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A Felten

Publications and source records attributed to A Felten.

At least 19 recordsLinked to original sources
PubMed2002

[Prevalance of nosocomial infections in tetraplegic upper extremity surgery. Prospective study of twenty patients].

INTRODUCTION: Many risk factors of nosocomial infection may be met with tetraplegic patients. The objective of this work was to study the prevalence of colonization by 3 multiresistants bacteria (methicillin resistant staphylococcus aureus (MRSA), Klebsiella pneumoniae with widened spectrum beta lactamase or multi-resistant Acinetobacter baumannii) on this population. MATERIAL AND METHODS: It was about a prospective study for which we included 20 consecutive patients coming from a rehabilitation of long stay center to have a surgical operation of palliative reanimation of the upper limb. For each patient, the first morning of his hospitalization, many sites cultures were carried out for bacteriological analysis whose results were returned in 48 h to the operator. No patient was excluded. RESULTS: Five patients (25%) showed the presence of SARM. One patient (5%) showed the presence of Klebsiela pneumoniae. One of the patients carrying a SARM was also carrying Acinetobacter baumannii. Overall 6 patients were contaminated (30%) but no postoperative infection occurred, neither at the time of the hospitalization nor after the exit of the service. DISCUSSION: The various risk factors of nosocomial infection appearance met in tetraplegic patient were analyzed. This study showed that the cares of tetraplegic patients limited to the maximum the risk of nosocomial infection appearance (no one in this series) in spite of an important contamination met in this type of population which presents long durations of hospitalization, main risk factor regularly met.

Acinetobacter Infections↗
PubMed2000

In vitro activity of fusidic acid against streptococci isolated from skin and soft tissue infections.

The in vitro activity of fusidic acid was evaluated against 242 strains of streptococci isolated from skin and soft tissue infections during a prospective multicentre study. Nearly 90% of strains were isolated from dermatology, emergency and medicine units. Groups A, B, C and G streptococci represented, respectively, 41.9, 20.6, 4.4 and 27.8% of the strains. The activity of fusidic acid was dependent on the media used. MICs were generally one dilution lower with heart infusion agar than with Mueller-Hinton agar supplemented with 5% horse blood (MIC(90) for the whole streptococcal population = 8 mg/L and 16 mg/L, respectively). The distribution of MICs was unimodal and only two strains displayed MICs of fusidic acid >/= 64 mg/L. In both media, fusidic acid was moderately active against streptococci. However, antibiotic concentrations obtained in the skin exceed the MIC(90) of fusidic acid for streptococci, possibly explaining its clinical efficacy in the treatment of common cutaneous infections.

Anti-Bacterial Agents↗
PubMed1999

Lactobacillus species identification, H2O2 production, and antibiotic resistance and correlation with human clinical status.

Lactobacilli recovered from the blood, cerebrospinal fluid, respiratory tract, and gut of 20 hospitalized immunocompromised septic patients were analyzed. Biochemical carbohydrate fermentation and total soluble cell protein profiles were used to identify the species. Hydrogen peroxide production was measured. Susceptibility to 19 antibiotics was tested by a diffusion method, and the MICs of benzylpenicillin, amoxicillin, imipenem, erythromycin, vancomycin, gentamicin, and levofloxacin were determined. A small number of species produced H2O2, and antibiotic susceptibilities were species related. Eighteen (90%) of the isolates were L. rhamnosus, one was L. paracasei subsp. paracasei, and one was L. crispatus. L. rhamnosus, L. paracasei subsp. paracasei isolates, and the type strains were neither H2O2 producers nor vancomycin susceptible (MICs, >/=256 microgram/ml). L. crispatus, as well as most of the type strains of lactobacilli which belong to the L. acidophilus group, was an H2O2 producer and vancomycin susceptible (MICs, <4 microgram/ml).

Adolescent↗
PubMed1998

[Peptostreptococcus magnus osteoarticular infections after orthopedic surgery. 14 cases and pathogenicity factors].

We report a retrospective study of 14 Peptostreptococcus magnus bone and joint infections, following orthopaedic prostheses or implantation of fixation devices, diagnosed in two Paris hospitals between 1992 and 1996. Five patients experienced a knee joint infection after anterior cruciate ligament reconstruction with 4 artificial grafts, and 9 caught joint or wound infections, after limb traumatic injuries or bone neoplastic ruptures involving femur, tibia, calcaneum and humerus, treated by arthroplasty or osteosynthesis with implantation of biomaterials. Septic arthritis was experienced one week to one year after reconstructive surgery, and had evolved for several months to years before etiologic diagnosis in 5 cases. Specimens of pus, tissues or removed implants produced numerous slow growing small colonies of Gram positive cocci arranged in clumps on culture media incubated in anaerobic atmosphere only. In 10 patients, the same organism was disclosed in several separate specimens. The identification of P. magnus was assessed by the enzyme profile (rapid ID 32A API strips), gaz liquid chromatography, catalase and coagulase production, resistance to novobiocin and Na polyanethol sulphonate. Antibiotic sensitivity testing performed by disc method was constant to penicillin G, amoxicillin, cefuroxime, cefoxitin, imipenem and pristinamycin with penicillin G MICs < 0.125 mg/l and metronidazole MICs < 1 mg/l. Erythromycin, clindamycin, rifampicin, tetracycline and fosfomycin were active against more than 70% of P. magnus. All patients were cured after a prolonged course of various antibiotics and surgical removal of the foreign material whenever possible. We studied in vitro binding of P. magnus with extracellular matrix proteins adsorbed onto biomaterials, by particle agglutination assays of latex beads coated with proteins. Eighty one% of strains bound to collagen, 69% to fibrinogen and 46% to fibronectin. Comparison of orthopaedic strains with strains of other infections and from skin showed a correlation between P. magnus from bone and joint infections and their fibrinogen binding ability (69% against 20%, p < 0.05).

Adolescent↗
PubMed1997

Streptococcal pyrogenic exotoxin A, streptolysin O, exoenzymes, serotype and biotype profiles of Streptococcus pyogenes isolates from patients with toxic shock syndrome and other severe infections.

The determination of protein M and T serotypes, biotypes and pyrogenic (erythrogenic) exotoxin A (SPE A), streptolysin O (SLO), streptokinase (SK), hyaluronidase (HA) and cysteine proteinase release by 212 S. pyogenes isolates from patients with severe invasive group A streptococcal (GAS) infections, among them 74 cases of streptococcal toxic shock syndrome (STSS) has been investigated. M1 or M3 serotypes were expressed by 25% of the isolates (53/212), whereas 59% (125/212) belonged to 15 other different serotypes and 16% (34/212) were untypeable. Of the 74 isolates from STSS patients, 42% (31/74) expressed M1 and to a lesser extent M3 serotypes versus 19% of the non STSS isolates (26/138). Among the ten different biotypes known, biotypes 1 and 3 were prevalent, particularly the former in the case of STSS isolates. SPE A was detectably produced by about 25% (54/212) of the strains. However, as high as 40.5% of the STSS isolates (30/74) versus 17.4% of non STSS isolates (24/138) released SPE A. Moreover, 67% of the SPE A producing strains were of serotype M1 or M3. SK and HA were released by 71% and 10% of the isolates respectively. All strains released SLO (4 to 256 HU/ml) and 85% cysteine proteinase. No relationship between toxin or enzyme titer and the type of disease or clinical origin of the strains was found. Culture supernatants of all isolates showed moderate to high lymphocyte transforming activity with index values ranging from 14.5 to 50.3 including those strains which did not release detectable amounts of SPE A suggesting that SPE C and other mitogenic factor(s) are released by the isolates investigated.

Adolescent↗
PubMed1995

[Effects of intraperitoneal insufflation on hematogenous seeding of abdominal infections. Preliminary results of an experimental study in rats].

Most laparoscopic procedures require the creation of a pneumoperitoneum. In order to evaluate the potential hazards of bacteriemia related to insufflation, we conducted a study in the rat. Two groups of 20 Wistar rats were used for this study. Peritonitis was induced by opening the terminal ileum. Twenty-four hours later, 20 rats were insufflated at a mean pressure of 6 mm Hg (Group I). After one hour of insufflation, an hemoculture was performed via direct intracardiac puncture and in the other group of 20 non-insufflated rats (Group NI). Five of the 18 hemoculture were positive in the Gr. I (27.7%) and 6 out of 20 in the Gr. NI (30%) (chi 2 = 0.238 p = 0.62 non significant difference). These results suggest that insufflation does not facilitate hematogenous dissemination of bacteria from intraperitoneal sepsis in this animal model.

Animals↗
PubMed1995

[Critical analysis of tests for rapid detection of Staphylococcus aureus, Pastorex Staph plus, Slidex Staph-kit and Staph aureus in clinical isolates].

One hundred and seventy three clinical isolates of mannitol fermenter staphylococci, including 120 S. aureus (38% methicillin resistant) and 53 coagulase negative staphylococci were assayed for direct detection of S. aureus on colonies. Three new rapid slide agglutination tests were compared: Pastorex Staph Plus, Slidex Staph Kit and Staph aureus. Each one detects fibrinogen receptor and protein A. According to the addition of monoclonal antibodies, Pastorex Staph plus is intended to detect capsular antigens 5 and 8, and Slidex Staph kit to detect a surface glycopolysaccharide. Sensitivities of these tests were equal, Pastorex Staph plus 95%, Slidex Staph kit 94.2%, Staph aureus 95.8%. Among meticillin-resistant S. aureus, sensitivities reached 91.3%, 87% and 91.3% respectively. Specificities over coagulase negative staphylococci which gave conclusive results were 92.5%, 90.2% and 90.4% respectively. The validity of these results was checked over 100 staphylococcal primary isolates of medical samples in April 1994. Over 62 S. aureus (29% methicillin-resistant) Pastorex Staph plus and Staph aureus sensitivities were 96.8% and 98.4% respectively and specificities were 94.6% and 91.9% over 37 coagulase negative staphylococci which gave conclusive results. Staph aureus test sensitivity is at least equivalent to second generation tests as well in primary cultures as in subcultures The best specifity is achieved with Pastorex Staph plus, which contains latex particles without red blood cells.

Humans↗
PubMed1988

Biotypes, serotypes, and susceptibility to antibiotics of 60 Haemophilus influenzae strains from genitourinary tracts.

Sixty strains of Haemophilus influenzae were isolated from the genitourinary tracts of adults: 19 from cervicovaginal secretions, one from a woman with bartholinitis, 37 from urethral exudates, and three from urine. Non-capsulated strains were recovered predominantly, and biotype III accounted for 28 isolates and biotype IV for 25. Many of the H influenzae strains were found to be resistant to one or more of the antibiotics commonly used against sexually transmitted diseases. Resistance to tetracycline was prevalent and was found in 17 of the strains. Ten strains were ampicillin resistant and beta lactamase producing. Kanamycin resistance was less common (two strains). Trospectomycin (U-63366), a new spectinomycin analogue, was eight to 16 times more active than spectinomycin. All the quinolones tested were very active against all strains and may provide an effective alternative for the treatment of resistant H influenzae in genitourinary infections.

Adult↗
PubMed1987

[Diagnostic value of the study of anti-Chlamidia antibodies in salpingitis. 379 cases].

Antibodies to Chlamydia were assayed by complement fixation (CF) and inclusion indirect immunofluorescence (IFI) in sera collected from 379 patients with salpingitis: 30.3% of the patients had total and IgM antibodies at IFI and CF antibodies (profile I); 26.6% of the patients had total and IgM antibodies at IFI without CF antibodies (profile II); 31.6% of the patients had only total antibodies at IFI without specific IgM and without CF antibodies (profile III); 11.3% of the patients were Chlamydia antibody negative (profile IV). In the control group of 50 pregnant women apparently non infected, the profile distribution was 2% profile I, 8% profile II, 38% profile III, and 54% profile IV. Detection of IgM antibodies to Chlamydia trachomatis in 57% of patients with salpingitis, taking only one specimen, suggested recent or active chlamydial infection. CF antibodies indicated diffuse infection. Total antibodies correlated well with IgG antibodies detected by ELISA. Their finding was by no means diagnosis for Chlamydia being the cause of tubal infection, although titers observed in salpingitis patients were higher than in controls.

Adolescent↗
PubMed1986

[The drug combination amoxicillin-clavulanic acid compared to the triple combination ampicillin-gentamicin-metronidazole in the treatment of severe adnexal infections].

Forty-four patients with severe pelvic inflammatory disease were randomly divided into two groups. Single drug therapy with the amoxicillin-clavulanic acid was used in 22 patients (group A). The other 22 patients (group B) were given a combination of ampicillin, gentamicin and metronidazole. Clinical results were comparable in both groups with 91% successes and 9% improvements in group A, against 86% successes, 9% failures, and 5% non-interpretable results in group B. The difference between the two groups was not statistically significant (p = 11.6%). 30% of patients in each group had positive serologic tests for Chlamydiae. This had no influence on therapeutic results but led to secondary prescription of a cycline. Because amoxicillin-clavulanic acid is active against aerobic and anaerobic pathogens, including beta-lactamase-producing microorganisms, it is a satisfactory alternative to the ampicillin-gentamicin-metronidazole combination, especially as it is simpler to use, less toxic and less expensive.

Amoxicillin↗
PubMed1986

[Capnocytophaga infections. Apropos of 8 cases].

Eight Capnocytophaga infections are described: bacteremia in immunodepressed patients (three cases), endocarditis (one case), pneumopathy (one case), buccal infection (two cases) and endometritis during use of an intrauterine contraceptive device (one case). The role of this bacterium in infections presented by immunodepressed patients is discussed in terms of literature data. Identification of the genus posed no problems. Species diagnosis is considered in terms of the use of conventional biochemical tests and the API ZYM collection.

Adult↗
PubMed1984

[Diagnostic problems of tuberculoid cervical adenitis. Apropos of 70 cases].

Pathologic criteria in tuberculoid adenitis enable differentiation between follicular adenitis with or without caseous necrosis and that involving suppurative necrosis. The absence of specific etiology is emphasized. Seventy cases of tuberculoid adenitis are analyzed. Of the 62 cases of adenitis labelled tuberculous, bacterial confirmation was obtained in only 22 (35%), suggesting probable diagnosis by excess for the remaining 40 cases. Related bacteriologic problems concern isolation of B.K. of the 3 cases classified as sarcoidosis, it was important to obtain data from broncho-alveolar lavage and serum conversion enzyme assay. Four patients with adenitis were diagnosed as having cat-scratch disease from positive specific intradermal reactions, the probable discovery of the responsible agent thus providing a bacteriologic diagnosis.

Adolescent↗