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Acinetobacter baumannii is a feared pathogen in the burn center due to its opportunistic nature and its multidrug resistance. Our purpose was to study the incidence density of Acinetobacter baumannii colonization and infection and to determine the antibiotic susceptibility of the strains isolated in patients hospitalized in the Trauma and Burn Center Burn Unit in Tunisia. Our retrospective study included 1517 non-repetitive strains of Acinetobacter baumannii, between January 2012 and September 2020, with an average rate of 12.2% of the service's bacterial ecology. The incidence density of Acinetobacter baumannii colonization and infection was 13.7? days of in-patient stay and 14.1? days of in-patient stay, respectively. A positive and statistically significant correlation between Acinetobacter baumannii colonization and infection (rs=0,7; p=0.005) was noted in our study. The colonization strains were mainly isolated from central catheters (71.2%) and skin swab samples (22.9%). Infections were dominated by bacteremia (47.6%) and respiratory tract infections (25.4%). Bacteremia was microbiologically documented in 53% of cases. The most common source of bacteremia was central catheters (60.8%), skin (22.2%) and respiratory tract (15.5%). The rates of resistance inAcinetobacter baumannii to the antimicrobial agents tested were high: ceftazidime (85.2%), pipéracillin-tazobactam (95.6%), imipenem (95.3%), amikacine (91.1%), ciprofloxacin (93.5%), rifampicin (36.4%) and cotrimoxazole (88.1%). The resistance of colistin was noted in 1.8% of cases. [ABSTRACT FROM AUTHOR]

Antibiotics are one of the greatest advances in modern medicine. Antibiotic resistance is one of the most serious threats to global health, aggravating the prognosis of immunocompromised patients, especially burn patients. Our objective was to study the consumption of antibiotics of critical importance according to the WHO and the correlation between antibiotic resistance in Pseudomonas æruginosa and the consumption of these antibiotics. Our study took place in the Medical Laboratory in collaboration with the Trauma and Burn Center's Burn Unit in Tunisia. In our retrospective study, 1384 non-repetitive strains of Pseudomonas æruginosa responsible for colonization or infection were included, between January 2012 and December 2019. Pseudomonas æruginosa was the most isolated bacterial strain in the service, with an average rate of 15.9% of the service's bacterial ecology. The antibiotic resistance rates tested were high: 77.1% to piperacillin-tazobactam, 56% to ceftazidime, 74.9% to imipenem, 78.8% to amikacin, 54.7% to ciprofloxacin and 32.8% to fosfomycin. Among our strains, 81.8% were multi drug-resistant strains. The analysis of the correlation between the level of consumption of antibiotics and the antibiotic resistance levels in Pseudomonas æruginosa showed that the increased consumption of piperacillin-tazobactam increased resistance not only to piperacillin-tazobactam but also to imipenem and amikacin as well as multi drug resistance. Similarly, the increase in the consumption of fosfomycin correlates with resistance to piperacillin-tazobactam and imipenem. [ABSTRACT FROM AUTHOR]

Pseudomonas æruginosa (PA) is among the major agents of infection in burns. Multidrug-resistant strains are commonly isolated, which hampers the management of these patients. Our purpose was to study the incidence density of PA colonization and PA infection and to investigate the antibiotic susceptibility of strains isolated in patients hospitalized in the Trauma and Burn Center's Burn Unit (TBC-BU) in Tunisia. It is a retrospective study including 1649 non-repetitive strains of PA during an 8-year period (2012- 2019). PA was the most common organism in TBC-BU bacterial ecology (15%). The incidence density of PA colonization and PA infection was 16.1‰ days of in-patient stay (DH) and 16.5‰ DH, respectively. A positive and statistically significant correlation was found between PA colonization and PA infection (rs=1; p=0,004). The colonization strains were mainly isolated from skin (25.1%) and central catheters (22.3%). Bacteremia was the most common infection (19.5%). The skin was the most common source of bacteremia (22.1%) followed by central catheters (18.3%). The highest rates of antibiotic resistance were found with piperacillin-tazobactam (72.4%), ceftazidime (49.4%), meropenem (74%), imipenem (70.5%), amikacin (74.6%), ciprofloxacin (56.5%) and fosfomycin (35.3%). We did not identify any colistin-resistant strain. The multidrug resistance rate was 78%. The metallo-carbapenemase-producing strains rate was 14.4%. [ABSTRACT FROM AUTHOR]

This study was retrospective, conducted over seven years at the Trauma and Burn Centre. Its purpose was to establish the bacteriological profile and antibiotic resistance of isolated bacteria in patients admitted to the Burn Intensive Care Unit. Identification was carried out according to the conventional methods and antibiotic susceptibility was analyzed according to the standards of the Antibiogram Committee of the French Society of Microbiology. Pseudomonas aeruginosa was the main isolated bacterium, followed by Staphylococcus aureus, Klebsiella pneumoniae and Acinetobacter baumannii. These strains were isolated mainly from haemocultures (37%). The resistance of Pseudomonas aeruginosa to ceftazidime increased from 9.2% in 2012 to 53.5% in 2018. The resistance to imipenem and ciprofloxacin was 63.3% and 42.9%, respectively. Four strains were resistant to colistin. The resistance of S. aureus to meticillin decreased from 65.3% in 2012 to 41.6% in 2018. All strains were susceptible to glycopeptides, tigecycline and linezolid. A. baumannii was multi-resistant to antibiotics with 81.8% resistance to ceftazidime, 88.9% to amikacin, 90.5% to ciprofloxacin and 94.5% to imipenem. Sixteen strains were resistant to colistin. Concerning K. pneumoniae, 77.5% of strains were resistant to cefotaxime and 5.2% to imipenem. Two strains were resistant to colistin. Vancomycin resistance in Enterococcus faecium increased from 33.4% in 2012 to 72.2% in 2018. Multidrug resistance in burn patients calls for an epidemiological surveillance of bacterial ecology and the application of hygiene measures. [ABSTRACT FROM AUTHOR]

Introduction: the World Health Organization has estimated that the global incidence of neonatal deaths was 2,8 million in 2015, of which 47,6% were due to infections. These infections can affect newborns babies ages 0-1 month through 3 months. Methods: this is a prospective study conducted from 1 March to 30 June 2015 in the Neonatology service of the Laquintinie Hospital at Douala. All symptomatic newborns with or without anamnestic criteria and all asymptomatic newborns, with at least an infectious risk and a positive blood culture or an abnormal blood count or positive C-reactive protein were included in the study. Results: of the 310 newborns enrolled in the study, 300 were retained for neonatal infection, corresponding to a total incidence of 96.8%. We performed 104 cultures, of which 25 were positive, corresponding to an incidence of confirmed neonatal infection of 24%. The factors associated with infection were unexplained preterm birth < 35 weeks of amenorrhea (45,1%) and neonatal resuscitation (34,8%). Fever (56%) and neurological disorders (48.8%) were the most frequent clinical symptoms. Gram-negative bacteria were the most frequent germs (56%). Imipenem (95%) and amikacin (66.7%) were the most effective antibiotics. Outcome was favorable in 66,4% of cases and the overall mortality rate was 33,6%. Conclusion: this study revealed a high prevalence of neonatal bacterial infection in this Hospital. Bacterial ecology was dominated by Gram-negative bacteria. It was recorded a significant resistance to the most widely used antibiotics and a fairly high mortality. [ABSTRACT FROM AUTHOR]

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The article discusses research projects and scientific advancements as of 2012. Topics include studies of the microbiomes of bacteria which live on the human body, with information on microbiology research programs including the Human Microbiome Project (HMP); research on the neurological aspects of the internal compass of carrier pigeons and other migratory birds; and information on the neurological aspects of leadership and social dominance.

Abstract: Objective: The groupe hospitalier Sud Reunion (GHSR) is a 1130-bed hospital center, located on the Reunion Island, (Indian Ocean). We studied the profiles of antibiotic resistance in 2005, and compared those with previous data collected in 1997–1998, and with Metropolitan France and European data. Material and methodology: All bacteriological strains isolated from diagnostic samples in 2005 were analyzed according to CA-SFM recommendations. Results: Since 1997, the rates of resistance to enterobacteria (betalactam, aminoside, quinolone, trimethoprim-sulfamethoxazole), Pseudomonas aeruginosa (ticarcillin, amikacin, ciprofloxacin, fosfomycin), Acinetobacter baumanii (amikacin) has decreased significantly. The rate of methicillin-resistant Staphylococcus aureus (1997: 3.6 %, 2005: 13.4 %) has increased but less than in Metropolitan France. The rate of Streptococcus pneumonia with decreased susceptibility to penicillin has increased (1997: 25.5 %, 2005: 42.9 %), as for Haemophilus influenzae which present an important increase of betalactam resistance (1997: 15.5 %, 2005: 37.8 %). Conclusion: By comparing our data to 1997 and Metropolitan French data, it seems that the GHSR has managed to protect its hospital-based microbial ecology. However, community germs showed increasing resistance, probably because of an increasing antibiotic pressure, but with resistance rates often inferior to Metropolitan French ones. [ABSTRACT FROM AUTHOR]

Abstract: Management of febrile neutropenic patients is described in guidelines. Each cancer center can adapt these according to its local bacterial ecology. We present a retrospective study made in a cancer center from 2001 to 2003. Method: Three hundred and fifteen febrile neutropenic episodes after chemotherapy (66% for solid tumor) were analysed. Results: For 279episodes, no antibiotic therapy was given before admission. Clinical or radiological manifestations occurred in 46%; microbiologically documented infections by hemocultures in 28% (Gram positive: 42%; Gram negative: 51%) and by puncture in 14% (Gram negative: 58%). The length of pyrexia was inferior to 7days in 88% and neutropenia inferior 7days in 80.8%. 79.7% of episodes were treated with one of the three antibiotic therapy recommended by the center (ceftriaxone+tobramycin; ceftriaxone+ciprofloxacin; ceftriaxone+ofloxacin); 13.3% were treated with an other therapy; 7% received no antibiotic therapy. 68.5% of patients treated with one of the three antibiotic therapies, became afebrile without changing the antibiotic protocol. Conclusion: In our study, there were a majority of Gram negative bacteria except for Pseudomonas aeruginosa. The three antibiotic therapy recommended by the center (third generation cephalosporin+aminoglycosides or fluoroquinolones) were effective and glycopeptide was not necessary in first intention treatment. [Copyright &y& Elsevier]

Summary: The vaginal bacterial ecosystem is at higher risk for disturbances during pregnancy. And yet, its maintenance at an adequate level is probably the best way to decrease the risk of getting urogenital infections in the mother. Bacterial vaginosis and urinary infections are the most common ones and cannot be dissociated from each other as pregnant women with vaginal bacteriosis are at increasing risk for urinary tract infections. These urogenital infections can favour chorioamnionitis with or without a rupture of membranes. The biochemical factors accompanying both infections are contributors of initiating the inflammatory cascade and by the end a preterm labour. Antibiotics can in part prevent or resolve these infections and are therefore very often used in clinical practice. However, these drugs will also further accentuate the vaginal dysbacteriosis favouring the colonisation of the vaginal tract of the mother and the intestine of the neonate with multiresistant microorganisms, realizing in such a way a real vicious circle. Birth is the only time in our life when the gastrointestinal tract, while sterile, is colonised by bacteria originating from the maternal flora as well as by that of the close direct birth environment. There is now evidence that the invasive microbial environment, first encountered during the birth process, is opportunistically used by the host to initiate its own defence mechanisms but also all immune mechanisms allowing oral tolerance to diet antigen. In fact, these mechanisms are still immature at that stage. Recent epidemiological data support the hypothesis that some increasing immune deviances observed in the last decades could have been originated from a modification of the bacterial environment in young populations. Our modern approach to perinatal care may, to some extent, have modified inadequately the overall quality of this bacterial–host interface. Keeping all above data in mind but without any denigration of each evidence-based data already got, which have been associated with an improvement of our perinatal care, it is nevertheless urgent to focus now on this maternal and neonatal bacterial environment at birth, which could have been secondarily modified. It is with the aim of finding the best way to ameliorate, in the future, the bacterial colonisation of the newborn. It is indeed of concern in terms of public health owing all these putative associated short and long terms morbidities in the mother and her baby related to the disturbances of the bacterial environment at birth. [Copyright &y& Elsevier]

Abstract: The medical emergency ward makes a link between outpatients and hospitalized ones, so we can study community bacterial ecology. The antibiotic susceptibility in Escherichia coli strains isolated from urinary tract infections (UTI) of patients consulting at emergency ward of our hospital in 2002 and 2004 was determined and compared with the susceptibility of the same strains isolated from UTI of hospitalized patients on the same period. The antibiotic susceptibility was performed with Microscan (Dade Behring). All bacteria were tested against the following antimicrobial agents: amoxicilline (Amx), l''amoxicilline+clavulanic acid (AMC), nalidixic acid (NA), ciprofloxacine (Cip), cotrimoxazole (SXT), nitrofurantoin (Ft). Susceptibility in E. coli strains isolated from outpatients vary from 58 to 54% for Amx, from 88 to 83% for NA, from 96 to 89% for Cip, from 82 to 79% for SXT, from 94 to 96% for Ft and remains at 60% for AMC from 2002 to 2004. Susceptibility in E. coli strains isolated from hospitalized patients vary from 52 to 47% for Amx, 55 to 53% for AMC, from 79 to 70% for NA, from 87 to 79% for Cip, from 74 to 69% for SXT, from 93 to 92% for Ft. Susceptibility in E. coli strains isolated in the community from UTI outpatients is decreasing and it becomes worrying particularly concerning the fluoroquinolones, therefore empiric treatment of pyelonephritis by fluoroquinolones must be assessed again. [Copyright &y& Elsevier]

Abstract: Bacterial infections remain a major cause of morbidity and mortality in newborn infants. Objective. – To determine the bacterial ecology and pathological status of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of materno-foetal infections and to find out a drug prophylaxis. Method. – Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. An exploration was carried out in every newborn suspected of infection. Results. – Genital samples were collected from 306 pregnant women. Among them, 118 were at 29–32 weeks of gestation, 104 at 33–36, and 84 at 37–40. The most frequent germs were C. albicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. These pregnancies led to 334 live births with 27 cases of early-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19,7%) were most often linked. Conclusion. – Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of neonatal infections, as it has been done for Streptococcus agalactiae. But larger studies are required to evaluate the risk of maternofœtal infections and to state the drug prophylaxis. [Copyright &y& Elsevier]

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Introduction: Urinary tract infection is the second most common bacterial infection in children, after respiratory tract infection. The objective of this work was to study the bacterial ecology and antibiotic susceptibility of germs isolated during childhood urinary tract infections at the Paediatric University Hospital Charles-de-Gaulle in Ouagadougou., Patients and Method: This was a descriptive retrospective study covering the period from July 1 st , 2010 to June 30, 2015, including 141 children from 0 to 15 years old hospitalized in the medical paediatrics department for a urinary tract infection., Results: The hospital frequency of urinary tract infection was 0.7%. The mean age of the patients was 43.1 months. Female patients accounted for 57.4%, a sex-ratio of 0.7. Gram-negative bacilli were often involved (67.4%) with Escherichia Coli and Klebsiella in 35.5% and 22% of cases respectively. The main Gram-positive bacteria were staphylococci (15.5%), enterococci (11.3%) and streptococci (5.6%). Enterobacteriaceae isolated were sensitive to netilmicin (80%), chloramphenicol (76.4%), and furan (82.6%). All strains of staphylococcus were susceptible to furan, gentamicin, chloramphenicol and cefixime. In 66.7% of cases, the isolated strains of staphylococcus were resistant to amoxicillin., Conclusion: Urinary tract infection is a common problem in pediatrics. Its management must be early and adequate based on knowledge of the bacterial ecology in order to reduce the risk of long-term renal complications., (Copyright © 2021 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: The World Health Organization has estimated that the global incidence of neonatal deaths was 2,8 million in 2015, of which 47,6% were due to infections. These infections can affect newborns babies ages 0-1 month through 3 months., Methods: This is a prospective study conducted from 1 March to 30 June 2015 in the Neonatology service of the Laquintinie Hospital at Douala. All symptomatic newborns with or without anamnestic criteria and all asymptomatic newborns, with at least an infectious risk and a positive blood culture or an abnormal blood count or positive C-reactive protein were included in the study., Results: Of the 310 newborns enrolled in the study, 300 were retained for neonatal infection, corresponding to a total incidence of 96.8%. We performed 104 cultures, of which 25 were positive, corresponding to an incidence of confirmed neonatal infection of 24%. The factors associated with infection were unexplained preterm birth < 35 weeks of amenorrhea (45,1%) and neonatal resuscitation (34,8%). Fever (56%) and neurological disorders (48.8%) were the most frequent clinical symptoms. Gram-negative bacteria were the most frequent germs (56%). Imipenem (95%) and amikacin (66.7%) were the most effective antibiotics. Outcome was favorable in 66,4% of cases and the overall mortality rate was 33,6%., Conclusion: This study revealed a high prevalence of neonatal bacterial infection in this Hospital. Bacterial ecology was dominated by Gram-negative bacteria. It was recorded a significant resistance to the most widely used antibiotics and a fairly high mortality.

Introduction: For the last ten years, botulinum neurotoxin type A has become the gold standard for the treatment of neurogenic overactive detrusor. Bacterial colonization is common for these patients using clean intermittent self-catheterization, and toxin injections are at risk of urinary tract infections., Objectives: The aim of our study was to determine the prevalence of different germs and their resistance to antibiotics in patients with neurogenic bladder, treated with intravesical botulinum toxin injections., Material and Method: This epidemiologic study took place from September to October 2012 in a urodynamic and neurourology unit in a teaching hospital in Paris, France., Results: Eighty patients with a valid urine culture according to our protocol, were included. Fourty-four culture were positive with 45 bacteria. We found an Escherichia coli in 42.5%, a Klebsiella pneumoniae in 7.5%, a Citrobacter freundii and an enterococcus in 2.5%, and a Staphylococcus aureus in 1.25%. Penicillin resistance were found in 51.11%, 3rd generation cephalosporins in 8.89%, quinolones in 28.89% and sulfamids in 24.44%. None were resistant to fosfomycin., Conclusion: E. coli was the most frequent bacterium. No resistance to fosfomycin was found., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)