[Mycologic surveillance of the environment for preventive invasive aspergillosis. Proposals for standardization of the methodologies and implementation]. / Surveillance mycologique de l'environnement pour la prévention de l'aspergillose invasive. Propositions de standardisation des méthodologies et des modalités d'application.

A MAJOR RISK: The infection of immunodepressed patients by Aspergillus-type fungi increases morbidity and mortality, particularly in hematology units or during solid organ transplantation. Although present diagnostic means benefit from the progress over the last years, they remain limited and chemoprophylaxis protocols have still not demonstrated significant efficacy. THE NEED FOR RECOMMENDATIONS: Today, the handling of environmental risks is the only strategy that has proved its efficacy and usefulness. On the basis of administrative recommendations and data from the literature, a multicentric and pluri-disciplinary task force, grouping clinicians, microbiologists and hygienists, has assessed different methods and has proposed recommendations for the standardization and optimization of fungal surveillance of the environment.

[Evolution of antibiotic resistance of Streptococcus pneumoniae: results of Alsace observatory in 2005]. / Evolution de la sensibilité de Streptococcus pneumoniae aux antibiotiques: résultats de l'observatoire du pneumocoque Alsace (année 2005).

OBJECTIVES: Between 1st January 2005 and 31st December 2005, 232 strains of Streptococcus pneumoniae were collected in the Alsace county from participating laboratories (one from university hospital, 7 from general hospitals and 12 private laboratories) to assess their susceptibility to penicillin and evaluated serogroups of strains. METHOD: The coordinating centre performed MICs by the reference agar dilution test, interpreted according to CA-SFM breakpoints. Others antibiotics (erythromycin, cotrimoxazole, tetracycline...) were tested by agar diffusion, ATB-PNEUMO gallery or VITEK gallery (BioMérieux, France) by each participating laboratory. Data were processed, using 4th dimension software. RESULTS: Strains were collected from 151 blood samples, 38 ear pus, 11 cerebrospinal fluids, 8 pleural liquids and 24 representative pulmonary samples. The prevalence of pneumococci with decreased susceptibility to penicillin G (PDSP) is 35.1% (pulmonary samples excluded). The rate of PNSP decreases for all types of samples compared with other years of surveillance 2003 (44.0%). The rate of blood samples decreases for first time between the creation of Pneumococcal Observatory. The high-level resistance tend to decrease and began low. The PDSP are rather resistant to erythromycin, cotrimoxazole and fosfomycin. Among the PDSP, the most prevalent serotypes were 14, 19, 6 and 9. CONCLUSION: Among pneumococcal strains, the rate of PDSP tend however to decrease in 2005 compared with 2003. The rate stays inferior to the observed rates in other French counties where the same decreasing is described.

[The delay of a time-limitation for thawed blood. New perspectives]. / Le délai de péremption du sang décongelé. Nouvelles perspectives.

In order to comply with the needs for delayed transfusion in current practice (rare blood types dispatched to other centers, thawed blood not finally transfused to a patient, blood bank supply of Rh negative blood), we have investigated preservative media for thawed blood. We have previously shown that thawed RBC concentrates resuspended in isologous or autologous plasma remain viable and functional for 72 hours. We have extended these investigations by resuspending thawed RBC concentrates in an original synthetic preservative medium designed in our laboratory, containing: (table; see text) The following parameters have been investigated before freezing and during 15 days following thawing and washing: sterility, pH and 2,3-DPG, ATP and energy charge, free Hb levels in the supernatant, 24 h post-transfusion life and half-life of 51Cr-labeled RBC. This preservative allows the conservation of thawed RBC for up to nine days at +4 degrees C. During that time, sterility is maintained, pH is 6.80, 2,-3-DPG levels are 50% of the original values, ATP levels are 100% of the original values, free Hb is 122 mg per blood unit, energy charge is 0.90; RBC labeled 7 days after thawing showed a 89% survival rate 24 h after transfusion and a half-life of 19 days.