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Biomedical subjects

J Fleurette

Publications and source records attributed to J Fleurette.

At least 127 records · Page 7Linked to original sources
PubMed1987

Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia.

The prevalence of antibodies to 13 antigens of Legionellaceae were compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non Legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalized antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti L. pneumophila antibodies in a healthy population [almost nil for serogroups 2, 3, 4 and 5; 1.5% for serogroup 6, maximum of 2.5% for serogroup 1 (titres of 16)] confirms the positive and presumptive criteria that have been recommended by Centers for Disease Control (CDC). But as regards the other Legionellae studied, these criteria cannot be applied owing to the prevalences that are higher in healthy populations (until 14.5% with levels of 16-32 and 1% with levels of 64-128 for L. bozemanii) and clearly amplified in tuberculosis patients and in acute pneumonia. Although the significance of these antibodies remains to be discussed, with formalized antigens, it seems reasonable as regards these species to assign a threshold of 256 for the presumptive and positive criteria following seroconversion.

Adult↗
PubMed1987

[Pharmacokinetics of ceftriaxone in hemodialysis].

The influence of hemodialysis on the pharmacokinetics of ceftriaxone was studied in 5 patients with chronic renal failure, with a glomerular filtration rate of less than 5 ml/min, and treated by regular hemodialysis. A single dose of 2 g ceftriaxone was administered IV at the end of a hemodialysis, and venous samples were drawn 12 and 24 h thereafter. Two hemodialysis were performed at the 44th (HD1) and the 92nd (HD2) hour, and blood samples were drawn simultaneously on arterial and venous sides of the dialyzer at the onset of HD1 and at the end of HD2. Plasma ceftriaxone concentrations were measured on each sample by both microbiological and chromatographic (HPLC) methods. In these patients, ceftriaxone kinetics are considerably longer than in normal subjects, with an elimination half-life of 16 h, an apparent distribution volume of 800 ml/kg, but without decrease of plasma clearance, except in one patient who had hepatic cytolysis at the time of injection. Plasma concentrations on both sides of dialyzers, or before and after hemodialysis, are not significantly different, and the mean hemodialysis clearance ranges between 26 and 30 ml/min/m2 dialyzer area. According to these data, the dose-interval between successive administrations of ceftriaxone 2 g IV should be 48 h in patients with chronic renal failure, and supplemental doses do not appear necessary after hemodialysis.

Adult↗
PubMed1987

[Diffusion of ceftriaxone in the renal parenchyma].

Diffusion of ceftriaxone in renal parenchyma after IV injection (2 g) was studied in six patients with normal renal function, undergoing nephrectomy. Cortex and medulla of the kidney were studied. Blood samples, tissular fragments and urine were studied for drug concentration using HPLC and microbiologic assay 1, 12 and 24 h after injection. Both methods led to similar results. No difference in drug concentration was found between cortex and medulla. Tissular concentration of ceftriaxone remain higher than MIC for most Enterobacteriaceae strains until 24 h.

Adult↗
PubMed1987

[Doxycycline treatment of experimental legionellosis in guinea pigs infected by aerosol].

The efficacy of curative and preventive treatment by doxycyclin was studied with the same experimental model as during the study of erythromycin [14]. The infectious aerosol was done with a strain of Legionella pneumophila serogroup 1, Philadelphia (ATCC 33152). Male albinos Dunkin-Hartley guinea-pigs were exposed for 30 min to an aerosol dose of 1, 10 or 100 LD 50 (10(3), 10(4) or 10(5) viable organisms). After preliminary assays to find out the efficient posology, doxycyclin was administered intraperitoneally (IP) 18 h after the infection at a dosage of 60 mg/kg/day for 5 days in the animals infected with 1 LD 50, and 75 mg/kg/day in the animals with 10 and 100 LD 50. The preventive treatment (75 mg/kg/day) administered one day before and the day of the infection was tested with animals infected with 10 LD 50. The guinea-pigs were observed 8 days (weight, rectal temperature) and watched over 3 weeks after the end of treatment; serological and bacteriological tests (cardiac blood, lungs, spleen) were performed in every animal; doxycyclin assays (serum, lungs) during treatment were performed by high performance liquid chromatography (HPLC). The treatment of guinea-pigs infected by 1, 10 and 100 LD 50 gave a survival rate of 100%, 75% and 50% respectively. On the other hand the animals which received preventive treatment were all survivors. Seroconversions with antibody titres from 64 to 512 were observed for all the survivors. Bacteriological tests were all negative. The mean doxycyclin concentrations in serum (microgram/ml) and lung (microgram/g) were 1.66 and 11.42 after 24 h of treatment and 5.71 and 18.93 after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗
PubMed1986

[Infectious endocarditis in France. Epidemiological characteristics].

The epidemiological characteristics of infective endocarditis in France were established in a one-year survey of strictly defined cases. The incidence of the disease is 18 cases per year and per million inhabitants, i.e. 970 cases annually. Patients are generally treated in Teaching Hospitals (80% of the cases were at the end of the hospitalization period). The predominant pathogens are the streptococci non groupable in 40.4% of the cases (group D in 21.9%) and the staphylococci (20.8%). Patients with group D streptococci endocarditis are the older ones (mean age: 60 years). Staphylococcal endocarditis occurs in younger patients (mean age: 43 years), especially after cardiac valve prosthesis or unrecognized cardiac valve disease, and it is the most serious form, with a 45% mortality rate (overall mortality rate: 21%). One quarter of the patients undergo a surgical operation.

Adolescent↗
PubMed1986

[Multicenter study of the activity of pefloxacin on bacteria isolated in a hospital milieu].

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).

Bacteria↗
PubMed1986

Nosocomial infection and colonization by Klebsiella trevisanii.

During an 18-month period we identified two cases of septicemia and 24 examples of colonization of humans by Klebsiella trevisanii. Organisms were identified using the API 20EC and API 147 assimilation galleries. Of 147 clinical isolates initially identified as K. oxytoca, 18% were found to be K. trevisanii. Tracheal aspirate was the most common source of the organism. An extensive environmental sampling survey in the rooms of 12 colonized patients revealed a possible reservoir of the organism only once (a face cloth).

Aged↗
PubMed1986

[Treatment with erythromycin of experimental legionellosis in guinea pigs infected by aerosol].

The infectious strain L. pneumophila serogroup 1 Philadelphia (ATCC 33152) was cultured on charcoal dialysed yeast extract agar medium (CDYE agar) which produces more virulent strains than those grown on classical agar media. The aerosol was dispersed in a depression chamber by means of a nebuliser and the density was controlled by a density probe. Male albinos Dunkin-Hartley guinea pigs weighing 250-300 g were exposed for 30 minutes to an aerosol dose of 1 LD50 (10(3) viable organisms) and 10 LD50 (10(4) viable organisms). Erythromycin lactobionate (Abbott) was administered subcutaneously 18 hours after the infection, at dosages of 270 mg/kg/day for 4 days in the animals treated with 1 LD50 and for 6 or 7 days in the animals treated with 10 LD50. The guinea pigs were observed for 9 days (weight, rectal temperature; serological and bacteriological tests (cardiac blood, lungs, spleen) and erythromycin assays (serum, lungs) were performed and compared in the treated animals, the non-treated infected control animals and the control animals which only received erythromycin. The percentage survival in the treated guinea pigs after inhalation of 1 LD50 and 10 LD50 (2 tests) were 100%, 75% and 87.5% respectively. Three weeks after treatment, the survivors had antibody titres from 32 to 1,024; the bacteriological cultures and erythromycin assays were negative. In this study, an improvement in the treatment of experimental Legionnaires' disease was observed in comparison with previous experiments. The increased dosage and duration and the early initiation of treatment resulted in survival rates of 75%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Application of a micromethod to the study of the bactericidal activity of 2 antiseptics based on chlorhexidine gluconate].

Minimal bactericidal concentrations (MBCs) of two antiseptics containing chlorhexidine digluconate (5% for the A solution, 1.5% for the B solution) were determined using a microdilution method. This method is a miniaturization of the Afnor T 72150 standard for antiseptics and disinfectants. 133 hospital isolates were studied, including 68 Enterobacteriaceae, 11 Acinetobacter, 18 Pseudomonas, 1 Achromobacter, 23 Staphylococcus, and 12 S. faecalis. Each microplate was seeded with eleven of these strains and one reference strain (E. coli CIP 54127, P. aeruginosa CIP A22, S. aureus CIP 53154, and S. faecium CIP 5855). Ten microliter of a standardized inoculum (2 to 3 10(8) bacteria/ml) were added to 90 microliters of a solution containing the antiseptic. Each antiseptic was tested in various concentrations (1.95 to 125 mg/l for A and 1.17 to 75 mg/l for B). After five minutes contact at 21 degrees C, 1.5 microliter from each well was seeded on a neutralizing agar plate (letheen agar + 3% tween 80 + 0.3% lecithin + 3% saponin + 0.1% histidine). The neutralizing effectiveness of this plate on the antiseptics in the concentrations used had been ascertained previously. The Afnor T 72150 standard was established for each reference strain. MBCs 90 (in mg/l) found were as follows: 31.2 (A) and 18.8 (B) for Enterobacteriaceae, 15.6 (A) and 9.4 (B) for Acinetobacter, 31.2 (A) and 18.8 (B) for Pseudomonas, 62.5 (A) and 37.7 (B) for Staphylococcus and 125 (A) and 37.5 (B) for S. faecalis.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Infective Agents, Local↗
PubMed1986

[Proposal for a method of studying the activity of soap or antiseptic against the microbial flora of the hands after a single surgical scrub].

The authors, all members of the Antiseptics group of the Societé Française de Microbiologie, propose a standardised method for the evaluation of the activity of antiseptics on the microbial flora of the hands in the context of surgical scrubbing. This paper defines the aims of the method, its field of application and describes the media and materials required. The various phases of the preliminary study and the definitive trial also described.

Anti-Infective Agents, Local↗
PubMed1986

Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia.

The prevalence of antibodies to 13 Legionella antigens was compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non-legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalin-fixed antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti-L. pneumophila antibodies in a healthy population [almost 0 for serogroups (SG) 2, 3, 4 and 5; 1.5% for SG 6 and a maximum of 2.5% for SG 1 at a titer of 1: 16] confirms the criteria that have been recommended by the Centers for Disease control, USA. For the other legionellae studied, these criteria cannot be applied due to a higher prevalence in healthy populations (14.5% with levels of 1: 16-32 and 1% with levels of 1: 64-128 for L. bozemanii and progressively decreasing by as much as 2% for the other species: L. micdadei, L. longbeachae, L. gormanii, L. dumoffii and L. jordanis), in tuberculosis patients (12.1% with a level at 1: 64-128 for L. bozemanii, and for the same titer, 9.2% for L. gormanii, 5.7% for L. micdadei, 5% for L. longbeachae 2), and also in acute pneumonia (2 to 3.3% with levels of 1: 64-128 for L. longbeachae 1 and 2, L. jordanis, L. dumoffii, L. micdadei and L. bozemanii). Although the significance of these prevalences remains to be discussed, with formalin-fixed antigens, it seems reasonable for these species to assign a threshold of 1: 256 for the presumptive serodiagnosis following seroconversion.

Antibodies, Bacterial↗
PubMed1986

Pneumococcal infections during childhood: serotyping of pneumococcal strains from forty-six children.

The results of serotyping of forty-six strains of pneumococci isolated from children aged 3/12 to 14 9/12 years and diagnosed as having pneumonia, meningitis, primary peritonitis, otitis media, lymphadenitis, osteomyelitis, bacteraemia and conjunctivitis are presented. The results of serotyping and the frequency distribution of the detected serotypes were compared to the particular diagnoses established and the age at which the subjects involved had become ill. Questions of epidemiology and possibilities of immunoprophylaxis are discussed. Finally, the occurrence of pneumococci that are resistant to antibiotic agents are discussed since an isolated strain was found to show reduced susceptibility to penicillin G.

Adolescent↗
PubMed1986

Epidemiological evidence of legionellosis transmission through domestic hot water supply systems and possibilities of control.

The use of epidemiological markers for a survey is essential because of the ubiquity of legionellae, particularly L. pneumophila serogroup (SG) 1. The two settings under study were an administrative building associated with a fatal Legionnaires' Disease (LD) case due to L. pneumophila SG 1, and a hospital with 11 cases due to L. pneumophila SG 1 and 3 cases due to L. anisa. Monoclonal antibody serotyping allowed us to establish a link between the outbreaks of LD and the contamination of the hot water supply systems. Two subtypes of L. pneumophila SG 1 and L. anisa were detected in the hospital water system. However the finding of only one subtype of L. pneumophila SG 1 in the patients raised the problem of the difference in virulence of each Legionella strain. By means of aerosol tests on normal and cyclophosphamide-immunosuppressed guinea pigs, we demonstrated the potential pathogenicity of hospital water in the immunosuppressed animals. Two decontamination methods were applied: chlorination and a rise in hot water temperature. Time-limited control measures in the hospital were inadequate, resulting in only temporary eradication, followed by a rapid recolonization of legionellae and the appearance of new nosocomial cases. Decontamination of the administrative building was found to be effective when a constant concentration of 5 ppm free chlorine was obtained at tap outlets, and the water temperature was maintained at 55 C.

Cross Infection↗
PubMed1985

[Bacteriological diagnosis of infectious endocarditis. Evaluation of a system for eliminating antibiotics in the blood].

We carried out 310 blood-cultures on samples from patients receiving antibiotics for either known or suspected infective endocarditis or suspected septicaemia. The culture bottles were inoculated either directly or after the antibiotics had been removed from the blood sample by the Antimicrobial Removal Device System. Out of 63 bacterial isolates from 21 patients (15 infective endocarditis and 6 septicaemias), 45 were made by both methods, 16 only after treatment with the Antimicrobial Removal Device System and two only after conventional culture. Of the 45 paired isolates, eight were cultured more rapidly after Antimicrobial Removal Device System treatment compared with none by conventional culture. The Antimicrobial Removal Device System thus significantly increased the number of positive cultures and the speed of their isolation. In practice, Antimicrobial Removal Device System treatment proved useful in five of the 21 cases, but delayed culture in one. Its greatest value was in showing persistent bacteraemia in patients being treated for prosthetic valve endocarditis.

Anti-Bacterial Agents↗
PubMed1985

Isolation of Legionella anisa from a hospital hot water system.

Several cases of Legionnaires' disease occurred in a French hospital in 1982. Thirteen strains of a legionella-like organism with several unusual characteristics were subsequently isolated from the hospital hot water system. The various features of these strains show that they are identical to the new species 'Legionella anisa' described by the Centers for Disease Control. The possible pathogenicity of these strains to man and their relationship with the recently described Legionella bozemanii serogroup 2 are discussed.

Animals↗
PubMed1985

Studies on staphylococci from toxic shock syndrome in France, 1981-1983.

Staphylococci from 22 cases of toxic shock syndrome with onsets between 1981 and March 1983 have been studied. Another four cases were detected by abstract surveillance. Three of these patients died. The case histories show that the syndrome occurs in women during menstruation as well as in males and in children, and is associated with Staphylococcus aureus infections. The production of enterotoxins (A, B, C) and toxic shock toxin by S. aureus isolates from toxic shock syndrome was investigated. Twenty-two of the 23 isolates were found to be toxigenic: 7 produced enterotoxin A, 8 produced enterotoxin B, 3 produced enterotoxin C and 13 produced toxic shock toxin. The latter was found with enterotoxin A in five cases, and with enterotoxins A and B in only one case. Sixty-three percent of 46 S. aureus strains isolated from the vagina of patients with diseases other than toxic shock syndrome produced toxin; eight of these strains produced toxic shock toxin.

Adolescent↗