[Bacteriological diagnosis of bronchopneumopathies in patients under ventilation. Is distal brushing under fiber optics interesting?].
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Biomedical subjects
Publications and source records attributed to J Charrel.
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Twenty patients with severe nosocomial bacterial infections hospitalized in an intensive care unit were treated by ceftriaxone alone, in a single daily IV injection of 2 g. Clinical and bacteriological results show that ceftriaxone has good activity against enterobacteria. The four patients (20%) who failed to respond had superinfection by Pseudomonas aeruginosa, a finding that suggests that ceftriaxone should be used in combination with another antibiotic for the treatment of nosocomial infections. Pharmacokinetic results in our patients show that with the dosage used peak and trough serum levels are greater than the MICs of susceptible pathogens.
The authors report a case of Staphylococcus epidermidis prosthetic valve endocarditis. After two unsuccessful treatments, the association Gentamicin-Fosfomycin provided adequate serum bactericidal titers and had a good efficacy.
Concentrations of a disinfectant complex effective against hospital strains were determined using the dilution-neutralization method (AFNOR T72 150). Results were compared to those obtained with reference bacterial strains. A 99.999% reduction in viable bacteria requires significantly higher concentrations for hospital isolates than for reference strains.
Doxycycline was used to prevent infection in 40 patients undergoing oesophageal surgery (for carcinoma in 35 and for benign lesions in 5). Treatment began with induction of anaesthesia and continued in doses of at least 200 mg/day for a mean period of 10 days. Concentrations of the antibiotic were measured in the serum and colonic tissue of 20 patients, 2 hours on average after the first injection. Mean serum and tissue levels were 4.1 +/- 0.8 mcg.ml-1 and 2.9 +/- mcg.ml-1 respectively, with a tissue to serum ratio of 0.7. This ratio remained practically unchanged between the first and fourth hours post-injection. Doxycycline was successful in preventing post-operative infection in 75% of the cases. No infection due to anaerobic organisms was observed.
The authors studied, with the Autobac machine, the kinetics of antibacterial activity of fosfomycin against Staphylococcus aureus, Streptococcus D' Streptococcus pneumoniae, Neisseria meningitidis, Acinetobactor lwoffi, Haemophilus influenzae, Salmonella typhimurium, Escherichia coli, Proteus rettgeri, Klebsiella pneumoniae, Serratia marcescens and Pseudomonas aeruginosa. A correlation appears between the kinetics of fosformycin antibacterial action and the microbial growth rate.
A standard hand-washing technique was used in order to test the relative effectiveness of eight both detergent and alcoholic preparations intended to surgeon's hands disinfection. A single four or seven minutes washing with alcoholic solutions was shown to eliminate a much larger proportion of the skin flora than could be removed by a single four or seven minutes hand-washing with detergent antiseptic preparations. Authors have also determined effect of wearing surgical rubber gloves after skin disinfection and compared viable bacterial counts in hand washings immediately after the antiseptic treatment and when gloves had been worn for one hour.
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