Abstract: Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditis.
Abstract: BACKGROUND: Tramadol is a synthetic analog of codeine with opioid and local anesthetic properties. It is used as a central-acting analgesic, and recently, in subcutaneous or intradermal injections, as a local anesthetic. We investigated in vitro the antibacterial activity of tramadol in the absence of any local anesthetics against Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa pathogens that can cause infectious complications after local or regional anesthesia. METHODS: Bacterial cultures were grown for 18 h, diluted in sterile physiological saline, and incubated for 6 or 24 h at 37 degrees C with 6.25, 12.5, or 25 mg/mL tramadol. The mixtures were then plated onto blood agar and colony counts were recorded after 24 h incubation at 37 degrees C. RESULTS: Tramadol had bactericidal activity against E. coli and S. epidermidis compared with controls: at 25 mg/mL for 6 h or at 12.5 mg/mL for 24 h, tramadol decreased by approximately 7 log(10) (P < 0.001) the colony counts of E. coli (100% kill). Similar results were obtained with S. epidermidis, with approximately 6 log(10) reduction (100% kill) when tramadol was used at 25 mg/mL for 24 h (P < 0.001). The antibacterial effect of 25 mg/mL tramadol was lower against S. aureus and P. aeruginosa, reducing the growth of these strains by approximately 3log(10) after 24 h (P < 0.001). CONCLUSIONS: Tramadol has dose- and time-dependent bactericidal activity against E. coli and S. epidermidis, as well as antibacterial activity against S. aureus and P. aeruginosa. The antibacterial properties of tramadol may be useful for reducing the risk of bacterial infection after local or regional anesthesia.
Abstract: The excision of the staphylococcal chromosomal cassette mec (SCCmec) from methicillin-resistant Staphylococcus aureus (MRSA) strains results in methicillin-susceptible S. aureus (MSSA) strains. In order to determine the proportion and diversity of multidrug-resistant MSSA (MR-MSSA) strains derived from MRSA strains, 247 mecA-negative isolates recovered in 60 French hospitals between 2002 and 2004 were characterized. The spa types of all strains were determined, and a subset of the strains (n = 30) was further genotyped by multilocus sequence typing. The IDI-MRSA assay was used to test the isolates for the presence of the SCCmec element, which was detected in 68% of all isolates analyzed. Molecular analysis of the samples suggested that 92% of the MR-MSSA isolates were derived from MRSA clones of diverse genetic backgrounds, of which the clone of sequence type 8 and SCCmec type IV(A) accounted for most of the samples. High variations in incidence data and differences in the molecular characteristics of the isolates from one hospital to another indicate that the emergence of MR-MSSA resulted from independent SCCmec excisions from epidemic MRSA isolates, as well as the diffusion of methicillin-susceptible strains after the loss of SCCmec. MR-MSSA could constitute a useful model for the study of the respective genetic and environmental factors involved in the dissemination of S. aureus in hospitals.
Abstract: Secondary peritonitis includes community-acquired and nosocomial peritonitis. These intra-abdominal infections have a common pathogenesis but some microbiological differences, particularly with respect to the type of bacteria recovered and the level of antimicrobial susceptibility. This report describes a prospective observational study of 93 consecutive patients with secondary peritonitis during an 11-month period. Community-acquired peritonitis accounted for 44 cases and nosocomial peritonitis for 49 cases (post-operative in 35 cases). Fifteen multidrug-resistant (MDR) bacteria were recovered from 14 patients. In univariate analysis, the presence of MDR bacteria was associated significantly with pre-operative and total hospital lengths of stay, previous use of antimicrobial therapy, and post-operative antimicrobial therapy duration and modifications. A 5-day cut-off in length of hospital stay had the best specificity (58%) and sensitivity (93%) for predicting whether MDR bacteria were present. In multivariate analysis, only a composite variable associating pre-operative hospital length of stay and previous use of antimicrobial therapy was a significant independent risk-factor for infection with MDR bacteria. In conclusion, knowledge of these two factors may provide a more rational basis for selecting initial antimicrobial therapy for patients with secondary peritonitis.
Abstract: The aim of this study was to compare methicillin-resistant Staphylococcus aureus strains collected in eight hospitals located in the same region of France (Brittany) over a short period (January 1999-July 2000). Ninety-two isolates of methicillin-resistant S. aureus were characterised by their pulsotype and their antibiotype. Pulsotype analysis permitted the definition of three clusters. Two of them comprised 83% of the studied isolates. Phenotypic analysis showed two major antibiotypes, widespread in Brittany but with a heterogeneous geographic distribution and one antibiotype fitting the definition of glycopeptide intermediate S. aureus. These data argue for the high epidemicity of methicillin-resistant S. aureus among the same region.
Abstract: We report a detailed characterization of methicillin-susceptible Staphylococcus aureus isolates from five French hospitals negative for both the mecA and the ccrAB loci but positive for the IS431::pUB110::IS431::dcs structure, present in some Staphylococcus cassette chromosome mec (SCCmec) types. The presence of SCCmec-associated elements suggests that this unusual resistant phenotype is due to a partial excision of SCCmec from epidemic methicillin-resistant S. aureus. The hypothesis of a genetic relatedness is strengthened by common sequence and spa types and similar susceptibility patterns.
Abstract: At this time, many antibiotics have decreased activity against Streptococcus pneumoniae, a major agent of infectious disease. In this study, we evaluated antibiotic susceptibility and serogroups of strains isolated from bacteraemia, meningitis and acute otitis media in adults and children over the 1997-2003 period in Brittany, France. In 2003, 62% of the isolates were not susceptible to penicillin and 11% were fully resistant. The prevalence of erythromycin resistance was 63%. Resistance rates were higher among isolates recovered from children than adults. Serogroups 19 and 14 were the most frequently isolated, especially the 19 one among children. The emergence of this serogroup might be a consequence of the use of heptavalent conjugate vaccine introduced in 2001 in France. Future surveillance after vaccination will be needed to detect emerging serogroups and resistance among S. pneumoniae.
Abstract: OBJECTIVE: The use of topical polymyxin and tobramycin to prevent intensive care infections is controversial. Moreover, these antibiotics are ineffective against methicillin-resistant Staphylococcus aureus. A decontamination regimen using mupirocin and chlorhexidine could prevent acquired infections, including those involving S. aureus. Because these two regimens could have a complementary role, we evaluated their effects when given both alone and combined. DESIGN: The authors conducted a multiple-center, placebo-controlled, randomized, double-blind study performed according to a 2 x 2 factorial design. SETTING: The study was conducted at three polyvalent medical intensive care units at university-affiliated hospitals in France. PATIENTS: Adult patients (age, > or =18 yrs) intubated for <48 hrs who were likely to be ventilated for >48 hrs. INTERVENTION: Two regimens were used: topical administration of polymyxin/tobramycin (or placebo) and nasal mupirocin with chlorhexidine body washing (or nasal placebo with liquid soap). The patients (n = 515) received polymyxin/tobramycin alone (n = 130), mupirocin/chlorhexidine alone (n = 130), both regimens (n = 129), or all placebos (n = 126) for the period of mechanical ventilation plus 24 hrs. MEASUREMENTS AND MAIN RESULTS: The incidence of total infections acquired from the date of randomization until the termination date of study treatments plus 48 hrs was assessed. There were fewer acquired infections with both regimens than with polymyxin/tobramycin alone (odds ratio, 0.44; 95% confidence interval, 0.26-0.75; p = .003), mupirocin/chlorhexidine alone (0.43; 0.25-0.73; p = .002), or all placebos (0.42; 0.25-0.72; p = .001). There were no differences between polymyxin/tobramycin alone (0.95; 0.59-1.54; p = .84) and mupirocin/chlorhexidine alone (0.98; 0.60-1.58; p = .92) vs. all placebos. The probability of freedom from infection was higher with both regimens than with polymyxin/tobramycin alone (p = .002), mupirocin/chlorhexidine alone (p < .001), or all placebos (p < .001). Infection rates were also significantly lower with both regimens than with polymyxin/tobramycin alone (p = .017), mupirocin/chlorhexidine alone (p < .001), or all placebos (p < .001). CONCLUSION: Acquired infections were substantially reduced by mupirocin/chlorhexidine plus polymyxin/tobramycin, whereas each regimen given alone was ineffective. Whether both regimens could increase Candida infections deserves further investigation.
Abstract: This report describes the distribution of species and capsular groups in a collection of 143 strains of Pasteurella recovered from human patients. The organism isolated most frequently was Pasteurella multocida subsp. multocida. As in animals, most of the group A strains were recovered from the respiratory tract. The distribution of species in relation to the animal source suggests that P. multocida subsp. multocida is more infective than other Pasteurella species or subspecies for man.
Abstract: BACKGROUND: In this study, we investigated the relationship between changes in antibiotic resistance and distribution of staphylococcal cassette chromosome (SCC) types amongst methicillin-resistant Staphylococcus aureus (MRSA) isolates expressing the most frequently encountered profiles of antibiotic resistance over an 11 year period in the University Hospital of Rennes, France. METHODS: Antibiotic susceptibilities were determined by agar diffusion. SCC typing was performed using PCR. PFGE demonstrated that isolates were phylogenetically related. RESULTS: Fourteen profiles of antibiotic resistance were defined among MRSA isolates. For each resistance profile, only one SCC type was associated: four patterns corresponded to SCC type I or IA, nine to SCC type IV or IVA, and none to types II and III. One was not typed. PFGE indicated that isolates with SCC type I or IA belong to a single genetic lineage, which also includes most of the epidemic isolates, which carry SCC type IVA. In contrast to type I or IA, isolates with SCC type IV or IVA were found to be associated with several different PFGE clusters, although not all of these represent epidemic isolates. CONCLUSIONS: During the course of the study, the spectrum of antibiotic resistance in MRSA isolates decreased. This occurred due to the emergence of strains with SCC type IV or IVA, which are susceptible to more antibiotics than type I or IA strains. The greater prevalence of such isolates could not be linked conclusively to the presence of SCC type IV or IVA, or to one particular PFGE cluster.
Abstract: Strains of enterobacteria that cause urinary tract infections are able to grow in urine with high tonicity. In such conditions bacterias adapt to osmotic forces by incorporation of osmoprotectant compounds including glycine betaine. Accumulation of toxic analogues in bacteria, using inducible betaine transporters, has been previously proposed for development of antibiotics. In this study we report antibacterial effect of two analogues against 82 strains of Escherichia coli isolated form urinary tract infections. Minimal inhibitory concentrations have been measured with and without osmotic stress. The betaine analogues have antibacterial effect against E. coli strains, but only in presence of an osmotic stress.
Abstract: The in vitro activity of the oxazolidinone linezolid was studied alone and in combination with three antibiotics acting on different cellular targets. Oxazolidinones are bacterial protein synthesis inhibitors that act at a very early stage by preventing the formation of the initiation complex. Combinations of linezolid with gentamicin, vancomycin or rifampicin were evaluated against four methicillin-resistant Staphylococcus aureus strains, using killing curves in conjunction with scanning electron microscopy. Time-kill curves were performed over 24 h using an inoculum of 5 x 10(6)- 1 x 10(7) cfu/mL. Linezolid was studied at concentrations of 1 x, 4 x and 8 x MIC, with partner drugs at 8 x MIC. Addition of linezolid resulted in a decrease of antibacterial activity for gentamicin and vancomycin, and linezolid was antagonistic to the early bactericidal activity of gentamicin. Linezolid, in combination with rifampicin, showed an additive interaction for susceptible strains and inhibited rifampicin-resistant variants. Linezolid plus rifampicin appeared to be the most active combination against methicillin-resistant S. aureus strains in time-kill experiments.
Abstract: The distributions of the antibiotic resistance patterns in a population of Staphylococcus aureus isolates from a teaching hospital were studied over a 9-year period. The results indicate the existence of successive major epidemic methicillin-resistant strains and the emergence of a methicillin-susceptible strain with an unusual resistance pattern. Our findings suggest that this methicillin-susceptible S. aureus strain could be derived from the dominant gentamicin-susceptible methicillin-resistant S. aureus strain with the loss of a 40-kb DNA fragment.
Abstract: Throughout 1999, clinical microbiology laboratories of 13 hospitals in Brittany have recovered Streptococcus pneumoniae isolates in 832 patients, 312 (37.5%) female and 518 (62.2%) male. Two hundred fifty five of them (30.6%) were children. One hundred eighty eight isolates were recovered from blood cultures (22.6%), 16 from CSF (1.9%), 449 from lungs (54%), and 88 from ear exsudates (10.6%).A 5 microgram oxacillin-disk test was used to detect isolates with reduced susceptibility to penicillin G. Determination of MICs of penicillin G, amoxicillin and cefotaxime were then performed by agar dilution method on 402 strains previously categorized resistant or intermediate.Five hundred forty six isolates were PSDP, 33.5% of them were resistant to penicillin G, 2.2% to amoxicillin and 0.2% to cefotaxime. As expected, a decreased susceptibility to beta-lactamins was frequently associated with resistance to macrolides, cotrimoxazole and tetracycline. Among PSDP, the most prevalent serotypes were 23 (23.7%), 14 (23.5%) and 19 (19.1%).In Brittany, the constant rise of PSDP (1993-1994: 28.5%; 1997: 56.4%; 1999: 65.6 %) could be perhaps explain by analysis of social and demographic data.
Abstract: The MICs of seven quinolones, nalidixic acid, pefloxacin, ofloxacin, d-ofloxacin, ciprofloxacin, sparfloxacin and levofloxacin, were determined by agar dilution method comparatively to those of amoxycillin, cefpodoxime, doxycyclin and clarithromycin against 75 clinical isolates of Pasteurella multocida, P. dagmatis and P. canis. Time-kill method was performed for three selected P. multocida isolates. Fluoroquinolones were the most active agents. At concentration of 0.016 mg/L of sparfloxacin or levofloxacin the 75 isolates were inhibited. The MICs of levofloxacin and sparfloxacin showed that the activity of these molecules was two to four times higher than that of the other quinolones studied. Time-kill studies showed a complete killing in six hours with the CMI x 2 of pefloxacin, ofloxacin, ciprofloxacin, sparfloxacin and levofloxacin. This result was obtained more rapidly with the quinolones than with amoxicillin or cefpodoxime. Doxycycline and clarithromycin were devoid of bactericidal activity.
Abstract: Well-defined community- and nosocomially-acquired isolates of Escherichia coli responsible for urinary tract infections were studied for their resistance to beta-lactams, quinolones, and co-trimoxazole, antibiotics widely used for treatment of urinary infections. For each strain, an antibiogram was obtained using the Vitek automat, which estimates the minimal inhibitory concentrations of various drugs. Nosocomial strains were significantly more amoxycillin-resistant than community strains (P = 0.01) and were also significantly more resistant to co-trimoxazole (P = 0.025) and first generation quinolones (P = 0.02) than the latter. To determine whether this was due to transmission of strains within the hospital, DNA restriction patterns, established using XbaI enzyme and separation by pulsed-field gel electrophoresis, were compared. Extreme genomic diversity was found among both the community and nosocomial strains. The increased frequency of resistance among nosocomial strains is thus not due to transmission of resistant hospital strains but probably results from the selection of resistant strains from the endogenous flora of patients.
Abstract: We determined the resistance to quinolone of 309 Salmonella enterica subsp. enterica serotype Typhimurium strains isolated from humans and animals (cattle, pigs, or poultry) in 1995 or 1996. Nalidixic acid resistance increased from 8.5% in 1995 to 18.6% in 1996. The highest resistance levels correlated with a mutation at Ser-83 (or Asp-82). All strains remained ciprofloxacin susceptible. Human and animal isolates were compared by pulsed-field gel electrophoresis, and the banding patterns of the human isolates most closely matched those of the bovine isolates.
Abstract: Thirty-six isolates, from man or swine, of Pasteurella multocida subsp. multocida producing (n = 13) or not producing (n = 23) the dermonecrotic toxin (DNT) were studied by numerical analysis, capsular typing and ribotyping. Toxigenic strains were also characterised by restriction fragment length polymorphism (RFLP) of the toxA gene and pulsed-field gel electrophoresis (PFGE). Numerical analysis differentiated the Pasteurella species and subspecies, but did not discriminate between toxigenic and nontoxigenic strains. RFLP demonstrated that toxA was located in a conserved part of the chromosome of all toxigenic strains. Ribotyping provided evidence of a close association between DNT production and one of the six EcoRI ribotypes designated as E2. In contrast, PFGE provided evidence for significant DNA polymorphism amongst the toxigenic strains. Results of phenotypic and genotypic studies suggested that toxigenic strains do not form a clone within the subspecies multocida. No difference was found between toxigenic strains of porcine or human origin by biochemical characterisation, capsular serotyping or genomic typing methods.
Abstract: To determine the prevalence of quinolone resistance in Salmonella typhimurium strains from humans or animals (cattle, poultry, swine), the S. typhimurium strains isolated at a teaching hospital and at the central veterinary laboratory of the same district between January 1, 1995, and December 31, 1996 were studied. Susceptibility to nalidixic acid was determined using the disk diffusion method. Strains with decreased susceptibility to nalidixic acid were subjected to minimal inhibitory concentration (MIC) determination for pefloxacin, ofloxacin, ciprofloxacin, norfloxacin, levofloxacin, and grepafloxacin. Decreased susceptibility to nalidixic acid was demonstrated for 41 of the 309 strains studied and increased from 8.5% in 1995 to 18.6% in 1996. MIC90 values of fluoroquinolones for strains with decreased susceptibility to nalidixic acid were lower than 1 mg/L, which is the cutoff above which a strain is classified as susceptible, but were higher than for strains that were susceptible to nalidixic acid. These low levels of resistance may be the first step in selection of mutant strains with high levels of resistance to fluoroquinolones. This warrants continued monitoring of resistance of Salmonella to fluoroquinolones.
Abstract: Vibrio hollisae is a pathogenic Vibrio species known to cause gastroenteritis in humans after the consumption of shellfish. All cases of infection reported previously were restricted to the Atlantic and Pacific coasts of the United States. A case of gastroenteritis and bacteremia in a previously healthy 76-year-old man who ate cockles from the Quiberon Bay in Brittany, France, is described. This is the first report of Vibrio hollisae infection in Europe.
Abstract: Vancomycin-resistant enterococci have been isolated with increasing frequency since 1988. Thus far, most of these resistant enterococci have belonged to the Enterococcus faecium species, and epidemiological studies have shown a wide diversity among interhospital and intrahospital isolates. This report presents an epidemiologic investigation of 25 vancomycin-resistant Enterococcus strains--24 Enterococcus faecium and one Enterococcus gallinarum--isolated from the stools or blood of adult patients receiving intravenous vancomycin prophylaxis during neutropenia and hospitalized in a single hematologic unit. Macrorestriction patterns of total DNA and of ribosomal DNA regions were used to analyze the strains. Strains produced different total DNA restriction fragment length polymorphism patterns after SmaI digestion. Ribotyping was less discriminative than pulsed-field gel electrophoresis. The results confirmed the genetic unrelatedness of the strains. Prolonged vancomycin administration, commonly used in hematologic units, could be involved in the selection of endogenous resistant enterococcal strains.
Abstract: Ribotyping was used to determine whether a relationship exists between endotracheal tube colonisation with Staphylococcus epidermidis and bacteremia with this organism. Over a three-week period, four mechanically ventilated preterm babies presented with five episodes of infection and bacteremia. For each blood specimen obtained for culture a tracheal aspirate sample was collected at the same time by suctioning. After DNA extraction and cleavage by EcoRI, hybridisation was performed with a digoxigenin-labelled 16S-rDNA probe from Escherichia coli. Five different band patterns were recognised on the membrane. In two children the same band pattern was found in Staphylococcus epidermidis isolated from both blood and tracheal aspirate. Ribotyping thus could be used to differentiate a series of infections from an outbreak and showed that a relationship may exist between tracheal colonisation and bacteremia in mechanically ventilated newborns.
Abstract: Bactericidal activities of ciprofloxacin and sparfloxacin were compared to other antibiotics active against human isolates of Pasteurella multocida. Three human isolates of Pasteurella multocida were used for killing-curve studies with ciprofloxacin and sparfloxacin comparatively to others antibiotics. At 2x the MIC, ciprofloxacin and sparfloxacin exhibited a killing of more than 99.9% of the initial viable cells that was achieved within 6 h of incubation. These activities were faster than those of amoxycillin and cefpodoxime. No regrowth was observed after 24 h of incubation. Doxycycline and clarithromycin used at MICx2 had no bactericidal activities. It was concluded that fluoroquinolones, namely ciprofloxacin and sparfloxacin, can be considered having good bactericidal activity against P. multocida.
Abstract: The presence of Pasteurella multocida in the oropharynx of 58 pig, cattle or rabbit breeders whose livestock had suffered from pasteurellosis was investigated using a selective medium. Blood samples for serological studies were collected at the same moment. Nineteen breeders were found to host one P multocida subsp multocida strain. Oropharyngeal carriage of P multocida was found to be more frequent in pig breeders (42% of individuals) than in cattle (10%) or rabbit (0%) breeders. Genomic polymorphism among 10 D2 strains was found by restriction endonuclease analysis using pulsed-field gel electrophoresis (REA-PFGE). Antibodies to P multocida were found in the sera of 32 of these 58 breeders, whereas only 2 of the 70 controls had antibodies. These results, recorded from healthy individuals, show that P multocida, acting as an opportunistic bacterium, may be responsible for occupational diseases. Nevertheless, the strong prevalence of specific antibodies makes the presence of antibodies in the sera of these breeders an insufficient indication of a current patent infection.
Abstract: Out of 900 dialysates analysed over 15 months at the Rennes Regional Hospital, 116 cloudy specimens with a leucocyte count of more than 100/mm3 were studied. Three methods of laboratory diagnosis based on physical or chemical disruption of leucocytes were evaluated: saponin incorporated in the agar medium, sonication, and the Isolator lysis centrifugation system. Sensitivity was improved (52%) for the three methods combined compared with the standard method (37%). The Isolator system (51%, P < 0.05) gave the best results. Direct microscopic examination nevertheless remains essential for its indicative value (sensitivity 33% of positive dialysates). The leucocyte count was correlated with the percentage of culture positivity (43% from 100-200/mm3 compared with 62% from 500-1000/mm3); 80% of organisms were Gram-positive bacteria and most were coagulase-negative staphylococci. Opportunistic pathogens such as Corynebacterium jeikeium were frequently isolated.
Abstract: This prospective study aimed to determine the prevalence of Helicobacter pylori infection in relation to the occurrence and severity of NSAIDs induced gastropathy. A total of 111 patients were studied-66 were taking NSAIDs and 45 were control patients. All patients underwent endoscopy during which antral biopsy specimens were taken to determine H pylori status (Gram and Giemsa staining, urease test, and cultures). The NSAID group comprised: group I, patients without mucosal damage (n = 28); group II, patients with gastropathy (n = 26); and group III, patients with bleeding associated with NSAID induced gastropathy (n = 12). Control patients had neither dyspeptic symptoms nor endoscopic lesions. There were no differences in age, sex ratio, or presence of H pylori (26% v 24%) between the NSAID and the control groups. Among patients taking NSAIDs, H pylori infection was more frequently (p < 0.02) diagnosed in those who presented with gastropathy (groups II and III: 37%) than in those without lesions (group I: 11%). The frequency of H pylori infection increased significantly with the severity of gastropathy (group I = 11%; group II = 31%; group III = 50%; p < 0.03). H pylori infection was associated with chronic active gastritis (group I = 21%; group II = 35%; group III = 67%; p < 0.05). These data suggest that H pylori may be a risk factor of NSAID induced gastropathy.
Abstract: A case of postoperative Pediococcus acidilactici septicemia with parallel isolation of the organism from hepatic specimens is presented. Laboratory methods to identify this vancomycin-resistant gram-positive cocci are described. Very few cases of documented infections due to this bacterium have been reported in the literature.
Abstract: Several Pasteurella multocida strains were examined for their ability to produce extracellular enzymes that cleave immunoglobulin A and G (Ig A and Ig G) molecules. Two strains isolated from human pulmonary and genital infections produced proteases that cleaved human IgA and IgG, colostral IgA and human myeloma IgA1 and IgA2. Human IgM was not degraded by these enzymes. Examination of cleavage digests showed two main fragments with different electrophoretic mobilities. The two P. multocida strains produced a protease that cleaved IgA and IgG heavy chains outside the hinge region, and differed in this respect from the hinge-cutting proteases of other bacteria. Protease production may be a virulence mechanism for P. multocida strains.
Abstract: Forty-nine Acinetobacter baumannii strains belonging to three biotypes and isolated from four hospitals were differentiated by electrophoretic typing of their esterases. Six main kinds of esterases were distinguished by their spectra of hydrolytic activity toward seven synthetic substrates. The electrophoretic variations of these enzymes were used to define ten zymotypes among the three biotypes. Esterase electrophoresis appeared to be more sensitive than biotyping, and could represent an additional marker for epidemiological analysis.
Abstract: Ninety-four clinical isolates of Pasteurella multocida of human origin were tested for dermonecrotic toxin (DNT) production by three methods: dermonecrotic test in guinea-pigs, Vero cell culture cytotoxicity and ELISA. The strains were isolated from patients living in a rural area with widespread intensive pig breeding. Six strains were found to be toxigenic by the three tests. A major protein band of Mr 145 Kda corresponding to DNT on immunoblots was demonstrated in extracts from these strains. All were isolated from respiratory tract (diseases 5, healthy carriage 1). The difference between isolates from the respiratory tract and isolates from wounds inflicted by pets was statistically significant with regard to DNT production (p less than 0.02). A possible role of the toxin in pulmonary diseases caused by P. multocida has yet to be established.
Abstract: A selective culture medium for isolation of Pasteurella multocida was prepared by incorporating 2 mg of amikacin per liter, 4 mg of vancomycin per liter, and 4 mg of amphotericin B per liter into Mueller-Hinton blood agar. Use of this medium revealed the presence of P. multocida in the oropharynges of 19 of the 49 pig breeders who were examined.
Abstract: A new case of fatal systemic legionnaires' disease is reported in an infant. This 8 month-old boy was given a protracted treatment with adrenocorticotropic hormones for infantile spasms. Legionella pneumophila type I was found in tracheal secretions and there was multivisceral involvement at autopsy. The mode of contamination and the severity of the disease are discussed in the light of the immunosuppressive properties of the glucocorticoids administered over a period of 4 weeks.
Abstract: The authors describe a case of neonatal Proteus mirabilis septicemia accompanied by cerebral abscess formation despite the presence of therapeutically effective antibiotic levels utilised to treat the disorder. The occurrence of such brain abscesses during the course of effective antibiotic therapy raises the question of the mechanism behind their formation. Cerebritis may occur very early in the clinical course of the infection without being due to failure of antimicrobial therapy.
Abstract: Exploratory and therapeutic hospital techniques, the frequency of iatrogenic or pathogenic immunodepression and the ever increasing age of the population are factors that augment the risk of nosocomial infections. Some of these infections are unavoidable, but others can be prevented. Appropriate hygienic measures and a rational use of antibiotics contribute to this prevention. We describe here two methods that can be used to watch for nosocomial infections. The one-day recording or prevalence survey method is meant to provide a snapshot image in a given hospital. Longitudinal supervision is more difficult to carry out, but it enables the situation to be more precisely evaluated in each health care centre. Supervision must be regarded as a descriptive stage in the assessment of the local situation as regards the prevalence and incidence of nosocomial infections. It should make it possible to determine priorities in the measures to be taken to prevent most of these infections.
Abstract: To estimate the rate of infectious diseases and the efficiency of medical care in our hospital, we conducted a prevalence survey of both infections and antibiotic use on 588 inpatients. Results showed that 125 patients (21% of the total) had infections; of these, 56 had nosocomial infections. A third of the patients had been receiving antimicrobial drugs; among them, 30% were receiving the drugs for prophylactic reasons. A misuse in the prophylaxis of infections was determined, particularly in the duration of treatment. The study demonstrated that an effective infection-control program and an antibiotic policy are required in our hospital.
Abstract: Most of Enterobacter cloacae strains produce chromosomally determined class I beta-lactamases when they are exposed to beta-lactams. Imipenem is a strong inducer of these enzymes but is poorly affected by them. We compared the effect of imipenem on inducible, non-inducible and stably derepressed strains of E. cloacae using the killing curve system. With antibiotic concentrations of 0.5 mg/l or more, an intense dose-dependent bactericidal effect was observed within 4 to 6 hours. However the bactericidal activity was incomplete. With an inoculum as low as 10(5) bacteria/ml a regrowth was observed after 24 hours. Among the surviving bacteria imipenem had the same bactericidal kinetic than on the parental strain. Similar results were observed with inducible, non-inducible and stably derepressed strains.
Abstract: An in situ ELISA was performed directly on the adherent cell monolayer in order to determine the susceptibility of herpes simplex virus isolates to acyclovir. Various fixation procedures and antisera conjugated to different enzymes were tested. The use of glutaraldehyde for fixation and beta-galactosidase as a labelling enzyme was shown to give the best results. As with other currently used assays, 50% inhibitory doses were subject to an inoculum effect. The data obtained indicate that this assay is suitable for routine determination of herpes simplex virus susceptibility to antiviral drugs.
Abstract: Fifty-four clinical isolates of Pasteurella are classified into different taxa. P. multocida subsp.multocida is more frequently encountered than other subspecies of P. multocida. P. canis is only identified from wounds inflicted by animals. The frequency of isolation of different species and subspecies is comparable with that observed from animal isolates. The distribution of the strains in the capsular types is different according to the origin, human or animal, of the strains.
Abstract: An IV vancomycin treatment induces a reduction of Gram positive cocci (Staphylococcus, Enterococcus) of the aerobic salivary and fecal flora. Some of these strains persisted during and after treatment, but remained susceptible to vancomycin. Others isolated Gram positive cocci were resistant to vancomycin before and after treatment. They were identified as Pediococcus sp., and Leuconostoc sp. There is a reduction of the number of Gram positive cocci, without increase of Gram negative rods, Lactobacillus, or Candida which are always resistant to vancomycin.
