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Biomedical subjects

M Mounier

Publications and source records attributed to M Mounier.

At least 19 recordsLinked to original sources
PubMed2004

Evaluation of the microbial safety of a new 1.5 l enteral feeding diet reservoir system.

BACKGROUND & AIMS: Microbial safety is essential during enteral nutrition (EN) as it can be the origin of gastrointestinal symptoms, but can also lead to systemic infections. The use of large-volume diet reservoirs could limit the risk of contamination and reduce nursing time, due to fewer repeated manipulations. The aim of the study was to evaluate in vivo the microbial safety of a new 1.5l enteral feeding diet reservoir system. METHODS: After validation of the study settings under standard laboratory conditions, 86 EN lines with sealed fittings were connected to 1.5l diet reservoirs under hospital/patient conditions. Microbial identification and quantification at different sampling times and points were performed. RESULTS AND CONCLUSIONS: No microbial contamination was observed in the diet reservoirs and in the nutrition lines above the drip chamber, demonstrating the microbial safety of this system. Retrograde contamination of the distal nutrition line end at completion of EN was observed and may be affected by the cumulative time of use of the tube. The contaminating microbial species were essentially bacteria of normal oral and digestive flora.

Bacteria↗
PubMed2002

[Methi-resistant Staphylococcus aureus in dermatological practice: origin, risk factors and outcome].

BACKGROUND: Increased frequency of methiresistant Staphylococcus aureus (MRSA) in inpatients is a day to day problem. OBJECTIVE: To determine the origin of MRSA, the causes for contamination, and potential complications in a department of Dermatology. PATIENTS AND METHODS: A retrospective study of patients hospitalized in a dermatology department with cutaneous MRSA during 1997-1998. We considered age, type and duration of dermatitis, geographic origin of patients on admission, previous hospitalizations, time between arrival in the ward and positive MRSA, and complications requiring systemic antibiotics. RESULTS: Out of 4579 of our patients, 53 (0.011 p. 100) had positive MRSA. They were on average 70.86 years-old (26 to 97). The most common underlying dermatitis was leg ulcers (30) and foot sores (4). Dermatitis had lasted for more than 1 month in 48 patients. Most of the patients (40) had their MRSA on admission to our ward. Twenty six patients admitted from home had MRSA; only 9 had never been in an hospital. Six patients had diabetes mellitus. Thirty two patients healed with local treatment for their dermatitis. Thirteen patients have had some complications (erysipela 1, osteoarthritis 3, septicemia 2, febrile syndrome 9). DISCUSSION: Most patients with MRSA had leg ulcers or foot sores, confirming liability of chronic wounds to MRSA colonizing. Thirty one out of 40 patients with MRSA at arrival had been previously hospitalized. Hospitalization increases the risk of MRSA contamination. Treatment of MRSA is essentially that of the underlying dermatitis. However, it is still necessary to monitor the lesion for complications.

Adult↗
PubMed1999

[Multidrug resistant bacteria in a psychiatric milieu].

Isolation rates of multiple-drug resistant (MDR) bacteria were evaluated retrospectively in a psychiatric care facility. Over the six-year study period, 66 MDR bacterial strains were found. Methicillin-resistant Staphylococcus aureus contributed half of all MDR strains and 31% of all S. aureus strains. Among Pseudomonas aeruginosa strains, 22% were resistant to ticarcillin or imipenem, and among Enterobacteriaceae, 4.1% were MDR strains (production of a derepressed cephalosporinase or of an extended-spectrum beta-lactamase). Although most MDR strains were probably acquired during hospitalizations in short-term care facilities outside our institution, patient-to-patient transmission, either direct or via other individuals, cannot be ruled out. These data indicate that psychiatric care facilities should adopt the MDR strain monitoring strategies already used in other hospitals.

Bacteria↗
PubMed1996

[Carriage of Staphylococcus aureus. A severity factor of erysipelas?].

INTRODUCTION: Occasional superinfection or co-infection with Staphylococcus aureus led us to search for S. aureus carriage prospectively in patients with non-necrotizing bacterial dermophypodermitis, in particular erysipelas. PATIENTS AND METHODS: This prospective study included immunocompetent patients with bacterial dermophypodermitis without signs of toxicity or local manifestations suggesting necrotizing fasciitis. Bacteriology tests included: 1) direct immunofluorescence for streptococcus (groups A, C, G) on skin biopsies taken on day 0, 2) samples from the nasal orifices, the intergluteal fold, and potential skin portals for bacteriology culture, and 3) assay of antistreptolysine O and antistreptodornase B on day 0 and 15. RESULTS: The study group included 42 patients (23 females, 19 males, mean age 64 +/- 3.5 yr). In 39 cases (93%) bacterial dermohypodermitis was located on the lower limb with a potential skin portal in 36 cases (86%). Sample culture, direct immunofluorescence or serology findings demonstrated presence of streptococci in 33 cases (79%). Nasal, intergluteal or potential portal were identified in 19 patients (45%) including 16 with demonstrated presence of streptococci. The rate of cure after oral pristinamycin did not vary significantly between carriers (79%) an non-carriers (91%) of Staphylococcus aureus. Drainage of a localized abscess was successful in 5 of 6 patients after initial failure of antibiotic treatment; 4 of them were carriers of S. aureus. CONCLUSION: This prospective study demonstrated that cutaneous-mucosal carriage of Staphylococcus aureus is frequent in patients with non-necrotizing dermohypodermitis. This carriage is not a factor of over-morbidity as shown in this group of infections largely dominated by erysipelas.

Anti-Bacterial Agents↗
PubMed1995

[Evolution of the susceptibility to penicillin G of Streptococcus pneumoniae at the Limoge University Hospital Center].

A systematic detection of Streptococcus pneumoniae strains with reduced susceptibility to penicillin has been realized at Limoges Hospital during two years half. Of 302 strains isolated, 27 had reduced susceptibility to penicillin (8,9%), and, for 15 strains (5%), the MIC of penicillin G reached at least 2 mg/l. The frequency of strains with reduced susceptibility to penicillin increased from 1992 to 1994: 8,2% in 1992, 8,7% in 1993 and 12,2% in 1994. The resistance level exhibited by pneumococcus strains increased since 1992: the percentage of resistant strains (MIC mg/l > 1) was 2,7% in 1992, 6,9% in 1993 and 7,3% in 1994. Most of the strains with reduced susceptibility to penicillin belonged to serotype 23 (52%) and were isolated from blood cultures, cerebral-spinal or pleural fluids (41%).

France↗
PubMed1995

[Dynamics of the nasal colonization by methicillin resistant Staphylococcus aureus in patients hospitalized in an intensive care unit].

Prospective study on MRSA nasal cariage was done during two months in an intensive care unit in Limoges University Hospital. Nasal swab specimens were taken daily and cultured on selective and non selective media. Sixty eight patients were included in this study (878 swab collected, 575 MRSA isolated). Patients mean âge was 62 years and stay period mean was 12.3 days (median: 7 days). Among these patients, 16 were already carrying MRSA when entering in the unit and 26 became positive for MRSA during their stay. The mean colonisation delay was 5.5 days (median 4 days). All patients, except one, have shown a nasal carriage during all their stay. During the study period, 17 patients became infected and only two patients neither carried nasal MRSA before and during infection. In all cases, glycopeptide treatment did not affect nasal carriage. Colonisation and infection risk factors were discussed.

Adolescent↗
PubMed1995

[Adenoviruses from stool samples in hospital units. Comparison with main pathogens in gastroenteritis (rotavirus, Campylobacter, Salmonella)].

During a six-years period (1988-1993), a total of 14,644 stool samples from in-patients of Limoges University Hospital were examined for the presence of principal enteric pathogens, such as adenovirus, rotavirus, Campylobacter, Salmonella, Shigella and others. Stools were processed for identification of bacteria by standard methods and viruses were detected in fecal specimens using antigen detection methods: ELISA (Enzyme Linked Immunosorbent Assay) and latex agglutination test. The decreasing rates of presence of enteric agents were respectively 6% for rotavirus, 3.2% for Salmonella, 2% for adenovirus, 1.6% for Campylobacter and 0.2% for Shigella, but according to the lack of sensibility of latex agglutination test, adenovirus prevalence was probably underestimated. Concerning the distribution of enteric pathogens throughout the year, our data demonstrate that rotavirus were rather shed during the months from January to April, adenovirus between April and August, Campylobacter during summer and Salmonella from July to October. The two thirds of Campylobacter and rotavirus infections and the half of adenovirus and Salmonella infections were identified during the ten first years of life. The highest prevalence occurs before 5 years old, during the 2nd year of life for adenovirus (4.4%) and rotavirus (22.3%) and during the 3rd year of life for Campylobacter (6.84%) and Salmonella (8.6%).

Adenovirus Infections, Human↗
PubMed1995

[Bacterial dermo-hypodermatitis in adults. Incidence and role of streptococcal etiology].

INTRODUCTION: The frequency of bacterial dermohypodermal infections would appear to be increasing in western countries, particularly severe necrotizing forms. PATIENTS AND METHODS: We attempted to determine: (1) the incidence of the two most well-defined forms of bacterial dermohypodermal infections (erysipelas and necrotizing fasciitis) in a retrospective study of hospitalized cases seen over a period of 13 years in the Limoges University Hospital and (2) the role of streptococci as causative agents in bacterial dermohypodermal infections in the adult by collecting bacteriological data in 174 cases of erysipelas and 31 cases of necrotizing fasciitis. RESULTS: This retrospective analysis confirmed that the annual incidence of erysipelas was constantly increasing over the study period (1978-1991) while the annual incidence of necrotizing fasciitis was much lower and more constant. The two incidence curves were not parallel. Bacteriology, detection of streptococci (groups A, B, C or G) in skin specimen was better with direct immunofluorescence (64 p. 100) than with latex agglutination (47 p. 100) or classic culture techniques (28 p. 100) for erysipelas. Streptococci were determined to be the causative agent in 79 p. 100 (137/174) of the cases of erysipelas using at least one of the 3 bacteriological tests and/or serology. Group A streptococci predominated (67 p. 100 of the cases). For necrotizing fasciitis, streptococci was identified with classical culture technique, latex agglutination and/or serology in 12/131 cases (39 p. 100), again with a group A predominance (7 cases). In the other cases, multiple microbial flora (12 cases) were found including Staphylococcus aureus (3 cases) and Serratia liquefaciens (1 case). CONCLUSION: These results show that streptococci (group A predominantly and group G to a lesser extent) were the major, though not exclusive, causative agents in bacterial dermohypodermal infections in the adult, including necrotizing forms.

Adult↗
PubMed1994

[Antibacterial activity of clarithromycin and its hydroxylated derivative and two other macrolides against thirty strains of Streptococcus pneumoniae].

Macrolides are widely used in the treatment of respiratory infections. Here, the authors compared the activity of different 14-membered macrolides: erythromycin (Ery), roxithromycin (Rox), clarithromycin (Cla) and its 14-hydroxy metabolite 14-OH clarithromycin (14-OH) against 30 strains of Streptococcus pneumoniae isolated at the Dupuytren hospital (Limoges, France) from upper respiratory tract sputum, ophthalmic sputum, blood samples and CSF. Twenty strains were susceptible to macrolides and 10 were resistant. Three strains from the susceptible and 7 from the resistant were resistant to penicillin. Furthermore, for all the macrolides except Rox and 14-OH, susceptibility tests were performed by the disk diffusion method on Mueller-Hinton agar. MICs50 of Cla and Ery were 0.06 mg/l. They were two-fold increased for 14-OH (0.125 mg/l) and four-fold increased for Rox (0.25 mg/l). We noted that for 3 resistant strains, MICs of Cla were four-fold decreased than MICs of Ery. Ery, Cla and 14-OH had bactericidal activity against pneumococcus strains susceptible to these antibiotics at 4 and 8 times the MIC after 6 or 18 h. The difference between MIC and MBC was small (1 or 2 two-fold dilutions) for Ery, Rox and Cla. For 14-OH, this difference was within 2 to 4 two-fold dilutions. The bactericidal activity is similar to that of amoxicillin and cefotaxim. A microdilution chequeboard technique was used against 3 strains and the FIC index did not show synergistic effect of combining Cla and 14-OH. The activity of Cla and 14-OH against 5 strains was not modified in the presence of 50% fresh pooled human serum inactivated at 56 degrees C or not.

Anti-Bacterial Agents↗
PubMed1994

[Concentration of amoxicillin in neonates after infusion to the mother during labor].

Amoxicillin is effective against S. agalactiae (MIC 50 = 0.03 mg/l). Neonatal prophylaxis of GBS infection had already been studied but very few data are available regarding pharmacokinetic of these antibiotics. In this study, 58 pregnant women with GBS colonisation and/or with epidemiologic risk factors received intrapartum antibiotic infusion at the beginning of the labor (1 g amoxicillin every 6 hours until the delivery). At delivery, cord blood and gastric fluid were taken in delay from 0.5 to 6 hours after the beginning of the infusion. Dosages were done in triplicate with a microbiological method using Bacillus subtilis ATCC 6633 as test strain. In cord blood amoxicillin appeared as early as the first half hour. Concentration were from 5 to 7 mg/l between 1 hour and 4 hours after the beginning of the infusion, and from 3 to 4 mg/l after 4 hours. In gastric fluid, concentrations obtained were over 1 mg/l after 1.5 hour and over 3 mg/l after 2.5 hours with good efficiency even after the sixth hour. The protocol using a slow intrapartum amoxicillin infusion (1 g) gave concentrations in gastric fluid and cord blood over S. agalactiae MIC.

Adult↗
PubMed1992

[Study of intraocular diffusion of ofloxacin in humans and rabbits].

The diffusion of ofloxacin in infected and healthy human and rabbit eyes was investigated. In the human study, cataract surgery patients were given intravenous ofloxacin either as a single 200 or 400 mg dose or as two 400 mg infusions 12 hours apart. Samples of aqueous humor and plasma were collected between 1 and 12 hours after the end of the infusion. Levels in the anterior chamber increased with the dose; peak levels, which occurred after three hours, were 0.33 mg/l after 200 mg and 1.24 mg/l after two 200 mg doses given 12 hours apart. In the rabbit study, 16 hours after experimental infection of the left eye by injection of S. epidermidis into the vitreous, animals were given an intraperitoneal injection of 20 or 50 mg/kg ofloxacin. Dosages in the various ocular tissues showed that penetration into the eye varied with race (albinos greater than pigmented) and dose. Intraocular ofloxacin levels, including in the vitreous, increased two fold when the eye was infected; however, penetration into the sclera, choroid, and retina was comparable in infected and noninfected eyes. These findings in humans and animals suggest that ofloxacin in a dose of a least 400 mg is a useful agent for the treatment of prophylaxis of ocular infections.

Aged↗
PubMed1992

[Diffusion of piperacillin in the eye].

Intraocular diffusion of piperacillin was studied in 42 patients scheduled for cataract surgery (n = 35) or vitrectomy (n = 7). Piperacillin was administered intravenously (4 g/injection). Thirty-four patients were given a single dose and 8 were given two doses 12 hours apart. Peak piperacillin levels in the aqueous (7.3 mg/l) occurred one hour after the injection; levels in the vitreous were low (less than 0.6 mg/l). Intraocular diffusion of piperacillin was also studied in rabbits with an experimental Staphylococcus epidermidis infection of one eye; the other eye served as the control. In pigmented rabbits (6 Fauve de Bourgogne animals), increased diffusion and decreased elimination of piperacillin were seen in the aqueous, iris and cornea of the infected eyes, as compared with uninfected control eyes. In albino rabbits (6 New Zealand animals), results were less conclusive, with a difference between the infected and healthy eyes appearing only during the second hour following the injection. The good diffusion of piperacillin in the aqueous, especially in infected eyes (at least in rabbits), suggests that this drug may be useful for the treatment of ocular infections provided it is initiated early and given in combination with another antimicrobial exhibiting good intraocular diffusion.

Aged↗