[Pays de la Loire Pneumococcus Observatory: antimicrobial resistance of Streptococcus pneumoniae in 2007]. / Observatoire régional du pneumocoque en région Pays de la Loire: résistance de Streptococcus pneumoniae aux antibiotiques en 2007.

OBJECTIVES: Between 1st January and 31st December 2007, 331 Streptococcus pneumoniae strains were collected from 20 participating laboratories in the Pneumococcus Network Pays de la Loire county to assess their susceptibility to antibiotics and to evaluate serogroups of strains. METHOD: The coordinating centre performed MICs of penicillin G, amoxicillin and cefotaxime by the reference agar dilution method. Results were interpreted according to CA-SFM breakpoints. Sensitivity to other antibiotics were studied and serotyping of each strain performed. RESULTS: Three hundred and thirty one strains were isolated in 2007. They were collected from 30 cerebrospinal fluids, 239 blood samples, 53 middle ear fluids and nine pleural fluids. The percentage of pneumococci with decreased susceptibility to penicillin G (PDSP) was 39% and was higher in children (51%) than in adults (35%). The PDSP were often multidrug resistants especially with a high percentage of resistance to erythromycin (87.6% versus 8.4% for pneumococci sensitive to penicillin G). Finally, the most prevalent serogroup was the serogroup 19 (29.6% of isolates). CONCLUSION: A decrease of PDSP was observed since 2001 and high-level resistant strains to beta-lactams remain low. The rate of PDSP in Pays de la Loire is in the national average.

Cefotetan: comparative study in vitro against 226 Gram-negative clinical isolates.

The activity in vitro of the new cephamycin, cefotetan, was compared with that of cephalothin, cefoxitin, cefuroxime and cefotaxime against 226 recently isolated Gram-negative pathogens (207 Enterobacteriaceae and 19 Acinetobacter). Cefotetan was consistently more potent than cephalothin, cefoxitin and cefuroxime. Cefotaxime and cefotetan were essentially similar in activity against the Enterobacteriaceae with the singular exception of Enterobacter spp. which were markedly more susceptible to the former drug. None of the five agents was especially active against acinetobacter but cefotaxime was the best. Limited tests of bactericidal activity showed that the MBC differed from the MIC by a factor of 4 at most. Increasing the inoculum tested from 10(2) to 10(8) per ml had little adverse effect on the MIC of cefotetan. If the recommendations of the National Committee for Clinical Laboratory Standards for susceptibility to cephalosporins are applicable to cefotetan and the breakpoint criteria of less than or equal to 10 mg/l (sensitive) and greater than or equal to 32 mg/l (resistant) are acceptable, then only a few of the Enterobacteriaceae in this study were resistant. These resistant organisms were amongst Enterobacter spp. and Citrobacter spp.

[Dibekacin: diffusion in bronchial mucus]. / Dibékacine: diffusion dans le mucus bronchique.

The study of the bronchial concentration of dibekacin has shown a different degree of activity than that of gentamicin. This activity resembles that of amikacin with a three hour time lag from the appearance of the bronchial peak in relationship to the serum peak. In addition there seems to be a special passage mechanism for the antibiotic from the blood into the bronchial secretions since we observed an increase in the mucus/serum ratio through time.

[Outbreak of hand, foot and mouth disease in a day-nursery. A new clinical form? (author's transl)]. / Epidémie de maladie des mains, pieds et bouche dans une crêche. Une nouvelle forme clinique?

Ten cases of vesicular eruption affecting primarily the hands (4/10) and feet (6/10) occurred in a day-nursery for infants. An enterovirus related to coxsackie A 16 virus was isolated from two vesicular fluids and nine stools. The fact that the outbreak took place in the winter, the rarity of pharyngeal lesions (2/10), the high incidence of foot lesions and the presence of listlessness as only associated symptom lead to a discussion of the relationship between this small epidemic and true hand, foot and mouth disease.