A simultaneous evaluation of three multiparametric coagulation instruments: BFA, HEMOLAB and STA.

In the present paper, three multiparametric coagulation instruments were evaluated with regard to chronometric tests for aPTT (CK-Prest and automated APTT), PT (Recombiplastin and Thromborel), fibrinogen and factors of the prothrombin complex. Analysis of within-run precision and linearity and comparative studies showed the analytical performances of the instruments to differ according to the reagents used and emphasized the difficulty of finding the best compromise between instrument and reagent. On the basis of this study, the mechanical instrument appeared to be more versatile than the optical machines. This conclusion could however be modified after further evaluation of the recent new generation coagulation instruments.

[Evaluation of soluble bacterial antigens detected by electrosyneresis in infectious diseases in children]. / Evaluation de la recherche d'antigènes bactériens solubles par électrosynérèse en pathologie infectieuse de l'enfant.

The diagnostic interest of the search for soluble bacterial antigens, using counter-current immunoelectrophoresis (CIE) has been evaluated in 109 children hospitalized with acute infection. In meningitis, CIE was well correlated with cerebrospinal fluid (CSF) culture and allowed a rapid diagnostic orientation in 82% of meningitis which were confirmed by classical bacteriology (CIE has to be performed using CSF and concentrated urine). False positive results were observed with type B meningococcus, especially on urine samples. In respiratory infections, the search for soluble antigens was of no interest except for focal pneumonitis; in that case, CIE was more frequently positive (35%) than blood culture (28%) and led to a 31% increase of correct diagnosis (CIE must be performed using concentrated urine). Serum and pleural fluid investigations were less sensitive. CIE was not useful in case of upper respiratory or nonfocal broncho-pulmonary infection, due to its very low efficiency.

[Maternal-child transmission of Chlamydia trachomatis. A prospective inquiry in 168 pregnant women]. / Transmission materno-infantile de Chlamydia trachomatis. Enquête prospective chez 168 parturientes.

A prospective study was performed in 168 pregnant women in order to evaluate the frequency of perinatal transmission of Chlamydia trachomatis and to measure its effects on the child's health during his first 3 months of life. The micro-organism was detected by an immunoenzymatic method specific to Chlamydia antigens, and microimmunofluorescence was used for serological testing. Cervical smears taken at the end of pregnancy were positive in 3 women (1.7 per cent), while the sera of 37 women were positive for Chlamydia trachomatis. Altogether, 26.8 per cent of the women explored had had a contact with the micro-organism. Conjunctival smears taken from 1 month old infants were all negative, but 4 infants (out of 126) had positive nasal smears. The mothers of 2 of these had been exposed to the bacterium, but all 4 mothers had negative cervical smears. Antibody titres in 3-month old infants were 1.2 dilution on average below those found in the mothers. Women exposed to Chlamydia trachomatis are frequently unmarried; their pregnancies tend to shorter than normally, and their infants have more frequent episodes of rhinitis. These peculiarities are insufficiently pronounced to single out a population at risk that might benefit from detection of the bacterium.

[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.

[Chlamydia trachomatis in pediatrics]. / Chlamydia trachomatis en pédiatrie.

In developed countries, Chlamydia trachomatis (CT) is found on the cervix of the uterus in 2-8% of pregnant women. Two thirds of neonates from infected mothers are contaminated at delivery at the level of ocular, respiratory and digestive mucosal surfaces. This infection is responsible for 40% of neonatal conjunctivitis and afebrile pneumonitis in the second and third month after birth. In older children and adolescents, CT is responsible for genital infections contracted by venereal contact. The treatment requires taking a macrolide orally for 15 days. Prevention requires the detection of high-risk women, and hygiene in sexual intercourse.

[Diagnosis of neonatal Streptococcus B infection by the latex test]. / Diagnostic de l'infection néonatale à streptocoque B par un test au latex.

The detection of group B streptococcal soluble antigens was performed in 139 newborn infants suspected of infection. A qualitative agglutination test of sensitized latex particles (Wellcogen Strep B) was performed in the urine. The diagnosis of group B streptococcal infection was assessed by retrospective analysis of patient files using previously defined criteria. The correlation between the agglutination test result and the presence or absence of streptococcal infection was statistically significant; the test had a sensitivity of 81%, specificity of 97%, positive predictive value of 76% and negative predictive value of 98%. This study confirms the interest of such a test in the early diagnosis of group B streptococcal infection in infants.

[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 activity of ceftriaxone on Gram-negative bacilli with various resistance phenotypes to cephalosporins. Comparison with cefotaxime, cefmenoxime, moxalactam, ceftazidime]. / Activité in vitro de la ceftriaxone sur des bacilles Gram négatif présentant différents phénotypes de résistance aux céphalosporines. Comparaison avec céfotaxime, cefménoxime, moxalactam, ceftazidime.

In vitro activity of ceftriaxone was studied on 245 cephalothin-resistant strains of enterobacteria representing 7 different phenotypes of resistance to cephalosporins and on 130 Gram negative oxidative bacilli. Ceftriaxone was compared to cefotaxime, cefmenoxime, moxalactam and ceftazidime. With modal MICs of 0.015 to 0.25 mg/l, ceftriaxone is active on all phenotypes of enterobacteria not simultaneously resistant to cefamandole and cefoxitin. Among the bacteria with this last phenotype, only K. pneumoniae, C. Freundii and E. cloacae are occasionally found to have intermediate susceptibility or even resistance; ceftriaxone is more active than cefotaxime, cefmenoxime and ceftazidime with inhibition of 95.1% of strains at 4 mg/l. Moxalactam is superior to ceftriaxone against enterobacteria that are intermediate or resistant to both cefamandole and cefoxitin. Activity of ceftazidime is strongest against oxidative bacilli and weakest against enterobacteria regardless of phenotype.

[Bacteriological evaluation of a new system for transport and storage of urine: the UC and S Vacutainer system]. / Evaluation bactériologique d'un nouveau système de transport et de conservation de l'urine: le système Vacutainer UC et S.

A study realized on 360 clinical urine specimens compared results of the cytobacteriological examination obtained from freshly voided urines and from the same urines preserved during 24 hours at room temperature (20-22 degrees). A new system (UC & S Vacutainer system--Becton-Dickinson) was used for preservation. Urine preservation induced no change in count of leukocytes and erythrocytes present in urine and in bacterial count (agreement between the two numerations: 98.8 p. cent). Bacterial identification and determination of antibacterial activity of antibiotics remained also unchanged. Soluble antigens eventually present in urine were not altered by preservation on UC & S tubes. This study showed that UC & S Vacutainer system was very effective for preservation of urine clinical specimens.

[Effect of a ticarcillin-clavulanic acid (timentin) combination on bacteria resistant to ticarcillin]. / Activité de l'association ticarcilline-acide clavulanique (timentin) sur des germes résistants à la ticarcilline.

Sixty-nine ticarcillin-resistant strains (57 Gram negative bacilli and 12 S. aureus) were tested: MICs and MBCs were determined for clavulanic acid, ticarcillin, and both agents combined using a liquid micromethod. MICs were compared to results of disk antibiotic sensitivity tests. While clavulanic acid exhibits little antibacterial activity, its action is synergistic with that of ticarcillin making 100% of Staphylococci and 84.2% of Gram negative bacilli susceptible. Among the Gram negative bacilli tested, distribution is as follows: E. coli (9/9), Klebsiella (10/14), Enterobacter (1/3), Serratia (8/8), Proteus, Providencia (8/8), Salmonella (2/2), Acinetobacter (4/4), and Pseudomonas (6/9). Although strong bacteriostatic and bactericidal activities are already achieved with 4 mg, the best results are obtained with timentin 8 mg.

[Clinical trial of an antipneumococcal vaccine in elderly subjects living in institutions]. / Essai clinique du vaccin antipneumococcique chez des personnes âgées vivant en institution.

Pneumococcal vaccine effectiveness was assessed in a randomized trial among 1,686 old people (mean age: 74, standard deviation: 4 years) living in 24 geriatric hospitals and 26 homes for the aged in our district; 937 were vaccinated with Merck-Sharp and Dohme pneumococcal vaccine (14 serotypes). The 749 others composed the reference group. This study was performed during 2 years, since December 1980. Both groups were randomized after a two-criteria stratification: by clinical risk assessed before the study, and by type of homes for the aged. Forty pneumonias were diagnosed, with 13 proved pneumococcal etiology. The incidence of pneumonia was significantly reduced in the vaccinated group (p less than 10(-4) but the mortality rate was not modified. We concluded in favor of the effectiveness of pneumococcal vaccine: etiological fraction 77.1% (51.2%-89.3% confidence limits, 95% risk) in the population we studied. The incidence of pneumococcal-proved pneumonia was not significantly reduced.

[Contribution of pneumococcal serotyping and antibiotyping to the prevention and treatment of pneumococcal infections (1980-1982). Pneumococcal typing and vaccination (1980-1982)]. / Apport de la sérotypie et de l'antibiotypie des pneumocoques à la prévention et au traitement des pneumococcies (1980-1982). Typage des pneumocoques et vaccination (1980-1982).

During a 3-year period (1980-1982), 594 pneumococcal strains taken from 565 patients were serotyped. The distribution of the serotypes and their prevalence varied by sample and year. The theoretic vaccinal coverage, evaluated for the four main pathologies: pneumonia, otitis, meningitis, bacteriemia, is 79,1%. Among vaccinal serotypes, the types 19, 7, 3, 6, 1, and 23 are the most frequent, representing a cumulative incidence of 57,7%. In our region (Grenoble), the pneumococcus remains very sensitive to antibiotics. No strain resistant to penicillin G was observed. Erythromycin, doxycyclin, chloramphenicol, and cotrimoxazole preserve their potency with, respectively, 2,1%, 1,8%, 1,1%, and 1,9% resistant strains.