First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013.

In May 2013, Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection was diagnosed in an adult male in France with severe respiratory illness, who had travelled to the United Arab Emirates before symptom onset. Contact tracing identified a secondary case in a patient hospitalised in the same hospital room. No other cases of MERS-CoV infection were identified among the index case's 123 contacts, nor among 39 contacts of the secondary case, during the 10-day follow-up period.

[Salmonella meningitis in an infant due to a pet turtle]. / Méningite à Salmonelle chez un nourrisson due à une tortue domestique.

In humans, Salmonella most often causes self-limiting gastroenteritis, but more severe symptoms such as sepsis and meningitis can also occur and can sometimes have a fatal outcome. Even if the meningitis is not fatal, sequelae such as epilepsy, cranial nerve palsies, and hydrocephalus can occur. In the United States, it has been estimated that approximately 6% of the human cases of salmonellosis can be attributed to contact with reptiles or amphibians. The infection may take place by direct contact between reptile and human or indirectly via contact with an environment contaminated with Salmonella from a reptile. Salmonella enterica subsp. enterica serotype Vitkin is a common gut inhabitant of reptiles. Though human cases due to this organism are exceedingly rare, it may infect young infants and immunocompromised individuals with a history of intimate associations with reptiles. Gastroenteritis is the most common presentation ; others include peritonitis, meningitis and bacteremia. We report a case of meningitis caused by S. enterica subsp. enterica serotype Vitkin in a 1-month-old child due to a pet turtle.

[A case report of Cardiobacterium hominis endocarditis]. / Endocardite a Cardiobacterium hominis.

We here report a case of endocarditis due to Cardiobacterium hominis in a 53-year-old patient, who presented with large vegetations on the mitral valve. Good cooperation between clinicians and microbiologists and an efficient automated blood culture system were the decisive factors in establishing the diagnosis. Early and appropriate treatment prevented the septic embolisms often observed in this pathology.

[Pulmonary embolism disclosing activated protein C resistance]. / Embolie pulmonaire révélant une résistance à la protéine C activée.

Resistance to the activation of protein C is a recently discovered constitutional anomaly of coagulation which is responsible for thromboembolic events in young subjects. We report a case in a 26 year old man who presented with pulmonary embolus. Laboratory data was characterised by an absence of any lengthening of the activated cephaline time after adding purified activated exogenous Protein C. The confirmation of this anomaly is provided by the evidence of a mutation Arg 506 to Gln of Factor 5. The outcome is favourable with treatment by Heparin then by anti-Vitamin K.

Evaluation of glycopeptide use in nine French hospitals.

BACKGROUND: Adequate glycopeptide use is necessary to optimize efficacy and minimize adverse events and selection of drug resistant microorganisms. METHODS: We performed a multicenter prospective observational study of glycopeptides indications based on modified HICPAC criteria, and quality of prescription based on French consensus recommendations. We assessed the adequacy of indications, loading dose, maintenance dose, administration frequency, serum monitoring and its consequences. RESULTS: We evaluated 117 curative adult prescriptions from nine hospitals. Glycopeptide indications were adequate in 71% with either a clinical (55%) or microbiological justification (27%). The indication was more frequently adequate for vancomycin than for teicoplanin (77% vs. 60%, p=0.04). De-escalation therapy was performed in 48% of all documented infections and 78% of documented infections with betalactam susceptible strains. We observed high rates of correct maintenance dose (90%), administration frequency (88%), and serum monitoring (74%). Loading doses (43%), adequate serum monitoring timing (43%), correction of dose because of inadequate levels (32%) were less adequate. Overall, only three (3%) treatments were adequate for all evaluated items. CONCLUSION: Glycopeptide indications were adequate. However, the quality of prescription can be improved and should focus on loading doses and serum monitoring.