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Biomedical subjects

A Bouvet

Publications and source records attributed to A Bouvet.

At least 55 records · Page 3Linked to original sources

[Action of teicoplanin on coagulase negative staphylococci in hospital units of the hospital Hôtel-Dieu in Paris].

Teicoplanin, a glycopeptide antibiotic, is active against Staphylococci, with the exception of some strains of coagulase negative Staphylococci (SCN). Determination of the in vitro activity of teicoplanin by standard disk methodology is not sufficient, and has to be confirmed by the determination of the minimal inhibitory concentration (MIC) for all strains presenting an inhibition zone diameter below 17 mm. We have studied during four months, the susceptibility of SCN to teicoplanin isolated from different units of the hospital, and in particular from the haematology unit (HU). 186 strains were isolated, 35 p. cent from HU and 65 p. cent from the other units of the hospital. All strains belonged to 11 species: 136 S. epidermidis, 14 S. haemolyticus, 8 S. lugdunensis, 5 S. warneri, 4 S. saprophyticus, 3 S. sciuri, 3 hominis, 2 S. chromogens, 2 xylosus, 2 S. cohnii and 1 S. schleiferi. Twenty five strains out of 186 (13.4%) presented a MIC of 8 or 16 mg/l (MIC verified by the agar dilution method): 7 S. haemolyticus, 16 S. epidermidis, 1 S. warneri et 1 S. capitis. During this study SCN resistant to teicoplanin were never isolated. Twelve out of 25 came from the HU, which correspond to 18 p. cent of the isolated strains in this unit. This result was not significantly different, compared to that of the other units.

Dose-Response Relationship, Drug↗

Efficacy of temafloxacin in experimental Streptococcus adjacens endocarditis and autoradiographic diffusion pattern of [14C]temafloxacin in cardiac vegetations.

Temafloxacin, a new fluoroquinolone, alone or in combination with tobramycin, was compared with penicillin, tobramycin, and their combination in the therapy of rabbits with endocarditis caused by Streptococcus adjacens GaDT, a new species of nutritionally variant streptococci. Animals were injected intramuscularly for 4 days with temafloxacin (50 mg/kg of body weight twice daily [b.i.d.]) alone or combined with tobramycin (12 mg/kg once daily), with procaine penicillin (150,000 U/kg b.i.d.) alone or combined with tobramycin (12 mg/kg once daily), or with tobramycin (12 mg/kg once daily) alone. Another group of animals was treated with a higher dose of temafloxacin (100 mg/kg b.i.d.). Temafloxacin, penicillin, and tobramycin MICs and MBCs were 1 and 2, 0.015 and 1, and 8 and 16 micrograms/ml, respectively. Time-kill curves showed that the addition of tobramycin to penicillin or temafloxacin increased the killing rate. In vivo, treatment with temafloxacin (50 and 100 mg/kg b.i.d.) alone reduced the bacterial counts in vegetations (3.9 +/- 0.9 and 3.1 +/- 0.8 log10 CFU/g of vegetation) compared with those in the vegetations of control animals (7.5 +/- 0.9 log10 CFU/g of vegetation). This result was similar to that obtained with penicillin alone (4.5 +/- 0.8 log10 CFU/g of vegetation). The combination of temafloxacin (50 mg/kg) and tobramycin was as effective as penicillin plus tobramycin (2.5 +/- 0.3 versus 2.3 +/- 0.4 log10 CFU/g of vegetation, respectively). The autoradiographic pattern of [14C]temafloxacin diffusion into infected cardiac vegetations was studied. Thirty minutes after the end of infusion of 250 microCi of [14C]temafloxacin, the [14C]temafloxacin was homogeneously distributed throughout the vegetations. These data support further evaluation of quinolones in experimental endocarditis.

Animals↗

Heterosynapsis in two fertile but hypoprolific boars carriers of reciprocal translocations.

The authors report here two new cases of reciprocal translocations in two fertile and hypoprolific boars. Silver stained synaptonemal complexes in surface-spread pachytene nuclei from a boar heterozygous for a reciprocal translocation, and from another one carrying two different reciprocal translocations, were analyzed by electron microscopy. In such heterozygotes, cross-shaped quadrivalent configurations are expected to form in order to allow homologous pairing. In the same boar, the lengths of the fully synapsed arms of the quadrivalent varies from one quadrivalent to the other and heterosynapsis was obvious. Heterosynapsis was also observed with asymmetrical pairing of the non-homologous partners of the quadrivalent. This heterosynapsis is assumed to be a mechanism preventing spermatocyte loss, but inducing a secondary segregational type of impairment of fertility due to foetal wastage leading to reduced prolificacy.

Animals↗

Intraspecies variations in nutritionally variant streptococci: rRNA gene restriction patterns of Streptococcus defectivus and Streptococcus adjacens.

The rRNA gene restriction patterns of two species of nutritionally variant streptococci, Streptococcus defectivus and Streptococcus adjacens, were determined, and the results were compared with the electrophoretic migration profiles of penicillin-binding proteins. Reference strains belonging to various streptococcal species were used as controls. Our results correlated with the results of DNA-DNA hybridization experiments and confirmed the delineation of these two species. Moreover, they demonstrated that intraspecies variations occur and suggested that there are two subspecies of S. defectivus.

Genetic Variation↗

Ceftriaxone diffusion into cardiac fibrin vegetation. Qualitative and quantitative evaluation by autoradiography.

Heterogeneous diffusion of some antibiotics into fibrin rich infectious processes is one explanation of the difficulty to cure infections such as endocarditis. Ceftriaxone is a beta lactam antibiotic, potentially useful due to a broad spectrum of activity and its long elimination half-life. We investigated by means of autoradiography the diffusion of labelled ceftriaxone into large infected cardiac vegetations obtained in a rabbit model of endocarditis. Ten d after infection 250 microCi 14C ceftriaxone was injected over 30 min. Thirty min after the end of infusion (T30) vegetation/blood radioactivity ratio was 0.58 +/- 0.4 (n = 3). At T200, radioactivity decreased approximatively 3-fold, in blood and in vegetations simultaneously. Autoradiography showed that at T30, ceftriaxone was 20-30 times more concentrated at the periphery of vegetation than in the core. Autoradiography obtained at T200 showed a progressive diffusion toward the core. The diffusion gradient may explain the fact that high local concentrations are necessary to sterilize vegetations. The pattern of diffusion of antibiotics in fibrin is an important pharmacokinetic parameter for predicting in vivo activity.

Animals↗

[Icterohemorrhagic leptospirosis with acute respiratory distress syndrome and pulmonary hemorrhage].

We report a case of the respiratory distress syndrome occurring in a patient with leptospirosis ictero-haemorrhagica (LIH). The respiratory failure was associated with pulmonary haemorrhage. There was a rapid favourable outcome after treatment with antibiotics and artificial ventilation. The diagnosis of LIH has been confirmed by serological examination. The mechanisms of the pulmonary disorder during the course of LIH were discussed.

Adult↗

Epidemiological markers for epidemic strain and carrier isolates in an outbreak of nosocomial oxacillin-resistant Staphylococcus aureus.

An outbreak of nosocomial infections occurring in a postoperative intensive care unit was caused by a single strain of oxacillin-resistant Staphylococcus aureus. Six patients were infected, or colonized, by this strain, which was traced by using the following four epidemiological markers: antibiogram, bacteriophage type, capsular polysaccharide type, and esterase electrophoretic type. This strain was compared with S. aureus isolates obtained from the noses of 13 carriers from a group of 42 staff members. A good correlation in terms of phenotypic markers was found between the epidemic strain and a strain isolated from one carrier. Both exhibited the same pattern of multiple resistance as well as the same phage type, 77, capsular polysaccharide type, 5, and esterase electrophoretic type, 6. In contrast, an oxacillin-resistant strain, isolated from another carrier, differed from the epidemic strain by susceptibility to rifampin and by susceptibility to four additional bacteriophages. The other 11 strains isolated from carriers were susceptible to oxacillin and exhibited widely different phenotypes. These results confirm the interest of using several epidemiological markers to trace the spread of epidemic S. aureus strains and to delineate the carrier strains.

Bacterial Typing Techniques↗

[Value of agglutination tests for the rapid identification of isolated streptococci in medical microbiology].

The clinical need for rapidly and correctly differentiating pathogenic streptococci into Lancefield groups prompted the development of rapid agglutination techniques by the direct colony method. Pastorex Streptogroupe (Diagnostics Pasteur, France) and Streptex (Wellcome Diagnostics, USA) were tested on 90 streptococcal isolates and compared with the identification obtained by conventional procedures. No cross-reactions were observed with any of the 33 strains of enterococci and of the seven strains representative of other genus among Gram-positive bacteria. When combined with colonial morphology and hemolytic reaction, both Pastorex and Streptex were specific tests for identifying beta-hemolytic streptococci, with Pastorex being slightly faster.

Agglutination Tests↗

Evaluation of antibiotic diffusion into cardiac vegetations by quantitative autoradiography.

The reason bacterial endocarditis is difficult to cure has been controversial for many years. One explanation could be that antibiotic diffusion inside the vegetations is heterogeneous. This hypothesis was investigated by means of an autoradiographic study of diffusion of labeled antibiotics into large infected cardiac vegetations of nutritionally variant Streptococcus endocarditis in rabbits. Ten days after infection, 653 microCi of [3H]penicillin, 410 microCi of [3H]tobramycin, or 174 microCi of [14C]teicoplanin were injected iv over 30 min. Thirty minutes after the end of infusion (T30), vegetation/blood radioactivity ratios were 2.48 +/- 1.27, 2.49 +/- 0.67, and 3.94 +/- 1.19 for penicillin, tobramycin, and teicoplanin, respectively. Autoradiography clearly showed that distribution of the three drugs was different: Tobramycin was homogeneously distributed; penicillin was more concentrated at the periphery but still reached the center of vegetations; teicoplanin was concentrated only at the periphery. The same distribution pattern was observed with teicoplanin at T120 (i.e., one t1/2 beta later) and also after simultaneous infusion of a therapeutic dose (15 mg/kg) of cold teicoplanin. The diffusion gradient exhibited by some antibiotics could explain the difficulty in sterilizing vegetations despite high local concentrations, and the deleterious effect of the size of the vegetations on the therapeutic response.

Animals↗

Inducible, transferable resistance to vancomycin in Enterococcus faecalis A256.

A strain of Enterococcus faecalis (A256) was isolated from the urine of a patient with urinary sepsis and was found to exhibit susceptibilities (micrograms per milliliter) to various glycopeptides as follows: vancomycin, 256; teicoplanin, 16; 62208, 512; 62211, 4; and 62476, 16. As judged by growth rates before and after exposure to sub-MICs of glycopeptides, vancomycin and 62476 induced self-resistance, 62208 and 62211 induced slight self-resistance, and teicoplanin did not induce self-resistance. Vancomycin induced cross-resistance to all other glycopeptides tested, as judged both in growth experiments and by direct measurement of inhibition of peptidoglycan synthesis in cells exposed to sub-MICs of vancomycin. Thus, the spectra of activity of the glycopeptides were not correlated with their patterns of induction. There was a correlation between the increased synthesis of a 39-kilodalton (kDa) protein located in the cytoplasmic membrane and the induction of resistance. Protoplasts of A256 were susceptible to inhibition of peptidoglycan synthesis by vancomycin at levels similar to those for susceptible strains. Vancomycin resistance was transferable on filters from the parent strain to E. faecalis JH2-2 at a frequency of about 10(-7), and the 39-kDa protein was also inducible by glycopeptides in these transconjugants. We conclude that A256 is resistant to glycopeptides by virtue of the synthesis of a 39-kDa cytoplasmic membrane protein, that this protein is probably involved in preventing access of the glycopeptides to their peptidoglycan targets, and that this resistance is transferable, probably by conjugation.

Bacterial Outer Membrane Proteins↗

Direct testing of blood culture for detection of the serotype 5 and 8 capsular polysaccharides of Staphylococcus aureus.

Monoclonal antibodies (MAbs) reactive with serotype 5 and 8 capsular polysaccharides of Staphylococcus aureus have been used to test, by enzyme-linked immunosorbent assay (ELISA), blood culture fluids for the presence of S. aureus. A total of 748 blood cultures from 665 patients yielding 706 bacterial isolates belonging to more than 26 bacterial species were studied. All blood cultures containing bacterial strains belonging to species other than S. aureus were negative in ELISA. All 23 blood cultures containing serotype 5 S. aureus were positive in ELISA with the corresponding MAb. Out of 20 blood cultures containing serotype 8 S. aureus, 19 were positive with the corresponding MAb. All 5 blood cultures containing nontypeable S. aureus were negative in ELISA with both MAbs. This method provides reliable identification of serotype 5 or serotype 8 S. aureus by direct testing of blood culture fluids with ELISA.

Animals↗

Staphylococcus aureus strains which are not identified by rapid agglutination methods are of capsular serotype 5.

A total of 183 recent Staphylococcus aureus clinical isolates were tested with three commercially available rapid agglutination methods. The capsular polysaccharide type and resistance to oxacillin of these isolates were also determined. Seven isolates were not identified correctly by agglutination methods. All isolates not identified by the rapid methods were of capsular serotype 5, and of these isolates, six were resistant to oxacillin. The results suggest that these agglutination kits can be improved by the use of antibodies reactive with S. aureus capsular polysaccharide.

Agglutination Tests↗

[Pneumocystis carinii pneumonia in AIDS patients. Aspects of clinical evolution in 37 cases].

This study concerns 37 cases of Pneumocystis carinii pneumonia in AIDS patients. The time elapsed between human immunodeficiency virus (HIV) seropositivity and the onset of pneumocystosis has been established. Three clinical types are individualized. In cases with normal X-ray films of the chest, measurement of carbon dioxide transfer capacity, always reduced, has led to a bronchoalveolar lavage which provided an early diagnosis. In spite of good response to treatment, the prognosis of pneumocystosis is poor owing to the frequency of associated diseases.

Acquired Immunodeficiency Syndrome↗

Synaptonemal complexes analysis in a bull carrying a 4;8 Robertsonian translocation.

Synaptonemal complexes analysis was performed using electron microscopy on surface-spread spermatocytes of a bull heterozygous for the 4;8 Robertsonian translocation. In 19 cells examined, the longest autosomal complex showed kinetochores in a central position whereas the remaining autosomal complexes showed terminal kinetochores. Synapsis in the trivalent appeared complete in all cells, and the trivalents usually showed a CIS configuration. The arm ratio varied from 1.05 to 2.04 with an average of 1.32 +/- 0.43. Out of 47 cells showing X-Y bivalents, 34 showed a small synaptonemal complex at one extremity of the X chromosome, and an unstained gap in the Y chromosome. There was no association between the X-Y bivalent and the trivalent. The absence of association would explain the normal spermatogenesis noted in this bull, in contrast to human and mouse carriers of translocations which show impaired spermatogenesis due to the association between the rearranged chromosomes and the sex vesicle. Further studies involving bulls carrying one or more Robertsonian translocations are needed to determine whether this absence of association is a constant feature in cattle.

Animals↗

Folic acid therapy for alopecia in a Charolais calf.

A three-week old male Charolais calf which had a history of progressive hair loss and clinical signs, including crusts and brown patches similar to those in folic acid deficiency syndrome in man, was subjected to folic acid therapy. Daily oral administration of folic acid (1 mg/kg/day) resulted in the gradual disappearance of the crusts and patches within two weeks and a steady growth of hair and recovery to a normal state within two months. Folic acid, which is required for cellular turnover in a variety of tissues and organs including the hair follicle, may serve as an effective therapeutic agent in some types of alopecia triggered by a deficiency of either folic acid or the co-enzymes involved in the synthetic pathway of DNA.

Alopecia↗

Nutritionally variant streptococci develop ultrastructural abnormalities during experimental endocarditis.

Nutritionally variant streptococci (NVS) are fastidious micro-organisms responsible for most of the so-called negative blood culture endocarditis. In patients, the relative resistance of these bacteria to antibiotic treatment may be relevant to bacterial alterations in infected tissues. We used here a rabbit experimental model of endocarditis in order to examine, under scanning and transmission electron microscope, the NVS ultrastructure inside cardiac vegetations and to follow alterations at the different stages of the disease. In the early phase (day 7) of endocarditis, NVS were found dispersed inside vegetations and exhibited a typical streptococcal morphology similar to that observed during an in vitro balanced growth. In contrast, on day 11 and day 18, bacteria were found gathered as large and numerous clusters, in which they exhibited abnormal ultrasturctural features similar to those previously described during in vitro unbalanced growth. At this stage, ruthenium red staining revealed a large amount of exopolysaccharide surrounding the bacteria. None of these bacterial alterations were observed inside the vegetations of rabbits treated from day 7 to day 11 with penicillin or vancomycin. These abnormalities might be mainly related to nutrient limitation inside the clusters and could contribute to the pathogenicity of these micro-organisms.

Animals↗

3H-spiramycin penetration into fibrin vegetations in an experimental model of streptococcal endocarditis.

In-vivo diffusion of labelled spiramycin into fibrin was investigated in a rabbit model of left sided subacute endocarditis caused by a nutritionally variant streptococcus that produces large fibrin vegetations. Animals received one 30 min infusion of different doses of 3H spiramycin alone (73.4 +/- 3.5 microCi and 846 microCi) or 57.5 +/- 3.5 microCi in combination with 50 mg/kg 'cold' spiramycin. Thirty minutes after the end of infusion (T30) these vegetation/blood and vegetation/muscle ratios were between 1 and 2 and the vegetation/plasma ratio was between 2 and 4 for the three doses tested. Autoradiography showed that 3H spiramycin was homogeneously distributed throughout the vegetation in comparison with some other drugs. On the other hand, there were considerable differences in antibiotic concentration among different vegetations in a single animal.

Animals↗