammemi
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1002, Tunisia; (H.T.); (W.H.); (H.T.)
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Reference Laboratory for Poliomyelitis and Measles in the Eastern Mediterranean Region, Pasteur Institute of Tunis, University Tunis El Manar (UTM), Tunis 1002, Tunisia; (H.T.); (W.H.); (H.T.)
- Faculty of Medicine of Tunis, University of Tunis El Manar, 15 Rue Djebel Lakhdhar, La Rabta, Tunis 1007, Tunisia
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McCall C, Wu H, O'Brien E, Xagoraraki I. Assessment of enteric viruses during a hepatitis outbreak in Detroit MI using wastewater surveillance and metagenomic analysis. J Appl Microbiol 2021; 131:1539-1554. [PMID: 33550682 DOI: 10.1111/jam.15027] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/13/2021] [Accepted: 02/01/2021] [Indexed: 12/24/2022]
Abstract
AIMS This study investigates enteric viruses in wastewater during an outbreak of acute hepatitis caused by hepatitis A virus (HAV) in a large metropolitan area. Emphasis is given to caliciviruses and HAV. METHODS AND RESULTS Metagenomic analysis was performed to characterize enteric viruses excreted by the population of Detroit MI, during a hepatitis A outbreak that occurred in 2017 and 2018. Additionally, HAV, norovirus GII, and sapovirus were quantified, using qPCR, in 54 untreated wastewater samples collected over the course of 4 months. Correlation analysis was performed to identify associations between the number of disease cases and HAV concentrations in wastewater. HAV obtained the highest relative abundance among other enteric viruses detected in wastewater metagenomes. Metagenomic analysis also detected several other enteric viruses including astrovirus, enterovirus and hepatitis E virus. Average sapovirus concentrations of 1·36 × 106 gc l-1 were significantly greater than norovirus GII concentrations (2·94 × 104 gc l-1 ). Additionally, norovirus GI and GII along with sapovirus GI.1 were detected using metagenomics. HAV loads in wastewater were significantly correlated with the number of disease cases reported 1 week after wastewater sampling. CONCLUSIONS Surveying untreated wastewater is a promising method for detecting early signs of hepatitis A outbreaks and for routine environmental monitoring of enteric viruses circulating in the environment. SIGNIFICANCE AND IMPACT OF THE STUDY Authors demonstrate the usefulness of metagenomics for genogrouping and enteric viral surveillance.
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Affiliation(s)
- C McCall
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - H Wu
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - E O'Brien
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
| | - I Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, USA
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Upfold NS, Luke GA, Knox C. Occurrence of Human Enteric Viruses in Water Sources and Shellfish: A Focus on Africa. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:1-31. [PMID: 33501612 PMCID: PMC7837882 DOI: 10.1007/s12560-020-09456-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/16/2020] [Indexed: 05/02/2023]
Abstract
Enteric viruses are a diverse group of human pathogens which are primarily transmitted by the faecal-oral route and are a major cause of non-bacterial diarrhoeal disease in both developed and developing countries. Because they are shed in high numbers by infected individuals and can persist for a long time in the environment, they pose a serious threat to human health globally. Enteric viruses end up in the environment mainly through discharge or leakage of raw or inadequately treated sewage into water sources such as springs, rivers, dams, or marine estuaries. Human exposure then follows when contaminated water is used for drinking, cooking, or recreation and, importantly, when filter-feeding bivalve shellfish are consumed. The human health hazard posed by enteric viruses is particularly serious in Africa where rapid urbanisation in a relatively short period of time has led to the expansion of informal settlements with poor sanitation and failing or non-existent wastewater treatment infrastructure, and where rural communities with limited or no access to municipal water are dependent on nearby open water sources for their subsistence. The role of sewage-contaminated water and bivalve shellfish as vehicles for transmission of enteric viruses is well documented but, to our knowledge, has not been comprehensively reviewed in the African context. Here we provide an overview of enteric viruses and then review the growing body of research where these viruses have been detected in association with sewage-contaminated water or food in several African countries. These studies highlight the need for more research into the prevalence, molecular epidemiology and circulation of these viruses in Africa, as well as for development and application of innovative wastewater treatment approaches to reduce environmental pollution and its impact on human health on the continent.
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Affiliation(s)
- Nicole S Upfold
- Department of Biochemistry and Microbiology, Rhodes University, Grahamstown, 6140, South Africa
| | - Garry A Luke
- Centre for Biomolecular Sciences, School of Biology, Biomolecular Sciences Building, University of St Andrews, North Haugh, St Andrews, Scotland, KY16 9ST, UK
| | - Caroline Knox
- Department of Biochemistry and Microbiology, Rhodes University, Grahamstown, 6140, South Africa.
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Cella E, Golkocheva-Markova EN, Trandeva-Bankova D, Gregori G, Bruni R, Taffon S, Equestre M, Costantino A, Spoto S, Curtis M, Ciccaglione AR, Ciccozzi M, Angeletti S. The genetic diversity of hepatitis A genotype I in Bulgaria. Medicine (Baltimore) 2018; 97:e9632. [PMID: 29504993 PMCID: PMC5779762 DOI: 10.1097/md.0000000000009632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to analyze sequences of hepatitis A virus (HAV) Ia and Ib genotypes from Bulgarian patients to investigate the molecular epidemiology of HAV genotype I during the years 2012 to 2014. Around 105 serum samples were collected by the Department of Virology of the National Center of Infectious and Parasitic Diseases in Bulgaria. The sequenced region encompassed the VP1/2A region of HAV genome. The sequences obtained from the samples were 103. For the phylogenetic analyses, 5 datasets were built to investigate the viral gene in/out flow among distinct HAV subpopulations in different geographic areas and to build a Bayesian dated tree, Bayesian phylogenetic and migration pattern analyses were performed. HAV Ib Bulgarian sequences mostly grouped into a single clade. This indicates that the Bulgarian epidemic is partially compartmentalized. It originated from a limited number of viruses and then spread through fecal-oral local transmission. HAV Ia Bulgarian sequences were intermixed with European sequences, suggesting that an Ia epidemic is not restricted to Bulgaria but can affect other European countries. The time-scaled phylogeny reconstruction showed the root of the tree dating in 2008 for genotype Ib and in 1999 for genotype Ia with a second epidemic entrance in 2003. The Bayesian skyline plot for genotype Ib showed a slow but continuous growth, sustained by fecal-oral route transmission. For genotype Ia, there was an exponential growth followed by a plateau, which suggests better infection control. Bidirectional viral flow for Ib genotype, involving different Bulgarian areas, was observed, whereas a unidirectional flow from Sofia to Ihtiman for genotype Ia was highlighted, suggesting the fecal-oral transmission route for Ia.
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Affiliation(s)
- Eleonora Cella
- Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Elitsa N. Golkocheva-Markova
- NRL of Viral hepatitis, Virology department, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - Diljana Trandeva-Bankova
- NRL of Viral hepatitis, Virology department, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - Giulia Gregori
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome
| | - Roberto Bruni
- Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases
| | - Stefania Taffon
- Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases
| | - Michele Equestre
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità
| | - Angela Costantino
- Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases
| | - Silvia Spoto
- Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy
| | - Melissa Curtis
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA
| | - Anna Rita Ciccaglione
- Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases
| | - Massimo Ciccozzi
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome
| | - Silvia Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome
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Ouardani I, Turki S, Aouni M, Romalde JL. Detection and Molecular Characterization of Hepatitis A Virus from Tunisian Wastewater Treatment Plants with Different Secondary Treatments. Appl Environ Microbiol 2016; 82:3834-3845. [PMID: 27107113 PMCID: PMC4907194 DOI: 10.1128/aem.00619-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/12/2016] [Indexed: 12/17/2022] Open
Abstract
UNLABELLED Hepatitis A virus (HAV) is the main causative agent of hepatitis infection associated with waterborne outbreaks worldwide. In Tunisia, there is no specific surveillance system for HAV and current secondary wastewater treatment processes are unable to remove viral particles, which present a potential public health problem. Qualitative and quantitative analysis of HAV in 271 raw and treated wastewater samples from five sewage treatment plants (STPs) during 13 months was performed. Moreover, the efficiency of three secondary wastewater treatment processes (conventional activated sludge, extended aeration, and oxidation ditch activated sludge) was evaluated. Data obtained demonstrated that HAV is endemic in Tunisia and circulates with high prevalence in both raw (66.9%) and treated (40.7%) wastewater. HAV circulates throughout the year in the coastal areas, with the highest rates found during summer and autumn, whereas in central Tunisia, high levels were shown in autumn and winter. Total virus removal was not achieved, since no difference in mean HAV loads was observed in effluents (6.0 × 10(3) genome copies [GC]/ml) and influents (2.7 × 10(3) GC/ml). The comparison of the HAV removal values of the three different wastewater treatment methods indicates that extended aeration and oxidation ditch activated sludge had better efficiency in removing viruses than conventional activated sludge did. Molecular characterization revealed that the vast majority of HAV strains belonged to subgenotype IA, with the cocirculation of subgenotype IB in wastewater treatment plants that collect tourism wastewater. IMPORTANCE This report provides important data on the incidence, behavior, seasonality, and genotype distribution of HAV in the environment in Tunisia, as well as the risk of infection derived from its occurrence in effluents due to inadequate wastewater treatment. In addition, these findings seem to confirm that the prevalence of HAV depends on socioeconomic level, sanitary conditions in the communities, sewage facilities, the locality, and the climate. The wide dispersion of HAV in effluents proves the inefficacity of the current wastewater treatment processes used in Tunisia to remove virus; therefore, establishment of tertiary treatment processes or replacement of the medium-charge activated sludge (conventional activated sludge) by the low-charge version (oxidation ditch activated sludge) is absolutely needed. Rapid detection of the HAV genome in wastewater may provide a timely warning sign to health authorities to implement population protection measures.
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Affiliation(s)
- Imen Ouardani
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Syrine Turki
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Mahjoub Aouni
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Jesús L Romalde
- Departamento de Microbiología y Parasitología, CIBUS-Facultad de Biología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Efficiency of hepatitis A virus removal in six sewage treatment plants from central Tunisia. Appl Microbiol Biotechnol 2015; 99:10759-69. [PMID: 26286509 DOI: 10.1007/s00253-015-6902-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
The efficiency of six Tunisian sewage treatment plants (STP) for the removal of hepatitis A virus (HAV) from wastewater was analysed in order to evaluate the potential risk for human health linked to reuse or discharge of treated wastewater into the environment. The STP utilize different biological wastewater treatments including primary treatment, which involves the physical removal of organic and inorganic solids, and secondary treatment that involves different processes, such as activated sludge or lagoon. Quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) and conventional RT-PCR were used for the analysis of the 325 wastewater samples (163 raw and 162 treated) obtained. Results revealed highest contamination in west-central of Tunisia in raw wastewater with 62.96 % of samples positive for HAV and predominance during winter and autumn, whereas east-central region showed 50.62 % of positive samples with high prevalence from winter through summer. The quantitative analysis revealed a range between 4.29 × 10(1) and 1.24 × 10(5) RNA copies/mL in treated wastewater, showing clearly the inefficiency for total removal of HAV regardless of the treatment method used. The vast majority of HAV sequences belonged to the sub-genotype IA, except one that was assigned to sub-genotype IB.
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Abstract
Background: Viral hepatitis is an infection that has been reported to be present throughout the year, but some particular months are associated with higher incidences. The primary objective was to review and report on the current knowledge and evidence that existed on seasonality of different type of acute viral hepatitis worldwide in order to develop recommendations for future research, prevention and control. Materials and Methods: A systematic literature review was performed to identify all the primary reports and studies published during 1970-2013 on acute hepatitis A, B, C and E (AHA, AHB, AHC and AHE) in human subjects by searching PubMed, reference lists of major articles and correspondence with scientific experts. For each report or study included, the following information was extracted (as applicable to study): Location (country and setting), study population (number of cases, patients), seasonal or monthly rate and study duration. Results: There is no definite and consistent seasonal pattern has been observed on AHA; AHB; AHE and AHC, although evidence points towards spring and summer peak for hepatitis A, B, C and E. Multiple source of transmission such as; summer travel to an endemic area, swimming habits of the population in hot months, increase sexual contact, tattoo, poor hygiene and environmental sanitation and food habits (feco-oral transmission of viral hepatitis) probably exists and should be further investigated through analytical and epidemiological.
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Affiliation(s)
- Auda Fares
- Albert-Schlangen, Str.36 Bedburg-Germany
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11
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Migration pattern of hepatitis A virus genotype IA in North-Central Tunisia. Virol J 2015; 12:17. [PMID: 25886374 PMCID: PMC4327963 DOI: 10.1186/s12985-015-0249-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/28/2015] [Indexed: 01/20/2023] Open
Abstract
Background Hepatitis A virus (HAV) epidemiology in Tunisia has changed from high to intermediate endemicity in the last decades. However, several outbreaks continue to occur. The last reported sequences from Tunisian HAV strains date back to 2006. In order to provide an updated overview of the strains currently circulating in Tunisia, a large-scale molecular analysis of samples from hepatitis A cases was performed, the first in Tunisia. Results Biological samples were collected from patients with laboratory confirmed hepatitis A: 145 sera samples in Tunis, Monastir, Sousse and Kairouan from 2008 to 2013 and 45 stool samples in Mahdia in 2009. HAV isolates were characterised by nested RT-PCR (VP1/2A region) and sequencing. The sequences finally obtained from 81 samples showed 78 genotype IA and 3 genotype IB isolates. A Tunisian genotype IA sequence dataset, including both the 78 newly obtained IA sequences and 51 sequences retrieved from GenBank, was used for phylogenetic investigation, including analysis of migration pattern among six towns. Virus gene flow from Sfax and Monastir was directed to all other towns; in contrast, the gene flows from Sousse, Tunis, Mahdia and Kairouan were directed to three, two, one and no towns, respectively. Conclusions Several different HAV strains co-circulate in Tunisia, but the predominant genotype still continues to be IA (78/81, 96% isolates). A complex gene flow (migration) of HAV genotype IA was observed, with Sfax and Monastir showing gene flows to all other investigated towns. This approach coupled to a wider sampling can prove useful to investigate the factors underlying the spread of HAV in Tunisia and, thus, to implement appropriate preventing measures.
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12
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Béji-Hamza A, Khélifi-Gharbi H, Hassine-Zaafrane M, Della Libera S, Iaconelli M, Muscillo M, Petricca S, Ciccaglione AR, Bruni R, Taffon S, Equestre M, Aouni M, La Rosa G. Qualitative and Quantitative Assessment of Hepatitis A Virus in Wastewaters in Tunisia. FOOD AND ENVIRONMENTAL VIROLOGY 2014; 6:246-52. [PMID: 25129101 DOI: 10.1007/s12560-014-9163-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/24/2014] [Indexed: 05/18/2023]
Abstract
Hepatitis A causes substantial morbidity in both industrialized and non-industrialized countries and represents an important health problem in several southern Mediterranean countries. The objectives of the study were as follows: (a) to assess the occurrence of hepatitis A virus (HAV) in Tunisia through the monitoring of urban wastewaters collected at wastewater treatment plants (WTPs); (b) to characterize environmental strains; and (c) to estimate the viral load in raw and treated sewages, in order to evaluate the potential impact on superficial waters receiving discharges. A total of 150 raw and treated wastewaters were collected from three WTPs and analyzed by both qualitative (RT-PCR/nested) and quantitative (qRT-PCR) methods. Of these, 100 (66%) were found to be positive for HAV by the qualitative assay: 68.3% in influents and 64.7% in effluents. The vast majority of HAV sequences belonged to sub-genotype IA, with 11 different strains detected found to be identical to clinical strains isolated from Tunisian patients with acute hepatitis. Five unique variants were also detected, not previously reported in clinical cases. Only two IB strains were found, confirming the rarity of this sub-genotype in this country. The results of the present study indicate a wide circulation of the pathogen in the population, most probably in the form of asymptomatic infections, a finding consistent with the classification of the country as having intermediate/high endemicity. Quantitative data showed high viral loads in influents (3.5E+05 genome copies/liter, mean value) as well as effluents (2.5E+05 genome copies/liter, mean value), suggesting that contaminated water could be a critical element in transmission.
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Affiliation(s)
- A Béji-Hamza
- Laboratory of Transmissible Diseases and Biological Active Substances, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - H Khélifi-Gharbi
- Laboratory of Transmissible Diseases and Biological Active Substances, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - M Hassine-Zaafrane
- Laboratory of Transmissible Diseases and Biological Active Substances, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - S Della Libera
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - M Iaconelli
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - M Muscillo
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - S Petricca
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - A R Ciccaglione
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - R Bruni
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - S Taffon
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - M Equestre
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - M Aouni
- Laboratory of Transmissible Diseases and Biological Active Substances, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - G La Rosa
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Béji-Hamza A, Hassine-Zaafrane M, Khélifi-Gharbi H, Della Libera S, Iaconelli M, Muscillo M, Petricca S, Ciccaglione AR, Bruni R, Taffon S, Aouni M, La Rosa G. Hepatitis E virus genotypes 1 and 3 in wastewater samples in Tunisia. Arch Virol 2014; 160:183-9. [PMID: 25307960 DOI: 10.1007/s00705-014-2251-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
Hepatitis E represents an important public-health concern throughout the world. It is one of the leading causes of hepatitis in North Africa, Asia and the Middle East. In Tunisia, the true burden of HEV infection is still unknown. The objectives of the present study were to assess the occurrence of hepatitis E virus in Tunisia through the monitoring of urban sewage and to characterize the strains identified using molecular assays. A total of 150 sewage samples (raw and treated) were collected from three wastewater treatment plants located in the regions of Monastir and Mahdia and analyzed by nested RT-PCR using a qualitative assay targeting the methyltransferase gene in ORF1. Of these, only three samples (2 %) were found to be positive for HEV, one belonging to genotype 1 and two to genotype 3. The results of the present study indicate a low level of virus excretion among the Tunisian population. Both genotypes 1 and 3 are circulating in this country, however, possibly causing sporadic infections. The presence of the zoonotic genotype 3, known to be transmitted to humans mainly by swine and demonstrated in Tunisia for the first time in this work, raises the question of possible reservoir species, since pork products are not consumed in this country, pigs are not bred, and wild boar is not endemic. Further studies will be needed to gather information on the occurrence and diversity of HEV strains circulating among humans and animals in Tunisia, and on possible animal reservoirs.
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Affiliation(s)
- A Béji-Hamza
- Laboratory of Transmissible Diseases and Biological Active Substances, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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Lankarani KB, Mahmoodi M, Honarvar B, Nematollahi P, Zamiri N, Ghaffarpasand F. Determinants of poor outcome in patients with hepatitis A infection: a four-year retrospective study in Shiraz, Southern Iran. Arch Virol 2014; 159:1901-7. [PMID: 24557525 DOI: 10.1007/s00705-014-2017-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/01/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Kamran B Lankarani
- Community and Preventive Medicine, Health Policy Research Centre, Shiraz University of Medical Sciences, School of Medicine, Building No 2, 8th Floor, Zand Blvd, 7134853185, Shiraz, Iran
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15
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Gharbi-Khelifi H, Abid NBS, Beji A, Bhiri L, Harrath R, Sdiri K, Billaudel S, Ferre V, Aouni M. Seroprevalence and Molecular Characterisation of Human Hepatitis A virus in Serum Samples of Tunisian Patients with Clinical Symptoms of Viral Hepatitis. INDIAN JOURNAL OF VIROLOGY : AN OFFICIAL ORGAN OF INDIAN VIROLOGICAL SOCIETY 2012; 23:29-35. [PMID: 23729999 DOI: 10.1007/s13337-012-0063-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 02/28/2012] [Indexed: 11/27/2022]
Abstract
The aim of the present study was to investigate the seroprevalence of Hepatitis A virus antibodies in patients with clinical symptoms of viral hepatitis and molecular characterization of the detected isolates. The present study deals with the seroprevalence and the genetic diversity of HAV in 400 Tunisian patients presenting in dispensaries (160 patients) and in University Hospitals (240 patients) with hepatitis symptoms between 2006 and 2008. The patients with acute hepatitis were mainly from rural regions. However, the total number of patients was decreased over time. The collected samples were from patients with hepatitis symptoms occurring mainly during January-March (36.7, 26, and 35.5%) and September-December (39.4, 43.4, and 35.5%) during the three years of study, respectively. However, HAV infection was established for only 110 among 400 patients. The detected isolates were clustered within sub-genotype IA. The present study constituted another report of the continued surveillance of HAV infection in the region of Monastir and the molecular characterisation of the detected strains.
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Affiliation(s)
- Hakima Gharbi-Khelifi
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Faculté de Pharmacie de Monastir, Université de Monastir, Avenue Avicenne, 5000 Monastir, Tunisia
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16
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Gharbi-Khelifi H, Ben Salem Abid N, Sdiri K, Harrath R, Beji A, Bhiri L, Billaudel S, Ferre V, Aouni M. Characterization of outbreak hepatitis a isolates in five Tunisian childcare centers. Braz J Microbiol 2011; 42:1204-12. [PMID: 24031743 PMCID: PMC3768787 DOI: 10.1590/s1517-838220110003000046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Revised: 09/29/2010] [Accepted: 01/13/2011] [Indexed: 11/22/2022] Open
Abstract
In the present study, epidemiological survey and molecular characterization of hepatitis A virus during an outbreak in five Tunisian childcare centers in El-Mahres during October and November 2006 were carried out. Five well-water and five drinking water samples were included in the present study. Serological investigation and molecular characterization were carried out. All patients were IgM seropositive and the viral genome was detected in all clinical and well-water samples whereas it was not detected in drinking water from the five childcare centers. Sequence analysis showed that all Tunisian strains belong to sub-genotype IA. The genetic profile of the VP1/2A junction showed that the outbreak isolates underwent an amino acid substitution which was absent in virus’s strains detected previously in Tunisia. Further studies need to be conducted to evaluate the emergence of the virus’s strains in clinical and water samples and more epidemiological data need to be collected about the risk factors which may contribute to acute hepatitis.
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Affiliation(s)
- Hakima Gharbi-Khelifi
- Laboratoire des Maladies Transmissibles et Substances Biologiquement Actives LR99ES27, Faculté de Pharmacie de Monastir , Avenue Avicenne, 5000 Monastir , Tunisia
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17
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Amri I, Hmaïed F, Loisy F, Lebeau B, Barkallah I, Saidi M, Slim A. Détection du virus de l’hépatite A dans les coquillages en Tunisie par reverse transcription-nested PCR – recherche de corrélation entre la contamination virale et bactérienne. ACTA ACUST UNITED AC 2011; 59:217-21. [DOI: 10.1016/j.patbio.2009.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 10/16/2009] [Indexed: 10/20/2022]
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18
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Sdiri-Loulizi K, Hassine M, Aouni Z, Gharbi-Khelifi H, Chouchane S, Sakly N, Neji-Guédiche M, Pothier P, Aouni M, Ambert-Balay K. Detection and molecular characterization of enteric viruses in environmental samples in Monastir, Tunisia between January 2003 and April 2007. J Appl Microbiol 2011; 109:1093-104. [PMID: 20553345 DOI: 10.1111/j.1365-2672.2010.04772.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS A prospective study was performed to characterize the main human enteric viruses able to persist in sewage samples and in shellfish tissues, and to establish the correlation between environmental strains and viral infantile diarrhoea observed in the same area during the same period. METHODS AND RESULTS A total of 250 sewage (raw and treated) and 60 shellfish samples were collected between January 2003 and April 2007 in Monastir region, Tunisia. Group A rotavirus (RVA) was detected in 80 (32%) sewage samples, norovirus (NoV) in 11 (4·4%) and enteric adenovirus (AdV) in 1 (0·4%). Among 60 shellfish samples collected near sewage effluents, one was contaminated by NoV (1·6%). CONCLUSION Our data represent the first documentation in Tunisia, combining gastroenteritis viruses circulating in the environment and in clinical isolates. We observed a correlation between environmental strains and those found in children suffering from gastroenteritis during the same period study. This suggests the existence of a relationship between water contamination and paediatric diarrhoea. SIGNIFICANCE AND IMPACT OF THE STUDY Our results address the potential health risks associated with transmission of human enteric viruses through water-related environmental routes. The research findings will aid in elucidating the molecular epidemiology and circulation of enteric viruses in Tunisia and in Africa, where data are rare.
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Affiliation(s)
- K Sdiri-Loulizi
- Laboratory of Infectious Diseases and Biological Agents, Faculty of Pharmacy, Monastir, Tunisia.
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Kamal SM, Mahmoud S, Hafez T, EL-Fouly R. Viral hepatitis a to e in South mediterranean countries. Mediterr J Hematol Infect Dis 2010; 2:e2010001. [PMID: 21415943 PMCID: PMC3033107 DOI: 10.4084/mjhid.2010.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 02/04/2010] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis represents an important health problem in the South Mediterranean countries, Egypt, Libya, Tunisia, Algeria and Morocco. Emerging natural history and epidemiological information reveal differences in the overall epidemiology, risk factors and modes of transmission of viral hepatitis A, B, C, D, E infections in the South Mediterranean region. The differences in the in incidence and prevalence of viral hepatitis across North African countries is attributed to variations in health care and sanitation standards, risk factors and immunization strategies. The active continuous population movement through travel, tourism and migration from and to the South Mediterranean countries contribute to the spread of infections due to hepatitis viruses across borders leading to outbreaks and emergence of new patterns of infection or introduction of uncommon genotypes in other countries, particularly in Europe.
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Affiliation(s)
- Sanaa M. Kamal
- Department of Tropical Medicine, Gastroenterology and Liver Disease, Ain Shams University, Cairo, Egypt
| | - Sara Mahmoud
- Department of Tropical Medicine, Gastroenterology and Liver Disease, Ain Shams University, Cairo, Egypt
| | - Tamer Hafez
- Department of Tropical Medicine, Gastroenterology and Liver Disease, Ain Shams University, Cairo, Egypt
| | - Runia EL-Fouly
- Department of Tropical Medicine, Gastroenterology and Liver Disease, Ain Shams University, Cairo, Egypt
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El Solh AA, Alhajhusain A. Update on the treatment of Pseudomonas aeruginosa pneumonia. J Antimicrob Chemother 2009; 64:229-238. [DOI: 10.1093/jac/dkp201] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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