Antibiotic resistance patterns in Pseudomonas aeruginosa: an 8-year surveillance study in a French hospital.

The susceptibility to ticarcillin, piperacillin, ceftazidime, aztreonam, tobramycin, amikacin, ciprofloxacin and fosfomycin of 3876 strains of Pseudomonas aeruginosa isolated during the period 1989-1996 in a French hospital was investigated. The most frequently active agents were amikacin and ceftazidime to which 13.3% and 16.

Viridans group streptococci: an underestimated cause of spontaneous bacterial peritonitis in cirrhotic patients with ascites.

Objectives: The objective of the study was to examine the characteristics of spontaneous bacterial peritonitis (SBP) caused by streptococci, in particular viridans group streptococci (VGS), and to investigate a potential association between the long-term administration of norfloxacin and high-level resistance to fluoroquinolones in these organisms.

Methods: We reviewed 84 episodes of SBP and bacterascites caused by streptococci that occurred in 75 patients over a 6-year period. Isolates were tested for antibiotic susceptibility by the determination of minimum inhibitory concentrations.

Comparative activity of beta-lactam agents (carbapenem excepted) against Pseudomonas aeruginosa strains with CARB or OXA beta-lactamases.

Background: Ticarcillin resistance in Pseudomonas aeruginosa can be mediated by various beta-lactamases of the CARB and OXA groups.

Methods: We investigated the activity of seven beta-lactam agents and two beta-lactam-beta-lactamase inhibitor combinations against 216 P.aeruginosa strains with genotypically characterized beta-lactamases, including 137 CARB, 31 OXA-35, 25 OXA-10, 13 OXA-1 and 10 OXA-2.

Nosocomial and community-acquired spontaneous bacterial peritonitis: comparative microbiology and therapeutic implications.

In order to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis, 95 consecutive, spontaneous episodes were reviewed. Seventy of these episodes were bacteriologically documented. Fifty-three (55.

Identification of PSE and OXA beta-lactamase genes in Pseudomonas aeruginosa using PCR-restriction fragment length polymorphism.

Objective: A method using PCR-restriction fragment length polymorphism was developed to identify Pseudomonas aeruginosa beta-lactamase genes.

Methods: Two hundred and fifty-nine P. aeruginosa isolates were screened by PCR with 11 primer pairs designed to detect genes encoding PSE, OXA, TEM and SHV enzymes.

[Isolation of three species of Nocardia in a patient receiving long-term corticosteroid therapy].

Introduction: Nocardia are saprophyte bacteria of the environment responsible for systemic infections in immunodepressed patients, due essentially to long-term corticosteroids.

Observation: A patient having received corticosteroids for sarcoidoses for a year was hospitalised because of disseminated granulomatosis (neurological, respiratory, abdominal and cutaneous). Culture of various bacteriological samples isolated three species of Nocardia: N.

TEM-24 extended-spectrum beta-lactamase-producing Enterobacter aerogenes: long-term clonal dissemination in French hospitals.

Objective: To investigate interstrain relatedness of TEM-24-producing Enterobacter aerogenes clinical strains isolated between 1993 and 1998 in 10 French hospitals from nine areas by pulsed-field gel electrophoresis (PFGE) and plasmid patterns.

Methods: Fifteen TEM-24-producing strains and a set of 16 control strains having various other antibiotic resistance phenotypes were genotyped by PFGE. Plasmid DNA from TEM-24-producing strains and transconjugants was analyzed.

Association between nasal carriage of Staphylococcus aureus and infection in liver transplant recipients.

We reviewed the records of 87 patients who underwent liver transplantation and who were screened by use of nasal swabs on the day before surgery. Twenty-four patients harbored methicillin-susceptible Staphylococcus aureus (MSSA), and 8 harbored methicillin-resistant S. aureus (MRSA).

[Current microbiological problems. Antibiotic resistance and therapeutic problems raised by Pseudomonas aeruginosa].

Pseudomonas aeruginosa is characterized by its low intrinsic susceptibility to many antibiotics and its capacity to acquire additional resistance mechanisms to usually active drugs. Some beta-lactam resistance mechanisms are well known (penicillinase production, cephalosporinase overproduction) and others have been recently identified, such as active efflux systems, which confer coresistance to quinolones, and new beta-lactamases which are limited to a few countries (extended-spectrum beta-lactamases, imipenemase). Ceftazidime remains the most active beta-lactam agent.

Shigella and enteroinvasive Escherichia coli strains are derived from distinct ancestral strains of E. coli.

The differentiation between Shigella subspecies, and the phylogenetic position of Shigella clones within Escherichia coli clones was determined by analysis of restriction fragment length polymorphisms of rDNA (ribotyping). Seventy-five Shigella strains belonging to the four subspecies and 13 enteroinvasive E. coli (EIEC) strains were compared with the 72 E.

[Bacteria isolated from protected bronchopulmonary samples: variation as a function of the previous length of stay in the recovery room].

We retrospectively reviewed the variation of the organisms recovered from 403 protected bronchopulmonary specimens in three surgical intensive care units according to the time elapsed from admission. The predominant pathogens during the four first days were Haemophilus influenzae (33.3%), Staphylococcus aureus (18.

Clinical significance of bacteremia involving the "Streptococcus milleri" group: 51 cases and review.

Fifty-one cases of bacteremia due to the "Streptococcus milleri" group were analyzed. Among these were 40 patients with underlying diseases, and associated local infections were present in 27 patients. The most frequent sites of infection were the thoracic cavity and the digestive and hepatobiliary tracts.

Purulent pleurisy caused by Campylobacter lari.

An 80-year-old debilitated patient developed purulent pleurisy caused by a Campylobacter lari isolate. The patient underwent surgical drainage and received antibiotic therapy with amoxicillin/clavulanic acid and ofloxacin. Antibiotic susceptibility data showed that the isolate was fully sensitive to clarithromycin, tetracycline, aminoglycosides.

Multi-resistant Pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit.

From July 1995 to November 1996, multi-resistant Pseudomonas aeruginosa O11 was isolated from 36 patients admitted to a neurosurgery intensive care unit. The strain was resistant to ticarcillin, ceftazidime, imipenem, gentamicin and ciprofloxacin, and susceptible to amikacin. Nine patients were colonized only; the remaining 27 patients had at least one infected site (17 urinary infections, 10 pneumonias and four with sinusitis).

Long-term investigation of the clonal dissemination of Klebsiella pneumoniae isolates producing extended-spectrum beta-lactamases in a university hospital.

Seventy isolates of Klebsiella pneumoniae with extended-spectrum beta-lactamases (ESBLs) were compared. These were isolated from 51 patients on 10 separate wards in one hospital over an 18-month period between 1992 and 1994. Antibiograms were determined and the isolates were typed by pulsed-field gel electrophoresis of their DNA digestion with XbaI.

Analysis of a case of recurrent bacteraemia due to group A Streptococcus equisimilis by pulsed-field gel electrophoresis.

An 86-year-old woman with a history of metastatic breast cancer developed two episodes of streptococcal bacteraemia and erysipelas separated by an interval of 3 months. The isolates belonged to Lancefield group A but were biochemically identified as Streptococcus equisimilis. The similarity of the two isolates was established by DNA macrorestriction analysis and pulsed-field gel electrophoresis, indicating that the second episode was due to relapse and not reinfection.

Epidemiological typing of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates responsible for five outbreaks in a university hospital.

Thirty-seven isolates of extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae implicated in five nosocomial outbreaks (I-V) on three distinct wards of our hospital were compared using capsular typing, biotyping, antibiotyping, enzyme electrophoresis typing and DNA macrorestriction analysis with Xba I resolved by pulsed-field gel electrophoresis. The isolates from each outbreak had common phenotypic and genotypic characteristics indicating that they were related epidemiologically. Isolates from outbreaks I (four patients) and V (13 patients), although they occurred in two different wards (neurology and surgery) and three years apart, produced the same ESBL with a pI of 7.

Differentiation of human and animal strains of Streptococcus dysgalactiae by pulsed-field gel electrophoresis.

The genetic diversity among 54 human isolates and 33 animal isolates belonging to the species Streptococcus dysgalactiae (20 alpha-haemolytic Streptococcus dysgalactiae, 23 Streptococcus equisimilis, 43 group G streptococci and one group L streptococcus) was evaluated by macrorestriction analysis of chromosomal DNA with SmaI and resolution by pulsed-field gel electrophoresis. This technique revealed a high degree of intraspecies polymorphism, leading to the differentiation of 80 distinct banding patterns, and identified the presence of two major clusters, one containing isolates of human origin and the other isolates of animal origin. These results suggest than human and animal isolates of S.

Pulsed-field gel electrophoresis is more discriminating than multilocus enzyme electrophoresis and random amplified polymorphic DNA analysis for typing pyogenic streptococci.

The SmaI restriction endonuclease digestion patterns of chromosomal DNAs from 99 pyogenic streptococci belonging to Lancefield group A (41 Streptococcus pyogenes), group C (seven S.dysgalactiae, 11 "S. equisimilis", three S.

Septicemia caused by Streptococcus canis in a human.

We describe a case of septicemia due to Streptococcus canis in a 77-year-old man. The organism was presumably transmitted from a domestic animal. Ulcers of the lower limbs were the likely portals of entry.

Arbitrary primed PCR rules out Clostridium difficile cross-infection among patients in a haematology unit.

Eight out of 20 (40%) patients with haematological malignancies hospitalized in the same unit of our hospital from 24 January to 24 April 1995, suffered from diarrhoea due to Clostridium difficile. The C. difficile isolates were characterized by serotyping and by arbitrary primed polymerase chain reaction (AP-PCR) using three different 10-mer oligonucleotides.

Elution of six antibiotics bonded to polyethylene vascular grafts sealed with three proteins.

The elution of six antistaphylococcal antibiotics from vascular polyethylene grafts sealed with albumin, gelatin, or collagen were studied in an in vitro system. The antibiotics tested were pefloxacin, vancomycin, teicoplanin, fusidic acid, pristinamycin, and rifampicin. The grafts were impregnated by simple soaking in antibiotic (1 mg/ml).

Activities of piperacillin, ceftazidime, cefepime and cefpirome against Pseudomonas aeruginosa strains with intrinsic ticarcillin resistance.

The in vitro activities of cefepime and cefpirome against 44 intrinsically ticarcillin-resistant strains of Pseudomonas aeruginosa were compared to their activities against 20 ticarcillin-susceptible strains by MIC determination and the disk test. Time-killing curves were constructed for piperacillin, ceftazidime, cefepime and cefpirome against two susceptible and two resistant strains. The activities of cefepime and cefpirome against the resistant strains were impaired, and most of the strains were of intermediate sensitivity to these agents.