Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R Leclercq.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Eighteen patients with major depressive disorder of the endogenous subtype (8 unipolars and 10 bipolars) were submitted to blood sampling at 15 min interval for 24 h with polygraphic sleep recording during an acute episode of depression. Plasma growth hormone (GH), adrenocorticotrophin (ACTH) and cortisol were measured in each sample. The depressed patients hypersecreted GH during the daytime and had hypercortisolism which was evident throughout the 24 h span. The nadir of ACTH and cortisol rhythms was advanced by an average of 3 h as compared to the timing observed in normal subjects. These abnormalities were more pronounced and more consistent in patients with unipolar rather than bipolar depression. These results are consistent with the hypothesis that disorders of circadian time-keeping may characterize major endogenous depression.
Hypothetical mechanisms have been postulated to explain the presence of proteins in urine after severe exercise. Recently, it has been shown that several amino acids inhibit tubular protein reabsorption. Seven healthy men, hyperhydrated, were studied during a 2-min bicycle exercise at supramaximal load. The subjects were tested without or with lysine perfusion (0.4 g/kg body wt iv). In both testing conditions, blood lactate increased to 13.8 mmol/l. Total protein urinary excretion increased to 1.10 and 1.67 mg/min, without and with lysine perfusion, compared with 79 micrograms/min at rest. In the meantime, albumin excretion increased 48- and 74-fold, respectively, while beta 2-microglobulin excretion increased 97- and 1,043-fold compared with basal values. The renal clearance of albumin increased to 8.4 microliters/min without lysine and to 12.0 microliters/min with lysine perfusion (rest 0.18). beta 2-Microglobulin clearance increased to 10.0 and 39.3 ml/min, respectively (rest 0.05). These data clearly demonstrate that postexercise proteinuria is of mixed type after exhaustive short-term exertion. Both increased glomerular permeability and partial tubular reabsorption inhibition to proteins appear to be involved.
Minimal inhibitory concentrations (MIC) of miokamycin (M) were evaluated by agar dilution, comparatively with erythromycin (E) and josamycin (J) for 81 bacterial strains chosen as a function of susceptibility and resistance to Macrolides-Lincosamides-Streptogramins group (MLS). On Gram positive cocci, mode MIC of E, J, and M for strains sensitive to MLS were respectively (micrograms/ml): Staphylococci: 0.25; 1; 2-Streptococci and Pneumococci: 0.016; 0.03-0.12; 0.06-0.25-Enterococci: 0.5; 0.5-1; 1-2. Activity of the three antibiotics was similar against Staphylococci resistant to lincomycin and streptogramin A, those resistant to streptogramins A and B, on Staphylococci and Streptococci only resistant to lincosamides by inactivation. M, as J, was active on coagulase negative (Staphylococci resistant to E by inactivation and on MLBB inducible Staphylococci; on these strains, M is a resistance non-inducible macrolide. Activity of E, J and M was reduced on MLSB inducible Streptococci. The three antibiotics were inactive on Staphylococci Streptococci and Enterococci MLSB resistant constitutive. On Haemophilus, E (2-8 micrograms/ml) was more active than J (2-16) and M (8-32). Thus, M, as J, was shown to be among macrolide antibiotics of resistance non-inducing type on MLSB inducible resistant Staphylococci; its activity was slightly inferior to that of J, but very similar to that of spiramycin, other macrolide of this group.
Expression of disk-diffusion method of the activity of penicillin G against 68 strains of ungroupable streptococci susceptible to this drug (MIC less than or equal to 0.12 mg/l), 30 strains with a reduced susceptibility ("s") (0.25 mg/l less than or equal to MIC less than or equal to 1 mg/l), and 16 resistant (R) (MIC greater than or equal to 2 mg/l) has been studied. Generally, the R strains exhibited reduced inhibition zone diameters around the penicillin G disks but were best screened with an oxacillin disk (5 micrograms) as it has been proposed for the pneumococci. The study of the relations between the MICs of penicillin G and zone diameters obtained with oxacillin disks showed that the strains with oxacillin zones of less than 21 mm were R or "s". The strains with oxacillin zones less than 26 mm should be tested for sensitivity to penicillin by measurement of MIC. The resistance was crossed towards amoxicillin, cefotaxime, and at a lower degree imipenem. However, the routine test of amoxicillin and cefotaxime did not allow the detection of the resistance to these drugs. Amoxicillin and cefotaxime might not be tested by disk-diffusion method because of the cross resistance to penicillin G. Combinations of penicillin G with gentamicin resulted in bactericidal effects in 6 h or less for 6 of 7 strains tested.
Combinations of piperacillin (PIP) with 3 systemic fluoroquinolones: pefloxacin (PEF), ofloxacin (OFL) and ciprofloxacin (CIP) were evaluated by checkerboard technique (bacteriostatic activity) and by time-killing curve technique (bactericidal activity as a function of time) for 4 bacterial strains with following MICs (micrograms/ml): 1 E. coli (PIP: 1, PEF: 0.12, OFL: 0.06, CIP: 0.016); 1 S. marcescens (0.25, 0.06, 0.06, 0.016); 2 P. aeruginosa (2, 1, 0.5, 0.12 and 4, 2, 2, 0.25). Bacteriostatic activity of the 3 combinations showed only different or additive effects (index FIC: 0.62 to 1.5). If the bactericidal activity was defined as a less than or equal to 3 log 10 decrease in CFU/ml in 3-6 h and less than or equal to 4 log 10 in 6-24 h, PIP was not bactericidal at MIC x 8 for all strains; nevertheless, combinations of PIP 2 + PEF 0.25, OFL 0.12 or CIP 0.016 on E. coli and PIP 1 + PEF 0.25, OFL 0.25 or CIP 0.06 on S. marcescens showed bactericidal activity, superior to each antibiotic singly. For P. aeruginosa a less than or equal to 4 log 10 decrease in 6-24 h was observed only in combination with PIP 16 + PEF 1, OFL 1 or CIP 0.25 and PIP 32 + PEF 4, OFL 4 or CIP 0.5. Combinations of PIP with quinolones showed synergistic effects: bactericidal activity was more rapid and prolonged with such combinations at concentrations near MICs and obtained with usual therapeutic doses.
The purpose of this study was to determine the effects of cold stress on routine hematologic parameters when subjects are submitted on long-lasting exercise. Eight male subjects, aged 22.7 +/- 1.3 years with a peak oxygen consumption of 54.3 +/- 5.2 mL/kg/min performed, respectively at 20 degrees C and 0 degrees C, a two-hour submaximal cyclergometry at an intensity of 40% of that performed during a previous exhaustive test. A 21-gauge catheter was inserted into an ante cubital vein for collection of the blood samples. Platelets and WBC count was significantly (p less than 0.05) increased during exercise in both 20 degrees C and 0 degrees C environmental temperatures. A slight but not statistically significant increase of RBC, Hb and Hct and a plasma concentration during cold exposure was observed. Indices are unchanged in both experiments. The findings of this study suggest that physical exercise is a major factor inducing hypervolemia and that low thermal environment does not appear to be an effective factor influencing hematologic variables during exercise.
We treated 40 patients with urinary fistulas by interventional radiology. The antegrade percutaneous route, catheterization of the ureter and bypassing of the fistula enabled ureteral stenting in 36 patients (90 per cent). Criteria for successful treatment were healing of the fistula, normal renal function (evaluated by excretory urography and radionuclide studies) and absence of secondary stenosis at 6 months. Of the patients 28 (70 per cent) were treated successfully. The number of nephrectomies after failure of percutaneous techniques (5 of 40, or 12.5 per cent) seems lower than in the case of surgery. The results were excellent for fistulas occurring after endourology (all 9 successful) or after ureterointestinal anastomoses (7 of 8). On the other hand, the results appear disappointing in patients with fistulas in transplanted kidneys (3 of 4 failures).
We examined the resistance phenotype and the genetic basis of lincosamide modification in 25 clinical isolates of Staphylococcus spp. inactivating lincomycin and clindamycin. The strains were resistant to high levels of lincomycin but remained susceptible to clindamycin. However, MBCs and inoculum effects showed that the activity of clindamycin was impaired. The distribution in these strains of nucleotide sequences related to linA and linA', the genes encoding lincosamide nucleotidylation in Staphylococcus haemolyticus BM4610 and S. aureus BM4611, respectively, was studied by dot blot hybridization. The genes responsible for lincosamide inactivation in Staphylococcus spp. were found to constitute a family of related sequences which are not species specific.
Plasma ACTH, cortisol, and GH concentrations were measured at 15-min intervals for 24 h in 11 men suffering from major depressive illness during an acute episode of depression and during clinical remission following antidepressant treatment with either electroconvulsive therapy or amitriptyline. Seven age-matched normal men also were studied. During the acute phase of the illness, the patients had abnormally short rapid eye movement sleep latencies, hypercortisolism, early timing of the nadirs of the ACTH-cortisol rhythms, and shorter nocturnal periods of quiescent cortisol secretion. GH was hypersecreted during wakefulness, and a major pulse occurred before, rather than after, sleep onset. After treatment, rapid eye movement sleep latencies were lengthened, and cortisol levels returned to normal due to a decrease in the magnitude of episodic pulses. Moreover, the timing of the circadian rhythms of ACTH and cortisol as well as the duration of the quiescent period of cortisol secretion were normalized. The amount of GH secreted during wakefulness decreased to normal values, with fewer significant GH pulses. The major elevation of GH secretion in the early part of the night occurred later than that during the depressive episode. These results demonstrate that a disorder of circadian rhythmicity characterizes acute episodes of major depressive illness and that this chronobiological abnormality as well as the hypersecretion of ACTH, cortisol, and GH are state rather than trait dependent.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Nocardia asteroides frequently causes primary lung infection with possible hematogenous dissemination to various organs, especially in patients with altered immune responses. The preponderance of pulmonary infections suggests an airborne route of contamination. We report a case of pulmonary nocardiosis in a previously healthy intravenous heroin abuser. The clinical and epidemiologic data strongly suggest a paraphernalia blood-borne infection in this patient, a mode of contamination which has not been previously reported.
The aim of the present study was to evaluate a heart transplanted patient who ran a 20-km race 9 months after surgery. Thirty-six healthy male subjects were studied during the same run and served as control group. Biochemical variables were determined in blood and urine samples collected before and after the race. Post-exercise blood urea increased by 23% (P less than 0.05) in the control group but remained unchanged in the patient. Blood lactate increased far more in the transplanted patient (7.07 mmol/L) than in the control subjects (2.53 mmol/L). The exercise induced a 5.46- and 0.67-fold increase in creatine phosphokinase activity in the transplanted patient and control group, respectively. The creatinine and urea urinary excretion and clearance decreased by 40%-60% after exercise for all subjects. It may be concluded that the heart transplanted patient responded for most registered variables in the same way as normal subjects, but some differences occurred on the renal side due to the use of an immunosuppressive drug.
Staphylococcus haemolyticus BM4610 was resistant to high levels of lincomycin and susceptible to macrolides, clindamycin, and streptogramins. This resistance phenotype, not previously reported for a human clinical isolate, was due to inactivation of the antibiotic. The gene conferring resistance to lincomycin in strain BM4610 was carried by a 2.5-kilobase plasmid, pIP855, which was cloned in Escherichia coli. Plasmid pIP855 caused inactivation of both lincomycin and clindamycin in S. haemolyticus and in E. coli but conferred detectable resistance to lincomycin only in S. haemolyticus and to clindamycin only in E. coli.
The 24-h profile of plasma ACTH and cortisol levels was determined in 18 men suffering from major depressive illness (8 with unipolar depression and 10 with bipolar depression) as well as in 7 age-matched normal men. Blood was sampled every 15 min. The circadian variation and episodic fluctuations were analyzed for each individual profile. Both unipolar and bipolar depressed patients had higher 24-h mean cortisol levels (P less than 0.01) than normal men, but no significant difference in 24-h mean ACTH level was found. The nadir of cortisol secretion occurred almost 3 h earlier in older normal subjects and patients with unipolar depression, regardless of age, than in younger normal subjects. This shift paralleled a similar advance of the ACTH nadir. Early timing of the quiescent period of ACTH-cortisol secretion was also found in several patients with bipolar depression, but did not reach significance at the group level. The hypercortisolism in the depressed patients was associated with an increase in the magnitude, but not the number, of cortisol secretory episodes. About 90% of the cortisol pulses could be related to a concomitant ACTH pulse in normal subjects as well as in both groups of depressed patients. However, concomitant ACTH and cortisol pulses were less correlated in magnitude in depressed patients than in normal subjects. These results indicate that major depressive illness is associated with disturbances of pituitary-adrenal function. The early timing of the nadir of ACTH-cortisol secretion suggests that disorders of circadian time keeping may characterize major endogenous depression.
Explore the source record for details and available documents.