Biomedical subjects
Publications and source records attributed to M J Dupont.
The persistence of Vibrio cholerae, biotype el tor, in a patient treated with trimethoprim-sulfamethoxazole was due to the acquisition of a conjugative resistance plasmid. The plasmid, with a molecular size of 72 megadaltons, belonged to incompatibility group 6-C and conferred resistance to ampicillin, chloramphenicol, sulfonamide, and trimethoprim.
Explore the source record for details and available documents.
We isolated a Pseudomonas aeruginosa strain which was initially cefsulodin-susceptible (J1, MIC = 4 g/l) and became resistant (J2, MIC greater than 64 g/l) after 12 days of treatment of the patient with cefsulodin. Strain J2 had a constitutive beta-lactamase with hydrolytic activities similar to those of a cephalosporinase and an isoelectric point at 8.1. This enzyme (Case) may be related to the ld type. Concomitant development of resistances to various beta-lactams stable to Case suggests that other mechanisms of resistance may be involved.
Analysis of 20 cases of staphylococcal septicemia, observed over 1 1/2 months in a general hospital, confirms that these infections are frequent and severe. They occurred in compromised hosts and were nosocomial infections in 2/3 of cases. An intravenous device (particularly a central venous catheter) was associated with 70% of staphylococcal septicemia. Study of bacterial susceptibility to antibiotics and clinical course leads to advocate that high risk patients with fever be initially given rifampin combined with netilmicin.
Two cases of severe septico-pyohaemia due to Fusobacterium necrophorum are reported. Clinical data from human cases and experimental results from infections of laboratory animal with Fusobacterium necrophorum suggest: the important role of individual factors which enhance anaerobic growth (i.e. decrease of tissular redox potential); the involvement of thrombophlebitis with septic thrombi increasing the frequency of metastases; the early and long-lasting bacterial localisation in tissues, particularly in the liver where the proliferation of Fusobacterium necrophorum in Küpffer cells impairs macrophage function.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors report the antibiotic susceptibility and serotyping identification of 1 123 Pseudomonas aeruginosa strains isolated during one year (1972-1973) in the Besancon C.H.U. Eighty per cent of strains are sensitive to 3.2 mcg/ml of Gentamycin (G); to 6.4 mcg/ml of Colistin (Co); to 25 mcg/ml of Rifampicin (R) and 400 mcg/ml of Carbenicillin (Ca). Tobramycin (T) and Lividomycin (L) are active on G-resistant strains in the ratio: CMI.T/CMI.G = 0.12 and CMI.L/CMI.G = 0.25. Among the serotypes, the most common are the 3 (19% of the total), 6 (18.2%) and 5 (11.9%). The serotype 11 (9.5% of the total) is the most resistant to Carbenicillin (CMI m = 400-800 mcg/ml), to Gentamicin (CMI m = 4 mcg/ml) and to Colistin (CMI m = 6.4 to 12.5 mcg/ml). Urinary tract bacteria are more resistant (CMI.Ca 400 mcg/ml; CMI.G = 3.2-6.4 MCG/ML; CMI.R = 25-50 mcg/ml) than fecal bacteria (CMI.Ca 100-200 mcg/ml; CMI.G 1.6 mcg/ml; CMI.R 12.5-25 mcg/ml). This resistance seems essentially linked to bacterial localization, not to serotype: indeed it is possible to find in the same patient, several resistant serotypes in the urinary tract, although bacteria in other sites remain sensitive.
OBJECTIVES: The prognosis of septicaemia due to Pseudomonas aeruginosa is severe with mortality ranging from 32 to 73%. We retrospectively studied 82 episodes in order to determine whether risk factors could be identified. METHODS: Eighty-two episodes of Pseudomonas aeruginosa septicaemia, observed between 1986 and 1991, were analyzed. Risk of death within 2 days of the first positive blood culture (mortality = 19.5%) were assessed with univariate and multivariate analyses. RESULTS: Patient age ranged from 1 to 92 years. Most had been hospitalized in medical wards (49%) or intensive care units (28%) (NS). The type of septicaemia (several bacteria in 21%), the source of the infection (nosocomial in 78%), portal, predisposing factors (cancer, haematologic disease: 54%) and MacCabe index were not significantly correlated with risk of death at two days following first positive blood culture. With univariate analysis body temperature below 38,5 degrees C was significant (p = 0.007) for death at day 2 and appropriate antibiotic treatment after diagnosis was significant (p < 0.001) for absence of death on day 2. For multivariate analysis, chemotherapy and shock syndrome were significant (p = 0.005 and 0.09 respectively) for death at day 2 and appropriate antibiotic treatment was significant (p = 0.005) for absence of death on day 2. CONCLUSION: Antibiotic prescription appears to be the most easily controlled significant factor predictive of outcome in Pseudomonas aeruginosa septicaemia.