Antimicrobial Resistance in Outpatient Escherichia coli Urinary Isolates in Dakar; Senegal

Background: Data regarding the evolution of antimicrobial resistance are needed to suggest appropriate empirical treatment of urinary tract infections (UTI) in developing countries. To assess the antimicrobial susceptibility of Escherichia coli; the predominant pathogen in community-acquired UTI; a prospective multicenter study was carried out in Dakar; Senegal. Methodology: From February 2004 to October 2006; 1010 non-duplicate E. coli strains were collected from four centres. Antimicrobial susceptibility testing was performed using disk diffusion method according to the recommendations of the CA-SFM (2004). Results: Most of the isolates were resistant to amoxicillin (73.1); amoxicillin- clavulanic acid (67.5); cephalothin (55.8); and trimethoprim/sulfamethoxazole (68.1). Extended spectrum beta-lactamase was detected in 38 strains. The overall resistance rates to nalidixic acid; norfloxacin and ciprofloxacin were 23.9; 16.4and 15.5; respectively. Most of the strains were susceptible to gentamicin; nitrofurantoin and fosfomycin (respective susceptibility rates; 93.8; 89.9; and 99.3). During this period; a significant decrease in sensitivity was observed for cephalothin; fluoroquinolones and trimethoprim/sulfamethoxazole (p0.001). Conclusions: These data suggest that trimethoprim/sulfamethoxazole may no longer be used as empirical treatment for community- acquired UTI in Dakar. In order to preserve the activity of fluoroquinolones for future years; alternatives such as fosfomycin or nitrofurantoin should be considered

Interlaboratory study comparing the microbiological potency of spiramycins I, II and III.

An interlaboratory study has been performed to determine the relative potencies of spiramycins (SPMs) I, II and III by diffusion or/and turbidimetric assays with Bacillus subtilis or Staphylococcus aureus as the test organisms. Six laboratories from three countries participated. Experimental procedures were according to the European Pharmacopoeia, 3rd ed. The activity of SPM I is markedly higher than that of SPM II and III. By diffusion, the activities of SPM II and III relative to SPM I were found to be 57 and 72%, respectively. The interlaboratory relative standard deviations (RSD) varied from 3.6 to 16.3%. By turbidimetry, the activities of SPM II and III relative to SPM I were found to be 45 and 52%, respectively. The interlaboratory RSD values varied from 2.6 to 7.7%. The results of the study were analyzed according to the ISO 5725-2 guidelines to determine the repeatability, the between-laboratory and the reproducibility variances of both methods.

Neomycin: microbiological assay or liquid chromatography?

In a multicentre study involving six laboratories, a microbiological assay was performed on three neomycin samples containing respectively, 0.12, 2.1 and 11% (m/m) of neomycin C, as well on a pure neomycin C sample. The potency was determined according to the European Pharmacopoeia method but using a neomycin B base standard. The relative standard deviations between laboratories (RSD) on the potencies varied from 4.8 to 50%, depending on the sample examined. The RSD increased with the neomycin C content of the samples and the highest RSD values were observed for the pure neomycin C sample. The activity of neomycin C relative to neomycin B was found to be 62% by diffusion (RSD:41%) and 56% by turbidimetry (RSD: 50%). This confirmed that the presence of neomycin C in a neomycin sample influences the reproducibility of the microbiological assay. T estimate the influence of this effect on official standard, their composition was verified by liquid chromatography. The neomycin C base content of the standards varied between 0.4 and 5.8% (m/m). Based on the results obtained and on formerly published reports discussing problems encountered with microbiological assay of neomycin, it is proposed to introduce liquid chromatography in official monographs to replace microbiological assay.

[Celioscopy with peridural anesthesia. Techniques, indications, results in 220 cases]. / La coelioscopie sous anesthésie péridurale. Techniques, indications, résultats à propos de 220 cas.

The authors used epidural anaesthesia to carry out laparoscopy in 220 patients. The chief indications for the laparoscopies were GIFT (intratubal transfer of gametes) and tubal sterilization. The technique used was slightly different according to the indications for the use but they had to be sure of anaesthetising up to T4. In 90% of cases the patients tolerated the procedure well. No change in ventilation or in metabolic measurements. As far as fertilization was concerned studies carried out in various parameters failed to show any untoward side effects due to the use of local anaesthetics. Finally so long as the anaesthesia is only used for a short length of time this technique seems to be suitable for day cases.

Failure of amphotericin B spray to prevent aspergillosis in granulocytopenic patients.

We tested the efficiency of a nasal spray of Amphotericin B (AmB) in leukemic patients, in an attempt to prevent pulmonary Aspergillosis. From January to July, 8 cases of invasive Aspergillosis (IA) in 19 new leukemic patients were identified. Between July and September 15 patients were treated by prophylactic nasal spray of AmB (daily dose 5 mg). Compliance was excellent, but nevertheless typical IA developed in 5 patients. We conclude that at the dosage used prophylactic administration of nasal spray of (AmB) does not prevent IA.

[Use of the MS2 automated system in the determination of the activity of 5 antiseptic drugs: quality control]. / Application de l'automate MS2 à la détermination de l'activité de cinq médicaments antiseptiques en contrôle de qualité.

The study of growth curves of Klebsiella pneumoniae and Staphylococcus aureus in presence of five antiseptics, established using a MS2 Abbott system is presented. From our results, the advantages of automation after the adaptation of the method for the determination of bactericidal properties are examined. This technique may be proposed for the quality control of such drugs.

Susceptibility of Torulopsis glabrata in the presence of six antifungal agents determined by comparison of growth at several pHs.

We describe a method using an automated system whereby fungistatic activities can be determined in several conditions. The process was adapted to Torulopsis glabrata, and it showed that benzalkonium chloride, chlorhexidine gluconate, and thimerosal preserve fungistatic activities in acidic medium, whereas acidification reduces the activity of povidone iodine and poloxamer.

[Quantitative determination of bacterial endotoxins by the chromogenic limulus method: critical analysis and study of interactions between 3 divalent cations]. / Détermination quantitative des endotoxines bactériennes par la méthode "limulus" chromogénique: analyse critique et étude des interactions de trois cations divalents.

The reproducibility of the limulus amoebocyte lysate (LAL) test with the use of a chromogenic substrate was evaluated in the presence of 5 bacterial endotoxins (2 from Escherichia coli, 1 from Salmonella, 1 from Serratia marcescens and 1 from Vibrio cholerae) and the FDA reference endotoxin EC5. Endotoxins from E. coli 055B5, S. marcescens and V. cholerae were significantly more active than the reference endotoxin (p less than 0.01). Addition of Mg2+ activated the LAL chromogenic reaction (optimum = 160 mmol/l added), whereas Ca2+ in concentrations above 5 mmol/l inhibited the reaction. As little as 0.3 mmol/l Zn2+ strongly inhibited the reaction. Inhibition by Zn2+ was partly suppressed by addition of 160 mmol/l Mg2+. These divalent cations modified the LAL chromogenic reaction when added in the first step of the reaction (incubation with endotoxin and LAL reagent). The LAL chromogenic reaction was not modified by divalent cations when these were added in the second step of the reaction (with the chromogenic substrate).