J Croize

University Joseph Fourier - Grenoble 1, Grenoble, Rhône-Alpes, France

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Publications (131)260.91 Total impact

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    ABSTRACT: Streptococcus pneumoniae is an important cause of acute otitis media (AOM). The aim of this study was to evaluate trends in antibiotic resistance and circulating serotypes of pneumococci isolated from middle ear fluid of French children with AOM during the period 2001-2011, before and after the introduction of the PCV-7 (2003) and PCV-13 (2010) vaccines. Between 2001 and 2011 the French pneumococcal surveillance network analysed the antibiotic susceptibility of 6683 S. pneumoniae isolated from children with AOM, of which 1569 were serotyped. We observed a significant overall increase in antibiotic susceptibility. Respective resistance (I+R) rates in 2001 and 2011 were 76.9% and 57.3% for penicillin, 43.0% and 29.8% for amoxicillin, and 28.6% and 13.0% for cefotaxime. We also found a marked reduction in vaccine serotypes after PCV-7 implementation, from 63.0% in 2001 to 13.2% in 2011, while the incidence of the additional six serotypes included in PCV-13 increased during the same period, with a particularly high proportion of 19A isolates. The proportion of some non-PCV-13 serotypes also increased between 2001 and 2011, especially 15A and 23A. Before PCV-7 implementation, most (70.8%) penicillin non-susceptible pneumococci belonged to PCV-7 serotypes, whereas in 2011, 56.8% of penicillin non-susceptible pneumococci belonged to serotype 19A. Between 2001 and 2011, antibiotic resistance among pneumococci responsible for AOM in France fell markedly, and PCV-7 serotypes were replaced by non-PCV-7 serotypes, especially 19A. We are continuing to assess the impact of PCV-13, introduced in France in 2010, on pneumococcal serotype circulation and antibiotic resistance. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · Jan 2015 · Clinical Microbiology and Infection
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    ABSTRACT: We report a case of transfusion-associated bacteremia caused by Psychrobacter arenosus. This psychrotolerant bacterium was previously isolated in 2004 from coastal sea ice and sediments in the Sea of Japan, but not from humans. P. arenosus should be considered a psychrotolerant bacterial species that can cause transfusion-transmitted bacterial infections.
    Full-text · Article · Jul 2013 · Emerging Infectious Diseases
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    ABSTRACT: INTRODUCTION: The surveillance of Clostridium difficile infections (CDI) in France was reinforced after the emergence of the PCR-ribotype 027 epidemic clone in 2006; notification of case clusters or severe cases by healthcare facilities (HCF) became mandatory. The French Public Health Surveillance Institute (InVS) and the C. difficile National Reference Center (NRC) launched a national, prospective, multicentric survey to complete available data, in 2009. The survey had for objectives to assess CDI incidence and to characterize the strains responsible for CDI. PATIENTS AND METHODS: Every month from March to August 2009, HCF notified the total number of new CDI cases, admissions, and patient-days (PD) to the InVS. A subset of participating HCF sent strains, isolated in March 2009 from CDI patients, to the NRC. RESULTS: One hundred and five HCF with acute care wards and 95 with rehabilitation/long-term care (RLTC) wards participated in the 6-month epidemiological study. The incidence of CDI was 2.28 or 1.15 cases per 10,000 PD in acute care (n=1316 cases) or RLTC (n=295 cases), respectively. Seventy-eight HCF participated in the microbiological study. Two hundred and twenty-four (94.9%) of the 236 strains received by the NRC were toxigenic. The five major PCR-ribotypes were 014/020/077 (18.7%), 078/126 (12.1%), 015 (8.5%), 002 (8%), and 005 (4.9%). CONCLUSION: The incidence of CDI in 2009 in France remained lower than in other European countries, suggesting a successful impact of the 2006 recommendations for CDI control.
    Full-text · Article · Mar 2013 · Médecine et Maladies Infectieuses
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    ABSTRACT: We describe a septic loosening of a hip prosthesis in a 71-year-old woman caused by Gardnerella vaginalis. Infection was confirmed by culture and molecular identification of this bacterium. The patient was treated by one-step exchange of prosthesis and antibiotic therapy combining trimethoprim-sulfamethoxazole and rifampin, with favourable evolution.
    No preview · Article · Sep 2012 · Journal of clinical microbiology
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    ABSTRACT: We present three unrelated post-cataract surgery endophthalmitis cases caused by Rhizobium radiobacter, hospitalized in three different hospitals. Early diagnosis was obtained in two cases by bacterial DNA detection in vitreous samples. All patients recovered from infection, but pars plana vitrectomy was needed in two patients due to rapid clinical deterioration.
    Full-text · Article · Jan 2012 · Journal of clinical microbiology
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    ABSTRACT: We report two severe cases of infant botulism diagnosed at Grenoble University Hospital, France, respectively in 2006 and 2009. Both cases were characterized by a delay in diagnosis, severe neurological manifestations and extended period of hospitalization in intensive care unit, but a complete recovery. Infant botulism is a rare but life-threatening disease. It primarily affects infants, and the main risk factor is honey ingestion. Diagnosis should be systematically evoked by pediatricians in infants suffering from constipation, fatigue, muscle weakness, difficult feeding and altered cry, but before the onset of generalized flaccid paralysis, so as to administer specific treatment (BabyBIG®, a human derived botulinum antitoxin) at an early stage of the disease when it is most effective. In conclusion, parents should be aware of the role of honey as a source of spores of Clostridium botulinum and therefore infant botulism in the first year of life.
    No preview · Article · Dec 2011 · European Journal of Pediatrics
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    ABSTRACT: Antimicrobial resistance of Streptococcus pneumoniae in France is closely monitored by the pneumococcus surveillance network, founded in 1995, which collects data from regional observatories (Observatoire Régionaux du Pneumocoque [ORP]). In 2007, 23 ORPs analyzed the antibiotic susceptibility of 5,302 isolates of S. pneumoniae recovered in France from cerebrospinal fluid, blood, middle ear fluid, and pleural fluid, as well as from adult respiratory samples. The study showed that 38.2% of the strains were nonsusceptible to penicillin, 19.3% nonsusceptible to amoxicillin, and 10.5% nonsusceptible to cefotaxime. The percentage of pneumococcus nonsusceptible to penicillin varied according to both the sample and the age of the patient (child/adult): blood (27.8%/32.5%), cerebrospinal fluid (33.7%/34.6%), middle ear fluid (60.2%/27.5%), and pleural fluid (50.0%/31.0%). Between 2003 and 2007, the frequency of penicillin resistance in invasive pneumococcal disease gradually decreased from 46.4% to 29.0% in children and from 43.8% to 32.7% in adults. This decrease coincided with the introduction of a seven-valent pneumococcal conjugate vaccine into immunization programs and with a general reduction in levels of antibiotic consumption in France.
    No preview · Article · Mar 2011 · Microbial drug resistance (Larchmont, N.Y.)
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    ABSTRACT: Antibiotic-resistant Streptococcus pneumoniae (Sp) are described around the world. The present national surveillance study report analyzes more than 6000 Sp strains, isolated from adults across France in 2001 and 2003, from blood cultures (3086 in 2001 and 3164 in 2003), cerebrospinal fluid (respectively, 238 and 240), or middle ear fluid (respectively, 110 and 100). The proportion of isolates with reduced susceptibility to penicillin fell significantly between 2001 and 2003 from 46.5% to 43.9%. The proportion of high-level resistant strains to penicillin minimal inhibitory concentrations (MIC > 1 mg/L), amoxicillin, and cefotaxime (MIC > 2 mg/L) slightly decreased but remained low: 10.6%, 1.2%, and 0.2% in 2003. Resistance to other antibiotics (erythromycin, cotrimoxazole, tetracycline, and chloramphenicol) also decreased. Decrease in prevalence of penicillin-resistant Sp varied according to specimen source. The proportion of penicillin nonsusceptible pneumococci decreased in blood cultures and middle ear fluids between 2001 and 2003 but increased in cerebrospinal fluid (43.4% and 46.5%, respectively). Serotypes covered by the heptavalent vaccine accounted for 42.4% of all isolates recovered in 2001 and 46.1% in 2003. Prevalence of antibiotic-resistant Sp decreased in 2003 in France.
    No preview · Article · Sep 2009 · Microbial drug resistance (Larchmont, N.Y.)
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    ABSTRACT: The usefulness of two quantitative real-time PCR assays (qrt-PCRmip targeting Legionella pneumophila, and qrt-PCR16S targeting all Legionella species) performed on lower respiratory tract (LRT) samples for diagnostic and prognostic purposes in 311 patients hospitalized for community-acquired pneumonia (CAP) in Rhône-Alpes (France) was evaluated. The Now Legionella urinary antigen test (UAT) from Binax (Portland, ME, USA) was used as a reference test. Samples were divided into two groups. Group A included 255 CAP patients admitted to Chambery hospital in 2005 and 2006. The Now Legionella UAT was positive in 14 patients. Sensitivities, specificities, positive predictive and negative predictive values for both qrt-PCR tests were 63.6, 98.7, 77.7 and 97.4%, respectively. Group B included 56 consecutive legionellosis patients diagnosed during a 4-year period (2003-2006) at the Grenoble University Hospital. The qrt-PCR16S and qrt-PCRmip displayed a sensitivity of 82.14 and 80.4%, respectively. Among the 70 legionellosis cases, L. pneumophila serogroup 1 was isolated in 15; qrt-PCRmip was positive in another 36, suggesting L. pneumophila infection, whereas the Legionella species involved could not be determined in the remaining 19 cases. The Legionella burden in LRT samples at the time of admission was determined in 46 patients using qrt-PCR16S tests, 44 for qrt-PCR mip groups A and B patients. It varied from 1.9 to 8.35 log(10) DNA copies/mL of LRT sample for qrt-PCR16S and from 1.9 to 8.11 log(10) DNA copies/mL of sample for qrt-PCRmip. High bacterial loads in LRT samples at hospital admission were significantly associated with higher Fine classes, the need for hospitalization in an intensive care unit and for prolonged hospitalization.
    Full-text · Article · Jul 2009 · Clinical Microbiology and Infection
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    ABSTRACT: The purpose of this study was to evaluate the possibility of using a semi-automated repetitive DNA sequences-based polymerase chain reaction (rep-PCR) for typing Pseudomonas aeruginosa isolates. rep-PCR profiles obtained by the DiversiLab system of 84 P. aeruginosa isolates from distinct epidemiological situations were obtained. rep-PCR groupings were in good agreement with the origin of these isolates. Linked rep-PCR profiles were observed for isolates recovered from a same family of cystic fibrosis (CF) patients, for the etiological agents of clustered cases of nosocomial infections, and for some isolates recovered from a same hospital room. rep-PCR and pulsed-field gel electrophoresis SpeI restricted genomic DNA (PFGE-SpeI) profiles were compared. In a few instances, rep-PCR revealed genetic divergences among isolates of a same group of PFGE-SpeI profiles. These divergences could reflect genetic drifts among closely related isolates, as illustrated by those observed between clinical and environmental isolates of a same group of PFGE-SpeI profiles. The interpretation of such differences will require further studies, but the rep-PCR analysis of P. aeruginosa diversity appeared to be an appropriate method to investigate infra-specific genetic relatedness.
    No preview · Article · Jun 2009 · European Journal of Clinical Microbiology
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    ABSTRACT: Acinetobacter baumannii isolate KAR was uncommonly more resistant to cefepime and cefpirome than to ceftazidime and cefotaxime. Cloning and expression of the β-lactamase gene content of this isolate into Escherichia coli TOP10 identified ß-lactamase RTG-4 (or CARB-10), which corresponds to the first reported extended-spectrum CARB-type enzyme. RTG-4 is a plasmid-encoded Ambler class A β-lactamase whose sequence differs by 4 amino acid substitutions from the narrow-spectrum β-lactamase RTG-3. RTG-4 hydrolyzes cefepime and cefpirome and weakly hydrolyzes ceftazidime due to the single Ser-to-Thr substitution at Ambler position 69. RTG-4 is less susceptible to inhibition by tazobactam and sulbactam than RTG-3. Expression of β-lactamase RTG-4 in a wild-type A. baumannii reference strain showed that it conferred resistance to cefepime and cefpirome. The genetic environment of the blaRTG-4 gene was made of a peculiar transposon located on a ca. 50-kb plasmid. ISAba9, located upstream of blaRTG-4, may be responsible for its acquisition by recognizing a secondary right inverted repeat sequence, thus acting by a one-ended transposition process.
    Full-text · Article · May 2009 · Antimicrobial Agents and Chemotherapy
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    ABSTRACT: Two clonally related Acinetobacter baumannii isolates, A1 and A2, were obtained from the same patient. Isolate A2, selected after an imipenem-containing treatment, showed reduced susceptibility to carbapenems. This resistance pattern was related to insertion of the ISAba1 element upstream of the naturally occurring blaOXA-66 carbapenemase gene as demonstrated by sequencing, reverse transcription-PCR analysis, and inactivation of the blaOXA-66 gene.
    Preview · Article · Apr 2009 · Antimicrobial Agents and Chemotherapy
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    ABSTRACT: Use of a chlorhexidine gluconate-impregnated sponge (CHGIS) in intravascular catheter dressings may reduce catheter-related infections (CRIs). Changing catheter dressings every 3 days may be more frequent than necessary. To assess superiority of CHGIS dressings regarding the rate of major CRIs (clinical sepsis with or without bloodstream infection) and noninferiority (less than 3% colonization-rate increase) of 7-day vs 3-day dressing changes. Assessor-blind, 2 x 2 factorial, randomized controlled trial conducted from December 2006 through June 2008 and recruiting patients from 7 intensive care units in 3 university and 2 general hospitals in France. Patients were adults (>18 years) expected to require an arterial catheter, central-vein catheter, or both inserted for 48 hours or longer. Use of CHGIS vs standard dressings (controls). Scheduled change of unsoiled adherent dressings every 3 vs every 7 days, with immediate change of any soiled or leaking dressings. Major CRIs for comparison of CHGIS vs control dressings; colonization rate for comparison of 3- vs 7-day dressing changes. Of 2095 eligible patients, 1636 (3778 catheters, 28,931 catheter-days) could be evaluated. The median duration of catheter insertion was 6 (interquartile range [IQR], 4-10) days. There was no interaction between the interventions. Use of CHGIS dressings decreased the rates of major CRIs (10/1953 [0.5%], 0.6 per 1000 catheter-days vs 19/1825 [1.1%], 1.4 per 1000 catheter-days; hazard ratio [HR], 0.39 [95% confidence interval {CI}, 0.17-0.93]; P = .03) and catheter-related bloodstream infections (6/1953 catheters, 0.40 per 1000 catheter-days vs 17/1825 catheters, 1.3 per 1000 catheter-days; HR, 0.24 [95% CI, 0.09-0.65]). Use of CHGIS dressings was not associated with greater resistance of bacteria in skin samples at catheter removal. Severe CHGIS-associated contact dermatitis occurred in 8 patients (5.3 per 1000 catheters). Use of CHGIS dressings prevented 1 major CRI per 117 catheters. Catheter colonization rates were 142 of 1657 catheters (7.8%) in the 3-day group (10.4 per 1000 catheter-days) and 168 of 1828 catheters (8.6%) in the 7-day group (11.0 per 1000 catheter-days), a mean absolute difference of 0.8% (95% CI, -1.78% to 2.15%) (HR, 0.99; 95% CI, 0.77-1.28), indicating noninferiority of 7-day changes. The median number of dressing changes per catheter was 4 (IQR, 3-6) in the 3-day group and 3 (IQR, 2-5) in the 7-day group (P < .001). Use of CHGIS dressings with intravascular catheters in the intensive care unit reduced risk of infection even when background infection rates were low. Reducing the frequency of changing unsoiled adherent dressings from every 3 days to every 7 days modestly reduces the total number of dressing changes and appears safe. clinicaltrials.gov Identifier: NCT00417235.
    Full-text · Article · Apr 2009 · JAMA The Journal of the American Medical Association
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    ABSTRACT: In the context of reducing endoscopy-related infectious risk and new national guidelines on microbiological samples from bronchoscopy, the results of a surveillance program set up in a hospital center were analyzed. Over 4 years, scheduled samples were taken from disinfected bronchoscopes. Bacteriology and mycology tests were used to search for microorganisms. The results were interpreted as falling within three levels: target, alert, and action. Factors that could explain the contamination were studied: age of the bronchoscope, number of uses per year, brand, and model. Out of 96 scheduled samples taken, the compliance rate for the period was 83% and increased (p=0.06) over the 4 years. We identified 15 Pseudomonas (six aeruginosa and nine other species), one Stenotrophomonas, one enterobacterium, and two filamentous fungi. None of the factors studied had a significant effect on sample contamination. The microbiological surveillance of bronchoscopes is an indispensable part of the quality assurance of bronchoscope maintenance. It can lead to maintenance of the bronchoscope when a noncompliant result is found.
    No preview · Article · Apr 2009 · Revue des Maladies Respiratoires
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    ABSTRACT: Context Use of a chlorhexidine gluconate-impregnated sponge (CHGIS) in intravascular catheter dressings may reduce catheter-related infections (CRIs). Changing catheter dressings every 3 days may be more frequent than necessary. Objective To assess superiority of CHGIS dressings regarding the rate of major CRIs (clinical sepsis with or without bloodstream infection) and noninferiority (less than 3% colonization-rate increase) of 7-day vs 3-day dressing changes. Design, Setting, and Patients Assessor-blind, 2 x 2 factorial, randomized controlled trial conducted from December 2006 through June 2008 and recruiting patients from 7 intensive care units in 3 university and 2 general hospitals in France. Patients were adults (>18 years) expected to require an arterial catheter, central-vein catheter, or both inserted for 48 hours or longer. Interventions Use of CHGIS vs standard dressings (controls). Scheduled change of unsoiled adherent dressings every 3 vs every 7 days, with immediate change of any soiled or leaking dressings. Main Outcome Measures Major CRIs for comparison of CHGIS vs control dressings; colonization rate for comparison of 3-vs 7-day dressing changes. Results Of 2095 eligible patients, 1636 (3778 catheters, 28 931 catheter-days) could be evaluated. The median duration of catheter insertion was 6 (interquartile range [IQR], 4-10) days. There was no interaction between the interventions. Use of CHGIS dressings decreased the rates of major CRIs (10/1953 [0.5%], 0.6 per 1000 catheter-days vs 19/1825 [1.1%], 1.4 per 1000 catheter-days; hazard ratio [HR], 0.39 [95% confidence interval {CI}, 0.17-0.93]; P=.03) and catheter-related bloodstream infections (6/1953 catheters, 0.40 per 1000 catheter-days vs 17/1825 catheters, 1.3 per 1000 catheter-days; HR, 0.24 [95% CI, 0.09-0.65]). Use of CHGIS dressings was not associated with greater resistance of bacteria in skin samples at catheter removal. Severe CHGIS-associated contact dermatitis occurred in 8 patients (5.3 per 1000 catheters). Use of CHGIS dressings prevented 1 major CRI per 117 catheters. Catheter colonization rates were 142 of 1657 catheters (7.8%) in the 3-day group (10.4 per 1000 catheter-days) and 168 of 1828 catheters (8.6%) in the 7-day group (11.0 per 1000 catheter-days), a mean absolute difference of 0.8%(95% CI,-1.78% to 2.15%) (HR, 0.99; 95% CI, 0.77-1.28), indicating noninferiority of 7-day changes. The median number of dressing changes per catheter was 4(IQR, 3-6) in the 3-day group and 3 (IQR, 2-5) in the 7-day group (P<.001). Conclusions Use of CHGIS dressings with intravascular catheters in the intensive care unit reduced risk of infection even when background infection rates were low. Reducing the frequency of changing unsoiled adherent dressings from every 3 days to every 7 days modestly reduces the total number of dressing changes and appears safe. Trial Registration clinicaltrials.gov Identifier: NCT00417235
    No preview · Article · Mar 2009 · JAMA The Journal of the American Medical Association
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    ABSTRACT: Introduction In the context of reducing endoscopy-related infectious risk and new national guidelines on microbiological samples from bronchoscopy, the results of a surveillance program set up in a hospital center were analyzed. Methods Over 4 years, scheduled samples were taken from disinfected bronchoscopes. Bacteriology and mycology tests were used to search for microorganisms. The results were interpreted as falling within three levels: target, alert, and action. Factors that could explain the contamination were studied: age of the bronchoscope, number of uses per year, brand, and model. Results Out of 96 scheduled samples taken, the compliance rate for the period was 83% and increased (p=0.06) over the 4 years. We identified 15 Pseudomonas (six aeruginosa and nine other species), one Stenotrophomonas, one enterobacterium, and two filamentous fungi. None of the factors studied had a significant effect on sample contamination. Conclusion The microbiological surveillance of bronchoscopes is an indispensable part of the quality assurance of bronchoscope maintenance. It can lead to maintenance of the bronchoscope when a noncompliant result is found.
    No preview · Article · Mar 2009
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    ABSTRACT: Les observatoires régionaux du pneumocoque (ORP), créés à partir de 1995, participent aux côtés du Centre national de référence des pneumocoques et de l’Institut de veille sanitaire à la surveillance étroite de l’évolution de la résistance du pneumocoque aux antibiotiques. En 2007, les 23 ORP français ont étudié la sensibilité aux antibiotiques et le sérogroupe de 5 302 souches de pneumocoque isolées de liquides céphalo-rachidiens (LCR), d’hémocultures, de pus d’otite moyenne aiguë, de liquides pleuraux de l’enfant et de l’adulte (≥ 16 ans) ainsi que de certains échantillons pulmonaires de l’adulte (≥ 16 ans). L’étude a montré que 38,2 % des souches étaient de sensibilité diminuée à la pénicilline (PSDP), 19,3 % à l’amoxicilline et 10,5 % au céfotaxime. Le pourcentage de PSDP différait selon les régions, allant de 29 % en Alsace à 50 % à Paris Ile-de-France Ouest. Il était plus élevé chez l’enfant (50,2 %) que chez l’adulte (33,7 %) et variait selon le prélèvement (enfant/adulte) : hémocultures (27,8 %/32,5 %), LCR (33,7 %/34,6 %), pus d’otite moyenne aiguë (60,2 %/27,5 %), liquides pleuraux (50 %/31 %). Les PSDP étaient souvent multirésistants avec en particulier un pourcentage élevé de résistance à l’érythromycine (84,2 % contre 12,7 % pour les pneumocoques sensibles à la pénicilline). Enfin, le sérogroupe majoritairement rencontré était le sérogroupe 19 (25,2 % des isolats).
    No preview · Article · Dec 2008 · Revue Francophone des Laboratoires
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    ABSTRACT: French regional pneumococcal observatories, created from 1995, participate alongside the National Reference Center for Pneumococci and the Institut de Veille Sanitaire at the close monitoring of the evolution of resistance of pneumococci to antibiotics. In 2007, 23 regional pneumococcal observatories studied the antibiotic susceptibility and serogroup of 5302 strains of Streptococcus pneumoniae recovered from cerebrospinal fluids (CSF), blood, middle ear fluid, pleural fluid in the child and the adult (≥ 16 years) as well as from some broncho-pulmonary samples in the adult. The study showed that 38.2% of the strains were non-susceptible to penicillin (PNSP), 19.3% to amoxicillin and 10.5% to cefotaxime. The percentage of PNSP varied according to the region, ranging from 29% in Alsace to 50% in Paris Ile de France west. PNSP were higher in children (50.2%) than in adults (33.7%) and varied according to the sample (child / adult): bloodstream (27.8%/32.5%), CSF (33.7%/34.6%), middle ear fluid (60.2%/27.5%), pleural fluid (50%/31%). The PSDP were often multiresistant with a high percentage of erythromycin resistance (84.2% versus 12.7% in penicillin-susceptible isolates). Finally, the most common serogroup was serogroup 19 (25.2% of the strains).
    No preview · Article · Dec 2008 · Revue Francophone des Laboratoires
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    ABSTRACT: Background: Acquired extended-spectrum beta-lactamases (ESBLs) are rarely identified in Acinetobacter baumannii. This study was initiated by the isolation in 2007 in a University Hospital in Grenoble, France, of an A. baumannii isolate (KAR) exhibiting decreased susceptibility to expanded-spectrum cephalosporins. Methods: PCR experiments were performed using primers specific for several class A beta-lactamase genes. Plasmids were extracted by the Kieser technique. Results: Strain KAR has been isolated from a wound infection of a patient who had been transferred from Morocco. This isolate was resistant to PEN, FEP and CPO and surprisingly of intermediate susceptibility to CAZ and CTX. Synergy tests performed with clavulanate and FEP showed the production of an ESBL. PCR for known ESBL genes were all negative and cloning allowed to identify a blaCARB-type gene encoding an ESBL. The deduced determinant termed CARB-10 differed from the narrow-spectrum CARB-8 by a single amino acid substitution. Site-directed mutagenesis and kinetic analysis confirmed the ability of CARB-10 to hydrolyze FEP and CPO, but not ceftazidime. In addition, CARB-10 was less susceptible to class A beta-lactamase inhibitors as compared to CARB-8. Analysis of the genetic environment of blaCARB-10 identified the insertion sequence ISAba9 which might have mobilized the beta-lactamase gene by one-ended transposition. Preliminary experiments might indicate of chromosomal-location of the blaCARB-10 gene. Conclusion: This study identified a novel CARB-type enzyme which is the first one that possesses ESBL properties. Beta-lactamase CARB-10 may be the source of resistance to expanded-spectrum cephalosporins in A. baumannii KAR. This finding indicates that evolution of CARB-type enzymes, as previously known for TEM and SHV enzymes, may lead to ESBL derivatives.
    Full-text · Conference Paper · Oct 2008
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    ABSTRACT: Background: In France, an increasing proportion of penicillin-non-susceptible pneumococci (PNSP) has been observed since 1987 reaching 52% in 2001. A national campaign to improve antibiotic use was launched in 2002. To evaluate trends in antibiotic resistance in IPD, data from a national survey program between 2003 and 2007 were analysed. Methods: During this period, 11,434 S. pneumoniae isolated from meningitis (1,083) or from blood culture (10,351) were studied for their resistance to penicillin G (PEN), amoxicillin (AMX), cefotaxime (CTX), erythromycin (ERY), cotrimoxazole (SXT) and tetracycline (TE). Results: Year 2003 2005 2007 CSF n= nb of isolates C*/A** n=99/229 n=104/264 n=95/292 PEN % I+R (C/A) 47.5/46.3 43.5/36.7 33.7/34.6 AMX % I+R (C/A) 23.2/26.6 15.3/17.8 16.9/14.7 CTX % I+R (C/A) 18.2/15.3 12.5/9.9 10.5/7.8 Blood n= nb of isolates C/A n=362/3125 n=397/3159 n=370/2938 PEN % I+R (C/A) 46.1/43.6 34.3/37.7 27.8/32.5 AMX % I+R (C/A) 25.7/27.8 17.4/22.3 12.2/17.4 CTX % I+R (C/A) 17.5/15.7 9.8/13.1 6.5/9.3 * C = children<16 years, **A = adults ≥ 16 years Susceptibility trend of IPD isolates (CSF+blood) to 6 antibiotics from 2003 to 2007 (I+R)% 2003 2005 2007 PEN 44,1 38,3 32,2 AMX 27,3 21,3 16,6 CTX 15,8 12,6 8,9 ERY 47,4 41,2 34,5 SXT 33 29 23,7 TE 27,2 25,1 19 Conclusion: From 2003 to 2007 the PNSP in IPD has decreased from 44.1% to 32.2% both in adults and in children. A decrease in the resistance to other antibiotics was also observed.
    Full-text · Conference Paper · Oct 2008

Publication Stats

839 Citations
260.91 Total Impact Points

Institutions

  • 2008-2013
    • University Joseph Fourier - Grenoble 1
      Grenoble, Rhône-Alpes, France
  • 2012
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2011
    • University Hospital Estaing of Clermont-Ferrand
      Clermont, Auvergne, France
  • 2007-2009
    • University of Grenoble
      Grenoble, Rhône-Alpes, France
    • University of Lyon
      Lyons, Rhône-Alpes, France
  • 1982-2009
    • Centre Hospitalier Universitaire de Grenoble
      • Service de Réanimation Médicale
      Grenoble, Rhône-Alpes, France
    • Centre Hospitalier Régional et Universitaire de Besançon
      Becoinson, Franche-Comté, France
  • 1993
    • Centre Hospitalier Victor Dupouy
      Argenteuil, Île-de-France, France
  • 1991
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 1986
    • Centre Hospitalier Universitaire de Dijon
      Dijon, Bourgogne, France