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1.
M.A. Alioua A. Labid K. Amoura M. Bertine D. Gacemi-Kirane M. Dekhil 《Médecine et maladies infectieuses》2014
Aims
The authors had for aim to assess whether an in-hospital spread of the European community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone was on-going in Annaba, Eastern Algeria.Material and methods
We carried out a molecular epidemiological study of S. aureus strains causing infections in 4 hospitals located in Annaba, between February and October 2010.Results
Our study revealed a very low healthcare-associated MRSA (HCA-MRSA) infection incidence rate of 0.34 per 1000 patient-days. However, the rates of HCA-MRSA strains (85/119) and CA-MRSA (7/29) among S. aureus strains are much higher than those found in France. The European CA-MRSA clone (clonal complex 80, Staphylococcal Cassette Chromosome mec IVc, spa type t044, lukS/F-PV-positive) accounted for 14.1% of all healthcare-associated (HCA) MRSA infections.Conclusion
This study confirmed the emerging role of CA-MRSA as HCA pathogens in North-African Africa. 相似文献2.
S. Elhamzaoui A. Benouda F. Allali R. Abouqual M. Elouennass 《Médecine et maladies infectieuses》2009
Objectives
The aim of this study was to assess the in vitro activity of several antimicrobial agents against Staphylococcus aureus (S. aureus).Method
This 2 year study was made in two Moroccan teaching hospitals. Four hundred and sixty-one non-repetitive clinical S. aureus strains were isolated and collected from various samples collected in several units between March 2006 and March 2008.The susceptibility of strains was determined by the agar disk diffusion method.Results
The rate of methicillin resistance was 19.3% for S. aureus isolates. 53.93% of S. aureus strains were resistant to gentamycin, and all strains were susceptible to glycopeptides.Conclusion
The rate of MRSA was high. Resistance to methicillin is often associated with resistance to gentamycin and fluoroquinolones. Vancomycin and teicoplanin were still effective on S. aureus in the two university hospitals. 相似文献3.
Objective
Screening for (methicillin-sensitive [MSSA] or -resistant [MRSA]) Staphylococcus aureus (SA) nasal carriage in health care workers in contact with fragile patients is a recurrent question. We wanted to assess carriage among infectious diseases healthcare workers.Methods
Voluntary health care workers were recruited during the 2010 Yearly French Congress (Journées Nationales d’Infectiologie, JNI). An anonymous double nasal swab was performed followed by PCR examination (GeneXpert MRSA/SA nasal tests) carried out on the Cepheid stand. Health care workers were also asked to fill in a questionnaire. Results were available 1 hour later but kept anonymous.Results
One hundred and fifty-two tests and questionnaires were selected. MRSA was isolated from four health care workers (2.4%). MSSA was isolated from 52 health care workers (34.2%). Sex, clinical activity of health care workers, hospital size, and systematic screening of patients did not affect carriage.Conclusions
The prevalence of MSSA in nasal carriage in France is similar to the European one but the prevalence of MRSA is higher. This raises the question of a targeted decolonization in health care workers. 相似文献4.
Objectives
The aim of our study was to confirm the identification of 113 meticillin-resistant Staphylococcus aureus (MRSA) strains by pyrosequencing, to determine the susceptibility of these clinical isolates to various classes of antibiotics, to determine the minimum inhibitory concentration (MIC) to glycopeptides, and to detect mecA and luk-PV genes.Methodology
The Staphylococcus species was identified by pyrosequencing of the variable region (V3) of the 16SrRNA. The susceptibility of these 113 strains of MRSA to antibiotics was determined by the disk diffusion method on Mueller-Hinton agar. The MIC of glycopeptides was determined by using the dilution method on solid media. mecA gene and luk-PV gene were detected by PCR.Results
The disk diffusion method proved full susceptibility to vancomycin, teicoplanin, and linezolid; whereas MIC (dilution method) indicated that 5/113 strains were resistant to teicoplanin, giving a probability of having heterogeneous glycopeptide intermediate S. aureus (hGISA) strains. The mecA gene was detected in all MRSA strains ruling out the probability of having new variants of this gene in the tested strains. The luk-PV gene was detected in 28 out of 113 MRSA strains (24.8%).Conclusion
The originality of this study was the detection of hGISA strains knowing that they were susceptible to glycopeptides according to the diffusion method. Thus it is necessary to check the level of susceptibility of MRSA clinical isolates to glycopeptides for immunodeficient patients, by determining the MIC. 相似文献5.
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 Streptococcuspneumonia with decreased susceptibility to penicillin has increased (1997: 25.5 %, 2005: 42.9 %), as for Haemophilusinfluenzae 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. 相似文献6.
Objective
The authors investigated the role of femA regulating gene on methicillin-resistant Staphylococcus aureus (MRSA).Methods
High-level MRSA, low-level MRSA, and methicillin-susceptible Staphylococcus aureus (MSSA) were determined by agar diffusion methods. β-lactamase was then detected by nitrocefin and the presence of mecA was determined by PCR. Only β-lactamase-negative but mecA-positive isolates were included in further studies. The femA gene and its 250 bp upstream sequence were amplified by PCR. Expression levels of femA were determined by real-time fluorescent quantitative PCR. The 250 bp upstream sequence of femA was labeled by BrightStar Psoralen-Biotin and was detected by electrophoretic mobility shift assay (EMSA).Results
The expression levels of femA in the three different groups (MSSA, low-level MRSA, and high-level MRSA) ranged from 3.53 × 10–3% to 29.91%, 5.54 × 10–3% to 3.1 × 102%, and 13.88% to 5.50 × 104%, respectively. EMSA could detect the signal shift in 55 high-level MRSA isolates but not in four low-level MRSA and four MSSA strains.Conclusion
The expression levels of femA in high-level MRSA (non-β-lactamase-producing) were higher than in low-level MRSA and MSSA. The femA regulating gene probably lies in the 250 bp upstream sequence in MRSA. High-level expression of femA seems to be essential for high-level MRSA. 相似文献7.
Malaria attacks due to P. vivax or P. ovale in two French military teaching hospitals (2000 to 2009)
Context
Non-falciparum malaria is less studied than Plasmodium falciparum malaria, both in endemic and non-endemic zones.Patients and method
A retrospective study was made of the medical files of patients managed for attacks of malaria due to Plasmodium vivax or Plasmodium ovale, between 2000 and 2009, in two French military teaching hospitals.Results
Seventy-five percent of attacks occurred after a stay in French Guiana, in the Comoros Archipelago, or in the Ivory Coast Republic. The most frequent symptoms two months after coming back were a flu-like syndrome with headaches, and occasional digestive symptoms, without any difference between the first attack and recurrence. One third of patients presented with anemia, 78% with thrombocytopenia, and 12% with liver dysfunction.Discussion
This study was the most important made in France on imported non-falciparum malaria. Military patients and immigrants accounted for a majority of patients due to the specificity of military hospitals and local recruitment. Clinical and biological features were not specific and did not allow guiding the diagnosis. Diagnostic tools were less sensitive for P. ovale.Conclusion
Patient management could be optimized by more efficient diagnostic tools, specific guidelines for the diagnostic and therapeutic management, and a dedicated medical training for family practitioners as well as hospitals practice. 相似文献8.
9.
A. Mayet F. Berger R. Haus-Cheymol V. Pommier de Santi C. Verret L. Ollivier S. Duron A. Spiegel X. Deparis R. Migliani 《Médecine et maladies infectieuses》2010
Objectives
Pertussis surveillance in the French general population was stopped in 1986. Pertussis was added to the list of illnesses surveyed by the military epidemiological surveillance network ecause of outbreaks having occurred among French servicepersons and in military high schools. This study had for aim to report the results of the first year of surveillance.Design
Pertussis declaration criteria were those recommended in 2006 by the French council for public hygiene. The data concerning active military servicepersons was collected by physicians of all military medical units. An anonymous declaration form was used for data collection.Results
In 2007, 66 cases of pertussis were reported in the military forces, 10 of which were excluded after a negative biological test. The classification of the 56 included cases was: 46% biologically confirmed cases, 20% clinically confirmed cases, 14% suspected cases, and 6% epidemiologically confirmed cases. The incidence density rate was 16.3 cases for 100,000 servicepersons-years. Age under 20 was associated with a 4.6 fold higher risk to develop pertussis.Conclusions
The high incidence rate observed in individuals under 20 years of age could reflect a shift of pertussis reservoir to young adults, as observed in industrialized countries after generalization of vaccination programs. However, several years of surveillance will be needed to confirm this hypothesis. Meanwhile, the military epidemiological network could constitute an important surveillance marker of pertussis among adults in France. 相似文献10.
C. Gros Y. Yazdanpanah A. Vachet M. Roussel-Delvallez E. Senneville X. Lemaire 《Médecine et maladies infectieuses》2012
Objective
The authors had for aim to describe the epidemiological and clinical characteristics, and the treatment of patients presenting with skin and soft tissue infections due to Panton–Valentine leukocidin (PVL) producing Staphylococcus aureus in the Nord-Pas-de-Calais (NPDC) region, North of France.Methods
We included patients presenting with PVL producing S. aureus infection from seven hospitals in the NPDC region, between February 2004 and April 2008. We retrospectively collected patient data using a standardized questionnaire. The features of patients presenting with skin and soft tissue were then analyzed.Results
PVL producing S. aureus was isolated from 64 patients. Fifty-four patients presented with skin and soft tissue infections. The mean age of patients was 23.8 years (63% male patients). The mean number of persons living with the infected patient was 4.5 (vs. 2.5 in NPDC). The lesions were abscesses with inflammatory signs in 64.8% of the cases (20% were necrotic). Among the patients, 70.3% carried a methicillin resistant strain. Antibiotics per os were used for 83.3% of patients; the first-line antibiotics were considered inadequate in 53.3% of the cases. Among the patients, 83.3% underwent surgery. Fourteen out of 38 patients with available data had been exposed to antibiotic therapy during the three months before hospital management.Conclusion
Recent exposure to antibiotics and living with a high number of persons are reasons to suspect a PVL producing S. aureus infection in patients with skin abscess. 相似文献11.
J.-F. Faucher A.-P. Bellanger N. Shaniya L. Hustache-Mathieu B. Hoen C. Chirouze 《Médecine et maladies infectieuses》2014
Objectives
We assessed the compliance to recommendations for the routine management of Plasmodium vivax/ovale malaria, and analyzed the impact of discrepancies on the quality of care.Patients and methods
We reviewed the cases of P. ovale and P. vivax malaria treated at the Besançon University Hospital, France (2008–2013).Results
Chloroquine was prescribed in 44% of the 18 cases (4 due to P. ovale, 14 to P. vivax). Radical cure with primaquine was prescribed after the first bout of malaria for 6 patients. The primaquine dose prescribed was inferior to the recommended one for 4 patients. The mean delay between schizonticide treatment and primaquine cure was 43 days.Conclusions
The delay before access to primaquine radical cure was the only parameter, likely to alter treatment effectiveness, but also difficult to shorten. Future national guidelines should take into account that not all patients have access to primaquine treatment immediately after schizonticide treatment. 相似文献12.
Objective
The aim of this study was to screen Staphylococcus aureus negative for production of coagulase or clumping factor and for presence of selected adhesin genes.Methods
Sixty coagulase-negative and 20 clumping factor-negative S. aureus strains were studied. Detection of methicillin resistance was performed using the agar screen technique with 6 mg/L of oxacillin and was confirmed by amplification mec A gene. The presence of bone binding protein (bbp), collagen binding protein (cna), fibronectin A binding protein (fnbA), fibronectin B binding protein (fnbB) and clumping factor A (clfA) genes was detected by multiplex PCR.Results
Almost all (98%) of the strains were positive for clfA gene. There were fnbA and fnbB in 85%, cna in 54% and bbp in 5% of strains found. No correlation between presence of the particular genes and clinical samples was observed. The prevalence of fnbA, fnbB and cna was statistically higher in coagulase-negative than in clumping factor-negative strains (89, 89, 66 and 70, 70, 15%, respectively). Similarly, all of these genes were more often observed in MRSA than in MSSA atypical strains. The cna was detected only in coagulase-negative MRSA. 相似文献13.
Objective
The aim of this study was to determine the antimicrobial activity of amoxicillin–clavulanic acid against Escherichia coli urinary strains, especially those resistant to amoxicillin, and to analyze the results according to the susceptibility testing methods.Method
This prospective study was made from April to May 2008, on 301 E. coli strains isolated from urine samples. The susceptibility to antibiotics was studied by agar disk diffusion according to French Society of Microbiology Antibiogram Committee recommendations. MIC were determined with the E-test.Results
According to the antibiogram, 59.8% of strains were resistant to amoxicillin, 33.2% to amoxicillin–clavulanic acid, 1.7% to cefotaxim, 8.3% to nalidixic acid, 6.6% to ofloxacin, 4.7% to ciprofloxacin, 4.7% to gentamicin and 38.1% to cotrimoxazole. After determining the MIC of E. coli strains resistant to amoxicillin and susceptible to amoxicillin–clavulanic acid, 37.5% (n = 30) remained susceptible, 61.25% (n = 55) were of intermediate susceptibility and only one strain (1.25%) was resistant.Among E. coli strains resistant to amoxicillin and intermediately susceptible to amoxicillin–clavulanic acid, 83.3% (n = 55) remained intermediately susceptible, 13.7% (n = 9) became susceptible and two strains (3%) were resistant.Conclusion
The susceptibility testing methods, especially for amoxicillin–clavulanic acid, must be standardized to avoid the discrepancies noted between standard antibiograms and an accurate determination of MIC. 相似文献14.
Objective
This study had for aim to assess pneumococcal vaccination rates in hospitalized patients.Design
A prospective study was carried out in two medical wards of the Nice University Hospital, France. Patients were included from December 31, 2007 to February 12, 2008.Results
Hundred and thirty-seven patients, aged 62 ± 20 years, were included. Pneumococcal vaccination was indicated for 62 patients (45 %). Among these 62 patients, 53 (85 %) had not been vaccinated in the previous 5 years, for the following reasons: no medical advice on vaccination (36 cases), no medical consultation in the past years (nine cases), patient opposed to vaccination (two cases), physician opposed to vaccination (one case), miscellaneous (five cases). Among the 53 patients, seven were vaccinated during their hospital stay and 13 were advised to be vaccinated by their general practitioner.Conclusions
This study highlights a low rate of pneumococcal vaccination in hospitalized patients, mainly due to insufficient counseling from physicians, both in community or in hospital practice. 相似文献15.
Objectives
We investigated the prevalence and the risk factors of nasal carriage of Staphylococcus aureus carrying Panton-Valentine leukocidin genes [Sa PVL(+)] in pupils.Study population and methods
Two hundred and fifty-seven pupils were screened by nasal swabbing. The detection of 16S rRNA, mecA and luk-PV genes was performed by PCR and the risk factors were assessed with the statistical analysis of a questionnaire.Results
Thirty-one percent of pupils were colonized, with 16.4% of isolates carrying the luk-PV gene and 8.8% the mecA gene. Children aged 7 years or more and living in a boarding school were the factors promoting nasal carriage 60% of children who presented with an abscess in the previous year were carriers of luk-PV gene Sa.Conclusion
The study revealed a high prevalence of luk-PV gene among methicillin-susceptible strains and a statistically significant correlation between the presence of this gene and presenting with an abscess. 相似文献16.
Background
Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital.Methods
A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors.Results
Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus.Conclusion
The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents. 相似文献17.
A.-S. Barret M. Charron P. Mariani-Kurkdjian M. Gouali E. Loukiadis B. Poignet-Leroux A. Godron G. Gault M. Faure A. Mailles 《Médecine et maladies infectieuses》2013
Introduction
An outbreak of shiga-toxin producing Escherichia coli infections occurred in southwest France in June 2012. The outbreak was investigated to identify the source of infection, and guide control measures.Methods
Confirmed outbreak cases were patients who developed bloody diarrhoea or haemolytic uremic syndrome (HUS) between 28 May and 6 July 2012, with E. coli O157 isolates showing indistinguishable patterns on pulse field gel electrophoresis (PFGE). A standardized questionnaire was administered to patients to document food consumption and other risk exposures. Their purchase was checked through their supermarket shopper card data.Results
Six patients (four with HUS and two with bloody diarrhea) were confirmed outbreak cases. Fresh ground beef burgers from one supermarket were the only common food exposure, identified by interviews and shopper card data. The PFGE profile of shiga toxin-producing E. coli O157 isolated from the suspected beef burgers was identical to those from the human cases. The suspected beef burgers were no longer on sale at the time of investigation but three patients confirmed as outbreak cases had deep-frozen some at home.Conclusion
Shopper card data was particularly useful to obtain precise and reliable information on the traceability of consumed food. Despite the expired use-by date, a recall was issued for the beef burgers. This contributed to preventing other cases among consumers who had deep-frozen the beef burgers. 相似文献18.
M. Chironna S. Tafuri M.S. Gallone A. Sallustio D. Martinelli R. Prato C. Germinario 《Public health》2014
Objectives
To describe an outbreak of acute gastroenteritis in people who had eaten at a hash house in southern Italy.Study design
Case–control study.Methods
A clinical case of gastroenteritis was defined as a person who had eaten at the hash house from 29 August to 4 September 2011 and who experienced defined gastrointestinal symptoms within 72 hours, or a person with a laboratory-confirmed salmonella infection without symptoms. A convenience sample was enrolled as the control group. Environmental and human samples were collected, and Salmonella infantis was identified by polymerase chain reaction. Univariate analysis was performed for each food type, and multivariate analysis was performed for each food type and demographic variable (gender, age).Results
Twenty-three cases of gastroenteritis were notified between 1 and 4 September 2011, two of which were admitted to the local hospital. Multivariate analysis showed that porchetta [odds ratio (OR) 22.0, 95% confidence interval (CI) 3.2–152.6, z = 3.13, P = 0.002] and roasted meat (OR 14.4, 95% CI 1.7–122.0, z = 2.45, P = 0.014) were associated with gastrointestinal symptoms. Environmental and human isolates exhibited the same sequence type (ST 32).Conclusions
This experience highlighted that, in the control of a foodborne outbreak, integrated epidemiological and laboratory surveillance enables rapid identification of the source of infection, thus reducing the risk of an epidemic. 相似文献19.
P. Cholley M. ThouverezH. Gbaguidi-Haore M. SaugetC. Slekovec X. BertrandD. Talon D. Hocquet 《Médecine et maladies infectieuses》2013
Objectives
We had for objective to measure the incidence and the clonal diversity of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBL) in order to assess the role of patient stay in amplification of the phenomenon, in our teaching hospital.Material and methods
We measured the quarterly incidence rates of E. coli and K. pneumoniae producing or not producing ESBL in clinical samples between 1999 and 2010. The incidence of ESBL-producing isolates was season-adjusted. We determined the pulsotype of and identified the ESBL in all non-redundant strains isolated between 2009 and 2010.Results
The incidence for 1000 hospitalization days increased from 0.00 to 0.44 for ESBL-producing E. coli, from 0.012 to 0.24 for ESBL-producing K. pneumoniae, from 1999 to 2010. Fifty-three different clones of E. coli were identified among the 61 genotyped isolates. The 28 K. pneumoniae isolates genotyped clustered into 11 different clones, among which one major epidemic clone that included 18 isolates. Respectively 66 and 75% of E. coli and K. pneumoniae isolates produced a CTX-M group 1 ESBL.Conclusion
The hospital seems to play a different role in the amplification of ESBL according to the producing species (K. pneumoniae or E. coli). ESBL-producing E. coli seem to have a limited cross-transmission within the hospital and seem to be added to non-producers. Conversely, ESBL-producing K. pneumoniae seem to be cross-transmitted within the hospital and to replace non-producers. 相似文献20.