Biomedical subjects
Publications and source records attributed to D Christol.
A case of cat-scratch disease in an 8 year-old girl is reported. The inoculation injury followed by regional lymphadenopathy was typical of Parinaud syndrome. This patient also had vertebral lesions on scintigraphy, x-rays and CT scan. While the oculoglandular localization spontaneously improved within a few weeks, osteomyelitic lesions remained grossly unchanged after almost 2 years of follow-up.
Minimal inhibitory concentrations (MICs) of pefloxacin were evaluated by agar dilution for 3422 bacterial strains isolated in nine hospitals. Enterobacteriaceae proved very sensitive to pefloxacin: 62 p. 100 of 1743 strains tested had MIC less than or equal to 0.12 and 90 p. 100 less than or equal to 1 microgram/ml; but the percent of strains with MIC greater than or equal to 2 varied among the different groups of Enterobacteriaceae: 2.7 p. 100 for E. coli to 39 p. 100 for Serratia. 55 p. 100 for Pseudomonas and 81 p. 100 of Acinetobacter were inhibited by 1 micrograms/ml or less (mode MIC 1 and 0.5 micrograms/ml). Haemophilus sp.: 0.03 and 0.06 micrograms/ml and Gonococci were very sensitive to pefloxacin. The spectrum of pefloxacin extended to Gram positive cocci: MIC of Staphylococci were 0.06 to 8 micrograms/ml (mode MIC: 0.5); Enterococci, other Streptococci and Pneumococci were less sensitive: 2 and 4 micrograms/ml for the majority of strains. Concerning anaerobic bacteria, pefloxacin was more active against Clostridium (0.5 to 1 microgram/ml generally), than against Bacteroides (4 to 16 micrograms/ml).
IgG antibodies to lymphadenopathy-associated virus ( LAV ) were found by a specific enzyme-linked immunosorbent assay in 18/48 (37.5%), patients with acquired immunodeficiency syndrome, 38/51 (74.5%) patients with lymphadenopathy syndrome, 8/44 (18%) homosexual men without lymphadenopathy, and 1/100 unselected blood donors.
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This work reports a multicenter study of antibacterial activity of cefatiolene (RP 42 980), a new third generation cephalosporin, in comparison with cefotaxime and lamoxactam. On the basis of MIC, activity of the three products is similar or Gram negative rods, but cefotaxime is a little more active on Enterobacteriaceae. The activity against Staphylococci requires further studies, indeed the determination of IC 50 of some strains showed a better activity of cefatiolene, but this was not observed by determination of MIC. As cefotaxime and contrary to lamoxactam, cefatiolene is active at low concentrations on other Streptococci than Enterococci, but a little on Bacteroides.
Respiratory distress, main clinical symptom of P. carinii pneumonia, is unexplained. We wondered if it could be linked with a lung surfactant anomaly. We have shown in the bronchoalveolar fluid lavage of P. carinii-infected rats: a very significant decrease of the phospholipid content; a lowering of the phospholipid/protein ratio; and an increase in phospholipase activities, partly due to the activation of an inactive phospholipase into the active form. We conclude that, in P. carinii-infected rats, there is an increased catabolism of lung surfactant.
Although the first French case of Legionnaires' disease (LD) was diagnosed in 1979 and the first six serogroups of L. pneumophila and L. longbeachae serogroup 2 were demonstrated in environmental samples from the Paris area, the incidence of the disease has not yet been evaluated in France. Prevalence of antibodies, as detected by an immunofluorescent assay, in the Paris population of our study ranged from 0.9 to 2.2%. LD was demonstrated in 155 (4.4%) of 3502 patients investigated mainly by serology. In a prospective study in a respiratory intensive care unit 20 (7.8%) cases of pneumonia out of 257 were caused by L. pneumophila. 171 of the 175 cases of LD diagnosed in Paris during 33 months were caused by L. pneumophila serogroup 1. Risk factors and epidemiological features of patients are similar to those described in other countries.
Gram-negative aerobic bacilli (Enterobacteria, Pseudomonas, Acinetobacter) isolated in clinical circumstances at the microbiology of the Claude Bernard Hospital, Paris, are classified according to their resistance to the usual beta-lactam antibiotics routinely tested: ampicillin, carbenicillin, cefalotin. The MICs of mezlocillin were measured on 204 strains and compared to the results obtained with older drugs in each group.
The authors draw the following conclusion on the basis of 85 cases of children hospitalised for infectious diseases : -amongst childhood infectious diseases, measles between the ages of 7 and 14 is most commonly associated with complications in the form of otitis (50 as against 19 other diseases). -Staphylococcus aureus was the dominant organism in measles otitis, but in addition to a particular affinity of this organism for measles, it is also necessary to bear in mind contamination by hospital flora, amongst which staphylococci are especially representative, in view of the late development of the otitis and the multiresistance of staphylococci isolated after the 4th day of admission. -Bacteria seen in other exanthematous fevers were more varied but if there is not rapid cure of the otitis, the generally sensitive flora is replaced by a multiresistant hospital flora, once again dominated by staphylococcus aureus and Gram negative bacilli. - The role played by such flora was seen to occur particularly on the 4th day of hospitalization, implying a twofold increase in the period of hospitalisation when compared with cases where paracentesis was performed before this time.
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Discovered in 1950-51 by two great parisian medical teams, inoculation lymphoreticulosis, also called cat's scratch disease, is locoregional adenitis whose aetiology is imperfectly determined. Following, often bu not always, cat's scratch, it may evolve to suppuration. Pus is always aseptic. Attributed to Bedsonia's family micro-organism, no cultivation was possible up to date. Evolution is as a rule favourable, but disease is poorly accessible to tetracycline family's antibiotics. Diagnosis is possible by intradermoreaction. The antigen used is tyndallised pus of homologous infection. The role of the cat, still healthy, has not yet been explained.
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We studied 64 cases of bacterial endocarditis which required heart surgery for hemodynamic defects and/or failure of the antibiotic therapy. We performed a bacteriologic and histologic investigation of the removed valves. The organisms were evidenced through culture and specific stainings. According to the different organisms we evaluated the best duration of antibiotic therapy to achieved sterilization, and suggest a helpful medical and surgical treatment for the bacterial endocarditis.
Pneumocystis carinii pneumonia can only be diagnosed once the microorganism is demonstrated. The authors review and illustrate various staining technics, and discuss for each of them specific advantages. All samples must by systematically examined both by phase contrast microscopy and by light microscopy after Gomori-Grocott and Gram-Weigert stains. This morphological study is completed by ultrastructural photographs.
The authors have been interested over the last year in the detection of pneumocystis carinii in patients with immune deficiencies, whether natural or artificial. After a brief historical and general introduction, they discuss their procedures, the pathological substances available, the staining techniques and the examination of autopsy specimens. They undertook experimental work on this micro-organism, e.g. the development of the germ in immuno-depressed rats and, from this material, numerous varied trials of culture and inoculation in new-born animals, chick embryos and cell cultures. Microphotographs illustrate this work which is still in progress.