Semiquantitative culture of catheter tips.
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Biomedical subjects
Publications and source records attributed to P Legrand.
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The results of a simplified quantitative broth dilution quantitative tip culture (QTC) of 331 central venous catheters were compared with clinical data prospectively recorded in critically III patients to diagnose bacteremic or nonbacteremic catheter-related sepsis (CRS) (36 catheters), as opposed to contamination (42 catheters) or simple colonization from a distant septic focus (seven catheters). Thirty-five of 36 catheters associated with CRS yielded 10(3) colony-forming units per milliliter (CFU/mL) or more, and 3.8 X 10(2) Candida organisms grew from one. In contrast, 5 X 10(2) CFU/mL or less grew from 37 of 42 contaminated catheters. A QTC of 10(3) CFU/mL or more was 97.5% sensitive and 88% specific for the diagnosis of CRS. The QTC appeared especially useful for the diagnosis of CRS secondary to blood-borne seeding of catheters, or associated with coagulase-negative staphylococci.
Newly-hatched chickens from two lines selected for high or low abdominal fat/live weight ratio, were fed on a stock low-lipid diet (2.9 wt % lipids) for nine weeks. Linoleic acid made up 54.3% of dietary fatty acids. Their abdominal adipose tissue and liver triglycerides were then isolated for fatty acid analysis. The linoleic acid content of abdominal fat triglycerides was higher in lean than in fat chickens (19.2 vs 16.4% of triglyceride fatty acids, respectively). This difference was highly significant. Conversely, the level of monounsaturated fatty acids in the abdominal fat triglycerides was significantly lower (especially palmitoleic acid) in lean than in fat chickens. The proportion of linoleic acid in liver triglycerides was also higher in lean than in fat chickens (12.2 vs 5.5% of triglyceride fatty acids). The higher dilution of dietary linoleic acid within the depot fat of the fat line chickens shows that the flux of endogenous fatty acids from the liver was larger in these animals than in the lean ones. Moreover, the elevated amounts of palmitoleic acid (virtually absent from the diet) in the depot and liver triglycerides of fat chickens, was most likely caused by a higher delta 9-desaturating activity in the liver of the latter animals.
In 12 patients infected with an Enterobacter cloacae (E. cl.) initially susceptible to the 3rd generation cephalosporins, we observed the emergence in vivo of variants resistant to most of the new beta-lactam antibiotics (carboxy-penicillins, ureido-penicillins, 3rd generation cephalosporins and aztreonam). These variants remained susceptible to mecillinam and imipenem. The variant emerged under treatment with cefotaxime in 3 cases, with moxalactam in 3 cases, with aztreonam, carbenicillin, and ticarcillin in 1 case each and without treatment in 1 case. An aminoglycoside was combined with the beta-lactam antibiotic in 6 cases. Therapeutic failure was attributed to emergence of the resistant variant in 6 out of 12 cases (with an aminoglycoside in 3 cases, with the beta-lactam antibiotic alone in 3 cases). These case reports underline the importance of bacteriological monitoring of patients infected with E. cl. treated with a beta-lactam antibiotic. The susceptibility to beta-lactam antibiotics of the E. cl. strains isolated during treatment should be systematically retested.
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The results of bacterial cultures from transtracheal aspiration and from aspirations obtained by a new telescoping plugged catheter were compared in specimens taken from 13 patients with suspected anaerobic infections of the lower respiratory tract. When all bacterial isolates (potential aerobic pathogens, aerobic nonpathogens, and anaerobes) were counted with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 22 false negatives and 14 false positives. The results of the 2 methods were in complete agreement in only 3 paired specimens cultured aerobically and in only 6 paired specimens cultured anaerobically. When only potential aerobic pathogens and anaerobes were considered with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 11 false negatives and 7 false positives, and the results of the 2 methods were in complete agreement in 9 paired specimens cultured aerobically and 6 paired specimens cultured anaerobically. Our results suggest that fiberoptic bronchoscopy using the telescoping plugged catheter technique may be an acceptable method for collecting specimens from the lower respiratory tract, but further studies comparing this method with transtracheal aspiration are needed.
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The site of integration and the molecular orientation of a prophage Mu integrated within the resistance transfer factor component of plasmid R100-1 have been determined on the physical map of the plasmid. This allowed us (i) to determine the direction of deoxyribonucleic acid transfer from oriT during conjugation and (ii) to demonstrate the unidirectionality of replication in conditions of exponential growth (by determining the strand preference of Mu-specific Okazaki fragments).
Using counter-immunoelectrophoresis (CIE), the authors have looked for pneumococcal antigens in biological fluids in 141 pneumococcal infections cases (70 meningitis, 25 empyema, 40 pneumonia, 5 peritonitis, 1 pericarditis). The best results (superior to bacteriological results) were obtained with CSF and pleural fluid. Testing sputum by CIE seems to have a real interest in pneumonia. CIE associated with bacteriology, gives more than 20% increase in aetiological diagnosis in pneumococcal infections and permits to set accurate aetiological diagnosis in less than two hours.
For a period of 17 months, 670 pneumococci, mostly isolated in the Paris area, have been typed with contercurrent-immunoelectrophoresis ; 338 of them come from cases of pneumonia, bacteremia, meningitis and acute otitis media. An important regrouping of the most frequent serotypes among the 83 known serotypes makes possible a vaccinal prophylaxis. The tetradecavalent vaccine which is now for sale in USA gives, in the four main pathologies of this enquiry, a coverage superior to 80 percent. Choosing the 14 most frequent serotypes of the four main pathologies of their data the authors propose the following vaccinal formula : 1, 3, 4, 5, 6, 7, 8, 10, 12, 14, 15, 18, 19, 23.
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Examinations for soluble bacterial antigens using counter-immunoelectrophoresis (C.I.E.) was carried out in 151 patients suspected of suffering from various infectious syndrome were successful for S. pneumoniae, H. influenzae b, N. meningitis, sero-group B and D streptococcus. Thus meningitis and pneumonia represent those areas in which the technique is particularly useful. Apart from its rapidity--result in a hour--C.I.E., in association with bacteriology, makes possible an increase in aetiological diagnosis of 27% with H. influenzae b, 24% with S. pneumoniae and 6% with N. meningitidis (lower result by virtue of technical difficulties with sero-group B). Thus using this technique we were able to reach an aetiological diagnosis in 10 (23.8%) out of 42 cases of purulent meningitis where blind antibiotic therapy had already been given. These two advantages--rapidity and increase in aetiological diagnosis--justify the introduction of this simple technique in every medical microbiology laboratory.
Using counterimmunoelectrophoresis (CIE) the authors have assayed for soluble bacterial S. pneumoniae, N meningitidis group A, B, C. H. influenzae type b antigens, biological fluids in 216 patients (meningitis: 136; pneumonia: 76; miscellaneous: 4) during 16 months. Because of heterogeneous recruiting (the bacteriology was carried out by different laboratories) the increase in aetiological diagnosis given by CIE is only statistically valid for the bacteriologic negative group when blind antibiotic therapy had already been given. In this group, CIE makes a notable increase in diagnosis of 22,1 % +/- 10,1 in meningitis and 25,5% +/- 12,7 in pneumonia. Various physiopathological aspects are considered concerning soluble bacterial antigens detection during the course of the disease. This method seems very useful and accurate; and therefore should be used in every microbiologic laboratory.
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