Incidence of Staphylococcus aureus with reduced susceptibility to glycopeptides in two French hospitals.

OBJECTIVES: To determine the incidence of Staphylococcus aureus isolates with reduced susceptibility to glycopeptides among all clinical isolates collected consecutively in two French hospitals between November 1998 and April 1999. METHODS: Methicillin-resistant and -susceptible S. aureus isolates were screened on vancomycin- or teicoplanin-supplemented agar plates. Glycopeptide MICs were determined by the E test procedure with a high inoculum and by an agar dilution technique. Glycopeptide-intermediate S. aureus isolates were identified as homogeneously or heterogeneously resistant to vancomycin by performing population analysis. RESULTS: Of the 640 isolates recovered from 518 patients, three from the same patient and two from two different patients showed homogeneous or heterogeneous intermediate resistance to vancomycin. CONCLUSION: The incidence of glycopeptide-intermediate S. aureus (homogeneously or heterogeneously resistant) in a non-selected patient population, i.e. regardless of predisposing factors and glycopeptide therapeutics, remains low in the two French hospitals involved in the study, representing 0.6% of isolates.

Rapid diagnosis of Mycobacterium tuberculosis infections by an ELISA-like detection of polymerase chain reaction products.

A polymerase chain reaction (PCR) assay was developed for the detection in clinical samples of mycobacteria belonging to the Mycobacterium tuberculosis complex. PCR products were detected with a simple and rapid colormetric method. With this method, 50 fg of M. tuberculosis DNA were detectable with the repetitive DNA-sequence-derived primers, corresponding to 10 genome equivalents. Detection of M. tuberculosis in 258 clinical samples by PCR was compared with detection by culture. PCR was positive for 56 of 57 culture-positive and Ziehl-Neelsen-staining-positive (ZN) samples, 11 of 18 culture-positive and ZN-negative samples. The presence of groEL DNA sequences was also investigated by PCR for all the specimens with the same revelation protocol. Three of the eight false-negative samples with the repetitive element-derived primers were found to contain groEL DNA sequences specific for the Mycobacterium genus. Among the 183 culture-negative samples, 30 were positive by PCR. When clinical data were known, the diagnosis of tuberculosis was established for the patients from whom those samples had been obtained. The results show that the rapid and simplified PCR assay described here is slightly more sensitive than culture and can be used in routine clinical practice.

[Determination of bactericidal minimum concentrations of 3 antiseptics and 1 disinfectant on 580 hospital gram-negative bacilli]. / Détermination de la concentration minimale bactéricide de trois antiseptiques et un désinfectant sur 580 souches de bacilles gram négatifs d'origine hospitalière.

Minimal bactericidal activities (MBCs) of three antiseptics (povidone iodine, chlorhexidine digluconate, benzalkonium chloride) and one disinfectant (sodium hypochloride) where determined, on 580 hospital Gram negative bacilli. Previously the Afnor T 72-150 standard for antiseptic and disinfectant was established for two reference strains E. coli CIP 54 127 and P. aeruginosa CIP A 22. No difference was found between the MBC obtained with these strains in Afnor standard and in microdilution method. Microdilution method allows to test 11 hospital isolates and one reference strain. A strain was considered as resistant when the MBC was one dilution higher than the reference strain MBC. Results were as follows: None strain was resistant to sodium hypochloride and povidone iodine; 18.2% Enterobacteriaceae were resistant to chlorhexidine digluconate with 94.2% of Proteus; 4% of Enterobacteriaceae were resistant to benzalkonium chloride with 89.5% of Proteus and only 1.8% other bacilli. Results obtained in the present study are similar as those previously published particularly with Proteus; nevertheless other studies have reported P. aeruginosa strains resistant to chlorhexidine digluconate and benzalkonium chloride; this last point was not observed in our study.