Search PubMed⌕ Search

Biomedical subjects

N Lambert-Zechovsky

Publications and source records attributed to N Lambert-Zechovsky.

At least 37 records · Page 2Linked to original sources

Analysis of genetic relationships among strains of groups A, C and G streptococci by random amplified polymorphic DNA analysis.

Random amplified polymorphic DNA (RAPD) analysis was evaluated for its capacity to distinguish species and strains within species of groups A, C and G streptococci. The 99 strains tested, previously typed by multilocus enzyme electrophoresis (MLEE), included 41 group A streptococci (Streptococcus pyogenes), 25 group G Streptococcus spp. (GGS), seven S. dysgalactiae, 11 S. equisimilis, four S. canis, three S. equi and eight S. zooepidemicus. The combined data obtained with three single primers distinguished 82 types. RAPD analysis provided taxonomic results that were in general agreement with previous species classification based on DNA-DNA homology and MLEE. The intraspecies typing efficiency of the technique was significantly improved by the parallel use of several primers. RAPD analysis had greater discriminatory power than MLEE for GAS and GGS. There was not total agreement between the two techniques as RAPD distinguished strains with identical electrophoretic types, whereas MLEE differentiated strains with identical PCR types. RAPD analysis did not distinguish all GAS strains with different biotypes and its already high discriminatory power was further enhanced by concomitant biotyping.

Animals↗

Persistence of Staphylococcus aureus strains among cystic fibrosis patients over extended periods of time.

Pulsed-field gel electrophoresis (PFGE) of SmaI macrorestriction fragments of chromosomal DNA was used to confirm the persistence of methicillin-sensitive Staphylococcus aureus isolates in the sputum of 25 cystic fibrosis patients in five French hospitals. Three-to-eight consecutive isolates, with the same esterase electrophoretic type isolated from each patient over a period of 12-28 months, were analysed. Consecutive isolates with indistinguishable PFGE profiles were found in 12 patients (48%) and consecutive isolates with similar PFGE profiles showing minor differences of one-to-four fragments (similarity coefficient >/=84%) were found in 11 patients. Consecutive isolates with different PFGE profiles were obtained from only two patients, but the profiles found in each patient were more closely related to each other than to other profiles. The results were in agreement with esterase electrophoretic typing for 23 patients, and we considered that those patients were infected with a single persistent strain. For any given patient, variations in antibiotypes and phage types of consecutive isolates were not associated with major genotypic variations. PFGE is useful in confirming the persistence of S. aureus strains in cystic fibrosis patients over long periods.

Anti-Bacterial Agents↗

[Comparison of the activity of beta-lactams against Pseudomonas aeruginosa according to phenotypes of resistance].

The in vitro activity of ticarcillin, ticarcillin-clavulanic acid, piperacillin, piperacillin-tazobactam, cefsulodin, ceftazidime, cefepime, cefpirome and aztreonam was evaluated against 130 isolates of Pseudomonas aeruginosa with various beta-lactam phenotypes. MICs were determined by the agar dilution method and inhibition method and inhibition zones by the disk test. The resistance mechanisms were characterized by the iodometric method. The activity of cefepime was greater than that of cefpirome whatever the resistance phenotype. Some ticarcillin-susceptible strains were intermediate to cefepime and cefpirome. Most strains with a penicillinase or "intrinsic resistance" phenotype were susceptible to ceftazidime but intermediate to cefepime and cefpirome. Only 10% of cephalosporinase-over-producing strains remained susceptible to cefepime.

Anti-Bacterial Agents↗

Activity of beta-lactamase inhibitor combinations on Escherichia coli isolates exhibiting various patterns of resistance to beta-lactam agents.

The efficacy of the clinically available beta-lactam/beta-lactamase inhibitor combinations (amoxicillin/clavulanic acid (CA), ticarcillin/CA, amoxicillin/sulbactam, and piperacillin/tazobactam) was evaluated on 300 amoxicillin-resistant Escherichia coli isolates having the main patterns of beta-lactam resistance. The patterns, which reflect the production of various beta-lactamase enzymes, were analyzed by a principal component analysis of susceptibility to 11 beta-lactam antibiotics or beta-lactam/beta-lactamase inhibitor combinations. Sixty-two percent of strains were not very susceptible to penicillins, cephalothin, or any beta-lactam/beta-lactamase inhibitor combinations except for piperacillin/tazobactam; these strains may represent high-level broad-spectrum beta-lactamase (so-called penicillinase) production phenotype or inhibitor-resistant TEM-like enzyme production phenotype. Of the strains, 14.7% were resistant to amoxicillin and ticarcillin compatible with low-level broad-spectrum beta-lactamase production phenotype; 5.7% were cefoxitin resistant and were postulated to present a high-level cephalosporinase production phenotype; and 2.6% were resistant to cephalothin only, attributable to a low-level cephalosporinase production phenotype. Three percent of strains were intermediate or resistant to cefotaxime and may produce an extended-spectrum beta-lactamase, and the remaining strains (12 %), resistant to all tested antibiotics except for cefotaxime and piperacillin/tazobactam, were hypothesized to produce both broad-spectrum beta-lactamase plus cephalosporinase. The minimal inhibitory concentration (MIC) for these phenotype patterns indicated that combinations of CA plus amoxicillin or ticarcillin, or sulbactam plus amoxicillin, restored the activity of penicillins against phenotype 1 strains, whereas these combinations remained inactive against the other phenotype strains. Piperacillin plus tazobactam showed the best in vitro effect against the strains of all resistance phenotypes.

Amoxicillin↗

Microbiology of nosocomial sinusitis in intensive care unit patients.

We performed a 2-year microbiological study of specimens of sinus fluid recovered from patients with suspected nosocomial sinusitis in six intensive care units. Over that period, 103 cases of sinusitis were documented by positive culture. The number of cases varied widely from one unit to another and was particularly high in the neurosurgical unit. Cultures were often polymicrobial. The main pathogens were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae. Streptococcus pneumoniae and Haemophilus influenzae were far less frequently isolated. Anaerobes and yeasts were often associated with aerobic bacteria. The pathogen involved was also recovered from bronchopulmonary samples in 50 patients and from blood cultures in seven patients.

Bacteria, Anaerobic↗

Identification and typing of pyogenic streptococci by enzyme electrophoretic polymorphism.

Polyacrylamide-agarose gel electrophoresis was used to study polymorphism of lactate dehydrogenase (LDH), nucleoside phosphorylase (NSP), phosphoglucose isomerase (PGI), hydroxybutyrate dehydrogenase (HBD), adenylate kinase (ADK) and esterases of 44 strains of Streptococcus pyogenes, 25 group G streptococcal strains, 11 "S. equisimilis" strains, seven S. dysgalactiae strains, four S. canis strains, three S. equi strains and seven S. zooepidemicus strains. Analysis of LDH, NSP, PGI, HBD and ADK provided valuable interspecies differentiation, by showing that four groups of strains corresponded to the four known DNA homology groups. Esterases showed greater intraspecies variation than the other enzymes. The combined analysis of the six enzymes indicated 31 zymotypes among S. pyogenes, 14 in group G streptococci and 11 in "S. equisimilis" strains. This was shown to be an effective technique for typing pyogenic streptococci.

Adenylate Kinase↗

Brain abscess due to Bacillus macerans following a penetrating periorbital injury.

We report a case of a brain abscess due to Bacillus macerans and Clostridium sp. following a penetrating periorbital injury by a wooden branch. Intracranial penetration by and retention of a foreign body were not suspected initially, and neurological symptoms developed only 2.5 months later. Previously reported cases of brain abscesses due to Bacillus species are reviewed.

Bacillaceae Infections↗

[Oropharyngeal flora. Epidemiologic survey of prevalence].

OBJECTIVES: Epidemiological surveys which are not frequently carried out in medical practice should provide useful information for the choice of antibiotics to be prescribed in community-acquired infections particularly with the recent development of therapeutic difficulties due to resistant strains. We therefore analyzed the prevalent pharyngeal flora in a general patient population. METHODS: The study was conducted during a single 24-hour period in 1991 by 43 general practitioners and included 645 subjects consulting for benign affections. No patient selection was made. Two pharyngeal swabs were obtained from each subject and cultured in aerobic and anaerobic conditions. Internationally accepted methods for identifying bacteria in pharyngeal samples all performed by one well-equipped laboratory. Beta-lactamase activity was determined with the nitrocephine technique, both directly and after culture. RESULTS: Patient age varied from 16 to 45 years; most (68.5%) consulted for reasons other than ear-nose-throat affections. Only 41 patients (4.3%) consulted for sore throat and 65.4% had not received antibiotics for at least 6 months. Haemophilus influenzae was found in 59.6% of the patients, 20% of the strains were beta-lactamase producers as were 83.7% of the Moraxella catarrhalis strains identified. CONCLUSION: These factors are indicators of potential risk of therapeutic failure when using beta-lactams unstable to beta-lactamases for the treatment of pharyngeal infections.

Adolescent↗

Comparative efficacy and safety of cefprozil and amoxycillin/clavulanate in the treatment of acute otitis media in children.

Cefprozil is a new oral cephalosporin with activity against the most common pathogens isolated in acute otitis media. This randomized study enrolled 361 patients (mean age 29 months). Physical examination and culture via tympanocentesis were required less than 48 h before therapy. One hundred and ninety-one patients were evaluable for clinical efficacy; 99 received cefprozil (20 mg/kg/day bd) and 92 received amoxycillin/clavulanate (13.3 mg/kg/day tid). Duration of treatment was 7-9 days for 81 patients, 10 days for 105 patients and 11-16 days for five patients. The treatment groups were comparable with respect to demographics, severity of infection and number of previous episodes. Clinical evaluations of efficacy were based on physical examination including otoscopy within a 14 day period after therapy. Satisfactory clinical responses were achieved in 84% of cefprozil-treated patients and 87% of amoxycillin/clavulanate-treated patients. Pathogens most commonly isolated included Haemophilus influenzae (33%) and Streptococcus pneumoniae (22%). All 361 patients were evaluable for safety. Adverse clinical events were reported in 13% (24) of cefprozil-treated patients and 20% (36) of amoxycillin/clavulanate-treated patients. Cefprozil, administered twice a day, is comparable to a regimen of amoxycillin/clavulanate three times a day in the treatment of acute otitis media in children.

Acute Disease↗

[Epidemiological studies of the susceptibility of Pseudomonas aeruginosa to antibiotics].

The susceptibility to antibiotics of 1367 non-replicate strains of Pseudomonas aeruginosa isolated at Beaujon Hospital between 1990 and 1992 was investigated and compared with the serogroup O and the strain origin (ward, sample). Five betalactam resistance patterns were distinguished according to susceptibility to ticarcillin, piperacillin, ceftazidime and aztreonam,: 1 = SSSS, 2 = RRSS, 3 = RRRR, 4 = RSSR, 5 = RRSR. The other antibiotics studied were imipenem, tobramycin, amikacin, ciprofloxacin and fosfomycin. Resistance to all antibiotics, fosfomycin excepted, was higher in intensive care units than in other wards. The respective frequencies of the phenotypes were: 70.3%, 4.3%, 11.8%, 10.2% and 3.4%. The frequency of pattern 3 steadily increased between 1990 and 1992 at the expense of pattern 1, whereas patterns 2, 4 and 5 remained stable. The most common serogroups were O6 (15.8%), O11 (14.5%) and O1 (9.9%). The O11 strains were more widespread in intensive care units than in other wards and were more resistant to antibiotics. Most of the O12 strains displayed pattern 2 and were highly resistant to antibiotics.

Anti-Bacterial Agents↗

Killing kinetics of cefuroxime against Streptococcus pneumoniae in an in vitro model simulating serum concentration profiles after intramuscular administration.

The killing kinetics of cefuroxime against 25 Streptococcus pneumoniae isolates with penicillin MICs of < 0.1, 0.1-1.0 and 2 mg/l were studied in an in vitro model simulating the serum concentration profile in healthy adults following a single intramuscular injection of 500 mg. Cefuroxime was bactericidal against the isolates with exquisite or slightly diminished susceptibility to penicillin (-4 and -3.9 log10 cfu/ml killing, respectively) during the 6 h incubation period. In contrast, there was only a 2.8 log10 cfu/ml reduction in the initial inoculum of six of the eight isolates resistant to penicillin (MIC 2 mg/l). The two remaining penicillin-resistant isolates (cefuroxime MIC 8 mg/l) only showed a 2 log10 cfu reduction in the initial inoculum.

Adult↗

Molecular analysis of multiply recurrent meningitis due to Escherichia coli K1 in an infant.

Bacterial DNA polymorphism was used to document the occurrence of three separate episodes of meningitis caused by Escherichia coli K1 in an infant. The methods employed included determination of the restriction fragment length polymorphism of total DNA and of ribosomal DNA regions as well as DNA fingerprinting by the arbitrarily primed polymerase chain reaction. By these three genotypic approaches, the three isolates obtained from the infant's cerebrospinal fluid on days 9, 34, and 70, respectively, were found to share the same patterns, which were different from the patterns of control strains. Thus, these three episodes of E. coli K1 meningitis were due to a single strain. DNA-based typing techniques seem extremely promising as tools to be used in unraveling the complex mechanisms of recurrent meningitis.

DNA, Bacterial↗

Identification of a clone of Escherichia coli O103:H2 as a potential agent of hemolytic-uremic syndrome in France.

In a French multicenter study, six verocytotoxin-producing Escherichia coli strains were isolated from the stools of 6 of 69 children suffering from hemolytic-uremic syndrome. All strains belonged to serotype O103:H2, a serotype commonly associated with diarrhea in weaned rabbits in France. To determine whether the strains from humans and rabbits were genetically related, they were compared by analyzing their esterase electropherotypes and the restriction fragment length polymorphisms of the ribosomal DNA regions. A common clonal origin of these pathogenic strains was suggested by their identical esterase electropherotypes and their identical ribotypes, in addition to their identical serotypes. However, strains from humans, which are cytotoxic for HeLa cells through the production of verocytotoxin type 1, do not show adhesion in vitro to HeLa 229 cells and cannot infect rabbits. On the other hand, strains from rabbits do not carry the verocytotoxin type 1 gene, are not cytotoxic for Hela cells, and adhere to ileal villi and HeLa 229 cells because of the expression of their 32-kDa adhesin. Our results therefore identify a clone of verocytotoxin-producing E. coli O103:H2 as a potential agent of hemolytic uremic syndrome in France. They further suggest that clones from humans and rabbits probably have a common origin but that adaptation to the two species occurred by different mechanisms. Thus, they eliminate the hypothesis that the species is horizontally transmitted between rabbits and humans.

Bacterial Toxins↗

Arbitrarily primed polymerase chain reaction provides rapid differentiation of Proteus mirabilis isolates from a pediatric hospital.

During a systematic survey, maternal carriage of Proteus mirabilis was found over a 25-day period in 18 pregnant women admitted to the delivery ward of our hospital maternity. Five neonates born to these mothers were found to be colonized with P. mirabilis. We report here on the use of DNA fingerprinting by the arbitrarily primed polymerase chain reaction technique (AP-PCR) for the epidemiological investigation of this sudden outbreak. This approach was compared with the analysis of restriction fragment length polymorphisms of ribosomal DNA regions (ribotyping). Results of the AP-PCR and of ribotyping were in complete agreement in showing the genetic unrelatedness of the isolates obtained from each mother. Moreover, the results showed mother-to-infant vertical transmission of P. mirabilis in the neonates. AP-PCR is a rapid and discriminative method which seems particularly well suited to the epidemiological study of P. mirabilis.

Bacterial Typing Techniques↗

[Clinical, diagnostic and therapeutic aspects of Moraxella catarrhalis infections].

Moraxella catarrhalis is a Gram-negative diplococcus of the Neisseriaceae family now recognized as a cause of acute otitis media in pediatric patients and of lower respiratory tract infections in debilitated adults. The finding that 80% to 90% of strains produce beta-lactamases together with reports of cases of bacteremia and arthritis due to M. catarrhalis suggest an increasing pathogenic role for this organism. Antibiotic susceptibility testing suggests that the greatest bactericidal effect is provided by amoxicillin-clavulanic acid.

Aged↗