Search

Regional pneumococcal observatories in region Centre, created in 1997, participate with the others pneumococcal observatories alongside the National Reference Center for Pneumococci and the Institut de Veille Sanitaire at the monitoring of the evolution of resistance of pneumococci to antibiotics in France. Between 1997 and 2007, 2427 strains of Streptococcus pneumoniae were isolated in part from cerebrospinal fluids, blood and middle ear fluid, from children and adults. The prevalence of pneumococci with a decreased susceptibility to penicillin (PDSP) decreased strongly in region Centre: 56.8 % in 2001, 39.6 % en 2007. These data are similar to the French national data over the same period.

Seven hundred and ninety six strains of pneumococcus were collected in the Centre region, from 15 laboratories, between 1st April 1999 and 31st of March 2000. Data were processed, using 4th dimension software, and concerned age, file number, consultation/hospitalisation, sample type, susceptibility to oxacillin (5 micrograms), results of the E-test for benzylpenicillin, amoxicillin, cefotaxime and results of the routine disc diffusion test. Strains with reduced susceptibility to benzylpenicillin (PRSP) were collected by the co-ordinating centre to perform MICs by the reference agar dilution test and serotyping. Out of 796 strains, 450 strains (56.7%) were categorised as PRSP and 400 of them were studied by the co-ordinating centre. Forty two percent of the samples originated from lungs, followed by 19.5% from blood samples, 15% from ear pus (85.7% PRSP) and 2.5% from CSF. Thirty nine percent of the patients were female. 36.6% were children under sixteen (70.1% PRSP) and 62.4% were adults (49.2% PRSP). Out of 400 PRSP 106 (26.5%) were characterised as resistant and 294 (73.5%) as intermediate to benzylpenicillin. Compared to the agar dilution test, 90% of the PRSP studied by E-test had a MIC value for benzylpenicillin within +/- 1 dilution. Thirty six strains of PRSP were resistant to amoxicillin (9% of the PRSP) and 10 (2.5% of the PRSP) to cefotaxime. Serotyping was done on 375 strains. The serotypes encountered were the following: 23 (26.9%), 14 (22.1%), 19 (19.5%), 6 (12.8%), 9 (9.9%) and 15 (5.1%).

Un malade est porteur d'une arthroplastie depuis plus de 2 ans : rage de dents, infection aigue, nettoyage au " Karcher". Quand faut-il arreter les antibiotiques ? L'etat de surface de l'implant doit probablement avoir un role car slime et biofilm protegent les bacteries. L'urgence du nettoyage avant 72 heures est primordiale. Les donnees experimentales ont montre que l'association : Rifampicine/ Fluoroquinolones etait utile mais devait durer 8 a 12 semaines en cas de staphylocoques. Certaines situations autorisent un traitement dit " suppressif" au long cours de plus de six mois. Il n'y a pas de vrais criteres de guerison : le dosage de la pro calcitonine semble contributif, et la ponction. Le bon critere de guerison est l'absence de rechute a plus de deux ans.

Summary A case of non 01 Vibrio cholerae bacteremia in a 65-years-old man is reported. We stress the fact that contamination occurred in Europe. This bacteremia in immuno-compromised patients is frequently fatal.

Summary Susceptibility of 121 isolates of coagulase-negative staphylococci to two antimicrobial agents, novobiocin and fosfomycin, was determined using the agar dilution method. Isolates included 45 strains of Staphylococcus saprophyticus, 26 strains of S. cohnii and S. xylosus, 24 strains of S. epidermidis and 26 strains of S. hominis, S. capitis, S. warneri and S. auricularis. The minimal inhibitory concentration average of fosfomycin for S. saprophyticus differed (p Out of 45 isolates of S. saprophyticus, 42 were resistant to fosfomycin. The results were very heterogeneous with regard to fosfomycin for all of the other coagulase-negative staphylococci. Resistance to fosfomycin, like resistance to novobiocin, could be used as a presumptive test for the identification of S. saprophyticus.

Resume La nature lipopolysaccharidique des antigenes de Brucella utilises dans les techniques serologiques est a l'origine de nombreuses reactions croisees (dont Yersinia enterocolitica). Afin d'apprecier les valeurs diagnostiques respectives de la sero-agglutination de Wright (S.A.W.), l'epreuve a l'antigene tamponne (E.A.T. ou Rose Bengale), la reaction de fixation du complement (F.C.), l'immunofluorescence indirecte (.I.F.I.) et la contre immuno-electrophorese a la Brucelline (C.I.E.), les serums de 214 patients, dont 44 (20 %) proviennent de patients brucellises, ont ete etudies. Les reactions les plus sensibles sont l'I.F.I. (sensibilite = 0,84) et l'E.A.T. (Se = 0,82). Les plus specifiques sont : C.I.E. (specificite = 0,99), I.F.I. (sp = 0,97) et F.C. (sp = 0,98). Les reactions d'agglutination (E.A.T. et S.A.W.) donnent lieu a de nombreuses interferences et les taux d'agglutinations sont voisins que l'infection soit due a Brucella ou a Yersinia enterocololitica 09. Qu'il s'agisse du depistage serologique des patients brucellises (enquete epidemiologique) ou du diagnostic serologique de brucellose, il est necessaire d'associer aux reactions d'agglutinations (E.A.T. ou S.A.W.) des reactions plus specifiques et/ou sensibles comme l'I.F.I., la F.C. ou la C.I.E. a la brucelline.

Resume 14 souches de Staphylococcus saprophyticus , isolees chez des malades atteints d'infection urinaire, ont ete identifiees pendant une periode de 8 mois dans un laboratoire hospitalier de microbiologie clinique. Ces souches representent 5,7 % des bacteries responsables de 333 infections urinaires observees pendant cette periode. Le role pathogene de cette bacterie chez la jeune femme est objective et oppose a celui des autres Staphylococcus isoles chez des malades deja hospitalises, de moyenne d'âge differente et ou ayant subi des explorations instrumentales au niveau du tractus urinaire. L'isolement et l'identification precise de Staphylococcus saprophyticus est indispensable, car sa signification pathologique merite d'etre individualisee tant sur le plan de la pathogenie, que sur ceux de l'epidemiologie, de la clinique, et de la therapeutique.

The transcortin capacity for cortisol (CBC, μg cortisol/100 ml) has been determined by gelfiltration using [1,2-3H]cortisol (De Moor et al. 1962; Doe et al. 1964). There was always 2 to 3% unspecific binding to CBC free plasma (heated to 60°C for 30 minutes) and to pure albumin. The protein binding found in unaltered plasma had to be corrected by subtracting this unspecific radioactivity to calculate the CBC, which had a normal range of 24 ± 8 μg cortisol/100 ml plasma (2 sd, n = 35). Eight states of hyperoestrogenism, 5 hypopituitarisms, 8 acromegalies, 3 congenital adrenal hyperplasias, 2 hirsutisms and 12 Cushing syndromes were tested. As a group only the CBC in hyperoestrogenism was high and outside the normal range. The CBC in two cases of Cushing syndrome and in two cases of acromegaly were low. The CBC has been followed before and under treatment with 2,2(4-chlorophenyl,2-chlorphenyl)1,1-dichlorethane (op'DDD). No significant changes were seen.

Resume Pour preciser l'action du sulfate de protamine sur les lipides circulants, decrite dans nos travaux anterieurs, une revision critique de cette action a ete entreprise sur une nouvelle serie de II sujets hypercholerolestemiques soigneusement selectionnes. presentant des hypercholesterolemies permanentes a serum clair, peu sensibles aux variations du regime alimentaire et habituellement assez stables. Un protocole experimental rigoureux, comportant des controles quotidiens de la lipidemie et la mise en œuvre de techniques differentes, a ete adopte. Il a ainsi ete possible: 1. (1) de faire la part des fluctuations quotidiennes spontanees de la cholesterolemie; 2. (2) de confirmer les diminutions paralleles de la lipidemie totale, de la cholesterolemie et du test phenolique de Kijnkki-, consecutives aux injections intraveineuses de sulfate de protamine, la diminution depassant 15% apres 3 jours pour la cholesterolemie; 3. (3) d'etablir une relation entre l'inactivite de l'une des preparations de sulfate de protamine etudiees et la presence de phenol. Les auteurs attribuent aussi la discordance apparente entre les effets observes et les effets classiquement admis du sulfate de protamine au delai plus long ecoule dans leurs observations outre l'injection et le prelevement sanguin.

Resume Les auteurs rapportent un cas d'endocardite bacterienne a Gemella haemolysans chez un homme de 68 ans sans cardiopathie prealable connue. Les difficultes du diagnostic differentiel avec l'espece Streptococcus morbillorum et les streptocoques du groupe Viridans sont evoquees.

Resume Un cas de septicemie a Lactobacillus acidophilus associe a une pyelonephrite est rapporte chez un malade de 65 ans sans antecedent d'infection urinaire connu. Les auteurs discutent la signification de la presence de Lactobacillus dans les urines.

Resume Les auteurs rapportent une observation de meningite a Neisseria meningitidis serogroupe 29 E chez une malade traitee pour myelome multiple. Cette observation montre que ce serogroupe conn comme «non virulent peut manifester un pouvoir pathogene chez les immunodeprimes.

Resume Une observation de neuro-meningite a Cryptococcus neoformans du sujet age sans antecedent pathologique connu est rapportee. Les commentaires portent essentiellement sur les difficultes du diagnostic biologique. Le serodiagnostic meme par des techniques sensibles (Elisa, Contreimmuno-electrophoresel sera negatif.