In vitro antibacterial activity of doripenem against clinical isolates from French teaching hospitals: proposition of zone diameter breakpoints.

The aims of the study were to determine the in vitro activity of doripenem, a new carbapenem, against a large number of bacterial pathogens and to propose zone diameter breakpoints for clinical categorization in France according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) minimum inhibitory concentration (MIC) breakpoints. The MICs of doripenem were determined by the broth microdilution method against 1,547 clinical isolates from eight French hospitals. The disk diffusion test was performed (10-µg discs) according to the Comité de l'Antibiogramme de la Société Française de Microbiologie (CASFM) method. The MIC(50/90) (mg/L) values were as follows: methicillin-susceptible Staphylococcus aureus (MSSA) (0.03/0.25), methicillin-resistant Staphylococcus aureus (MRSA) (1/2), methicillin-susceptible coagulase-negative staphylococci (MSCoNS) (0.03/0.12), methicillin-resistant coagulase-negative staphylococci (MRCoNS) (2/8), Streptococcus pneumoniae (0.016/0.25), viridans group streptococci (0.016/2), ß-hemolytic streptococci (≤0.008/≤0.008), Enterococcus faecalis (2/4), Enterococcus faecium (128/>128), Enterobacteriaceae (0.06/0.25), Pseudomonas aeruginosa (0.5/8), Acinetobacter baumannii (0.25/2), Haemophilus influenzae (0.12/0.25), and Moraxella catarrhalis (0.03/0.06). According to the regression curve, the zone diameter breakpoints were 24 and 19 mm for MICs of 1 and 4 mg/L, respectively. This study confirms the potent in vitro activity of doripenem against Pseudomonas aeruginosa, Acinetobacter, Enterobacteriaceae, MSSA, MSCoNS, and respiratory pathogens. According to the EUCAST MIC breakpoints (mg/L) ≤1/>4 for Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter, and ≤1/>1 for streptococci, pneumococci, and Haemophilus, the zone diameter breakpoints could be (mm) ≥24/<19 and ≥24/<24, respectively.

Correlation between the VITEK2 system and cefoxitin disk diffusion for the daily detection of oxacillin resistance in a large number of clinical Staphylococcus aureus isolates.

The aim of the present study was to compare the performance of the new VITEK2 AST-P551 card with the cefoxitin disk diffusion method for the daily detection of methicillin resistance with a high number of Staphylococcus aureus clinical isolates. Detection of the PBP2a protein or mecA gene was performed for each discordant case. Seventy (3.3%) isolates out of 2,107 clinical strains showed discordant results, two very major errors, four major errors and 64 minor errors. Fifty-nine (84%) discordant results were resolved, with a final overall agreement of 99.5%. Eleven (0.5%) strains remained discordant (minor error [mE]). Four of 370 MRSA strains were misclassified as susceptible in daily practice by the cefoxitin disk diffusion method. All of these strains were resistant to aminoglycosides and/or fluoroquinolones. The VITEK2 system is highly reliable for methicillin resistance detection at the routine level. Oxacillin-susceptible classified clinical strains with associated resistance patterns required attention.

Long-term evolution of a nosocomial outbreak of Pseudomonas aeruginosa producing VIM-2 metallo-enzyme.

From April 1996 to July 2004, an outbreak of metallo-beta-lactamase-positive (MBL) Pseudomonas aeruginosa occurred in the haematology ward at Nantes University Hospital in France. Fifty-nine patients were carriers of VIM-2-positive strains of whom 14 were infected (mostly urinary tract infections and pneumonia). Pulsed-field gel electrophoresis identified related isolates demonstrating resistance to all beta-lactams, aminoglycosides, fluoroquinolones, fosfomycin, rifampicin but not colistin. The bla(VIM-2) gene responsible for VIM-2 MBL was not plasmid-encoded but part of a novel type of class 1 integron. VIM-2-positive strains were mostly from urine samples and clinical data suggest that in the absence of therapeutic guidelines, piperacillin-tazobactam or aztreonam may be a reliable choice for treating infections with MBL-producing strains.

[Monitoring of antibiotic resistance of gram negative anaerobes]. / Surveillance de la résistance aux antibiotiques des anaérobies stricts à Gram négatif.

MATERIAL AND METHOD: Using an agar reference method (Norma M11-A5, National Committee for Clinical and Laboratory Standards) the minimal inhibitory concentrations of nine antibiotics were determined for 376 anaerobic strains. The following strains were investigated: 254 Bacteroides fragilis group (including 143 B. fragilis), 122 other gram-negative anaerobes (Bacteroides spp., Prevotella, Fusobacterium, Porphyromonas, Suterella, Desulfomonas, Veillonella). RESULTS: In the B. fragilis group resistance rates were: coamoxyclav 2.8%, ticarcillin 27.5%, ticarcillin-clavulanic acid 1.9%, piperacillin-tazobactam 1.9%, cefoxitin 6.2%, imipenem 0.8%, clindamycin 28.3%, respectively. Based on previous studies, resistance to imipenem remained low in 2003 and was only observed for B. fragilis. Resistance to clindamycin was maintained around 25%. No metronidazole resistance was observed, but decreased susceptibility was found for B. fragilis, B. merdae and Prevotella, as in 4.3% of gram-negative anaerobes. DISCUSSION: This study confirms the high resistance rate of gram-negative anaerobes to clindamycin, the efficient activity of imipenem, beta-lactam/beta-lactamase inhibitor combinations and metronidazole. However, reduced metronidazole susceptibility seems to be increasing.

[Clinical aspects and management of patients with tuberculous meningitis. Retrospective analysis from 1994 to 2005]. / Aspects cliniques et prise en charge thérapeutique des méningites tuberculeuses. Analyse rétrospective de 15 cas observés de 1994 à 2005.

Tuberculous meningitis remains a devastating disease with poor prognosis in terms of mortality or invalidating after-effects. Eighteen cases of tuberculous meningitis, occurred between 1994 and 2005, were re-examined retrospectively. Among the 18 patients, 13 were aged from 14 to 64 years, and 5 were older than 64. There was no gender dominance. Factors of risk were identified in 7 patients. British Medical Research Council staging was III in 9 patients, II in 2 patients and I in 7 patients. Protein and glucose levels in the cerebrospinal fluid sample were very variable ranging from 0.4 to 10.7 g/L and 0.4 to 3.7 mmol/L respectively. The cellular reaction was also very variable ranging from 0 to 250 elements, mostly lymphocytes. Antituberculous treatment was given to 15 patients, associated with corticosteroid therapy for 9 patients. Among the 18 patients, 11 died within 1 year, 4 were treated for a recurrence occurring up to 6 years after the diagnosis, 1 presented important neuropsychic after-effects and 2 patients survived without after-effects with a time ranging between 6 months and 1 year. The deceased patients were significantly older than the others. The risk of mortality was 4.5-fold greater among stage III patients than among stage I and II patients. The use of corticosteroids significantly reduced the risk of death.

Correlation of agar dilution and VITEK2 system for detection of resistance to macrolides, lincosamides and pristinamycin among Staphylococcus aureus and Staphylococcus epidermidis: association with genotypes.

The performance of the VITEK2 system was evaluated against the agar dilution reference procedure for testing susceptibility of Staphylococcus aureus and Staphylococcus epidermidis to macrolides, lincosamides and streptogramins (MLS). Eighty clinical isolates were selected according to their resistance phenotype and genotype. Results for erythromycin and clindamycin showed 100% agreement; results for lincomycin showed agreement of 78%, with one very major error and 17 minor errors; and results for pristinamycin showed agreement of 46%, with one major error and 43 minor errors. Most isolates resistant to lincomycin and streptogramin A (L SgAr phenotype) were falsely susceptible to lincomycin, and intermediately-resistant or resistant to pristinamycin, with the VITEK2 system. No resistance gene was detected. Most (80%) isolates resistant constitutively to MLS (MLS(r)BC phenotype) were falsely intermediately-resistant to pristinamycin with the VITEK2 system. The erm(A) gene was more common than erm(C) in MLS(r)BC strains. Resistance to pristinamycin alone (SgA SgB PTr phenotype), or associated with either lincomycin resistance (L SgA SgB PTr phenotype) or constitutive MLS(B) resistance (MLS(BC) SgA PTr phenotype), was well-characterised without discordant results. Resistance to pristinamycin was always associated with resistance to streptogramin A, encoded by the vga(A), vga(B), vgb(A) and vat(A) genes in association with the erm(A) or erm(C) genes.

[Efficacy and safety of extended-release clarithromycin (5-day short-course) vs telithromycin, in acute bacterial exacerbation of chronic bronchitis]. / Efficacité et tolérance de la clarithromycine, forme à libération modifiée en traitement court de cinq jours dans les exacerbations aiguës de bronchite chronique, comparativement à la télithromycine.

BACKGROUND: The extended-release formulation of clarithromycin (CLA-ER) allows using this macrolide as a single daily dose. The purpose of this study was to evaluate the efficacy and safety of the CLA-ER formulation (500 mgx2) vs telithromycin (TELI) (400 mgx2) as a short course 5-day treatment, once a day, in patients with AECB. METHOD: This randomized double-blind study was conducted in patients with AECB without severe airflow limitation (FEV1>35%), with sputum purulence (mandatory criterion), and with either increased sputum volume or increased dyspnea, or both (Anthonisen criteria I or II). RESULTS: Three hundred sixty-two patients were assessed (62.6 years of age+/-12.9, men: 58.8%) positive culture on inclusion for 53.8%, with Haemophilus influenzae (N=57), Moraxella catarrhalis (N=42), and Streptococcus pneumoniae (N=41). In the per protocol population, the clinical success rate at day 8 was 97% (161/166) vs 97% (146/151), 97.5% CI=[-4.12 -4.71], the clinical cure rate at day 30 was 78% (129/166) versus 77% (116/151), P=0.85, and mean time without recurrence was 62 days versus 61 days (P=0.51), in CLA-ER and TELI groups, respectively. Fourteen patients in the CLA-ER group (8.2%) and 20 patients in the TELI group (12.4%) experienced at least one treatment-related adverse event (P=0.21), upon which gastrointestinal events were the most commonly reported treatment-related ones. CONCLUSION: CLA-ER (1000 mg once a day) for 5 days is at least as effective as telithromycin in the treatment of AECB without severe airflow limitation and is well tolerated.

Rapid identification of Mycobacterium species.

Identification of Mycobacterium species is currently a long and fastidious procedure. We have developed a rapid (5-h) standard method using the API-ZYM system and rapid nitratase, urease and catalase tests. Pigmentation and growth rate were noted (but were only necessary for complete identification of 6% of strains). The tests were assigned numerical values from which a profile number was derived. A total of 716 strains were studied: 434 belonging to the M. tuberculosis complex and 282 other mycobacteria including 21 from M. avium complex. All M. tuberculosis complex strains were differentiated from all other mycobacteria and M. bovis was clearly separated from M. tuberculosis. All M. avium complex strains were differentiated from other mycobacteria. Among mycobacteria other than tubercle bacilli, 97% of the strains studied were identified. The method has proven to be simple, rapid and standardizable. It is suggested that the use of a code list could permit identification of most mycobacteria.

Activity of linezolid against Gram-positive cocci isolated in French hospitals as determined by three in-vitro susceptibility testing methods.

In total, 844 strains of Gram-positive cocci were collected from six university hospitals in France between September 1999 and January 2000. MICs of linezolid were determined: (i) for all strains by agar dilution (method A); (ii) by broth microdilution (method B) for staphylococci and enterococci; (iii) by Etest (method E) for beta-haemolytic streptococci and Streptococcus pneumoniae. Susceptibility to other antibiotics was determined by the disk diffusion method. MIC50 and MIC90 values were identical (2 mg/L) for methicillin-susceptible Staphylococcus aureus (n = 179) by methods A and B. Linezolid was active against methicillin-resistant S. aureus (n = 117), with an MIC90 of 2 mg/L (methods A and B), but with a lower MIC50 of 1 mg/L by method A. Of the 200 coagulase-negative staphylococci, 56.5% were methicillin-resistant and 43.5% were methicillin-susceptible. Linezolid had similar in-vitro activity by methods A and B (MIC50 and MIC90 values of 1-2 mg/L), irrespective of methicillin susceptibility. The MIC90 of linezolid for all enterococci (150 Enterococcus faecalis and 50 Enterococcus faecium) was 2 mg/L by both methods. MICs of linezolid for beta-haemolytic streptococci had a narrow range of 0.5-2 mg/L (method A) and 0.125-2 mg/L (method E). Pneumococci (n = 118), including 67 penicillin G-intermediate and -resistant strains, were all inhibited by linezolid 2 mg/L (MIC90 of 2 mg/L by methods A and E). No strain had an MIC of > 2 mg/L by agar dilution or Etest, or of > 4 mg/L by broth microdilution. Overall, the study confirmed the good in-vitro activity of linezolid and the very narrow range of MICs for Gram-positive cocci susceptible or resistant to other antibiotics, irrespective of the method used.

In vitro antibacterial activity of moxifloxacin against hospital isolates: a multicentre study.

OBJECTIVE: To evaluate the in vitro antibacterial activity of moxifloxacinin in comparison to that of other fluoroquinolones (ciprofloxacin, ofloxacin and trovafloxacin). METHODS: A total of 2,196 strains was collected in 11 French hospitals in 1998. Minimum inhibitory concentrations (MICs) (mg/L) were determined by agar dilution and agar diffusion was performed with 5-microg discs. Internal quality control was carried out with genetically defined strains. RESULTS: MIC50s and MIC90s of moxifloxacin against nalidixic acid (NAL)-susceptible Enterobacteriaceae (n = 663) were 0.12 and 0.5. As for other quinolones, the activity of moxifloxacin (4-32) was reduced against NAL-intermediate and NAL-resistant strains (n = 222). MIC50s and MIC90s of moxifloxacin were 2 and 4 for ciprofloxacin-susceptible P. aeruginosa (n = 128); moxifloxacin had no activity against ciprofloxacin-resistant strains (n = 56). The activity of moxifloxacin was maintained against NAL-susceptible A. baumannii (n = 11; 0.032-0.125), but reduced against NAL-resistant strains (n = 30; 16-32). H. influenzae (n = 97) and M. catarrhalis (n = 40) were inhibited by low concentrations (0.03-0.06 and 0.06-0.25, respectively). Moxifloxacin had better activity (0.06-0.12) than other tested quinolones against methicillin-susceptible S. aureus strains (n = 110); ciprofloxacin-resistant strains (n = 85) (2-8) were usually methicillin-resistant. Moxifloxacin was moderately active against enterococci (n = 149) (E. faecalis: 0.5-16; E. faecium: 2-4). Streptococci (n = 194) and pneumococci (n = 136), including 70 penicillin G-intermediate or G-resistant strains, were inhibited by low concentrations (0.25-0.5 for each species). Based on the regression curve, tentative zone diameter breakpoints could be > or =21 and <18 mm for MIC breakpoints of < or =1 and >2 mg/L, respectively. CONCLUSIONS: While retaining activity against Enterobacteriaceae, moxifloxacin was moderately active against P. aeruginosa. Its activity was inferior to that of ciprofloxacin for these species. This study confirmed the comparatively high in vitro activity of moxifloxacin against Gram-positive cocci and other pathogens isolated from community-acquired respiratory tract infections.

Pharmacokinetics and pharmacodynamics of two oral forms of cefuroxime axetil.

Cefuroxime axetil is a cefuroxime ester that can be administered by mouth. Two dosage forms (tablets and granules) have been developed for oral administration. We evaluated the pharmacokinetics and pharmacodynamics of these forms in an open cross-over study involving 12 healthy volunteers receiving single doses of 250 mg. The bioavailability of the two forms was different, the observed peak concentration and time-concentration curve values of the tablet form being, respectively, 39 and 27% higher than those of the granule form. However, ex vivo studies of serum bactericidal activity against Streptococcus pneumoniae showed no significant differences between the two formulations. This is in keeping with the fact that the bactericidal activity of samples from only six subjects gave evaluable data for Haemophilus influenzae; although small differences were found between the two formulations, further investigations are required. The pharmacodynamic approach is becoming an essential element in determining the equivalence of antibiotic dosage forms.

Pharmacokinetics of norfloxacin in the elderly.

9 elderly and 9 younger adult patients, with proven post-operative lower urinary tract infection were treated with 400 mg of norfloxacin twice daily for 5 days. Pharmacokinetics of norfloxacin were measured on days 1 and 5. Compared to the younger adult patients, the elderly showed a decreased creatinine clearance and, following the last dose on day 5, an increased maximum plasma concentration of norfloxacin, an increased area under the concentration-time curve and a decreased total body clearance of norfloxacin. These results confirm that in elderly, as in younger adult patients, the pharmacokinetics of norfloxacin can be described by a linear model and accumulation of the drug during repetitive multiple doses is predictable. The differences between the two groups cannot be considered as clinically significant so that no dose change would be required in elderly patients within the range of creatinine clearance studied.

Actinomycosis of the gallbladder due to Actinomyces naeslundii.

We report two cases of actinomycosis of the gallbladder due to Actinomyces naeslundii. Both patients presented with acute cholecystitis. After cholecystectomy with the removal of gallstones each patient made an uneventful recovery. The literature on cholecystitis due to Actinomyces is reviewed.

Compared sensitivities of 532 bacterial strains to six cephalosporins.

In this study measurements were made of the minimal inhibitory concentrations of 6 cephalosporins (cefamandole, cefuroxime, cefadroxil, cefoxatin and cefotaxime in comparison with cefalothin) against 532 bacterial strains isolated at the Regional Hospital Centre, Nantes, France, between 15.12.1977 and 15.3.1978. There were 163 Gram-positive bacteria of 2 species and 369 Gram-negative bacilli of 11 species and different genera. The results have been produced in the form of cumulative curves, in percentage for the most numerous genera or species. Cefalothin remained the most active on S. aureus and Listeria. Cefamandole came second. The action of the four other cephalosporins was very closely related to that in relation to S. aureus. For all the Gram-negative bacilli, Cefotaxime was the most active. Its MIC's can be up to more than 100 times lower than those of the other cephalosporins. Of the others, cefamandole appeared the best. It was difficult to classify the last four, as the MIC's may vary from one bacterial species to another. The bacterial activity (MBC) in a liquid medium was found for 178 of the strains (10 genera or species) of which one was Gram-positive (S. aureus). The ratio MBC/MIC (the measurements were taken in a liquid medium in all cases) confirmed the fact that all the cephalosporins are clearly bactericidal (the ratio was most often equal to 1 and sometimes to 2) for all the Gram-negative bacilli. Cefalothin and cefotaxime appeared the most bactericidal and cefamandole the least.

A new approach to optimal antibiotic dosage regimen by coupling pharmacokinetics and killing curve parameters.

Antibiotic therapy is directed against bacteria responsible for infectious pathology which are able to resist treatment mainly when the dosage is misadapted. The choice of the initial dosage regimen actually takes into account toxicological, bacteriological and pharmacokinetic parameters. The determination of the classical bacteriological data is performed in vitro using fixed drug concentrations that are far from human therapy conditions, and moreover the efficiency is not well defined. The estimation of the pharmacokinetic parameters is realized in animals, healthy subjects or ill patients but takes into account only the drug disposition without correspondence with the kinetics of the antibiotic effect on the bacteria. Thus, each type of evaluation is made independently from the others without any correlation between the observed phenomena. It appears, therefore, interesting to propose a new approach including pharmacokinetic and bacteriological data to enable approximation of drug efficacy. The coupled evaluation of individual pharmacokinetic estimation and the killing curve determinations of an antibiotic will allow this type of development. On the basis of these data, a preliminary profile of the optimal dosage would be possible. This methodology has been applied to three antibiotics: teicoplanin, amikacin and ofloxacin and demonstrates a time- or dose-dependent activity, with interesting possibilities for optimization of dosage.

[Campylobacter pylori and gastric mucosa: histological and bacteriological study and preliminary results of an epidemiological survey in the area of Nantes]. / "Campylobacter pylori" et muqueuse gastrique: étude histologique, bactériologique et résultats préliminaires d'une enquête épidémiologique dans la région nantaise.

The aims of this study were to: a) evaluate the prevalence of Campylobacter pylori (CP) in patients referred to a gastroenterology unit for upper digestive tract endoscopy, b) compare the results of histologic (Warthin-Starry method) and bacteriologic (direct and culture) examinations, c) correlate the presence and abundance of CP with the "activity" of chronic gastritis as assessed by antral and fundic specimens, and d) report the preliminary results of an epidemiological survey in the area of Nantes, France. CP was observed in 30 of the 64 patients studied (46 p. 100 of cases), and was significantly associated with chronic gastritis of either the superficial or interstitial (87 vs. 12 p. 100 of patients positive and negative, respectively for CP studies, p less than 10(-9], and preatrophic and/or atrophic types (40 vs. 12 p. 100 of patients positive and negative, respectively, for CP studies, p less than 0.01). CP was also present in 7 of 10 patients with duodenal ulcers and in 4 to 6 with gastric ulcers. Histologic and bacteriologic studies gave concordant results in 94 p. 100 of cases, and had the same sensitivity for diagnosis. Patients positive for CP studies had a statistically significant increased incidence of epigastric burns, and, at endoscopic examination, their fundic area appeared congestive more frequently. CP were dictated in both the antrum and fundus, but lesions of chronic gastritis were more prominent in the former. There was a statistically significant correlation between the degree of inflammation observed in the lamina propria and the number of CP present in the same area (antrum and fundus).(ABSTRACT TRUNCATED AT 250 WORDS)

[Antibacterial activity of urine after administration of ofloxacin for 5 days]. / Activité antibactérienne des urines après administration d'ofloxacine pendant 5 jours.

The antibacterial activity of ofloxacin was evaluated in urine over a period of 96 h after oral administration for 5 days of 200 mg twice a day in 12 healthy female volunteers. Bacteriostatic and bactericidal activity of urines were studied for five strains of enterobacterias recovered from urinary infections: two strains of Escherichia Coli Nal-S and Nal-R, two strains of Proteus mirabilis Nal-S and Nal-R, and one strain of Klebsiella pneumoniae Nal-S. Mean urinary concentrations of ofloxacin were very high during the first 12 h following last intake. They were still above 7 mg/l till the 48th hour and above 1.6 mg/l till the 72nd hour. Bactericidal activity of urine was present for 72 h in respect of four strains studied at that time; urine was not bactericidal as regards E. coli Nal-R. After 5 days of oral treatment with ofloxacin (200 mg b.i.d.), urine retains a bactericidal activity for at least 72 h against bacterial strains of urinary tract infections.

[Comparison of two methods of antibiotic sensitivity test: gel diffusion and automatic method using ABAC apparatus. II. Study on 399 strains isolated in hospital (author's transl)]. / Comparaison de deux méthodes d'antibiogramme: diffusion en gélose et méthode automatisée par l'appareil ABAC. II. Etude sur 399 souches isolées en milieu hospitalier.

The authors compared for routine use, the results obtained on 399 strains of Gram negative bacilli by two technics of antibiotic sensitivity: the technic of gel diffusion with imprenated discs and an automatic method (ABAC apparatus). Among the antibiotics used as a routine in our laboratory by the diffusion method and the 16 studied with the ABAC apparatus, 11 are common to both methods and were compared. The concordance of the results was greater than 90% for colistine (94.5%), oxolinic acid (93.5%), tobramycin (91.7%). It lies between 80 and 90% in the case of carbenicillin (89.1%), nalidixic acid (87.5%), kanamycin (87.2%). It is less in the case of gentamicin (77.9%), ampicillin (77.3%, chloramphenicol (76%), streptomycin (70.3%), minocycline with 55.9% gave the lowest results. The percentage of uninterpretable responses by ABAC was 0.7% for all 11 antibiotics. The correlations were good for the Enterobacteriaceae: Serratia (75.4%), Eschericia coli (87.5%). They are less in the case of Pseudomonas aeruginosa (71.6%). The ABAC makes sensitivity test automatic and appears a reliable method.

[Comparison of two methods of antibiotic sensitivity tests: gel diffusion and automatic method using ABAC apparatus. I. Variation and dispersion of the two methods (author's transl)]. / Comparaison de deux méthodes d'antibiogramme: diffusion en gélose et méthode automatisée par l'appareil ABAC. I. Variation et dispersion des deux méthodes.

The authors studied comparatively the sensitivity of 3 bacterial strains (P. Aeruginosa and two E. coli) with regard to antibiotics using an automatic method (ABAC) compared with a gel diffusion technic with impregnated disks. Each strain was tested by both methods 50 to 55 times. The diffusion method was easily reproducible with an average standard deviation of 2.23 mm. Its results were in agreement compared with the average diameter of measurements in 93.3% of cases. The automatic method gave results which agreed together in 95.7% of cases. It is thus reproducible. If one compares it with the results of the diffusion method, considered here as the reference method, we obtained the same response in 86.3% of cases. In 13.7% there was disagreement in interpretation (in most cases, the strain found intermediate in gel diffusion was considered sensitive on autoanalysis).

[Microgallery for the identification of anaerobic bacteria]. / Utilisation d'une microgalerie pour l'identification des bactéries anaérobies.

A microgallery for the identification of anaerobic bacteria (API 20A) was used with regard to 213 strictly anaerobic strains isolated between 1.12.74 and 30.11.75 in a hospital laboratory. Furthermore, 75 strains of Bacteroides fragilis isolated previously were added to this study. All the strains were identified by traditional methods. The results of tests performed with the microgallery alone permitted the species diagnosis in 72,2% of cases. Performing simultaneously complementary tests (7 to 9 Tubes, according to the nature of the bacteria) the species diagnosis was possible in 89.9% of cases. The main interest of this microgallery was its use for the identification of glucidolytic strains for it included the presence of 17 ternary substances. Its use for the other groups of strains was thus limited.