Bordetella holmesii bacteremia in a renal transplant recipient: emergence of a new pathogen.

Bordetella holmesii is a gram-negative rod that was initially identified in 1995. It causes bacteremia, pneumonia, and endocarditis mostly in patients with anatomical or functional asplenia. We report here, to the best of our knowledge, the first case of B. holmesii bacteremia in a renal transplant recipient following rituximab therapy for recurrence of membranoproliferative glomerulonephritis.

[The value of the C-reactive protein assay for the early diagnosis of neonatal infection at the maternity ward and pediatric service of a general hospital center]. / Intérêt du dosage de la protéine C-réactive pour le diagnostic précoce d'une infection néonatale dans la maternité et le service de pédiatrie d'un Centre Hospitalier Général.

Five hundred and ninety-four children hospitalized in the Maternity Ward and Pediatric Department of a General Hospital were enrolled in this retrospective study. Two CRP assays were performed with 24 hours of birth in 105 neonates at high risk for materno-fetal infection. Results suggested infection in 12 cases (2%). CRP kinetics were studied comparatively in these 105 patients and in 55 control neonates of identical gestational age. Differences between the two groups were evidenced and were already significant for the six to 12-hour age groups. Results indicated that the upper limit of normal is 6 mg at age 12 hours and 8 mg at age 24 hours, whereas levels above 12 mg at age 12 hours and 20 mg at age 24 hours are abnormal. This early marker for neonatal infection is especially valuable in general hospitals lacking sophisticated equipment for the management of neonates. The number of neonates referred from the maternity ward and unnecessarily treated by antimicrobial agents fell by 20% approximately, with no increase in risk. CRP assays proved sensitive in streptococcus B infections and were valuable for evaluating the effectiveness of antimicrobial therapy.