[Staphylococcus saprophyticus isolated from urine culture in outpatients: epidemiology and antimicrobial susceptibility (Label Bio Elbeuf study - November 2007-July 2009)]. / Staphylococcus saprophyticus isolés d'examens cytobactériologiques urinaires en ville : épidémiologie et sensibilité aux antibiotiques (étude Label Bio Elbeuf - novembre 2007-juillet 2009).

OBJECTIVE: The aim of the study was to determine the distribution and the antibiotic susceptibility of Staphylococcus saprophyticus patterns isolated from urine culture in outpatients (population: 57,000, Elbeuf, Normandie, France). DESIGN: Prospective study from November 2007 to October 2009 in collaboration with three private medical laboratories. Determination of susceptibility to oxacillin by disk diffusion (cefoxitin, and moxalactam), automated method (Vitek BioMérieux 2) and mecA PCR's detection. Determination of the minimum inhibitory concentration by microbroth dilution for other antibiotics. RESULTS: Five thousand and fifty-one bacterial strains isolated, 91 strains of S. saprophyticus (1.8%), 89 in women (2.25%) and two in men (0.18%). S. saprophyticus represented 10.3% and 14.5% of isolates (women respectively aged between 11 and 30; 16 and 20 years); S. saprophyticus is isolated less frequently in winter. mecA PCR detection was positive for two strains. All strains tested were susceptible to ciprofloxacin and furans. Only one strain is resistant to cotrimoxazole. CONCLUSIONS: S. saprophyticus is found mostly in women between 11 to 30 years. Cotrimoxazole (after susceptibility testing) is efficient in case of S. saprophyticus's cystitis. Furans (probabilistic treatment) have to be reevaluated because of the potential for serious adverse effects.

[Susceptibility to antibiotics of Escherichia coli isolated from community-acquired urinary tract infections]. / Sensibilité aux antibiotiques des Escherichia coli isolés d'infections urinaires communautaires.

OBJECTIVE: The authors had for aim to determine the distribution of bacterial isolates and the antibiotic susceptibility patterns of Escherichia coli from community-acquired urinary tract infections in an area covering 57,000 people (Elbeuf, Normandie, France). DESIGN: From November 2007 to October 2008, three private French laboratories consecutively collected 2344 bacteria including 1636 E. coli from outpatients. The antibiotic susceptibility of E. coli was determined using an automatized method (Vitek 2 Biomerieux). RESULTS: The global susceptibility of E. coli was: ampicillin: 57%; amoxicillin+clavulanic acid: 73%; cefixim: 96%; ceftriaxone: 98%; gentamycin: 96%; nalidixic acid: 82%; ciprofloxacin: 89%; fosfomycin: 98%; nitrofurantoin: 96% and cotrimoxazole: 81%. The susceptibility of E. coli to ciprofloxacin was higher in 15- to 65-year-old female patients (94%) than for older female (85%) or male patients (80%). CONCLUSIONS: In the Elbeuf area, third generation cephalosporins, aminoglycosides, nitrofurantoin, and fosfomycin were the most effective on E. coli isolated from community-acquired urinary tract infections. Fluoroquinolones were more active in 15- to 65-year-old female patients than in male patients and in female patients over 65 years of age. The rates of acquired resistance were related to the level of antibiotic prescription in the various populations.

[Evaluation of the carriage of Staphylococcus aureus in patients and the personnel of a hemodialysis center for the prevention of infections]. / Evaluation du portage de Staphylococcus aureus chez les malades et le personnel d'un centre d'hémodialyse en vue de la prévention des infections.

With the aim of improving the prevention of Staphylococcus aureus infections in hemodialysis patients, an evaluation of S. aureus nasal carriage was carried out at the hemodialysis center of CHU-Rouen between the 1st of January, 1991 and the 30th of June, 1991. The S. aureus strains were classified according to their antibiotypes, serotypes and lysotypes. The carriage rate appears to be similar to that of the general population but inferior to what has been previously reported in hemodialysis centers. We report our findings on nasal carriage strains. The risk of infection is low. The standards of hygiene, adopted by hospital personnel, seem to be effective although cross colonization may have possibly occurred. Taking into account the different epidemiologic circumstances encountered in each hemodialysis center it is, therefore, necessary to determine the rate of carriage and identify the personnel at risk (persistent carriers, patients with a previous history of S. aureus septicemia, meti-R strains) in order to implement prophylaxis accordingly to epidemic characteristics of each center.