[Activity of tigecycline against pathogen bacteria isolated in respiratory infectious disease in Europe. TEST study 2004-2007]. / Activité in vitro de la tigécycline vis-à-vis des germes pathogènes isolés d'infections respiratoires en Europe. Le Programme TEST 2004-2007.

Tigecycline (TGC), a semisynthetic glycylcycline, has a documented activity on Gram+ and Gram- pathogens including oxacillin-resistant (MRSA) and an extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Tigecycline Evaluation and Surveillance Trial (TEST) is an international surveillance study designed to assess the in vitro activity of TGC and 11 comparators against a range of important clinical pathogens from both the community and the hospital. The aim of this study was to assess efficacy of TGC, using this database, against pathogens implicated in community or hospital pneumonia and sinusitis. A total of 4163 isolates were consecutively collected in 21 European countries during three years (2004-2007). In all center, minimum inhibitory concentration (MIC) were determinated with the same Microscan panel (Dade-Behring). Tigecycline exhibited a good activity against respiratory pathogens, with the exception of Pseudomonas aeruginosa. Hundred percent of cocci Gram+ (Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus sp.) and 100% of Haemophilus sp. are inhibited with 0.5 mg/L, without effect of an associated beta-lactam resistance mechanism. TGC is active in vitro on 89% of Enterobacteriaceae, with MIC 90 less or equal to 2mg/L. Eighty-nine percent of Enterobacter sp. and 77% of Serratia sp. are susceptible with range of MIC 90 from 2 to 4 mg/L. These interesting results obtained in vitro are to be strengthened by clinical studies.

[Meaning of the Quantiferon TB Gold tube test in tuberculosis screening among the hospital staff in case of very old or recent positive skin tests]. / Signification de Quantiféron TB Gold en tube en dépistage de la tuberculose parmi le personnel hospitalier en cas d'intradermoréactions positives très anciennes ou récentes.

UNLABELLED: The tuberculin skin test or PPD performed on health professionals evaluates delayed hypersensitivity to a Mycobacterium tuberculosis (Mt) antigen mixture. A very positive or increased area of induration indicates latent tuberculosis. Yet, prescribing a treatment is often difficult because of the test's poor specificity. OBJECTIVE: To determine if the T-lymphocytes of the proband exposed to specific Mt antigens to secrete interferon-gamma (IFN-gamma) can be measured; observe an immunizing response to cellular mediation improves T it this specificity? PATIENTS AND METHODS: The Department of Occupational Health at CHR of Metz performed a Quantiferon TB Gold (tube method, Cellestis) test on three groups of employees distributed according to the anteriority of a very positive IDR (>15mm). The test measures by method ELISA, the quantity of IFN-gamma secreted by the lymphocytes T collected in 1ml of total blood, after in vitro stimulation by antigens ESAT-6, CFP-10 and TB7.7. Group I is composed of 53 people (46 women [W] and 7 men [M]) and related to a recent discovery of October 2006 and June 2007, whereas group II, includes 28 of them (25W and 3M), is made of subjects with known very positive PPD for eight to 27 years. The age (41 years on average) and the sex-ratio are identical for these two groups. Group III is made of employees having made a tuberculosis there is more than 30 years. In the group I, the rate of IFN was supervised at the end of the treatment among patients who received it. RESULTS: The test Quantiferon TB Gold was positive at 15 subjects of group I (13W and 2M), that is to say 28.3%, and unspecified in one case (1.9%); positive at nine subjects of group II (9W), that is to say 32.1%. These rates of positivity are not significantly different. According to the experts consulted in group I, an antituberculosis treatment was proposed 11 times with 10 effective treatments (one refusal). A proportioning after treatment was carried out among six patients. The rate of IFN remained positive at five of the six supervised patients. This test made it possible to avoid the treatment of the 37 employees with test Quantferon TB negative Gold found over the nine months period of recruitment of group I. The choice not to treat was facilitated. CONCLUSION: The test Quantiferon indeed allows to eliminate the false positive of the skin test (1.6) so avoiding useless, expensive treatments and unwanted effects of antituberculosis medicines . On the other hand, the persistent positivity of this test 30 years after one firstly infection or after a contact does not allow to use it at present as certain control of a latent infection, unless having a negative value known about the hiring pa.