Capnocytophaga canimorsus infections in human: review of the literature and cases report.

Capnocytophaga canimorsus, formerly designated Dysgonic fermenter 2 (DF-2) was first described in 1976; it is a commensal bacterium of dogs and cats saliva, which can be transmitted to man by bite (54% of cases), scratch (8.5%), or mere exposure to animals (27%). We present a review of the clinical and microbiological characteristics of the Capnocytophaga canimorsus infections and 12 cases of infection in France. Over 100 cases of human infections have been reported, mainly septicemia in patients with diminished defences, due to splenectomy (33%), alcohol abuse (24%), immunosuppression (5%). However 40% of septicemia occur in patients with no predisposing conditions. Other infections are less frequent: meningitis, endocarditis, arthritis, pleural and localized eye infections. These infections range from mild to fulminating disease, with shock, respiratory distress, disseminated intravascular coagulation. Dermatological lesions (macular or maculopapular rash, purpura) or gangrene are common. This fastidious Gram-negative bacterium grows slowly on chocolate agar or on heart infusion agar with 5% rabbit blood incubated in 5% CO2. In spite of a great susceptibility of bacteria to antibiotics, the mortality is of 30%. Because of the severity of these infections, taking into account this organism in the management of bites is necessary, especially in patients with predisposing factors.

Use of cryomicrotomy to study gastric diffusion of amoxicillin in guinea pigs.

Cryomicrotomy has been used as a new technique for removing gastric mucosae from adult guinea pigs for the study of amoxicillin secretion across gastric mucosae. This method allowed a very regular thickness of the removed surface layer of mucosa to be obtained with good reproducibility. Gastric superficial mucosa concentrations and gastric juice concentrations of amoxicillin were determined 1, 2, and 4 h after intramuscular administration (50 mg/kg) in 21 guinea pigs by a microbiological method. No antibiotic was detected in gastric samples at 4 h, except for a low-level mucosal concentration in one animal, thus indicating the short time that amoxicillin is present in gastric samples.

[Estimation with bacteriology of the evolution of nosocomial infections between 1989 and 1991 in an university hospital]. / Estimation à partir de la bactériologie de l'évolution des infections nosocomiales entre 1989 et 1991 dans un hôpital universitaire.

The bacteriological laboratory data base was studied with an original software (Bacterio) and an appropriate method ("doubles" and early samples are not taken in account) to estimate the nosocomial infections. The incidence rates for 100 hospitalizations at the University hospital of Nancy are 9.2, 8.2 et 8.2 for respectively 1989, 90 et 91. These values are corrected while taking into account a method's sensibility of 65%. The 1000 days of hospitalization's rates allow a better comparison between the medical departments. For the whole hospital, the results are respectively of 7.9, 7.2 and 7.5%. Even if the many bias described cannot always been checked, the method gives some evolutivity indicators which are very useful for the hygienists.

[Antibiotic sensitivity of forty-four strains of group EF4 bacteria: study of minimum inhibitory concentrations using the agar dilution method]. / Sensibilité aux antibiotiques de quarante-quatre souches de bactéries du groupe EF4: étude des concentrations minimales inhibitrices par dilution en gélose.

EF4 bacteria are found in animal saliva and may contaminate bite wounds. Minimum inhibitory concentrations of 36 antimicrobials against 44 EF4 strains were determined using dilution in Mueller-Hinton agar. EF4 bacteria were susceptible to aminopenicillins, carboxypenicillins, ureidopenicillins, third-generation cephalosporins, fluoroquinolones, rifampicin, and trimethoprime-sulfamethoxazole. Susceptibility was intermediate for penicillin G, low for macrolides and variable for aminoglycosides. EF4 bacteria were resistant to lincomycin and trimethoprime. Routine prophylactic treatment of bite-induced Pasteurella infections using an aminopenicillin or a cycline also protects against EF4 infection of the wound.

[Bacterio-expert: an integrated system for assisting in the validation of antibiotic sensitivity tests. Retrospective application in 4053 Staphylococcus]. / Bactério-expert: un système intégré d'aide à la validation des antibiogrammes. Application rétrospective sur 4,053 staphylocoques.

Bacterio-expert is a simple expert system for assisting in the validation of antibiotic sensitivity testing. This system is incorporated in a data acquisition and editing program for bacteriologic test (Bacterio program written in Turbo-Pascal for personal computer users by the same authors). The principles of this system are explained and results with 4,053 antibiotic sensitivity tests on Staphylococcus aureus isolates are reported. Approximately 10% of tests required corrections.

[Respiratory pasteurellosis. Apropos of 32 cases]. / Les pasteurelloses respiratoires. A propos de 32 observations.

The authors present the main characteristics of respiratory pasteurellosis on the basis of 32 personal cases. The predominant background is chronic obstructive lung disease consecutive, in most cases, to chronic bronchitis. In patients without chronic lung disease the infection occurs when the terrain is deficient. The most common clinical form is bronchitis; pneumonia, pleurisy and lung abscess are rare. The existence of asymptomatic carriers has been recognized. Clinical manifestations are devoid of pathognomonic signs and symptoms. Diagnosis rests on isolation of the micro-organism and can be completed by serodiagnosis and intradermal reaction to pasteurelline. The severity of respiratory pasteurellosis depends on the clinical form and the background. The curative treatment is simple and effective as a rule, but prevention is possible and recommended since pasteurellosis is a potentially severe infection.

Listeria monocytogenes endophthalmitis in a renal-transplant patient receiving ciclosporin.

Endophthalmitis due to Listeria monocytogenes developed suddenly in a 52-year-old man receiving immunosuppressive therapy for a renal transplantation carried out 2 months previously. The treatment combined low doses of ciclosporin and prednisone. The initial clinical picture was of acute hypertensive uveitis with hypopyon. Despite prompt paracentesis and appropriate antibiotic therapy, the long-term course was unfavorable, and enucleation became necessary. The occurrence of listeriosis is classic in renal-transplant recipients, but no ocular form has been reported hitherto.

[Corneal abscess caused by Pasteurella following cat scratch injury]. / Abcès de cornèe à Pasteurella consécutif à un traumatisme par griffe de chat.

Authors report a Pasteurella Multocida corneal abscess after a scratch from a cat. The evolution was torpid and needed a transfixiant keratoplasty. They recall bacterial tanks, infestation ways, clinical manifestations and bacteriological identification. They note the low occurrence of ophthalmological manifestations and the sensibility of Pasteurella to various antibiotics, especially Beta lactams, phenicol and cyclins.

[Dog bites and infection from bacterial inoculation. Necessity for appropriate therapeutic measures]. / Morsures de chien et infections bactériennes d'inoculation. Nécessité de mesures thérapeutiques appropriées.

The most recent statistics in France underline a doubly increasing preoccupation: the alarming rise in the frequency of bites by dogs (watchdogs or lapdogs), and the great number of pathogenic bacteria isolated from the bite wounds. During the last three years (1985, 1986, 1987), the Bacteriological Laboratory of Nancy received 390 samples, and 56% of them contained one or more bacteria. These bacteria basically were Pasteurella (61%), but other different species were isolated and identified recently: for example, the bacterial groups EF4, M5, IIj and especially DF2. The clinical feature is usually a wound which, neglected, is suppurating. But the bacteria of the DF2 group lead to general complications, very serious: more than 50 cases of septicemia have been published. In such cases, the notion of underlying pathology is important: alcoholism, cancer, splenectomy. Therefore, this new threat calls for great vigilance: curative treatment with antibiotic therapy adjusted to the isolated and tested bacterium; but, after all bites by a dog, real prophylaxis is systematically essential, with classical actions and antibiotic therapy (betalactamine or cycline) if the organism of the patient is deficient.

[Evaluation of a screening test for urinary infection]. / Evaluation d'un test de dépistage de l'infection urinaire.

The interest of using a reagent strip (Multistix-8 SG, Ames, Miles Laboratories) as a screen for urinary tract infection was evaluated in a clinical study involving several sites and 2,183 adult urine specimens of which 340 were infected. The results are expressed in terms of sensitivity, specificity, predictive value of a negative and positive test. The predictive value of a negative test for nitrites in combination with leucocytes (97.5%) justifies the use of the reagent strip in eliminating non-infected urine.

Immunological evidence for common antigenic sites in high-density lipoproteins from rainbow trout and man.

The plasma high-density lipoproteins (HDL, rho 1.085-1.21 g/ml) of rainbow trout (Salmo gairdneri) have been shown to contain large amounts of apolipoprotein (apo) AI (Mr 28,000) and several other apolipoproteins of Mr less than 14,000 (apo C-like) and of Mr 37,000-38,000, 44,000-45,000 and 53,000-54,000. Comparison of apo AI from trout and human HDL shows them to be similar in Mr and to have some cross-immunoreactivity, whereas apo AII differs in Mr but also possesses common antigenic sites. It is suggested that the major apolipoproteins of fish and human HDL may fulfil similar roles in lipid transport.

Immunoperoxidase localization of apolipoprotein D in human enterocytes and hepatocytes.

In this study we prepared a pure apolipoprotein D and obtained a specific antiserum to it. The purified apolipoprotein D migrated as a single band of Mr = 29,000 but appeared as five isoforms on isoelectrofocusing. The antiserum did not cross-react with other apolipoproteins. Immunoenzymatic staining revealed the presence of apolipoprotein D in the perinuclear area of the cytoplasm of isolated normal hepatocytes and HepG2 cells. Apolipoprotein D was also localized in intestinal epithelium and in liver cells. The intracellular distribution of apolipoprotein D was similar to that of apolipoprotein B. Our results indicated that apolipoprotein D, like many other circulating apolipoproteins, is synthesized in enterocytes and hepatocytes.

[Sensitivity to an amoxicillin-clavulanic acid combination, of deep tonsillar flora isolated in chronic tonsillitis]. / Sensibilité à l'association amoxicilline-acide clavulanique de la flore amygdalienne profonde isolée au cours d'amygdalities chroniques.

Deep tonsillar flora were identified in tonsils removed from 48 patients, children and adults, with chronic tonsillitis and recurrent sore throats or obstructive hypertrophy. Most specimens (38/48) cultured multiple germs (2 to 5 different species) with aerobic and anaerobic Gram+ and Gram-forms, some being beta-lactamase producers. Of the total of 135 strains isolated, 104 were aerobic and 31 anaerobic. The species of aerobic germs most frequently isolated were: Apart from alpha-hemolytic streptococci of undertermined group (38 strains), Haemophilus sp. : 14 (including 3 beta-lactamase + strains), Staphylococcus aureus: 15 (including 11 beta-lactamase + strains), Streptococcus A : 10, Enterobacteriaceae : 6, Neisseria sp. : 8 (including 1 beta-lactamase + strain). And among the anaerobic germs: Peptococcus : 3, Veillonella alc : 10, Fusobacterium nucleatum : 9, Bacteroides melaninogenicus : 6, Other Bacteroides : 2. Of the 127 strains tested, 102 were sensitive to amoxicillin and 121 to amoxicillin and clavulanic acid combination. The presence of a beta-lactamase producing bacterium in 1 of 3 specimens suggests the risk of failure of treatment with penicillin, prescribed classically for this type of affection.