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Abstract: Objective: The authors had for aim to assess the role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: Comparative antibiotic trials were collected through systematic search on Medline data base––well-designed studies were selected. Results: Eight equivalence studies were selected. No clear difference between antibiotics was demonstrated. The shortest treatment was as effective as the longest. Conclusion: No antibiotic has demonstrated its superiority. A new generation of antibiotic comparative trials for exacerbation of COPD is clearly needed. [Copyright &y& Elsevier]

Introduction et objectifs: Discuter les critères d’imputabilité attribuables à l’Human Herpes Virus 6 (HHV6), seul virus capable d’intégration génomique, lorsqu’il est retrouvé dans le liquide céphalo-rachidien (LCR) d’adultes immunocompétents au cours d’un épisode neurologique aigu. Matériels et méthodes: Étude rétrospective sur 4 ans de tous les cas finistériens d’épisodes neurologiques aigus, concernant des adultes immunocompétents, pour lesquels le génome d’HHV6 avait été détecté dans le LCR. Recherche des cas d’ADN intégré, cause la plus fréquente de détection d’HHV6 dans le LCR du sujet immunocompétent selon Ward et al. Les critères sont : une quantité d’ADN viral au moins égale à la quantité d’ADN cellulaire sur du sang total, une charge virale au moins égale à 4,0 log copies/ml dans le LCR, 6,0 log copies/ml dans le sang total ou 3,5 log copies/ml dans le sérum. Une hybridation in-situ prouvant l’intégration chromosomique. Résultats: Six des sept patients inclus présentent des critères d’intégration chromosomique du génome d’HHV6 au moment de l’épisode neurologique. Conclusion: Le diagnostic d’un épisode aigu de méningo-encéphalite attribué à HHV6 ne devrait pas être posé sans avoir étudié, au préalable, la possibilité d’intégration chromosomique du génome viral au sein de l’ADN leucocytaire du patient. [Copyright &y& Elsevier]

Purpose. – In a prospective study, we determined the predisposing conditions and the course of aerobic Gram-negative bacilli oropharyngeal colonization during the hospital stay in patients older than 70 years.Methods. – We studied 116 patients admitted in our internal medicine unit. Medical characteristics were documented for each patient. Oropharyngeal swabs were collected on the first, third, and seventh days after admission, and then once a week until discharge. Positive culture was defined as the presence of at least one colony of Gram-negative bacilli.Results. – We collected 306 samples from the 116 patients. The mean hospital stay was 10.6 days. Fifty patients (43%) had at least one positive oropharyngeal culture. Thirty-three patients (30%) were colonized on admission, but this prevalence decreased during hospital stay: 20% on the third day and 14% on the seventh day. In an univariate analysis, prior administration of antibiotics (P < 0.01) and use of nonsteroid anti-inflammatory drugs (P < 0.05) were associated with colonization.Conclusion. – Aerobic Gram-negative bacilli oropharyngeal colonization was transient during the hospital stay in the elderly. The use of nonsteroidal anti-inflammatory drugs and the previous treatment with antibiotics are possible risk factors for colonization. [ABSTRACT FROM AUTHOR]

Abstract: Pasteurella multocida is a rare cause of meningitis. We report a case of P. multocida meningitis following a recent neurosurgery procedure and review the 32 cases previously described. [Copyright &y& Elsevier]

Abstract: Shewanella putrefaciens is rarely involved in human infectious disease. We report here a case of soft tissue infection with bacteremia on a patient with risk factors (liver cirrhosis, diabetes mellitus). [Copyright &y& Elsevier]