[In vitro antibacterial activity of a new fluoroquinolone, sparfloxacin, against nosocomial bacteria, and concordance curve]. / Activité anti-bactérienne in vitro d'une nouvelle fluoroquinolone, la sparfloxacine sur les bactéries hospitalières et courbe de concordance.

Minimal inhibitory concentrations (MICs) of sparfloxacin (SFX) were determined by agar dilution for 3,164 bacterial strains isolated in 10 university hospitals; in addition, antibiograms by agar diffusion were performed with 5 micrograms disks. Activity of SFX against nalidixic acid (NAL) susceptible (S) Enterobacteriaceae was close to that of other fluoroquinolones (FQ) (MIC 50 and 90: 0.06-0.5 microgram/ml); like for other FQ, this activity was reduced against NAL intermediate and resistant (R) Enterobacteriaceae (2-16). MICs of SFX against P. aeruginosa were between 0.12 and 16 (1-32). SFX had also a good activity against NAL-S A. baumannii (CMI < or = 0.25) but this activity is reduced against NAL-R Acinetobacter (16). SFX was highly active against Haemophilus (0.016-0.06) gonococci (0.008), meningococci (0.008) and B. catarrhalis (0.008-0.03). SFX showed activity superior to the currently available FQ against methicillin susceptible staphylococci (0.06); the resistant strains [8] are usually methicillin resistant. SFX is more effective against enterococci (0.5), streptococci (0.25-0.5) and particularly pneumococci (0.25-0.5) including penicillin-resistant strains. The coefficient correlation of the regression curve is 0.876; for MIC breakpoints of 1 and 2 micrograms/ml, zone diameter breakpoints should be 20 and 16 mm.

[Compared antibacterial activity of a new fluoroquinolone, sparfloxacin (AT 4140, RP 64206) and four other fluoroquinolones against 332 strains of enteropathogen bacteria]. / Activité antibactérienne comparée d'une nouvelle fluoroquinolone, la sparfloxacine (AT 4140, RP 64206) et de 4 autres fluoroquinolones sur 332 souches de bactéries entéropathogènes.

The in vitro bacteriostatic and bactericidal activity of five fluoroquinolones--sparfloxacin, ciprofloxacin, ofloxacin, lomefloxacin and pefloxacin--was tested against 332 strains of enteric pathogens belonging to the genera Salmonella, Shigella, Escherichia, Yersinia, Vibrio, Campylobacter and Helicobacter. Some of the strains were resistant to one or several antibiotics. Each fluoroquinolone showed identical bacteriostatic activity against susceptible and resistant strains except of those resistant to nalidixic acid. MIC 90% were always below 1 mg/l. The MIC were lowest with ciprofloxacin followed by sparfloxacin and highest with pefloxacin. The five compounds showed different activity against nalidixic acid resistant strains: MIC 90% increased from 0.06 to 4 mg/l for Salmonella, from 0.5 to 4 mg/l for C. jejuni strains, from 0.12 to 16 mg/l for H. pylori strains. All strains remained susceptible to ciprofloxacin and sparfloxacin, but some were intermediate or resistant to the three other compounds. The minimal bactericidal concentrations of the five agents against the nalidixic acid susceptible or resistant strains were one or two times the corresponding MIC.

[Serology of anti-Pseudomonas aeruginosa and mucoviscidosis: diagnostic aid in the differentiation between colonization and infection]. / Sérologie anti-Pseudomonas aeruginosa et mucoviscidose: aide au diagnostic des états de colonisation et d'infection.

Serologic test for Pseudomonas aeruginosa have been found useful for differentiating colonization from infection, especially in chronic disease. A Western blot method was compared with the ELISA used routinely. The Western blot detected serum IgGs against P. aeruginosa outer membrane proteins, whereas the ELISA reacted with IgGs against soluble P. aeruginosa antigens. Among the 103 sera from 58 cystic fibrosis patients studied, all those with ELISA reactivity were positive by Western blot. The antibody response was detected earlier by Western blot than by ELISA, suggesting that the former technique may be useful for the early diagnosis of infection.

[Pseudomonas aeruginosa and imipenem: correlation between membrane protein D2 and resistance in fifteen strains isolated from patients with mucoviscidosis]. / Pseudomonas aeruginosa et imipénème: corrélation entre protéine de membrane D2 et résistance chez quinze souches isolées de patients mucoviscidosiques.

A characteristic feature of imipenem-resistant strains of Pseudomonas aeruginosa is loss or decreased expression of the outer membrane protein (OMP) D2, whose molecular weight is 45 to 49 kDa. D2 was studied in 15 strains of P. aeruginosa with intermediate susceptibility or resistance to imipenem recovered from the sputum of 15 patients with cystic fibrosis. The OMP was extracted using Sarkosyl and separated by SDS-PAGE electrophoresis. Electrophoresis patterns were compared to those of reference strains 3B and 3C which are resistant and susceptible to imipenem, respectively. Expression of D2 was normal in three strains, weak or very weak in 11 strains and absent in one strain. For 12 strains, the alteration of the D2 protein was consistent with previous reports. However, the finding of normal D2 production in three strains is unusual and suggests the possible presence of another mechanism of resistance.

[Detection of extended-spectrum beta-lactamases by the rapid ATB E technique. Value of the API V2.1.1 expert system]. / Détection des bêtalactamases a spectre elargi par technique Rapid ATB E. Intérêt du système expert API V2.1.1.

Twenty-two extended-spectrum betalactamase-producing strains of enterobacteriaceae recovered in the authors' hospital were tested using the Rapid ATB E coupled with the API V2.1.1. expert system. The expert system detected 90.9% of ESBL-producing strains. Two strains producing a SHV2 and a CTX1, respectively, escaped detection by the expert system despite concomitant resistance to aminoglycosides.

[Listeria monocytogenes nosocomial infection in the maternity ward]. / Infection nosocomiale à Listeria monocytogenes en maternité.

Nosocomial infection with Listeria monocytogenes 4b occurred in January 1990 in a maternity hospital in Grenoble. The 3 patients involved were born within a 24 hour-interval. The premature newborn responsible for contamination was asymptomatic. Two other newborns without any perinatal infectious risk presented with meningitis, one on the 5th day of life in the maternity hospital, the other one on the 11th day while already at home. The 3 strains of Listeria had the same serovar and lysovar. Epidemiologic investigations led to suspect a contamination in the delivery room and during the care of the children. Strict respect of hygiene orders is imperative to avoid nosocomial infections.

[Evaluation of a DNA probe test for the detection of Legionella SPP]. / Evaluation d'une technique de détection de Legionella SPP par sonde nucléique.

Seventeen suspension of Legionella pneumophila and ten of Legionella bozemanii in saline or bronchoalveolar lavage (BAL) fluid were tested using the Gen Probe technique. The detection threshold was found to be 10(3)-10(4) CFU/ml. Specificity and sensitivity were evaluated by using the probe on 8 suspensions of bacteria other than Legionella and by performing a comparative study of the probe test, direct immunofluorescence and culture with 103 specimens (BAL fluid in most instances) from 92 patients with possible legionellosis. Sensitivity was found to be acceptable (3 of the 4 culture-positive specimens were positive by the probe test) and specificity was 100% despite the fact that most (80/99) BAL specimens were not sterile and regardless of the cutoff level used to define positivity. The advantages of the DNA probe test, including rapidity, simplicity and objectivity, should be weighed against its disadvantage, i.e., only acceptable sensitivity and use of radioactivity.

[Azithromycin versus josamycin: treatment of 89 cases of acute pneumonia]. / Azithromycine versus josamycine: traitement de quatre-vingt-neuf pneumopathies aiguës.

In an open, multicenter randomized clinical trial on patients with acute pneumonia, 5-day therapy using a new oral macrolide antibiotic, azithromycin (Az), was compared with standard 10-day therapy using another macrolide, josamycin (J). Eighty-nine patients were treated (46 Az, 43 J); both groups were comparable, except in terms of the sex ratios. The causative agent was determined in 31 cases; streptococcal pneumonia was the most common diagnosis (48%). Cure rates were 93% for J and 80% for Az (p greater than 0.30), as judged by a fall in body temperature and an improvement in clinical condition and in radiographic findings. Among 6 failures, there were 4 cases of empyema (1 J, 3 Az). Of 6 deaths, 2 were pneumonia-dependent (1 J and 1 Az, Haemophilus and Streptococcus pneumoniae, respectively). We conclude that 5-day Az is as effective as 10-day J and that such short-course therapy is an advantage in the treatment of pneumonia caused by macrolide susceptible pathogens.

[In vitro effect of various antibiotics: beta lactams, aminoglycosides and fluoroquinolones alone and in combination against P. aeruginosa isolated from patients with mucoviscidosis]. / Activité in vitro de différents antibiotiques: bêtalactamines, aminoglycosides et fluoroquinolones seuls et en association vis-à-vis de P. aeruginosa isolès patients atteints de mucoviscidose.

The antibacterial activity of fluoroquinolones (ciprofloxacin and ofloxacin) combined with beta lactams (ceftazidime and imipenem) or aminoglycosides (tobramycin and amikacin) against 22 P. aeruginosa isolated from the sputum of patients with cystic fibrosis was determined by the checkerboard method and compared with the combination of beta lactams (with ticarcillin) with aminoglycosides. Synergistic association (defined as FIC index less than ou = 0.5) was founded for 23 to 41% of strains with beta lactams (except imipenem)/aminoglycosides, in 18% with ceftazidime/ciprofloxacin, in 13% with imipenem/ciprofloxacin, in 0 or 13% with quinolones/aminoglycosides. For a FIC index less than ou = 0.75, the values are highest with 82% for ciprofloxacin/ceftazidime and 50% for ofloxacin/ceftazidime. The CMI's achieved in these combinations may allowed concentrations near to sputum concentrations.

[Comparative in vitro bacteriostatic and bactericidal effect of 5 macrolides: roxithromycin, erythromycin, oleandomycin, josamycin and spiramycin against 284 hospital bacterial strains]. / Activité bactériostatique et bactéricide comparée in vitro de cinq marcolides: roxithromycine, érythromycine, oléandomycine, josamycine et spiramycine sur 284 souches bactériennes d'origine hospitalière.

The bacteriostatic and bactericidal activities of five macrolides (roxithromycin, erythromycin, troleandomycin, josamycin and spiramycin) were tested against 284 bacterial strains belonging to various species of Gram positive (staphylococci, streptococci, pneumococci, Listeria sp, Corynebacterium sp, Bacillus sp) and Gram negative bacteria (Neisseria sp, H. influenzae, P. multocida). The activity of these compounds on the whole strains showed near results: 71.8% of susceptible strains to erythromycin and spiramycin, 70% to josamycin, 67.6% to roxithromycin, 65.5% to troleandomycin. Resisting strains were MLSB resistant cocci Gram positive, H. influenzae and P. multocida strains. Species usually less studied (nongroupable streptococci, Corynebacterium sp, Bacillus sp) were very susceptible to macrolides with MICS equal or inferior to 1 mg/l for the two last genus. A bactericidal effect was observed for 38.8% of 72 tested strains (erythromycin), 36.1% (josamycin), 34.7% (spiramycin), 31.9% (roxithromycin), 20.8% (troleandomycin). Among various tested species, this bactericidal effect concerned especially group A streptococci, N. meningitidis and Corynebacterium (except D2 and JK species).

[Comparison of 2 systems of blood culture: Signal and Bactec]. / Comparaison de deux systèmes d'hémoculture: Signal et Bactec.

Two Bactec bottles (aerobic and anaerobic) and one single bottle Signal were used for detecting bacteremia in 405 patients (47 children and 358 adults). The two blood culture Signal and Bactec aerobic were continuous shaking for up to 24 hours. 10.3 p. cent of patients had positive cultures (62.3 p. cent Gram +, aero-anaerobic bacteria). Nine bacteremia were detected by only one system (4 for signal, 4 for Bactec) 77.1 p. cent of 83 strains were positive on the two systems together, but 7.2 p. cent only in the Bactec and 15.6 p. cent only in the Signal. The delay of growth give an advantage to the Bactec (67 p. cent in 24 hours). The advantages and the disadvantages of the two systems were analysed.

[In vitro antibacterial activity of cefpirome in combination with 4 aminoglycosides and 2 fluoroquinolones]. / Activité antibactérienne in vitro du cefpirome en association avec quatre aminoglycosides et deux fluoroquinolones.

Combinations of cefpirome with aminoglycosides (gentamicin, tobramycin, netilmicin, amikacin) and of cefpirome with fluorinated quinolones (pefloxacin, ofloxacin) were tested against 20 Enterobacteriaceae, 6 Pseudomonas aeruginosa, 6 Acinetobacter calcoaceticus, 6 group D Streptococci and 6 Staphylococcus aureus strains, susceptible, intermediate or resistant with a low level to these different compounds. Activity of combinations was evaluated using a broth microdilution checkerboard method and FIC indices determination. Combinations of cefpirome with aminoglycosides demonstrated a synergistic effect in 79.5% of cases, but a strong synergy (FIC less than or equal to 0.62) was observed in only 46% of cases. The higher rate of strong synergy concerned Enterobacteriaceae (50% of cases) and group D Streptococci (58.3%). Combination of cefpirome with gentamicin was the most active against Enterobacteriaceae and with a lower degree against P. aeruginosa, A. calcoaceticus and S. aureus. Combination of cefpirome with netilmicin was the best association against group D Streptococci. Combinations of cefpirome with fluorinated quinolones demonstrated frequently and additive (40.9%) or indifferent (36.3%) effect. When a synergistic effect was proved, it was always weak (FIC = 0.75). Combinations of two fluorinated quinolones with cefpirome gave similar results. No combination was antagonist. This study is a primary estimation of activity of cefpirome combined with other agents. It will be necessary to confirm these results against strains resistant with high level, especially against cefpirome, strains not discovered in clinical isolates at present.

[Role of E. coli enterotoxins in the etiology of infantile diarrhea. Comparison of an African country Yaoundé (Cameroon) and France (Grenoble)]. / Place des E. coli entérotoxigènes dans l'étiologie des diarrhées infantiles. Comparaison entre un pays africain Yaoundé (Cameroun) et la France (Grenoble).

The detection of heat-labile enterotoxin by two tests (culture on Y1 cells and GM1-ELISA) has been carried out on strains of E. coli isolated in stools of children with diarrheal disease (220 strains isolated in the Pasteur Institute in Yaoundé, Cameroon, and 133 stool specimens selected in Grenoble). This work was undertaken to determine the frequency of enterotoxigenic E. coli in two different populations. In Yaoundé the isolation rate (6%) is not very high in comparison with other developing countries. It should be observed that some strains belong to enteropathogenic serogroups. In Grenoble results confirm the very low frequency of enterotoxigenic E. coli in industrialized countries.

[Specific IgM and IgA antibodies in Chlamydia trachomatis infections in adults]. / Les anticorps spécifiques IgM et IgA dans les infections à Chlamydia trachomatis de l'adulte.

The authors have compared the prevalence of Chlamydia trachomatis specific serum IgM and IgA antibodies in two populations with Chlamydia positive total antibodies. The first population, P1 had a positive direct diagnosis, and the second had a negative one. IgM antibodies were found in 13.5 p. cent of P1 only. IgA were found in 51.9 p. cent of P1 versus 15.7 p. cent of P2. The interest of IgA detection is discussed, particularly towards deep infections where they could be an argument of an active infection.

[Comparative antibacterial activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) on hospital bacteria resistant to beta lactams]. / Activité antibactérienne comparée d'un nouveau monobactam, le carumonam (RO 17-2301, AMA 1080) sur des bactéries hospitalières résistantes aux bêtalactamines.

In vitro activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) was tested against 370 hospital bacterial isolates. Results were compared to aztreonam, cefotaxime, cefmenoxime, latamoxef, ceftazidime, ceftriaxone, pefloxacin against Enterobacteriaceae, to aztreonam, piperacillin, cefoperazone, cefsulodin, ceftazidime, imipenem and pefloxacin against P. aeruginosa. All Enterobacteriaceae strains produced cephalosporinases and all P. aeruginosa strains were ticarcillin resistant. MIC 90% of carumonam against Enterobacteriaceae strains was lower than 0.25 mg/l for P. mirabilis, P. vulgaris, P. stuartii, Salmonella sp., ranged from 0.25 to 0.5 mg/l for Klebsiella sp. and S. marcescens, from 1 to 2 mg/l for E. coli and P. morganii, and from 4 to 8 mg/l for C. freundii and E. cloacae. The rate of strains inhibited with 4 mg/l of carumonam was 95.3%. So carumonam was at the second place from eight tested products, after latamoxef (97.5% of susceptible strains). Carumonam was active against second generation cephalosporins resistant strains when these strains were susceptible or intermediate to cefotaxime. Strains resistant to this compound escaped to its action. Its activity against A. calcoaceticus was weak (22.6% of strains inhibited by 4 mg/l), but was superior to that of cefsulodin against ticarcillin resistant P. aeruginosa strains (54.5 versus 16.1% of susceptible strains). However carumonam was less active against this last species than ceftazidime or imipenem (92.6 and 91% of susceptible strains respectively).

[Identification of gram-negative aerobic and non-fastidious aero-anaerobic bacilli using the ATB 32 GN system]. / Identification des bacilles à gram négatif aérobies et aéro-anaérobies non exigeants par le système ATB 32 GN.

ATB 32 GN was tested with 279 gram negative non fastidious rods = 188 Enterobacteriaceae and 91 non-enterobacteriaceae. This micro-method included 32 carbon substrate's assimilation tests, read and interpreted automatically after incubation for one or two days at 30 degrees C. 93.5 p. cent of all bacteria are correctly identified (92.5 p. cent of Enterobacteriaceae and 95.6 p. cent of non enteric rods). 2.6 p. cent are misidentified and 3.9 p. cent are unidentified. The results these strains are analysed. This novel system of identification was possible utilised in a medical analysis laboratory.

[Detection of Chlamydia trachomatis in various pathological products. Comparison between direct IF-Chlamydiazyme and cultured cells]. / Détection de Chlamydia trachomatis dans divers produits pathologiques. Comparaison entre IF directe-Chlamydiazyme et cultures cellulaires.

Two immunologic technics of Chlamydia trachomatis detection: IF (Microtrack Syva-Bio-Merieux) and ELISA (Chlamydiazyme Abbott) are compared with cell cultures revealed by giemsa on 177 and 210 samples respectively. Sensibility, specificity, agreement among methods and predictive values are given for each nature of prelevement. The direct fluorescent antibody test is globaly more sensitive (94.7%) than Chlamydiazyme (78.9%), but less specific (96% against 100%). Two major inconveniences of IF are not recovered with Chlamydiazyme (extreme fastidiousness and subjective reading). The discordances between the three methods are discussed, as well as their respectives advantages and inconveniences.

[In vitro antibacterial activity of a new cephalosporin: cefpirome (HR 810). Comparison with ceftriaxone, cefotaxime, latamoxef and ceftazidime]. / Activité antibactérienne in vitro d'une nouvelle céphalosporine: le cefpirome (HR 810). Comparaison avec la ceftriaxone, le céfotaxime, le latamoxef et la ceftazidime.

In vitro activity of a new cephalosporin, cefpirome (HR 810) was tested using an agar dilution procedure against 393 hospital bacterial isolates. Results were compared to those obtained with ceftriaxone, cefotaxime, latamoxef and ceftazidime. Cefpirome was the most active drug against oxacillin-susceptible staphylococci and the only drug with activity against streptococci D (MIC 90%: 7 mg/l). Against Enterobacteriaceae strains with varying degrees of resistance to cephalosporins, results varied across species: activity of cefpirome was greater than that of the four other drugs for E. cloacae and C. freundii, similar to that of ceftriaxone for E. coli, S. marcescens, P. morganii and Salmonella sp., inferior to that of latamoxef for P. stuartii. However, against all Enterobacteriaceae strains as a whole, cefpirome proved the most active of the five agents tested (99.1% of strains inhibited by 4 mg/l) as a result of its greater activity against strains with resistance to second generation cephalosporins or cefotaxime. Cefpirome in a concentration of 4 mg/l inhibited 50% of tested P. aeruginosa strains (MIC 90%; 13 mg/l) and was inferior only to ceftazidime (MIC 90%: 4 mg/l). However, cefpirome exhibited no activity against A. calcoaceticus and L. monocytogenes.