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Background: To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD).Aim: The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tap water as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim.Methods: A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tap water specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tap water were genotyped using pulse-field gel electrophoresis.Findings: A total of 139 clinical specimens of P. aeruginosa and 19 tap water samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tap water was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens.Conclusion: Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa. [ABSTRACT FROM AUTHOR]

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent bacteriological data concerning pyelonephritis mainly focus on sensitivity to antibiotics and virulence factors. Epidemiologically, and regardless of age and sex of the patients, E. coli remains the most often isolated pathogen. Only 55% of E. coli strains (43% if isolated during a nosocomial infection) are sensitive to amoxicillin. Resistance to parenterally administered third generation cephalosporins remain exceptional. Fluoroquinolones remain very active, particularly in community-acquired infections (>95% sensitive strains). P. aeruginosa, S. aureus and enterococci are mainly isolated during nosocomial infections or in patients with a history of previous hospital admissions. Adhesion factors to urothelial cells are of uppermost importance in the pathogenesis of urinary infection. Adhesins G borne by fimbriae P are mainly concerned. Also, hemolysin is very often present in strains responsible for pyelonephritis. As to the search for these factors in the diagnosis of pyelonephritis, particularly in children, further studies are needed. The choice of antibiotherapy not only rests upon antibiogram data, but also upon pharmacological characteristics of the antibiotic. [Copyright &y& Elsevier]

Résumé: Nous rapportons un cas de méningite purulente à streptocoque A chez un patient porteur d’une brèche ostéoméningée. Ce cas permet de souligner plusieurs points intéressants : a) une cause rare de méningite bactérienne ; b) les diagnostics à évoquer dans la situation où l’examen direct du LCR est positif à cocci à Gram+ mais que l’antigène pneumocoque est négatif sur le LCR ; c) le pneumocoque n’est pas la seule bactérie responsable de méningite bactérienne associée à une brèche ostéoméningée. [ABSTRACT FROM AUTHOR]

Actinobaculum schaalii is a Gram-positive facultative anaerobe bacillus. It is a commensal organism of the genitourinary tract. Its morphology is nonspecific. Aerobic culture is tedious, and identification techniques have long been inadequate. Thus, A. schaalii has often been considered as a nonpathogen bacterium or a contaminant. Its pathogenicity is now well described in urinary tract infections, and infections in other sites have been reported. This pathogen is considered as an emerging one following the growing use of mass spectrometry identification. In this context, the aim of our study was to evaluate the number of isolations of A. schaalii before and after the introduction of mass spectrometry in our hospital and to study the clinical circumstances in which isolates were found. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The aim of our study was to determinate the frequency of candidemia, the species encountered and their susceptibility to antifungal agents in French hospitals in 2004. Methods: A prospective survey of septicaemia, including candidaemia was conducted among 193 non teaching French hospitals during October 2004. All bloodstream infections were reported and the bloodstream isolates sent to two coordinating centers. Species identification and susceptibility were performed by biologists as usual, and further confirmed by use of alternative methods, including Minimal Inhibitory Concentration (MIC) determination. Results: The survey was effective in 93 hospitals, where 2013 bloodstream infections were noticed, including 46 candidaemia (2,3%). Candida sp. Is the 7th pathogen responsible for bloodstream infection, without concern of the origin of the infection. Candidaemia was hospitally acquired in 80,4% of cases (N =37/46). Candidaemia represents 0,7% (N =9/1211) of community-acquired bloodstream infections but 4,5% (N =37/802) of nosocomial cases, placing Candida sp. at the 5th row of frequency in this last group. No mistakes were noticed during identification, but two strains were not named. After confirmation of identification, species are distributed as follows: 23 C.albicans (50%), 13 C.glabrata (28,3%), 5 C.tropicalis (10,9%), 3 C.parapsilosis (6,5%), 1 C.krusei (2,2%), and 1 C.kefyr (2,2%). The overall susceptibility is 97,7% for amphotericin B, 93,2% for 5-fluorocytosin, 88,6% for fluconazole, 70,5% for itraconazole, 95,5% for voriconzole and 100% of strains haved very low MIC for caspofungin. Concerning the two main species isolated, 95,5% of C.albicans strains remain susceptible to fluconazole, but only 69% of C.glabrata strains. Two strains, 1 C.albicans and 1 C.glabrata exhibit cross resistance to azoles. The majority of amphotericin, fluconazole, and itraconazole decreased susceptibility strains are found into C.glabrata strains, but susceptibility to 5-fluorocytosin and very low MCI to caspofungin remained in this species. Conclusion: Our survey allowed us to get data from French non-teaching hospitals in 2004 about frequency of candidaemia among septicaemia. Candida species distribution and in vitro susceptibility patterns of the strains isolated. Candidaemia is not a rare event, specially when septicaemia is nosocomially acquired. C.albicans is the main species isolated and remains highly in vitro susceptible to antifungals. One important feature is the frequency of C.glabrata in our survey. Considering its decreased susceptibility to azoles, this finding confirms the need for rapid identification of yeast isolated from bloodstream samples, and antifungal susceptibility testing each time it is available. [Copyright &y& Elsevier]

The article presents case study of a 60-year-old man who was diagnosed with Gram-negative bacilli community-acquired meningitis caused by capnocytophaga canimorsus. Topics discussed include use of drugs like meropenem, levofloxacin and metronidazole for treatment of the patient; observation of hearing loss upon audiogram; and use of antibiotic therapy involving cefotaxime upon the patient.

L’infection bactérienne transmise par la transfusion (IBTT) est l’une des complications parmi les plus redoutées de la transfusion sanguine. Nous rapportons le cas d’une enfant de 8 ans atteinte de dyskératose congénitale, en aplasie médullaire, transfusée régulièrement en concentrés plaquettaires depuis 5 ans. Le 18/02/15, elle reçoit un CPA du fait d’une thrombopénie à 9 G/L responsable d’un syndrome hémorragique cutanéomuqueux. La malade sous antibiothérapie préventive (Sporanox ® et Bactrim ® ) est apyrétique avant transfusion (36,3 °C). Vingt-cinq minutes après le début de la transfusion apparaissent bradycardie et dyspnée puis frissons, nausées, vomissements, céphalées et hyperthermie à 40,3 °C. Un IBTT est suspecté. La patiente est transférée en service de réanimation. Les GB sont à 0,25 G/L. Le 21/02 elle est placée sous assistance circulatoire du fait d’une défaillance myocardique. Le 24/02 l’EEG est plat et la malade décède le 25/02. Les examens bactériologiques retrouvent un Citrobacter koseri dans les hémocultures de la patiente et le CPA. La donneuse est une jeune femme de 19 ans ayant déjà donné 3 fois (sang total). Les produits de ses dons ont été transfusés sans effet indésirable déclaré. L’entretien pré-don n’avait relevé aucune symptomatologie infectieuse, la numération le jour du don montrait des GB à 5,83 G/L. Les prélèvements effectués le 26/02 retrouvent au niveau de la narine de la donneuse un C. koseri de même antibiogramme que celui retrouvé dans le CPA et les hémocultures alors que les prélèvements des autres sites (selles, peau, urine) sont négatifs pour ce germe. La comparaison des souches est en cours. L’examen ORL de la donneuse est sans particularité. [ABSTRACT FROM AUTHOR]