Search

Asbestos fibers were counted by using the transmission electron microscope in 42 wines from France and abroad. Fifteen samples were found to be significantly positive for chrysotile asbestos. Concentrations were in the range of 2–64 × 10 6 fibers per liter. Technical Investigations showed that the asbestos content of the wines was related to the process by which they were filtered. On the other hand, we found that abandoning the use of asbestos for filtering wines would not alter the wine from the enological point of view. [ABSTRACT FROM PUBLISHER]

Objective. – The authors had the aim of determining the epidemiology of nosocomial infections (NI) in a pediatric subgroup of acute lymphoblastic leukemia (ALL).Design. – This 5-year retrospective study in a pediatric onco-hematology unit analyzed the data of 67 de novo ALL cases (49 B ALL and 18 T ALL cases, sorted in low, average, and very high risk patients) and 10 cases in relapse. All these patients were treated according to the same European treatment protocols and a central venous catheter was inserted as soon as the diagnosis was confirmed.Results. – Twenty-nine NI were diagnosed in these 77 children, mostly during the induction period. Bacterial NI were predominant, fungal and viral infections seemed to remain only a minor threat. The most common bacteria were staphylocci, linked to the major predisposing factors such as central venous catheter and immunosuppression due to leukemia and its treatment. Moreover, the high-risk group of ALL seemed to predispose to NI in our population. Four cases in our cohort showed specific prophylactic and curative problems concerning multiresistant bacteria.Conclusions. – In this specific immunocompromised population, NI was always a predominant complication. Moreover, high-risk of leukemia was described as a new predisposing infection factor. Specific prophylactic and curative efforts are needed to improve the treatment and the outcome of this type of patients. [Copyright &y& Elsevier]

Japanese encephalitis is a mosquito-borne viral disease occurring in rural and rice-growing areas of Asia, where mosquitoes proliferate, transmitting the Flavivirus from viremic animals, mostly pigs, to humans. Japanese encephalitis has recently spread to previously non-affected regions, leading to serious outbreaks among non-immune populations. Although it has a high proportion of unsymptomatic infection, clinical encephalitis is usually severe, resulting in a very high mortality rate, and neurologic sequellae are common among survivors. Vaccines are used in several Asian countries. One of these vaccines is now available to French travellers, but only in international vaccination centres with an authorization from the French drug agency (Agence française de sécurité sanitaire des produits de santé). The aim of this paper is to clarify the recommendations for immunisation in each country of the affected regions. The area can be divided into three epidemiological zones, with tropical, subtropical and temperate characteristics. For the first two, vaccination is recommended before a long stay in a rural area, especially during the rainy season; in temperate climates, outbreaks occur in summer and autumn. However, local variations such as intensive rice-growing or development of pig breeding may interfere with these patterns. Long-term visitors should consult a local physician and prevention of mosquito bites is always recommended.

We describe a multiresistant Enterobacter aerogenes outbreak in an intensive care-unit. An epidemiology study based on phenotypic characters (species diagnosis and antibiotype) was completed by a genotypic study (pulsed field electrophoresis) to confirm bacterial clonality. The hygiene laboratory proposed numerous preventive measures to limit bacterial dispersion. We describe the role of bacteriologists, hygienists and medical staff to stop the bacterial dispersion.

This study concerning bacteriological controls of food for immuno-suppressive patients have shown that food sterilized in sterilizer or with pressure-cooker contains sporulated bacteria after treatment. Unit packaging or freeze-drying commercial foods offer no bacteriological quality guarantees. Clinicians have to define acceptable contamination rate according to their patients' condition.

Sanitary U bends are very contaminated places from a microbiological point of view. They may even be dangerous for immunocompromised patients. Although daily chloride disinfection of U-bends is ineffective, it seems to work when performed after each use of sanitary devices. On line disinfection reduces not only U-bend bacteriological contamination but also all surrounding surfaces.

General rules to prevent are categorized into four classes. The first one concern patient before operation: well-balanced nourishment latent infections treatment, digestive tract micro flora elimination, immunizations, antiseptic gargles, skin antisepsis. The second one concern operation: previous fumigation, very high efficiency filtration and laminar flow air, transplant care, antibioprophylaxis, operating theatre discipline. The third one concern post-operation days: cubicle initial fumigation, high efficiency filtration and positive pressure air, strict protective insulation, single-use things, controlled food, specific anti viral prevention, catheters and tubes removal or replacement. The fourth one concern going home patient: well-balanced nourishment, body hygiene and hands washing, infected people shunning, gardening and cleaning proscribing, medical follow-up and latent infections systematic detection.

Different methods are used to value nosocomial infections: direct valuation, simple comparison, case control study, standardized comparisons with adjustments. The cost of preventive methods need to be considered and integrated in cost-effectiveness analysis.

The aim of this study is to assess wether the use of the bacteriological filter Pall BB 22 15 placed on the Y piece of the anesthesia equipment decreases contamination and furthermore to evaluate the cost of this practice versus changing anesthetic circuits after every patient. Randomized trials are conducted with three "Engström" machines in three cardiac surgery operating rooms. The Y pieces were examined with qualitative and quantitative bacteriological analysis. Use filters is less expensive than changing circuit for each patient for a comparable efficacy.

The authors report 79 needle biopsies of the liver, using a Menghini needle, carried out as routine in untreated cases of pulmonary tuberculosis with positive sputum. Apart from the histological study, the authors carried out, in 30 cases, a bacteriological study of the liver fragment. The bacteriological and histological results are reported here in detail, then compared with those in the world literature. No significant correlation was found between the histological type of the suggestive hepatic lesions, e.g. follicular appearances or appearances of nodular küpferian hyperplasia and the radioclinical variety of pulmonary tuberculosis, e.g. parenchymatous, pleural or miliary. The authors emphasize the significance of each type of pathological lesion encountered, in particular, the appearance of nodular küpferian hyperplasia or intralobular, lymphohistiocytic islets, which seem to them remarkable by their relative frequency and their chararacter fairly suggestive of tuberculosis. In spite of the low number of pathological appearances obtained in these liver biopsies, the present study nevertheless permitted a few interesting conclusions on the blood spread of the tubercle bacillus and the significance of changes in the Küpfer system during common pulmonary tuberculosis.

Advances in the therapy of tumors or for the maintenance of grafts have improved survival in a large number of patients, but at the price of repeated complications due to the induced immunodeficiency state. Pulmonary infections are a frequent occurrence, and while some are easily recognized and treated, others must be precisely diagnosed, as only early specific treatment can avoid the often fatal outcome. Various techniques have therefore been developed to obtain specimens for microorganism isolation before having ultimate recourse to a surgical lung biopsy. It is in this field that the most marked progress is currently being made. The different microorganisms responsible for these affections are reviewed, the majority being common to the immunodeficiency state, while others are encountered more frequently as a function of the underlying disorder and of the ecological conditions in each centre.

The authors report the results of a study into mycobacterial contamination of bronchial fibroscopes over a 6 year period during which 8,750 fibroscopies were performed. On 19 occasions, there were two positive results on the same day which could have led to contamination (0.07 p. 100). In 12 cases, there was heavy bacterial contamination on the first examination and at least 5 colonies on the second. Crossed transmission was not observed. The authors emphasize the role of the accessory parts and connections which are often neglected and which may lead to false positive results in the following patients; a sterilisation procedure is proposed which seems to be effective as no mycobacterial contamination has been observed since it was introduced.