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Biomedical subjects

E Bingen

Publications and source records attributed to E Bingen.

At least 91 records · Page 5Linked to original sources
PubMed1998

[Multiresistant bacteria in pediatrics].

Microorganisms that are resistant to multiple antimicrobial agents are of great concern to pediatric clinicians. Children infected with antibiotic-resistant bacteria are at risk to not respond to initial therapy. Nosocomial infection of pediatric patients with multidrug-resistant organisms are similar to those found in adults especially for Staphylococcus aureus, coagulase-negative staphylococci, vancomycin resistant Enterococcus and Enterobacteriaceae resistant to third-generation cephalosporin. However on the contrary to adult patients, multidrug-resistant bacteria are found in community infections with penicillin-resistant Streptococcus pneumoniae and P. aeruginosa in CF patients.

Bacteria↗
PubMed1997

Molecular DNA analysis for differentiation of persistence or relapse from recurrence in treatment failure of Streptococcus pyogenes pharyngitis.

In the evaluation of treatment failure in group A streptococcal pharyngitis, it is essential to distinguish persistence or relapse with homologous streptococcal strains from the acquisition of new, unrelated strains. Randomly amplified polymorphic DNA analysis and restriction fragment length polymorphism analysis of total DNA were used as epidemiological tools to compare 122 pre- and post-treatment Streptococcus pyogenes isolates obtained from 61 patients. The results obtained by molecular typing showed that bacteriological failures were due to the original strains in 43 cases (70%) and to new strains in 18 cases (30%). In the present study, restriction fragment length polymorphism analysis of total DNA appeared to be more discriminative than randomly amplified polymorphic DNA analysis. Thus, molecular analysis of DNA is an effective way to distinguish recurrence from persistence or relapse and will be useful in assessing the efficacy of new antibiotic treatments.

Adolescent↗
PubMed1997

Staphylococcal scalded skin syndrome in a neonate.

A case of staphylococcal scalded skin syndrome in a neonate caused by mother-to-child transmission through breast-feeding is reported. Staphylococcus aureus isolates from mother and child were identified using random-amplified polymorphic DNA analysis, which is a simple and rapid method for comparing strains. This study confirms the need to avoid breast-feeding in cases of breast abscess.

DNA, Bacterial↗
PubMed1997

Possible person-to-person transmission of Escherichia coli O111--associated hemolytic uremic syndrome.

Over a 3-month period, ten children (aged 1-13 years) from a 15-km radius in southern Picardy developed typical D+ hemolytic uremic syndrome (HUS). Polymerase chain reaction, using two pairs of verocytotoxin 1-(VT1) and VT2-specific oligonucleotide primers and an internal control was used to detect VT genes directly from stools samples. VT2 gene was detected in seven of nine patients' stools and in 5 of 14 contacts' stool samples. A VT2-producing Escherichia coli (VTEC) O111 was isolated from five of nine children's stools and in 3 adults' stools of the 14 tested. A retrospective case-control study was performed which showed a higher rate of absence in school A, where the first four cases were detected, compared with a control school. The odds ratio for the whole school was 2.77 (confidence interval 1.46-5.26), and 15 (confidence interval 2.54-115.6) if only the nursery classes were considered. A culture of all food samples from households was always negative for VTEC. A retrospective cohort study performed in 89% of children attending school A showed no linkage between food or drink and gastroenteritis. These findings emphasize the potential for person-to-person transmission of VT2-producing E. coli O111, since the only salient risk factor was close contact.

Adolescent↗
PubMed1997

Prolongation of hospital stay and extra costs due to hospital-acquired infection in a neonatal unit.

A case-control study to evaluate the mean extra stay and corresponding cost of neonates acquiring a hospital-acquired infection (HAI) was performed on all patients admitted to a neonatology unit and discharged alive in 1994. Cases were identified from medical records. Controls were matched to cases for birthweight, gestational age, mode of admission to the unit, previous stay in an intensive care unit and presence of a central venous catheter. Costs were taken as those of the extra days attributable to HAI, i.e. the mean difference in the length of stay between cases and controls. Among a cohort of 616 neonates, 34 (5.5%) had one or more HAIs (average = 1.1). The mean extra cost per infected case was 52,192 FF (US$10,440), corresponding to 5.2 extra days in hospital.

Birth Weight↗
PubMed1997

Molecular markers for differentiation of multiresistant Klebsiella pneumoniae isolates in a pediatric hospital.

OBJECTIVE: To study the spread of extended-spectrum beta-lactamase-producing, but aminoglycoside-susceptible, Klebsiella pneumoniae strains in our hospital over an 8-month period, by using two genotypic markers. DESIGN: Ribotyping (using two endonucleases) and randomly amplified polymorphic DNA analysis (RAPD; using two different 10-mer primers) were applied to the epidemiological typing of clinical K pneumoniae isolates from stools, ileal fluid, or urine of hospitalized children. SETTING AND PATIENTS: The surgical intensive-care ward (S1: 9 patients, 17 isolates), surgical unit (S2: 2 patients, 2 isolates), and gastroenterology ward (GE: 1 patient, 1 isolate) of the Robert Debré Hospital of Paris, France. RESULTS: Ribotyping of the 20 clinical isolates, the type strain of the species, and two epidemiologically unrelated isolates with EcoRI and HindIII revealed 6 and 5 different patterns, respectively. Six ribotypes were identified by using these two enzymes. RAPD generated 6 distinct patterns, in complete agreement with ribotyping. Our genotypic results showed that 11 patients from wards S1, S2, and GE harbored genotypically related strains, suggesting nosocomial transmission and cross-colonization between and within the three wards. CONCLUSIONS: Ribotyping and RAPD appear to be reliable methods for distinguishing K pneumoniae strains. The spread of one strain of K pneumoniae in different units of our hospital was demonstrated by both methods. However, RAPD has the advantage of simplicity and rapidity conferred by polymerase chain reaction.

Cross Infection↗
PubMed1997

Evidence for the genetic unrelatedness of nosocomial Alcaligenes xylosoxidans strains in a pediatric hospital.

Restriction fragment-length polymorphism of ribosomal DNA and random amplified polymorphic DNA analysis were used to study the relationships among nine isolates of Alcaligenes xylosoxidans obtained from seven children in a pediatric hospital. All the children harbored only genotypically unrelated strains, thus excluding a common source of exposure or patient-to-patient strain transfer.

Adolescent↗
PubMed1997

Change in nasopharyngeal carriage of Streptococcus pneumoniae resulting from antibiotic therapy for acute otitis media in children.

BACKGROUND: Acute otitis media is the leading reason for antibiotic prescriptions in childhood. The increase in antibiotic resistance of Streptococcus pneumoniae is generally attributed to the extensive use of antibiotics and the selective pressure on the bacterial strains of the nasopharyngeal flora. OBJECTIVE: To evaluate the change in nasopharyngeal carriage of S. pneumoniae during antibiotic therapy prescribed for acute otitis media. METHODS: Between October, 1993, and March, 1994, we conducted a clinical trial comparing cefpodoxime-proxetil and amoxicillin-clavulanate in acute otitis media. From 364 children, 4 months to 4.5 years old, a nasopharyngeal sample was obtained before and after treatment. Antibiotic susceptibility was established by determining minimal inhibitory concentrations by the agar dilution method. Serotype and randomly amplified polymorphic DNA analysis were used to compare pre- and posttreatment S. pneumoniae strains. RESULTS: The risk for a child to carry penicillin-resistant S. pneumoniae (MIC > or = 0.125 mg/l) did not increase after antibiotic treatment: 84 of 364 (23.1%) before, 70 of 364 (19.2%) after. There was a significant decrease of penicillin-susceptible S. pneumoniae carriage, 117 of 364 (32.1%) before treatment compared with 24 of 364 (6.6%) (P = 0.0001) after treatment. However, among the children carrying S. pneumoniae at the end of the treatment there was an increase in the percentage of penicillin-resistant pneumococci: 84 of 201 (41.8%) before treatment and 70 of 94 (74.5%) after treatment. Among the 94 children carrying S. pneumoniae at the end of the treatment, 22 did not harbor pneumococcus before, 16 carried another genotypically different serotype and 56 harbored the same serotype. Among these 56 children 2 patients harbored strains that had increased MICs for the tested beta-lactam antibiotics. The randomly amplified polymorphic DNA analysis showed that in one case, the strains were genetically different. CONCLUSIONS: These data illustrate that antibiotic therapy did not increase the rate at which children carried penicillin-resistant S. pneumoniae, but there was an increase in the rate of resistance among the children carrying pneumococci at the end of the treatment, mainly as a result of reduction of susceptible strains.

Acute Disease↗
PubMed1997

Virulence patterns of Escherichia coli K1 strains associated with neonatal meningitis.

The prevalence of the ibe10 gene, of the pap, afa, and sfa adhesin-encoding operons, and of a 14.9-kb rrn-containing HindIII fragment was studied for 67 Escherichia coli neonatal meningitis strains, 58 E. coli K1 commensal strains, and 47 E. coli blood isolates from neonates without meningitis. ibe10, sfa, and the 14.9-kb HindIII fragment were observed significantly more often in the meningitis strains than in blood or commensal strains.

Adhesins, Bacterial↗
PubMed1997

Genotypic analysis of Burkholderia cepacia isolates from 13 French cystic fibrosis centers.

Burkholderia cepacia has been involved in outbreaks of pulmonary infection among patients with cystic fibrosis (CF), and the spread of a highly transmissible clone has been reported throughout the United Kingdom and Canada. These data prompted a DNA-based typing study of the strains recovered in French CF centers. Ninety-five isolates recovered from 71 patients attending 13 CF centers in 9 regions of France were characterized by randomly amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis (PFGE). Twenty-one genotypes were identified among the 95 isolates, and the results of RAPD and PFGE were concordant for 89 isolates (94%). Cross-colonization was demonstrated in 7 of the 13 CF centers. The investigation of serial isolates showed that most chronically colonized patients harbored a single B. cepacia strain. A geographically clustered distribution of B. cepacia genotypes was observed, except for one genotype, which was detected in four regions but was proven to be different from the genotype of the British-Canadian highly transmissible strain. The present study confirms the ability of B. cepacia to spread among CF communities in France and the importance of epidemiological surveys in the institution of prevention policies.

Bacterial Typing Techniques↗
PubMed1996

Genotyping of Helicobacter pylori isolates by sequencing of PCR products and comparison with the RAPD technique.

Two genotyping methods were performed on bacterial suspensions of the human pathogen Helicobacter pylori. A total of 29 clinical isolates were analysed by sequencing of a 294-bp PCR-derived internal segment of the essential ureC/glmM gene of H. pylori, and by random amplified polymorphic DNA (RAPD) using a single 11-bp oligonucleotide made up of an arbitrary nucleotide sequence. Each isolate exhibited a distinct sequence over a 210-bp stretch of the ureC/glmM gene. Similarly, the isolates bore different profiles when tested by RAPD fingerprinting. Successive strains arising from patients who relapsed following antibiotic treatment and strains isolated from two patients institutionalized in the same care centre had identical ureC/glmM gene sequences and RAPD profiles. Both methods were found to be discriminatory. However, PCR sequencing of the ureC/glmM gene appeared to be more reproducible and more reliable for distinguishing between strains than the RAPD technique.

Adolescent↗