Publications (6)29.06 Total impact
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Article: Time-to-positivity-based discrimination between Enterobacteriaceae, Pseudomonas aeruginosa and strictly anaerobic Gram-negative bacilli in aerobic and anaerobic blood culture vials.
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ABSTRACT: Time-to-positivity (TTP) of first positive blood cultures growing Gram-negative bacilli (GNB) was investigated. When anaerobic vials were positive first, TTP≤18hours differentiated Enterobacteriaceae from strict anaerobic Gram-negative bacilli (PPV 98.8%). When the aerobic ones were first, TTP≤13hours differentiated Enterobacteriaceae from Pseudomonas aeruginosa and other GNB (PPV 80.8%).Journal of microbiological methods 02/2013; · 2.43 Impact Factor -
Article: Emergence of Imipenem-resistant Gram-negative Bacilli in Intestinal Flora of Intensive Care Patients.
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ABSTRACT: Intestinal flora contains a reservoir of gram-negative bacilli (GNB) resistant to cephalosporins, which are potentially pathogenic for intensive care unit (ICU) patients; this has led to increasing use of carbapenems. The emergence of carbapenem resistance is a major concern for ICUs. Therefore, in this study, we aimed to assess the intestinal carriage of imipenem-resistant GNB (IR-GNB) in intensive care patients. For 6 months, 523 consecutive ICU patients were screened for rectal IR-GNB colonization upon admission and weekly thereafter. The phenotypes and genotypes of all isolates were determined, and a case-control study was performed to identify risk factors for colonization. The IR-GNB colonization rate increased regularly from 5.6% after 1 week to 58.6% after 6 weeks in the ICU. In all, 56 IR-GNB strains were collected from 50 patients: 36 P. aeruginosa, 12 S. maltophilia, 6 Enterobacteriaceae, and 2 A. baumannii. In P. aeruginosa, imipenem resistance was due to chromosomally encoded resistance (32 strains) or carbapenemase production (4 strains). In the Enterobacteriaceae strains, resistance was due to AmpC cephalosporinase and/or extended-spectrum β-lactamase production with porin loss. Genomic comparison showed that the strains were highly diverse, with 8 exceptions (4 VIM-2 producing P. aeruginosa, 2 K. pneumoniae and 2 S. maltophilia). The main risk factor for IR-GNB colonization was prior imipenem exposure. The odds ratio for colonization was already as high as 5.9 (95% CI, 1.5-25.7) after 1-3 days of exposure and increased to 7.8 (95% CI, 2.4-29.8) thereafter. In conclusion, even brief exposure to imipenem is a major risk factor for IR-GNB carriage.Antimicrobial Agents and Chemotherapy 01/2013; · 4.84 Impact Factor -
Article: Massive increase, spread, and exchange of extended spectrum β-lactamase-encoding genes among intestinal Enterobacteriaceae in hospitalized children with severe acute malnutrition in Niger.
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ABSTRACT: From the time of CTX-M emergence, extended-spectrum β-lactamase-producing enterobacteria (ESBL-E) have spread worldwide in community settings as well as in hospitals, particularly in developing countries. Although their dissemination appears linked to Escherichia coli intestinal carriage, precise paths of this dynamic are largely unknown. Children from a pediatric renutrition center were prospectively enrolled in a fecal carriage study. Antibiotic exposure was recorded. ESBL-E strains were isolated using selective media from fecal samples obtained at admission and, when negative, also at discharge. ESBL-encoding genes were identified, their environments and plasmids were characterized, and clonality was assessed with polymerase chain reaction-based methods and pulsed-field gel electrophoresis for E. coli and Klebsiella pneumoniae. E. coli strains were subjected to multilocus sequence typing. The ESBL-E carriage rate was 31% at admission in the 55 children enrolled. All children enrolled received antibiotics during hospitalization. Among the ESBL-E-negative children, 16 were resampled at discharge, and the acquisition rate was 94%. The bla(CTX-M-15) gene was found in >90% of the carriers. Genetic environments and plasmid characterization evidenced the roles of a worldwide, previously described, multidrug-resistant region and of IncF plasmids in CTX-M-15 E. coli dissemination. Diversity of CTX-M-15-carrying genetic structures and clonality of acquired ESBL E. coli suggested horizontal genetic transfer and underlined the potential of some ST types for nosocomial cross-transmission. Cross-transmission and high selective pressure lead to very high acquisition of ESBL-E carriage, contributing to dissemination in the community. Strict hygiene measures as well as careful balancing of benefit-risk ratio of current antibiotic policies need to be reevaluated.Clinical Infectious Diseases 10/2011; 53(7):677-85. · 9.15 Impact Factor -
Article: Development of a phenotypic method for detection of fecal carriage of OXA-48-producing enterobacteriaceae after incidental detection from clinical specimen.
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ABSTRACT: We report incidental isolation of an OXA-48-producing Escherichia coli strain in urine of a 62-year-old woman recently returning from a 2-month vacation in Morocco. Commercially available extended-spectrum beta-lactamase (ESBL)-targeting medium failed to detect it in the patient's stools, although a locally developed and easy-to-implement method using ertapenem-supplemented brain heart infusion (BHI) broths could.Journal of clinical microbiology 05/2011; 49(7):2761-2. · 4.16 Impact Factor -
Article: Maternal vaginal colonisation by Staphylococcus aureus and newborn acquisition at delivery.
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ABSTRACT: We studied 1139 mother-infant pairs where the mother had had at least one vaginal swab in the month before delivery and their babies had had gastric and ear swabs taken immediately after delivery. The prevalence of vaginal carriage of Staphylococcus aureus was 5.9% among 1139 pregnant women within 1 month of delivery. The colonisation rate of S. aureus in newborns was tenfold higher when the mother was a vaginal carrier than when she was not (31.3% vs. 2.7%; relative risk 11.6 [95% CI 7.0, 19.2]; P < 0.05). Among carriers, delivery by caesarean section compared with the vaginal route, significantly decreased the likelihood of S. aureus colonisation in the newborns (15.4% vs. 41.5%; relative risk 0.35 [95% CI 0.14, 0.98]; P < 0.03). No S. aureus colonisation was detected in the mothers of 58% of the colonised newborns suggesting extra-delivery colonisation routes. Consequences for newborns were unclear as only one case of S. aureus neonatal sepsis was observed.Paediatric and Perinatal Epidemiology 09/2010; 24(5):488-91. · 2.31 Impact Factor -
Article: Antimicrobial resistance in commensal flora of pig farmers.
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ABSTRACT: We assessed the quantitative contribution of pig farming to antimicrobial resistance in the commensal flora of pig farmers by comparing 113 healthy pig farmers from the major French porcine production areas to 113 nonfarmers, each matched for sex, age, and county of residence. All reported that they had not taken antiimicrobial agents within the previous month. Throat, nasal, and fecal swabs were screened for resistant microorganisms on agar containing selected antimicrobial agents. Nasopharyngeal carriage of Staphylococcus aureus was significantly more frequent in pig farmers, as was macrolide resistance of S. aureus from carriers. Nongroupable streptococci from the throat were more resistant to the penicillins in pig farmers. The intestinal isolation of enterococci resistant to erythromycin or vancomycin was not significantly higher in pig farmers in contrast to that of enterobacteria resistant to nalidixic acid, chloramphenicol, tetracycline, and streptomycin. Prevalence of resistance in predominant fecal enterobacteria was also significantly higher in pig farmers for cotrimoxazole, tetracycline, streptomycin, and nalidixic acid. We determined a significant association between pig farming and isolation of resistant commensal bacteria.Emerging infectious diseases 06/2004; 10(5):873-9. · 6.17 Impact Factor
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2010–2013
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Hôpital "Bichat - Claude-Bernard" – Hôpitaux Universitaires Paris Nord Val de Seine
Paris, Ile-de-France, France
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