Carbapenems.

Objective: To assess the relative strengths and weaknesses of carbapenems by considering their microbiological, clinical, pharmacokinetics and pharmacokinetic/pharmacodynamic (PK/PD) properties and defining optimal conditions of uses of the new generation of carbapenems.

Methods: Literature review.

Results: Except for ertapenem, the spectrum of activity is similar for all carbapenems, with little differences in activities of individual agents.

Increase in primary drug resistance of Mycobacterium tuberculosis in younger birth cohorts in France.

Background: Monitoring of primary drug resistance is of interest for long-term evaluation of the efficacy of a national tuberculosis program. The objective was to describe changes over time in primary drug resistance among new tuberculosis patients.

Methods: Stratified analysis by birth cohorts, region of birth, HIV-coinfection of data from 14,610 culture-positive new tuberculosis patients diagnosed by a network of university hospitals between 1995 and 2008.

Microbiologic characteristics and in vitro susceptibility to antimicrobials in a large population of patients with cardiovascular implantable electronic device infection.

Introduction: The incidence of cardiovascular implantable electronic device (CIED) infection is steadily increasing. However, no consensus has been reached with respect to the type and duration of antimicrobial therapy in this specific population of patients. The role played by new anti-Staphylococcus agents has not been defined.

Pharmacokinetics of free ertapenem in critically ill septic patients: intermittent versus continuous infusion.

Background: The aim of this paper was to compare the pharmacokinetic and pharmacodynamic (PK/PD) parameters of continuous (CI) and intermittent infusion (ITI) of ertapenem into critically ill patients with severe abdominal infections.

Methods: Twenty septic patients hospitalized in a university hospital intensive care unit were enrolled in the study. Half of the patients received ertapenem as an ITI 1 g bolus once daily, and the other half of the patients received the same dose via CI over 24 h following a 1-g loading dose.

[Cutaneous infection due to Mycobacterium chelonae during anti-TNF therapy].

Background: Mycobacterium chelonae is a ubiquitous, rapidly growing, opportunistic, non-tuberculous mycobacterium that can cause skin and bone tissue infections. We report a case of cutaneous infection due to M. chelonae following anti-TNF therapy.

A 10-year prospective surveillance of Mycobacterium tuberculosis drug resistance in France 1995-2004.

Drug resistance surveillance and trend monitoring resistance rates bring some insights into tuberculosis (TB) control. The current study reports the characteristics of TB and drug resistance during a 10-yr prospective surveillance of culture-positive TB in France. Data for the current study was collected from 1995-2004 via a sentinel network of laboratories from university hospitals that complied with the international recommendations for the surveillance of drug resistance.

[Molecular characterization and biodiversity of Mycobacterium tuberculosis in the Antilles-Guiana region and comparative analysis in a metropolitan region, Aquitaine].

Tuberculosis is a highly contagious infectious disease in recrudescence whose epidemiologic monitoring is reinforced by molecular biology. In this context, we were particularly interested in the cases of tuberculosis of French West Indies and French Guiana (FWI-FG). This study covered a period of two years (1997 and 1998) and focused on the demographical and epidemiological characteristics of the cases diagnosed by an analysis of their genotypes.

Snapshot of moving and expanding clones of Mycobacterium tuberculosis and their global distribution assessed by spoligotyping in an international study.

The present update on the global distribution of Mycobacterium tuberculosis complex spoligotypes provides both the octal and binary descriptions of the spoligotypes for M. tuberculosis complex, including Mycobacterium bovis, from >90 countries (13,008 patterns grouped into 813 shared types containing 11,708 isolates and 1,300 orphan patterns). A number of potential indices were developed to summarize the information on the biogeographical specificity of a given shared type, as well as its geographical spreading (matching code and spreading index, respectively).

[Is length of stay in the recovery room a risk factor for cross infections?].

Objective: To assess cross contamination for patients at the time of their stay in the recovery room (RR).

Study Design: Prospective study.

Patients And Methods: A prospective survey over 3 weeks with 75 adult patients admitted to RR after thoracic or neck surgery.

Gammadelta T lymphocytosis associated with granulomatous disease in a patient with common variable immunodeficiency.

Common variable immunodeficiency (CVID) is a heterogeneous group of immunodeficiency syndromes that involves defective production of specific antibodies and decreased serum concentrations of > or =1 immunoglobulin isotype. We describe a patient with an atypical case of CVID who had extensive granulomatous lesions that were partially attributable to mycobacterial infection. In the peripheral blood, there was a massive increase in the number of double-negative CD3+ T cells that expressed the gammadelta T cell receptor.

Global distribution of Mycobacterium tuberculosis spoligotypes.

We present a short summary of recent observations on the global distribution of the major clades of the Mycobacterium tuberculosis complex, the causative agent of tuberculosis. This global distribution was defined by data-mining of an international spoligotyping database, SpolDB3. This database contains 11708 patterns from as many clinical isolates originating from more than 90 countries.

Is a 24-h cyclic closed enteral feeding system microbiologically safe in geriatric patients?

Background And Aims: The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitored under clinical conditions simulating cyclic feeding over a 24-h period in geriatric patients.

Method: The set was connected after diet sampling (T0). After 5-h feeding, the set was disconnected and a sample taken (T5).

[Mycobacterial bovis BCG cutaneous infections following mesotherapy: 2 cases].

Introduction: Infectious complications following mesotherapy are usually due to ordinary bacteria or atypical mycobacteria. We report two new cases of mycobacterial bovis BCG infections following mesotherapy. To our knowledge only one case has already been reported.

[Annual incidence and risk factors for nosocomial bacterial infections in an acute care geriatric unit].

Purpose: Elderly inpatients are particularly exposed to the risk of nosocomial infections, thus the study of their risk factors and consequences is of interest.

Methods: Among 1,565 subjects referred to a short-term geriatric unit, patients hospitalised for a year for an acute event and unable to move themselves were followed up for the occurrence of nosocomial infections.

Results: Among these 402 immobilised patients (age: 86.

Increase in CD3+ CD4- T lymphocytes in patients with AIDS and disseminated Mycobacterium avium-intracellulare complex infection: a prospective study. GECSA. Groupe d'Epidemiologie Clinique du SIDA en Aquitaine.

In a retrospective study, an increase in double-negative (CD3+ CD4- CD8-) (DN) T lymphocytes has been shown to be an independent predictor of disseminated Mycobacterium avium complex (D.MAC) infection in patients with less than 100 CD4+ T cells per mm3. To better characterize this cell expansion, a prospective study was designed.

[Comparison of cases of isolated pulmonary tuberculosis with cases of other localizations of tuberculosis in the course of an active surveillance (Gironde, 1995-1996)].

Purpose: Data collected during the years 1995 and 1996 in the course of an epidemiological survey of tuberculosis in Gironde allowed comparison of pulmonary tuberculosis with extrapulmonary localizations, evaluation of the importance of each localization and highlighting of potential risk factors.

Methods: Patients living in Gironde who had evidence of either clinical, radiological or bacteriological expression of tuberculosis were included in the survey. Statistical comparisons were done using either Pearson's Chi 2 or Fisher's exact test.

Primary cutaneous Nocardia asteroides infection after heart transplantation.

Skin diseases due to Nocardia are rare in Europe and usually occur as the secondary localization of a pulmonary lesion in immunocompromised patients. We describe a cutaneous pyoderma and cold abscess due to Nocardia asteroides infection in a cardiac transplant recipient. An insect bite represents the wound of this soil saprophyte belonging to the actinomycetes.

[Comparative in vitro activity of cefepime: multicenter study in Aquitaine].

Over a 6 month-period (1st January to 30th June 1995), the results of antibiotic susceptibility testing routinely performed for beta-lactams against enterobacteria, Pseudomonas aeruginosa, and Acinetobacter in 7 laboratory hospitals of Aquitaine, have been collected and divided in susceptibility profiles. A total of 9269 strains (7323 enterobacteria, 1667 P. aeruginosa, 279 Acinetobacter) have been examined.

Progression of human immunodeficiency virus infection in patients with tuberculosis disease. A cohort study in Bordeaux, France, 1988-1994. The Groupe d'Epidémiologie Clinique du Sida en Aquitaine (GECSA).

To assess the role of Mycobacterium tuberculosis disease in human immunodeficiency virus (HIV) infection, the authors compared survival of tuberculosis patients and controls matched on year of HIV diagnosis and CD4+ lymphocyte count. Patients were selected in the Aquitaine Cohort, which follows, since 1985, all patients infected with HIV, aged more than 13 years, in five hospitals. Time of inclusion of controls was the date of diagnosis of tuberculosis for the corresponding tuberculosis patient.

[Bacterial infectious agents implicated in lower respiratory tract infections in general practice].

The consensus of the French Society of Infectious Diseases established in 1991 states that Streptococcus pneumoniae and Haemophilus influenzae are the main causal agents of community-acquired lower airway infections and that antibiotics constitute the "prudent" solution in case of acute bronchitis which persists more than one week or in case of pneumonia in "fragile" at-risk adults. The efficacy of these "probabilistic" recommendations depends on the epidemiology of the infectious agents. The objective of this study was to identify the causal germs in lower airway infections and determine their sensitivity to the antibiotics recommended in the consensus statement.