[Phenotype and genotype analysis of Torulopsis glabrata isolated from nosocomial infections]. / Analyse phénotypique et génotypique de souches de Torulopsis glabrata isolées lors d'infections nosocomiales.

Twenty-one strains of Torulopsis glabrata have been isolated in the hospital of Versailles during a three months period, in eight patients, and related to nosocomial infections. In order to know if they have been cross infected, a genotypic analysis (pulsed field electrophoresis) has been performed. The strains from four patients had the same karyotype, suggesting they had probably crossed infections. Since this kind of analysis is expensive and time consuming, we have tried a more practical approach. The susceptibility of the strains has been tested by Etest for five antifungal agents: amphotericin B, 5-fluorocytosine, ketoconazole, fluconazole et itraconazole. Statistical analysis of these results has not given the same classification of the strains of T. glabrata. Karyotyping by pulsed field electrophoresis of strains seems to be a better method to confirm strain clonality.

[Antibiotic sensitivity of enterobacteria in intensive care units]. / Sensibilité des entérobactéries aux antibiotiques en unités de soins intensifs.

Antibiotic therapy of intensive care patients is usually undocumented. The treatment is chosen according to epidemiologic and susceptibility data from microbiological laboratories. The aim of our study is to determine antibiotic susceptibility of enterobacteria isolated from intensive care patients during a five-month multicenter study in 18 French hospitals. Numerous (n = 1,113) strains were studied: 447 enterobacteria isolated from urine (n = 229), blood cultures (n = 106), respiratory tract specimens (n = 72), peritoneal fluids (n = 22), pus (n = 15) and catheters (n = 2). MICs of group 2 and group 3 enterobacteria were determined using the dilution agar method and were interpreted according to the CASFM (Comité de l'antibiogramme de la société française de microbiology) recommendations. Group 1 enterobacteria were most frequently isolated (67%). Only one Escherichia coli strain produced ESBL (0.3%). Among group 2 enterobacteria, one Citrobacter koseri strain produced ESBL. We did not isolate Klebsiella pneumoniae ESBL. Isolation of group 3 enterobacteria was frequent (24%). Thirty-five percent of group 3 enterobacteria were resistant to cefotaxime, 26% to ceftazidime and 16% to cefepime and cefpirome. Fourteen strains of this group produced ESBL: 13 Enterobacter aerogenes and one E. amnigenus.