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Dubos F, Marechal I, Husson MO, Courouble C, Aurel M, Martinot A. Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France. Arch Dis Child 2007; 92:1009-12. [PMID: 17626145 PMCID: PMC2083606 DOI: 10.1136/adc.2007.119891] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2007] [Indexed: 11/04/2022]
Abstract
BACKGROUND The impact of the heptavalent-pneumococcal conjugate vaccine on the incidence of pneumococcal meningitis in Europe has not yet been assessed. OBJECTIVE To determine whether heptavalent-pneumococcal conjugate vaccine implementation in northern France has resulted in a decrease in the incidence of pneumococcal meningitis in children. DESIGN Multicentre retrospective cohort study from 2000 through 2005. SETTINGS All paediatric departments of the 18 hospitals in northern France. PATIENTS Patients <18 years of age, admitted for laboratory-confirmed pneumococcal meningitis during the study period, were included. INTERVENTIONS Data were collected from medical files and the microbiological laboratories of each hospital and compared with the regional hospital discharge codes, using a capture-recapture method. MAIN OUTCOME MEASURES The study assessed and compared global and age-related incidence rates of pneumococcal meningitis in 2001 (pre-vaccine era) and 2005. RESULTS 77 cases were found through the capture-recapture method. The incidence rate of pneumococcal meningitis varied from 1.65/100,000 children <18 years in 2001 to 0.80/100,000 children in 2005 (53% reduction, 95% CI 31 to 74; p = 0.08). This has so far been significant only for children <2 years of age (8.9/100,000 in 2001 to 1.8/100,000 in 2005; 82% reduction, 95% CI 52 to 95; p = 0.03). CONCLUSION A decline in pneumococcal meningitis has been observed in infants since heptavalent-pneumococcal conjugate vaccination began in our area.
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Affiliation(s)
- F Dubos
- Paediatric Emergency and Infectious Diseases Unit, Department of Paediatrics, Jeanne de Flandre Hospital and Lille-2 University, Lille, France.
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Zebouh M, Thomas C, Honderlick P, Lemee L, Segonds C, Wallet F, Husson MO. Étude multicentrique portant sur l'évaluation d'une méthode simplifiée d'analyse bactériologique dans la surveillance des infections bronchiques à Pseudomonas aeruginosa survenant au cours de la mucoviscidose. ACTA ACUST UNITED AC 2005; 53:490-4. [PMID: 16087300 DOI: 10.1016/j.patbio.2005.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2005] [Accepted: 06/29/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sputum bacteriological analysis of cystic fibrosis (CF) patients colonised by Pseudomonas aeruginosa is difficult. The bronchial persistence of these bacteria involves phenotypical modifications and the many antibiotic treatments result in emergence of multiresistant strains. The aim of this study is to evaluate a new fast identification and sensitivity testing method of P. aeruginosa and other pathogenic bacteria in sputum of CF patients. It is based on applying a gradient of antibiotic (E-test strip) onto an agar plate inoculated with the sputum. OBSERVATIONS 310 sputum, collected from adults and children colonised by P. aeruginosa, were analysed by this new method. This method allowed a direct reading of the minimal concentration of antibiotic that inhibited the totality of Gram-negative strains and the detection of resistant pathogenic bacteria inside the ellipse of inhibition. Results obtained by this new method were compared with the conventional method for identification and antimicrobial sensitivity. CONCLUSION This new method, studying with CF patient colonised by P. aeruginosa, appears interesting, with a sensibility equal or higher than 89% in detection of the bacteria and their sensitivity to antibiotics. Furthermore it allows a saving of time and simplified results.
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Affiliation(s)
- M Zebouh
- Laboratoire de bactériologie-hygiène, hôpital A.-Calmette, CHRU de Lille, boulevard du Professeur-J.-Leclercq, 59037 Lille cedex, France
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Husson MO, Wizla-Derambure N, Turck D, Gosset P, Wallaert B. Effect of intermittent inhaled tobramycin on sputum cytokine profiles in cystic fibrosis. J Antimicrob Chemother 2005; 56:247-9. [PMID: 15932936 DOI: 10.1093/jac/dki179] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the anti-inflammatory properties of intermittent inhaled tobramycin. METHODS To establish this, we initiated a prospective study to measure the concentration of the three pro-inflammatory cytokines IL-8, IL-6 and TNF-alpha in the sputum from 20 cystic fibrosis (CF) patients (15 teenagers and 5 young adults) during cycles and off cycles. RESULTS A significant decrease in IL-8 (P = 0.001) and a more moderate decrease in IL-6 (P = 0.046) and TNF-alpha (P = 0.052) levels were observed during cycles, even if no significant decrease in the number of leucocytes was observed. CONCLUSIONS These results associated with a decrease in the Pseudomonas aeruginosa population can contribute in part to the beneficial effect of intermittent inhaled tobramycin on pulmonary function.
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Affiliation(s)
- M O Husson
- EA 3925, Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, Boulevard du Professeur J. Leclercq, Lille, France.
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Béghin L, Gottrand F, Michaud L, Vodougnon H, Wizla-Derambure N, Hankard R, Husson MO, Turck D. Energetic cost of physical activity in cystic fibrosis children during Pseudomonas aeruginosa pulmonary exacerbation. Clin Nutr 2005; 24:88-96. [PMID: 15681106 DOI: 10.1016/j.clnu.2004.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2003] [Accepted: 07/26/2004] [Indexed: 11/24/2022]
Abstract
Chronic pulmonary infection by Pseudomonas aeruginosa is observed in 50% of patients with cystic fibrosis and requires the use of recurrent intravenous therapy. A decrease of resting energy expenditure (REE) and an increase of physical activity (PA) after intravenous anti-P. aeruginosa therapy (IVAT) is observed while total energy expenditure (TEE) does not change. A decrease in the energetic cost of physical activity (ECPA) could be hypothesized but has never been studied. Our aim was to assess the evolution of ECPA after home IVAT in both standardized condition at hospital and in free-living condition twice before and after IVAT. Sixteen CF patients (nine boys, seven girls) chronically colonized by P. aeruginosa with a mean age of 12.1+/-2.3 years (range 7.1-14.6) were studied before and after IVAT. Each patient passed throughout a visit in hospital: weight, height and fat-free mass were measured. Then, energy expenditure (EE) measured by indirect calorimetry and heart rate (HR) were simultaneously recorded at different levels of PA: REE, and at different intensity of physical activities on a cycloergometer using an incremental increase of the power brake force. Physical activity energy expenditure (PAEE) was computed in laboratory condition using PAEE=EE-BEE (basal energy expenditure). Linear regression between PAEE and power brake force was fitted for each patient before and after IVAT. ECPA in standardized conditions was compared at different range of power brake force using area under the curve (AUC). After coming back at home, 24 h TEE using the heart rate monitoring technique and PA by triaxial accelerometry were simultaneously measured in free-living condition for 24 h during a school day. ECPA in free-living conditions was compared by the ratio PAEE:PA where PAEE=DEE-REE (DEE=daily energy expenditure). After IVAT, median AUC between 60 and 90 W in standardized condition decreased significantly by -15.4% (median 14.9, range 8.8-30.3 vs. median 12.6, range 8.5-17.6; P<0.05, Wilcoxon rank test) while the decrease for lower range of power work load did not reach significance. Spearman correlation was significant between variations of forced expiratory volume in 1 s and variation of AUC at 30-60 W before and after IVAT in standardized condition. In free-living conditions, ratio PAEE/PA did not vary significantly (median 3.4, range 1.6-6.4 vs. median 2.8, range 1.4-4.8; NS). Our data demonstrate a decrease of ECPA after IVAT in standardized conditions for moderate level of PA (60-90 W), but not in free-living conditions. The decrease of ECPA was probably due to a decrease in the energetic cost of breathing after IVAT, that is particularly relevant to promote PA in CF patients.
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Affiliation(s)
- L Béghin
- Division of Gastroenterology, Hepatology and Nutrition, and Cystic Fibrosis Center, Department of Paediatrics, Jeanne de Flandre University Children's Hospital and Faculty of Medicine, Lille, France
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Massoni-Cristante S, Loiez C, Adriensen B, Husson MO. [Evaluation of a E-test method to detect bactericidy of beta lactam-aminoglycoside associations against Pseudomonas aeruginosa isolates from cystic fibrosis]. Pathol Biol (Paris) 2003; 51:135-42. [PMID: 12781793 DOI: 10.1016/s0369-8114(03)00023-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Pulmonary infectious exacerbations with Pseudomonas aeruginosa are the major problem for patients with cystic fibrosis. Emergence of multi-resistant mucoid strains leads to complicate the choice of antibiotherapy. Therefore, synergic and bactericidal treatment must be used. Then, it is interesting to estimate the bactericidal activity of antibiotics associations in order to optimise the treatment. The aim of this work is to describe a new method of bactericidal antibiotics combinations by superimposing 2 E-test strips and to compare results with those obtained with a broth bactericidal method chosen as reference method. OBSERVATIONS Twenty strains of P. aeruginosa (13 mucoïd and 7 non mucoïd) were selected from expectorants of cystic fibrosis children. Four antibiotics combinations were tested (ceftazidime/tobramycine, cefepime/tobramycine, ceftazidime/amikacine, cefepime/amikacine). Two antibiotics combinations by superimposing E-test strips techniques were used: maximal concentration on maximal concentration (C(max)/C(max)) and minimal inhibitory concentration on minimal inhibitory concentration (MIC/MIC). The comparison of results between killing curves and superposition of E-test strips (C(max)/C(max)) show 88% agreements, 4% major discrepancies specially with mucoid strains and 8% minor discrepancies. The Cmax/Cmax method seems to give better results than MIC/MIC method. CONCLUSION The superposition of E-test strips method is an attractive method: it is rapid, easy to use and well correlated to broth bactericidal method.
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Affiliation(s)
- S Massoni-Cristante
- Laboratoire de bactériologie-hygiène, hôpital A.-Calmette, centre hospitalier régional universitaire, boulevard du Pr J.-Leclercq, 59037 Lille cedex, France
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Grignon B, Tankovic J, Mégraud F, Glupczynski Y, Husson MO, Conroy MC, Emond JP, Loulergue J, Raymond J, Fauchère JL. Validation of diffusion methods for macrolide susceptibility testing of Helicobacter pylori. Microb Drug Resist 2002; 8:61-6. [PMID: 12002651 DOI: 10.1089/10766290252913773] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Helicobacter pylori resistance to macrolides is increasing, and the need for susceptibility testing has become crucial. The only standardized method is agar dilution, which is not adapted to clinical practice. The present work aimed: (1) to optimize the technical conditions and to assess the reproducibility of the E-test and disk diffusion method for macrolides susceptibility testing of H. pylori, and (2) to assess the performances of these two phenotypic methods in detecting strains harboring a resistance mechanism to macrolides. We used 191 isolates collected in nine centers of France and Belgium. Phenotypic tests were performed on Mueller-Hinton agar supplemented with 10% horse blood, inoculated with a 2-day-old H. pylori suspension (10(8) CFU/ml), and incubated for 72 hr at 37 degrees C under microaerophilic conditions. The reproducibility studied on two randomly selected strains was better for disk diffusion than for the E-test for both clarithromycin and erythromycin. For a subset of 10 strains, the MICs of erythromycin and clarithromycin did not differ from more than one two-fold dilution when determined by E-test or agar dilution method. The breakpoints were for MICs: 1 mg/L for both clarithromycin and erythromycin and for inhibition diameters, 22 mm for clarithromycin and 17 mm for erythromycin. There was a 100% concordance between susceptibility to erythromycin and clarithromycin. However, the susceptible and resistant populations were better separated by testing erythromycin. Of 34 resistant strains, two lacked the A2142G and A2143G point mutations in 23S rRNA by PCR-RFLP. None of 15 tested sensitive strains were positive for one of these two point mutations. For clinical practice, we recommend to assess macrolide susceptibility of H. pylori by using one of these two phenotypic methods under the described technical conditions.
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Cuntz D, Michaud L, Guimber D, Husson MO, Gottrand F, Turck D. Local antibiotic lock for the treatment of infections related to central catheters in parenteral nutrition in children. JPEN J Parenter Enteral Nutr 2002; 26:104-8. [PMID: 11871733 DOI: 10.1177/0148607102026002104] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Central venous catheter-related (CVC) infections represent the most common complication of parenteral nutrition. These infections are usually treated by means of long-term systemic antibiotic treatment. The objective of this study was to determine the efficacy of combining a local antibiotic lock with a short systemic double antibiotic to treat CVC-related staphylococci infections. METHODS Any child with coagulase-negative staphylococci or Staphylococcus aureus septicemia, confirmed by a positive blood culture, was included in the study. A double antibiotic systemic treatment composed of amikacin and teicoplanin was started and continued for 5 days. The antibiotic treatment was combined from the first day (D0) with a local teicoplanin lock, which was left for 12 hours a day in the catheter for 15 days. Parenteral nutrition was continued on a nocturnal cyclic mode during antibiotic treatment. The efficacy of the treatment was evaluated by clinical (body temperature), biologic [C-reactive protein levels (CRP)], and bacteriologic (blood culture) measures. RESULTS Twenty CVC-related infection episodes in 13 patients were analyzed for the study. In the initial biologic test, CRP varied from 2 to 130 mg/L (mean 43 mg/L). After 3 days of treatment, CRP varied from 2 to 61 mg/L (mean 12 mg/L). The median time until normalization of temperature and CRP levels after the beginning of antibiotic treatment was 3.2 days (range 1 to 14 days) and 6.2 days (range 2 to 19 days), respectively. All blood cultures were negative for infection 48 hours after stopping the treatment. Only 1 therapeutic failure was observed during the treatment. The patient had persistent signs of clinical septicemia that required removal of the CVC. Two catheter-related infection recurrences were observed in the month after termination of the local antibiotic lock, which also required removal of the CVC. The central venous catheter was maintained in the other cases. CONCLUSIONS Teicoplanin antibiotic locks, combined with a short conventional systemic antibiotic treatment and continuation of cyclic parenteral nutrition, seem effective and well-tolerated treatments for CVC infections.
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Affiliation(s)
- D Cuntz
- Department of Pediatric Gastroenterology, School of Medicine, Hopital Jeanne de Flandre, Lille, France
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Kalach N, Benhamou PH, Bergeret M, Gottrand F, Husson MO, Barbier C, Dupont C, Raymond J. [Acquisition of secondary resistance after failure of a first treatment of Helicobacter pylori infection in children]. Arch Pediatr 2002; 9:130-5. [PMID: 11915493 DOI: 10.1016/s0929-693x(01)00720-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS To assess the frequency of acquisition of secondary Helicobacter pylori resistant-strains after a first course of antimicrobial treatment. PATIENTS AND METHODS A retrospective study was performed during the 1994-2000 period, in 15 girls and eight boys, mean age 10.9 +/- 4.8 years (1.4-17 years), with Helicobacter pylori gastritis (culture and antimicrobial susceptibility) presenting a failure of first course treatment, with during one week a proton pump inhibitor and amoxicillin together with either clarithromycin (n = 14) or metronidazole (n = 9). Two endoscopies were performed, the first at the time of diagnosis and the second after the failure of bacterial eradication demonstrated by a positive 13C urea breath test six weeks after the end of treatment. Antimicrobial susceptibility of all Helicobacter pylori strains was tested after each endoscopy and before starting a second course of the treatment. RESULTS Comparison of antimicrobial susceptibility before and after the first course of treatment showed that Helicobacter pylori strains were all sensitive to amoxicillin, clarithromycin-resistant in eight children (34.7%) before treatment vs 12 (52.1%) after treatment, p = 0.42, ns, metronidazole-resistant in 13 (56.5%) vs 12 (52.1%), p = 0.80, ns, and both clarithromycin and metronidazole-resistant in four (17.3%) vs seven (30.4%), p = 0.63, ns. Among the 14 children treated by a triple therapy including clarithromycin, three (21.4%) developed a secondary resistance to clarithromycin and in one metronidazole resistance was no more detected. Among the nine children treated with a triple therapy including metronidazole, none developed a secondary resistance to metronidazole and one developed a secondary resistance to clarithromycin. CONCLUSION This study shows the absence of amoxicillin-resistant strains, a high initial clarithromycin-resistant strains level (primary resistance), increasing after a first course of treatment, and for metronidazole a high initial level of resistance not influenced by treatment. Secondary clarithromycin-resistance of Helicobacter pylori strains following the first course of treatment could account for failure of bacterial eradication and suggests the importance of antimicrobial susceptibility.
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Affiliation(s)
- N Kalach
- Service de pédiatrie, hôpital Saint-Vincent-de-Paul, 82, avenue Denfert-Rochereau, 75674 Paris, France
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Husson MO, Pierreti A, Quelquejay J, Vaneecloo FM, Courcol RJ, Vincent C. [Bacterial epidemiological study of acute otitis media in children observed at home in the Nord Pas-de-Calais region]. Pathol Biol (Paris) 2001; 49:789-93. [PMID: 11776688 DOI: 10.1016/s0369-8114(01)00217-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this work is the study of the bacteriologic epidemiology of acute otitis media in infants observed at home in Nord Pas-de-Calais area, and the analysis of bacteria associated to recurrent otitis and clinical failure. OBSERVATIONS A total of 295 specimens of ear pus specimens were collected from children (mean age: 18 months; average: one month-12 years). Pneumococcus strains were isolated from 52% of samples and 80% of these showed resistance to penicillin. H. influenzae was found in 35% of specimens and the half produced a beta lactamase. Pneumococcus is the predominant pathogen isolated in prolonged otitis media, while H. influenzae is preferentially found during recurrent otitis media. The main bacteriologic cause of failure traitement was penicillin-intermediate or -resistant pneumococci. The therapy administered 48 to 72 hours before collection of ear pus sample in therapeutic failure was ineffective (oral cephalosporins or macrolides), or administered to low dosage (50 mg/kg/j). CONCLUSION Our results demonstrate, in opposition to other studies, Streptococcus pneumoniae as the most frequent pathogen in acute otitis media. They also show the excellent correlation between antibiotic therapy and clinical failures.
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Affiliation(s)
- M O Husson
- Laboratoire de bactériologie-hygiène, hôpital A. Calmette, CHRU, boulevard du Pr J. Leclercq, 59037 Lille, France.
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Gottrand F, Kalach N, Spyckerelle C, Guimber D, Mougenot JF, Tounian P, Lenaerts C, Roquelaure B, Lachaux A, Morali A, Dupont C, Maurage C, Husson MO, Barthélemy P. Omeprazole combined with amoxicillin and clarithromycin in the eradication of Helicobacter pylori in children with gastritis: A prospective randomized double-blind trial. J Pediatr 2001; 139:664-8. [PMID: 11713443 DOI: 10.1067/mpd.2001.118197] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this multicenter prospective, randomized, double-blind study was to assess the efficacy of the combination of omeprazole, amoxicillin, and clarithromycin (OAC) for the treatment of Helicobacter pylori gastritis in children. STUDY DESIGN Seventy-three children with dyspeptic symptoms were included in the trial (mean age 10.8 years; range, 3.3 to 15.4). Patients were randomized to receive OAC or amoxicillin and clarithromycin (AC) for 7 days. H pylori status was assessed before and 4 weeks after eradication treatment, by use of the carbon 13-labeled urea breath test. RESULTS In intent-to-treat analysis (n = 63), eradication rates were 74.2% (95% CI, 58.7 to 89.6) in the OAC group and 9.4% (95% CI, 0 to 19.5) in the AC group. In per-protocol analysis (n = 53), the eradication rate increased to 80% (95% CI, 64.3 to 95.7), remaining significantly higher than in AC group (10.7%; 95% CI, 0 to 22.2). Resistance of strains to clarithromycin was rare (3/39 = 7.7%) and was not associated with failure of treatment. Adverse events were reported in 24.6% of patients and remained mild. CONCLUSION This study shows that 1-week OAC triple therapy results in successful eradication of H pylori in 75% of children with gastritis.
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Affiliation(s)
- F Gottrand
- Department of Paediatrics, Jeanne de Flandre Hospital, Lille, France
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Bott L, Husson MO, Guimber D, Michaud L, Arnaud-Battandier F, Turck D, Gottrand F. Contamination of gastrostomy feeding systems in children in a home-based enteral nutrition program. J Pediatr Gastroenterol Nutr 2001; 33:266-70. [PMID: 11593120 DOI: 10.1097/00005176-200109000-00007] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND There are few data concerning the risk of contamination of enteral feeding systems via gastrostomy in children, and none for conditions that pertain to home-based care. METHODS To investigate the risk of contamination of enteral feeding systems during the home-based care of 20 children receiving gastrostomy tube feeding, five samples were taken for analysis: two samples before the enteral feeding period (gastrostomy, enteral feeding system) and three after this period (gastrostomy, distal giving set, liquid remained in container). Microorganisms were identified and counted. Different factors were studied to elucidate their role in bacterial colonization: acid suppressive therapy, gastrostomy tube or button, hanging feeding time, rate of enteral feeding, gastric pullulation and retrograde contamination, manipulation error, and use of open or closed enteral feeding systems. RESULTS Overgrowth was defined as a microorganismal load exceeding 10(4) colony-forming units (cfu)/mL. Overgrowth was present in 85% of gastrostomy samples before enteral nutrition started. Most microorganisms belonged to gastric flora. Some bacteria had an environmental origin or derived from cutaneous flora. Forty-five percent of the lines showed overgrowth at the end of enteral nutrition period, mainly with the same microorganism found in the gastrostomy. Closed enteral bags remained sterile, even if manipulation error occurred. Duration, rate of enteral feeding, and acid suppression treatment were not risk factors for overgrowth. CONCLUSIONS Retrograde contamination of gastrostomy feeding systems occurs frequently. The preferential use of closed enteral feeding systems is recommended for home-based enteral nutrition programs.
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Affiliation(s)
- L Bott
- Nestlé Clinical Nutrition, Noisiel, France
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Kalach N, Benhamou PH, Dupont C, Raymond J, Bergeret M, Gottrand F, Husson MO. Helicobacter pylori in children: acquisition of antimicrobial resistance after an initial course of treatment. J Clin Microbiol 2001; 39:3018-9. [PMID: 11499394 PMCID: PMC88287 DOI: 10.1128/jcm.39.8.3018-3019.2001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Husson MO, Quelquejay J, Fruchart A, Izard D. [Comparative antibacterial activity of cefotaxime, ceftazidime and cefepime with regard to different strains of Enterobacter aerogenes selected for their resistance to third generation cephalosporins]. Pathol Biol (Paris) 2000; 48:933-9. [PMID: 11204925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
After being confronted with the isolation in our laboratory of numerous antibiotic-multiresistant Enterobacter aerogenes strains, we studied the in vitro antimicrobial activity of cefotaxime, ceftazidime, and cefepime alone or in association with sulbactam. For that, we selected 67 isolates according to their low level of susceptibility to cefotaxime. First, we deduced from a synergy test in presence of clavulanic acid and cloxacillin the production of an extended spectrum beta-lactamase (ESBL) and/or an overproduction of a chromosomal cephalosporinase. Three groups of strains were thus defined: one group of ESBL strains, another group of overproducing strains of chromosomal cephalosporinase, and a last group that produced the two types of enzymes. Minimal inhibitory concentrations (MICs) of each cephalosporin alone or in presence of 8 mg/L of sulbactam, gentamicin or amikacin were measured. Our results demonstrated the best activity of cefepime: MICs were low with a value inferior to 4 mg/L independently of the type of beta-lactamase. They were lower than 0.5 mg/L in presence of sulbactam against ESBL-producing strains. The cephalosporins could be used in association with aminoglycosides according to their susceptibility.
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Affiliation(s)
- M O Husson
- Laboratoire de bactériologie-hygiène, hôpital A.-Calmette, boulevard Pr. J.-Leclercq, 59037 Lille, France
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Husson MO, Rolland C, Gottrand F, Guimber D, Kalach N, Spyckerelle C, Lenaerts C, Ganga-Zandzou PS. Evaluation of a Helicobacter pylori stool antigen test for the diagnosis and follow-up of infections in children. Eur J Clin Microbiol Infect Dis 2000; 19:787-9. [PMID: 11117645 DOI: 10.1007/s100960000371] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to evaluate the performance of a newly developed enzyme immunoassay kit (HpSA) for detecting Helicobacter pylori antigens in the stool of children. This study was comprised of 58 children referred to various endoscopy units for evaluation of gastrointestinal symptoms and upper gastroduodenal endoscopy and 11 children for post-therapy follow-up. In the first group, 23 children were diagnosed as positive for Helicobacter pylori using bacteriological and/or histological methods. Stool antigens were detected in 20 of these positive patients, for a sensitivity of 86.9% and a negative predictive value of 91.9%. Since only one false-positive reaction was observed with the HpSA kit, the specificity was 97.1% and the positive predictive value 95.2%. Results obtained for post-therapy follow-up were also promising. The HpSA assays were negative for the eight children whose infections were eradicated after therapy, and a positive result was obtained for two of three patients who had a persistent infection.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie-Hygiène, H pital Calmette, Lille, France
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Trivier D, Dubos JP, Mteyrek M, Codaccioni X, Courcol RJ, Husson MO. [Contribution of direct bacteriologic examinations to the diagnosis of early materno-fetal bacterial infection: the Lille experience]. Pathol Biol (Paris) 1999; 47:784-9. [PMID: 10573697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A prospective study was conducted in 3056 live-born infants delivered at the Jeanneade-Flandre maternity hospital of the Lille Teaching Hospital between January and August 1997. Clinical, laboratory test, and microbiological test findings were compared. A cohort of 1003 infants who remained in the maternity ward but were considered at increased risk of maternofetal infection (MFI) based on history and/or obstetrical criteria and/or neonatal criteria underwent routine collection of specimens including gastric fluid, auricular and anal swabs, amniotic fluid, and placental fragments. Microscopic examination of gastric fluid smears, the first result available to the clinician, was found to have 27.5% sensitivity (983 samples). Positive predictive value (PPV) was only 17.8% because of a high rate of colonization (16.8%), defined as absence of clinical symptoms and three peripheral specimens positive for the same organism. However, negative predictive value (NPV) was as high as 99.8% as a result of high sensitivity (97.8%) in the infected neonates. The gastric fluid smear was positive in 30% and 35% of neonates born to mothers with hyperpyrexia during early and late labor, respectively, and in 42% of neonates born to mothers with a history of group B streptococcus carriage during the pregnancy. Forty-two per cent of neonates with a history of fetal tachycardia had a positive gastric fluid smear. Diagnostic criteria for infection were three peripheral specimens positive for the same organism, C-reactive protein elevation, and/or one or more clinical signs suggestive of infection, and/or a positive central specimen (blood, CSF). The infection rate in infants who remained in the maternity ward was 1.6%. The most common causative organisms were group B streptococci. These findings illustrate the useful contribution of gastric fluid smears to the early diagnosis of MFI and confirm the predominant role of group B streptococci.
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Affiliation(s)
- D Trivier
- Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CHRU, Lille, France
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16
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Ghozzi R, Morand P, Ferroni A, Beretti JL, Bingen E, Segonds C, Husson MO, Izard D, Berche P, Gaillard JL. Capillary electrophoresis-single-strand conformation polymorphism analysis for rapid identification of Pseudomonas aeruginosa and other gram-negative nonfermenting bacilli recovered from patients with cystic fibrosis. J Clin Microbiol 1999; 37:3374-9. [PMID: 10488211 PMCID: PMC85573 DOI: 10.1128/jcm.37.10.3374-3379.1999] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We used capillary electrophoresis-single-strand conformation polymorphism (CE-SSCP) analysis of PCR-amplified 16S rRNA gene fragments for rapid identification of Pseudomonas aeruginosa and other gram-negative nonfermenting bacilli isolated from patients with cystic fibrosis (CF). Target sequences were amplified by using forward and reverse primers labeled with various fluorescent dyes. The labeled PCR products were denatured by heating and separated by capillary gel electrophoresis with an automated DNA sequencer. Data were analyzed with GeneScan 672 software. This program made it possible to control lane-to-lane variability by standardizing the peak positions relative to internal DNA size markers. Thirty-four reference strains belonging to the genera Pseudomonas, Brevundimonas, Burkholderia, Comamonas, Ralstonia, Stenotrophomonas, and Alcaligenes were tested with primer sets spanning 16S rRNA gene regions with various degrees of polymorphism. The best results were obtained with the primer set P11P-P13P, which spans a moderately polymorphic region (Escherichia coli 16S rRNA positions 1173 to 1389 [M. N. Widjojoatmodjo, A. C. Fluit, and J. Verhoef, J. Clin. Microbiol. 32:3002-3007, 1994]). This primer set differentiated the main CF pathogens from closely related species but did not distinguish P. aeruginosa from Pseudomonas alcaligenes-Pseudomonas pseudoalcaligenes and Alcaligenes xylosoxidans from Alcaligenes denitrificans. Two hundred seven CF clinical isolates (153 of P. aeruginosa, 26 of Stenotrophomonas maltophilia, 15 of Burkholderia spp., and 13 of A. xylosoxidans) were tested with P11P-P13P. The CE-SSCP patterns obtained were identical to those for the corresponding reference strains. Fluorescence-based CE-SSCP analysis is simple to use, gives highly reproducible results, and makes it possible to analyze a large number of strains. This approach is suited for the rapid identification of the main gram-negative nonfermenting bacilli encountered in CF.
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Affiliation(s)
- R Ghozzi
- Microbiology Laboratory, Hôpital Necker-Enfants Malades, Paris, France
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17
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Abstract
Comparison of iron uptake of four Helicobacter species (Helicobacter pylori, Helicobacter felis, Helicobacter acinonyx, and Helicobacter mustelae), associated with various degrees of gastritis in their respective host, with five other species which colonize the intestinal tract of various animals (Helicobacter fennelliae, Helicobacter cinaedi, Helicobacter muridarum, Helicobacter bilis, and Helicobacter hepaticus), demonstrated that the iron acquisition system differed according to the ecological niche of the organism. Gastric Helicobacter, except for H. pylori, which used iron from human lactoferrin, were nonsiderophore-producing organisms and were only able to obtain iron from heme and hemoglobin. Nongastric Helicobacter produced siderophores and were able to use for growth a wide range of iron sources (bovine and human lactoferrin and transferrin, heme, hemoglobin).
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Affiliation(s)
- L Dhaenens
- Laboratoire de bactériologie-hygiène, faculté de médecine Henri-Warembourg, Lille, France
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18
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Ganga-Zandzou PS, Michaud L, Vincent P, Husson MO, Wizla-Derambure N, Delassalle EM, Turck D, Gottrand F. Natural outcome of Helicobacter pylori infection in asymptomatic children: a two-year follow-up study. Pediatrics 1999; 104:216-21. [PMID: 10428997 DOI: 10.1542/peds.104.2.216] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES It is known that Helicobacter pylori can be acquired in early childhood. There is not enough data to know whether or not infected children should be treated. A better knowledge of the natural outcome and implications of H pylori infection may provide evidence that eradication therapy is beneficial in childhood. This prospective study looks at clinical symptoms, endoscopic, microbial, and histologic changes during a 2-year period in infected asymptomatic children. It is hoped that some prognostic indicators will be found that select out the children that later need therapy. PATIENTS AND METHODS During epidemiologic study of the prevalence of H pylori infection, 18 children aged 7 +/- 4 years (mean +/- 1 SD) were discovered to have H pylori infection and enrolled in the 2-year follow-up study. These patients had received no eradication therapy because they were asymptomatic. The follow-up for each patient consisted of an initial assessment, a clinical examination every 6 months, and an endoscopic reevaluation at the end of the first and second years. Gastric mucosal samples were analyzed for bacteriologic and histologic changes. Various factors were initially recorded: individual factors included sex, age, and housing conditions; microbial factors included bacterial load and the presence of the CagA gene. Inflammatory changes were also noted, such as the presence of active gastritis and nodular formation, and these were correlated with the histology which was described using the Sydney classification. Typing polymerase chain reaction-restriction fragment length polymorphism was performed to check the persistence of the same strain of H pylori in each patient. RESULTS All of the children were still infected after 2 years with the same strain as in the initial assessment with the exception of 1 child whose infection cleared spontaneously. The density of antral and fundal mucosal colonization with H pylori also remained stable. There were progressive inflammatory changes in this cohort, particularly between the first and second year (histologic score, 3.5 +/- 1.3 vs 5 +/- 1). Active antral gastritis occurred in 3 out of 14 and 1 out of 8 children during the first and second year, respectively. Gastritis became active in the fundus in 2 out of 14 and 2 out of 8 children during the same period. Increases in the histologic score were found particularly in male children, and children colonized by cagA- strains of H pylori during the follow-up. The frequency of nodular gastritis significantly rose from 11% (2 out of 18 children) to 64% (9 out of 14 children) after 1 year, and to 80% (8 out of 10 children) after 2 years. CONCLUSION These findings demonstrate a deterioration in the histologic features of the gastric mucosa of infected children despite stable H pylori colonization and the absence of symptoms.
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Affiliation(s)
- P S Ganga-Zandzou
- Unité de Gastro-entérologie, Hépatologie et Nutrition, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, Lille, France
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19
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Szczebara F, Dhaenens L, Armand S, Husson MO. Regulation of the transcription of genes encoding different virulence factors in Helicobacter pylori by free iron. FEMS Microbiol Lett 1999; 175:165-70. [PMID: 10386365 DOI: 10.1111/j.1574-6968.1999.tb13615.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Since free iron possesses a poor solubility under physiologic conditions and thus becomes a limiting nutrient for growth, a shift from high- to low-iron environmental conditions is an important signal for bacteria to coordinate the regulation of gene expression. Here, we studied and compared the level of transcripts corresponding to the vacA (cytotoxin), ureA (urease), cagA (cytotoxin-associated antigen) and fur (ferric uptake regulator) genes of Helicobacter pylori, grown under iron-sufficient and iron-restricted conditions. A significant increase in the accumulation of vacA and fur transcripts was observed under iron-restricted conditions. This up-regulation by low levels of iron seems to be not directly regulated by Fur, and certainly requires other regulatory factors. No statistical difference was defined in the accumulation of cagA and ureA.
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Affiliation(s)
- F Szczebara
- Laboratoire de Bactériologie-Hygiène, Faculté de Médecine Henri Warembourg, Lille, France
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20
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Trivier D, Savage C, Bauters F, Husson MO, Courcol RJ. [Determination of the nosocomial origin of vancomycin-resistance strains of Enterococcus isolated from stool of patients in a hematology department]. Pathol Biol (Paris) 1999; 47:430-6. [PMID: 10418013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Patients severely neutropenic, when hospitalized, occasionally receive selective digestive decontamination, and the risk of vancomycin-resistant strain selection is a drawback since glycopeptide resistance is often associated with betalactam and aminoglycosid resistance. Bacterial translocation can lead to multiresistant bacterial sepsis. Eighteen Enterococcus faecium strains were collected from patients hospitalized in the leukemia unit of the Universitary Hospital of Lille (CHRU, Pr Bauters) between October 1992 and July 1997 and were studied. Nosocomial acquisition or endogenous origin were investigated to choose well-adapted prevention. All the vancomycin-resistant strains were shown by Polymerase Chain Reaction having the van A gene. The clonality of these strains was investigated by Pulsed-Field-Gel-Electrophoresis after Sma I restriction. Pulsotype analysis showed variable homology (52%-100%). Our results do not show evidence of patient-to-patient E. faecium transmission and suggest vancomycin-resistant strains were independently selected by antibiotic therapy from individual fecal flora. Except when epidemic events or happen, this strain isolation is more related to antibiotic prescription than misuse of isolation techniques.
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Affiliation(s)
- D Trivier
- Laboratoire de Bactériologie-Hygiène, Centre hospitalier Docteur Schaffner, Lens, France
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21
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Canis F, Trivier D, Vic P, Ategbo S, Turck D, Husson MO. [Comparison of the pharmacokinetics of tobramycin administered in a single daily dose or in 3 doses in cystic fibrosis]. Pathol Biol (Paris) 1998; 46:449-51. [PMID: 9769880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
An aminoglycoside in association with beta-lactam antibiotic are usually the most efficient treatment for Pseudomonas aeruginosa infections in cystic fibrosis patients. Tobramycin has the lower MICs than the other aminoglycosides to Pseudomonas aeruginosa. The aim of the work was to compare pharmacokinetics of tobramycin after once daily (15 mg/kg/day; 11 patients) or thrice daily dose (5 mg/kg/day; 9 patients) in combination ceftazidime (CAZ 200 mg/day in 3 inj. IVD) in sputum and sera for two weeks. No statistical difference in the serum concentration obtained in each group of patients was observed between the first and the 14th day. Serum concentrations were three fold higher when tobramycin was administered in once daily dose. Low through concentrations were quickly obtained, but they were slightly higher after thrice daily doses. Bronchial concentrations were 2 to 2.5 superior and near the critical concentration of tobramycin. The clinical efficacy were comparable in the two regimens.
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Affiliation(s)
- F Canis
- Laboratoire de Bactériologie-Hygiène, Hôpital Calmette, CHRU, Lille, France
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22
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Vic P, Ategbo S, Turck D, Husson MO, Launay V, Loeuille GA, Sardet A, Deschildre A, Druon D, Arrouet-Lagande C. Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis. Arch Dis Child 1998; 78:536-9. [PMID: 9713009 PMCID: PMC1717599 DOI: 10.1136/adc.78.6.536] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare once daily with thrice daily tobramycin for treatment of Pseudomonas aeruginosa infection in patients with cystic fibrosis. DESIGN 22 patients with cystic fibrosis, mean (SD) age 11 (3.4) years (range 5.6-19.3), with pulmonary pseudomonas exacerbations were randomly assigned to receive a 14 day course of tobramycin (15 mg/kg/day) either in three infusions (group A) (n = 10) or a single daily infusion (group B) (n = 12), combined with ceftazidime (200 mg/kg/day as three intravenous injections). Efficacy was assessed by comparison of pulmonary, nutritional, and inflammatory indices on days 1 and 14. Cochlear and renal tolerance were assessed on days 1 and 14. Tobramycin concentration was measured in serum and sputum 1, 2, 3, 4, 8, and 24 hours after the start of the infusion. Analysis was by non-parametric Wilcoxon test. RESULTS Variables improving (p < 0.05) in both groups A and B were, respectively: weight/height (+4% and +3.1%), plasma prealbumin (+66 and +63 mg/l), forced vital capacity (FVC) (+14% and +11%), forced expiratory volume in one second (+15% and +14%), and forced expiratory flow between 25% and 75% of FVC (+13% and +21%). Improvement was not significantly different between groups. Renal and cochlear indices remained within the normal range. Serum peak concentration of tobramycin on day 1 was 13.2 (7.1) mg/l in group A and 42.5 (11.2) mg/l in group B (p < 0.001); serum trough was 1.1 (0.8) mg/l in group A and 0.3 (0.2) mg/l in group B (p < 0.01). Tobramycin concentrations in sputum were two to three times higher in group B than group A. CONCLUSIONS Once daily tobramycin combined with three injections of ceftazidime is safe and effective for the treatment of pseudomonas exacerbations in cystic fibrosis patients.
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Affiliation(s)
- P Vic
- Department of Paediatrics, Lille University Hospital, France
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23
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Husson MO, Fruchart A, Izard D. [Comparative study of the bactericidal activity of cefepime and cefpirome in association with glycopeptides against Staphylococci sensitive and resistant to methicillin]. Pathol Biol (Paris) 1998; 46:279-83. [PMID: 9769909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The aim of this study was to evaluate by a kinetic time-kill method the synergy and bactericidal activity of cefepime and cefpirome in association with vancomycin and teicoplanin against 4 coagulase-positive and 7-negative staphylococci strains. Among these 2 were susceptible to methicillin and 7 resistant. Antibiotic concentrations used for time-kill curves were 0.5 and 1 CMI for glycopeptides and 32 mg/l for cephalosporins. Bactericidal activity was defined as a 3 log10 reduction of the initial inoculum. Cephalosporins at 32 mg/l and teicoplanin at 1 CMI were not bactericidal, while vancomycin at 1 CMI was bactericidal in 24 to 48 h for 3 strains. Cefepime and cefpirome in association with vancomycin were bactericidal against all strains with no secondary regrowth. Bactericidal activity was observed for 6 and 9 strains with the combinations of cefepime-teicoplanin and cefpirome-teicoplanin respectively. In conclusion, despite no significant antistaphylococcal activity of cefepime and cefpirome, their association to glycopeptides improved the bactericidal activity of vancomycin and teicoplanin.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie-Hygiène, Faculté de Médecine, Lille, France
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24
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Gottrand F, Cullu F, Turck D, Vincent P, Michaud L, Husson MO, Martin-Delasalle E, Farriaux JP. Normal gastric histology in Helicobacter pylori-infected children. J Pediatr Gastroenterol Nutr 1997; 25:74-8. [PMID: 9226531 DOI: 10.1097/00005176-199707000-00012] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In adults, Helicobacter pylori infection is always associated with gastritis or ulcer. However, very active gastritis and ulcers are rarely seen in children. The aim of the present work was to study the relationships between H. pylori and gastric mucosa in children. METHODS Eighty infected children and adolescents including 48 (60%) neurologically impaired institutionalized patients, aged 2 months-22 years (mean 11.7 +/- 5.2 years) were studied retrospectively. All the patients underwent gastroscopy, and three antral and two fundic biopsy specimens were taken for histology and bacteriology. RESULTS A normal gastric mucosa was found in 22 of 80 patients (27.5%), whereas the others had gastritis (n = 58, 72.5%). There were no statistical differences between patients with normal histology and those presenting with gastritis for age, sex, ethnic background, symptoms, and the degree of bacterial colonization. The macroscopic aspect of gastritis was less frequently found in children with a normal histology compared with those with histological gastritis (p < 0.001). CONCLUSIONS These data show that H. pylori infection can be associated with a normal gastric histology in children.
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Affiliation(s)
- F Gottrand
- Service de Pédiatrie, Hôpital Huriez, Lille, France
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25
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Canis F, Cavallo JD, Husson MO. [Evaluation of bactericidal activity of cefpirome-aminoglycoside combination against Pseudomonas aeruginosa strains with intermediate sensitivity to cefpirome and in various phenotypes of beta-lactam resistance]. Pathol Biol (Paris) 1997; 45:420-3. [PMID: 9296096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The bactericidal activity of cefpirome (CPO)-aminoglycoside (AG) combination was assessed by a kinetic time-kill method against 8 strains of Pseudomonas aeruginosa showing intermediate susceptibility to cefpirome (MICS: 8-32 mg/l). Six strains had an acquired beta-lactam resistance mechanism (moderate cephalosporinase hyperproduction, OXA-2 or PSE-1 enzyme production, non enzymatic resistance) and one strain was resistant to tobramycin (TOB). Antibiotic concentrations used for time-kill curves were 1/2, 1 and 2x MIC for cefpirome, 8 mg/l for tobramycin and 16 mg/l for amikacin (AKN). Bactericidal activity was defined as a (4 log10 reduction of the initial inoculum. At the concentrations used in this study, CPO was not bactericidal; AG were bactericidal in 3 to 24 hours. CPO-AG combination was bactericidal against all the strains with no secondary regrowth. For 7/8 strains, the combination of CPO with TOB and/or AKN was more rapidly bactericidal than the AG alone. In conclusion, despite an intermediate susceptibility against numerous strains of P. aeruginosa, the CPO-AG combination is bactericidal at concentrations achievable with standard dosing regimens in man.
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Affiliation(s)
- F Canis
- Laboratoire de Bactériologie-Hygiène, Faculté de Médecine, Lille, France
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26
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Vachée A, Scheftel JM, Husson MO, Izard D, Ross P, Monteil H. [Tricentric study of the sensitivity of Pseudomonas aeruginosa serotyping to beta-lactams and aminoglycosides]. Pathol Biol (Paris) 1997; 45:357-62. [PMID: 9296084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this study was to evaluate the susceptibility of 300 Pseudomonas aeruginosa strains to 6 beta-lactams and to 2 aminoglycosides and to compare this susceptibility according to the serotype, the sample nature, the unit activity and the geographic situation of the hospital. The susceptibility level was ascertained using the disk method. Serotyping of the strains was also performed. Susceptibility level was 67% for ticarcillin, 82% for piperacillin-tazobactam combination, 85% for ceftazidim, 81% for cefepim, 74% for aztreonam, 83% for imipenem, 73% for tobramycin and 86% for amikacin. Non-serotypable strains represented 20.6%. The most common serotypes were O6 (19%) and O11 (13%). Discrepancies between cefepime and ceftazidime were found in 15 strains after MIC determination, 6 of them were O12 strains. It appears that strain susceptibility was function of the serotype distribution. Cefepime exhibited outstanding activity against P. aeruginosa, similar to ceftazidim activity.
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Affiliation(s)
- A Vachée
- Laboratoire de Bactériologie-Hygiène, CHRU Lille, France
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27
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Canis F, Husson MO, Turck D, Vic P, Launay V, Ategbo S, Vincent A, Courcol RJ. Pharmacokinetics and bronchial diffusion of single daily dose amikacin in cystic fibrosis patients. J Antimicrob Chemother 1997; 39:431-3. [PMID: 9096197 DOI: 10.1093/jac/39.3.431] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A single daily dose of amikacin 35 mg/kg by i.v. infusion over 30 min in 18 cystic fibrosis patients achieved mean serum peak and trough concentrations of 121.4 mg/L (+/- 37.3) and 0.88 mg/L (+/- 0.62), respectively. Pharmacokinetic parameters and bronchial diffusion of amikacin showed marked inter-patient variability. The highest concentrations in sputum were obtained at 2 h (10.95 +/- 7.55 mg/L) and decreased slowly to reach a mean concentration of 2.14 mg/L (range 0.2-3.8 mg/L) just before the following infusion. An increase in the body clearance of amikacin and a decrease in the volume of distribution according to age were observed.
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Affiliation(s)
- F Canis
- Laboratoire de Bactériologie-Hygiène, Centre Hospitalier Régional et Universitaire, Lille, France
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28
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Abstract
Iron acquisition plays an important role in bacterial virulence. Different studies have been initiated to define the mechanism by which Helicobacter pylori acquires iron. We had previously demonstrated that human lactoferrin (HLf) supported full growth of the bacteria in media lacking other iron sources. The ability of H. pylori to use HLf as an iron source had been found to be dependent on cell-to-protein contact. Since lactoferrin has been found in significant amounts in human stomach resection specimens from patients with superficial or atrophic gastritis, the iron uptake of H. pylori via a specific HLf receptor may play a major role in the virulence of H. pylori infection. In this study, by using affinity chromatography with biotinylated HLf and streptavidin-agarose, we identified a 70-kDa lactoferrin-binding protein (Lbp) from outer membrane proteins of H. pylori. This Lbp was only present when H. pylori was grown in an iron-starved medium, suggesting that it serves in iron uptake. Direct binding assays with increasing concentrations of biotinylated HLf demonstrated that the lactoferrin interaction with the outer membrane of H. pylori grown in iron-restricted medium was saturable. Competitive binding experiments with bovine and human lactoferrin and with transferrin of horse, bovine, and human origin indicated that this Lbp appeared highly specific for HLf. A number of other studies have focused on the importance of transferrin and lactoferrin receptors in pathogenic bacteria and their specificity with the host species. This observation might explain the very strict human specificity of H. pylori.
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Affiliation(s)
- L Dhaenens
- Laboratoire de Bactériologie-Hygiène, Faculté de Médecine Henri Warembourg, Lille, France
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29
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Szczebara F, Dhaenens L, Vincent P, Husson MO. Evaluation of rapid molecular methods for detection of clarithromycin resistance in Helicobacter pylori. Eur J Clin Microbiol Infect Dis 1997; 16:162-4. [PMID: 9105846 DOI: 10.1007/bf01709478] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Resistance of Helicobacter pylori to clarithromycin is due to point mutations at position A2143 or A2144 of the rrnH 23S rRNA gene, each mutation creating an additional restriction site for BsaI or MboII. A procedure combining PCR and RFLP analysis was evaluated for detection of these mutations using primers specific for the 23S rRNA gene, and BsaI and MboII enzymes. All clarithromycin-resistant isolates (8/8), as defined by the MIC, were found to be resistant by PCR-RFLP. No clarithromycin-sensitive isolates (14/14) gave a positive reaction.
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Affiliation(s)
- F Szczebara
- Laboratoire de Bactériologie-Hygiène, Faculté de médecine, Lille, France
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30
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Vic P, Ategbo S, Turck D, Husson MO, Tassin E, Loeuille GA, Deschildre A, Druon D, Elian JC, Arrouet-Lagandre C, Farriaux JP. Tolerance, pharmacokinetics and efficacy of once daily amikacin for treatment of Pseudomonas aeruginosa pulmonary exacerbations in cystic fibrosis patients. Eur J Pediatr 1996; 155:948-53. [PMID: 8911895 DOI: 10.1007/bf02282885] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Twenty cystic fibrosis patients aged 1.8-22 years (mean +/- SD: 9.6 +/- 4.8 years) with Pseudomonas aeruginosa pulmonary exacerbations were treated with amikacin (AM) (35 mg/kg/day in one daily 30 min infusion) associated with either ceftazidime (200 mg/kg/day in 3 i.v. injections) (n = 19) or imipenem (n = 1) at the same dose. Glomerular and tubular functions (creatinine clearance, 24-h proteinuria, beta 2 microglobulinuria, lysozymuria) and audiometry remained within normal ranges from day 0 to day 14. A peak concentration of AM of 83 +/- 19 mg/l and a trough concentration of 0.8 +/- 0.5 mg/l were observed in blood while AM levels in sputum were above the minimal inhibitory concentration 50 from 30 min to 16 h. No serum accumulation of AM was observed during the treatment. From day 0 to day 14, the following changes were observed: weight/height ratio: 96%-100% (P < 0.001); daily energy intake: 111%-128% of RDA (P < 0.001); prealbumin: 195-290 mg/l (P < 0.001); forced vital capacity (FVC): 66%-81% (P < 0.01); forced expiratory volume in 1 s: 60%-75% (P < 0.01); forced expiratory flow between 25% and 75% of FVC: 42%-56% (P < 0.01); nocturnal SaO2 also improved significantly; cardiac rate decreased from 89 +/- 18/min to 76 +/- 16/min (P < 0.001); respiratory rate decreased from 31 +/- 15/min to 26 +/- 10/min (P < 0.05); inflammatory parameters (white blood cells, polymorphonuclear cells, erythrocyte sedimentation rate) also improved. CONCLUSION Once daily amikacin administration associated with ceftazidime is well tolerated for the treatment of Pseudomonas aeruginosa pulmonary exacerbations in cystic fibrosis patients. Serum peak levels and diffusion in sputum are higher than with a conventional schedule.
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Affiliation(s)
- P Vic
- Service de Pédiatrie, Hôpital Huriez, Lille, France
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Dhaenens L, Szczebara F, Husson MO. In-vitro activities of clarithromycin and other antimicrobial agents against Helicobacter pylori isolated from children. J Antimicrob Chemother 1996; 38:318-9. [PMID: 8877551 DOI: 10.1093/jac/38.2.318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Vachée A, Devalckenaere A, Husson MO, Izard D. [In vitro study of antibacterial activity of cefepime (Axepim) against gram negative bacteria: comparison with cephalosporins and other beta-lactams]. Pathol Biol (Paris) 1996; 44:132-7. [PMID: 8761598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The susceptibility to cefepime and to other beta-lactams of 1017 inducible cephalosporinase-producing enterobacteria, 897 Pseudomonas aeruginosa strains, and 295 Acinetobacter baumanii strains was studied over a two-year period (July 1, 1993 to June 30, 1995). The isolates were from patients in visceral surgery, intensive care, and clinical hematology wards. Cefepime was compared to other third-generation cephalosporins and to imipenem, aztreonam, and the piperacillin-tazobactam combination. Cefepime was more active than the other cephalosporins against Enterobacter cloacae, Serratia marcescens and Citrobacter freundii. Activity of cefepime on the study isolates was also greater than that of aztreonam and of the piperacillin-tazobactam combination. Cefepime exhibited outstanding activity against Pseudomonas aeruginosa strains except those with the O12 serotype.
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Affiliation(s)
- A Vachée
- Laboratoire de Bactériologie-Hygiène, Faculté de Médecine, Lille, France
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33
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Husson MO, Gottrand F, Vachee A, Dhaenens L, de la Salle EM, Turck D, Houcke M, Leclerc H. Importance in diagnosis of gastritis of detection by PCR of the cagA gene in Helicobacter pylori strains isolated from children. J Clin Microbiol 1995; 33:3300-3. [PMID: 8586721 PMCID: PMC228692 DOI: 10.1128/jcm.33.12.3300-3303.1995] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The cagA gene has been detected by PCR and DNA hybridization in 45 Helicobacter pylori strains isolated from children. For each child, clinical symptoms, endoscopic aspect of the gastric mucosa, and histological gastritis were evaluated. Gene-positive strains were associated with hemorrhagic gastritis in 66.6% of the children, while gene-negative strains were associated with hemorrhagic gastritis in 11.2% of the children (P = 0.0001). In addition, 88.8% of gene-positive strains were associated with severe histological gastritis (scores of 3 and 4), and gene-negative strains were collected from the gastric mucosa with the same type of infiltration of neutrophils and lymphocytes in the lamina propia in 55.5% of the children. These differences were statistically significant (P = 0.017). Gene-positive strains were also isolated more frequently from children with vomiting (P = 0.04), while the absence of clinical signs was not significantly different in cagA gene-positive or -negative patients. All of these observations confirmed the role of this cagA gene as a marker of gastric inflammation in children. The detection of this gene might be helpful to determine the degree of inflammation of the gastric mucosa in the absence of abdominal symptoms. We might better understand the natural history of H. pylori infection if we studied the evolution of gastritis in children with regard to the cagA status of isolated strains.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie A, Faculté de Médecine, Hôpital C. Huriez, Lille, France
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Canis F, Husson MO, Vic P, Ategbo S, Turck D, Courcol R, Leclerc H. [Bacteriological monitoring of the treatment of Pseudomonas aeruginosa infections with amikacin administrated at once-daily dosis in patients with cystic fibrosis]. Pathol Biol (Paris) 1995; 43:343-51. [PMID: 7567127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The interest of the treatment with a single daily dose of amikacin (AMK) in cystic fibrosis (CF) patients with P. aeruginosa infections has been much debated. The aim of work was to study the efficiency of this treatment on (CF) patients with chronic bronchopulmonary P. aeruginosa infections previously treated for two weeks with the combination ceftazidime (CAZ 200 mg/day in 3 inj. IVD) and AMK (35 mg/day in one IV perf. of 30 minutes). The bacteriological supervision of this treatment was performed 1: by the determination of MICs before and after treatment, 2: by the decrease of P. aeruginosa colonization immediately after this treatment and during 11 months, 3: by the identification of P. aeruginosa strains with phenotypic methods (serotyping and antibiotyping) and with genotypic method (pulsed field gel electrophoresis). The use of AMK in a single daily dose in order to treat chronic lung infections colonized with P. aeruginosa susceptible to this antibiotic shows encouraging results as far as bacteriology is concerned: this treatment has given means to reduce colonization for a month in 15 of 18 patients. For 9 of the 18 patients, no P. aeruginosa strains were isolated for nine months. The serotyping and antibiotyping systems do not enable us to study the P. aeruginosa epidemiology. Genome macrorestriction fingerprinting of P. aeruginosa in pulsed field gel electrophoresis confirms that patient with CF were colonized with one or several clones. In our study no variation of these clones was noticed for the first eleven months. Genome macrorestriction fingerprinting appears to be one of the most effective methods for delineate strains of P. aeruginosa colonizing CF patients.
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Affiliation(s)
- F Canis
- Laboratoire de Bactériologie A, Hôpital Claude Huriez, CHRU, Lille, France
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35
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Vincent P, Gottrand F, Pernes P, Husson MO, Lecomte-Houcke M, Turck D, Leclerc H. High prevalence of Helicobacter pylori infection in cohabiting children. Epidemiology of a cluster, with special emphasis on molecular typing. Gut 1994; 35:313-6. [PMID: 8150338 PMCID: PMC1374581 DOI: 10.1136/gut.35.3.313] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Intrafamilial cases of infection with the same strain of Helicobacter pylori (H pylori) have been reported but these clusters were too small to distinguish between person to person spread or coinfection from a common environmental source. To gain more information on the mode of transmission of H pylori, an epidemiological survey with bacterial strain differentiation by restriction endonuclease analysis of chromosomal DNA was carried out in an institution of 117 children with encephalopathy (aged 3.5 to 19 years). All children with antibodies against H pylori had gastroscopy to obtain gastric biopsy specimens. The prevalence of infection (confirmed histologically or microbiologically, or both) was 38% (45/117), and rose to 67% in one of the five sections of the institution. H pylori was isolated in 34/45 cases, and 22 different strains were found of which five strains were present in more than one child. Up to seven children were infected by the same strain, five of them were living in the same section. Analysis of the characteristics of infected children showed the predominant role of living conditions and the period of time cohabiting in this unexpectedly high prevalence of H pylori infection in children living in good sanitary conditions.
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Affiliation(s)
- P Vincent
- Service de Bactériologie-A, Faculté de Médecine, Lille, France
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36
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Abstract
The presence of Helicobacter pylori in saliva specimens collected from infected children examined before and after specific therapy and from a non-infected pediatric population was detected by indirect immunofluorescence assay (IIF) using a specific monoclonal antibody. Among the 25 children with H. pylori-negative antral biopsies, 4 had in their salivas bacterial cells similar to H. pylori, but a retrospectively performed serologic test showed a positive response. No false-positive reaction was observed among non-infected and seronegative children. The observation of bacterial cells with H. pylori morphology in saliva by IIF was consistent with the presence of this bacterium in antral biopsies. A person-to-person transmission of H. pylori by saliva thus appeared to be possible.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie A, Lille, France
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37
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Abstract
Helicobacter pylori is known to be an etiologic agent of gastritis and peptic ulcer disease in humans. However, the mechanism by which this organism acquires iron has not been studied. For this investigation, H. pylori was grown in iron-restricted medium. Siderophore production was not detected by chemical assays, and the strains were unable to use enterochelin and pyochelin for growth in low-iron media. Human lactoferrin supported full growth of the bacteria in media lacking other iron sources, but neither human transferrin, bovine lactoferrin, nor hen ovotransferrin served as a source for iron. Since lactoferrin was found in significant amounts in human stomach resections with superficial or atrophic gastritis, the iron acquisition system of H. pylori by the human lactoferrin receptor system may play a major role in the virulence of H. pylori infection.
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Affiliation(s)
- M O Husson
- Laboratorie de Bactériologie A, Faculté de Médecine, Lille, France
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38
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Figura N, Owen RJ, Desai M, Bayeli PF, HGregorio LD, Russi M, Musmanno RA, Hawtin PR, Sharpstone D, Hayes L, Nøorgaard A, Nielsen H, Andersen LP, Geis G, Leying H, Suerbaum S, Opferkuch W, Tonokatsu Y, Hayashi T, Fukuda Y, Yamamoto I, Takami S, Tamura T, Shimoyama T, Lopez-Brea M, Martin E, C.Sanz J, Alonso M, Alarcon T, Michetti P, Porta N, Racine L, P.Kraehenbuhl J, L.Blum A, Cardeñoso L, Moran AP, Muotiala A, Pyhälä L, Kosunen TU, Helander IM, Roine RP, Salmela KS, Höök-Nikanne J, Salaspuro M, Daw MA, Xia HX, O’Morain C, Lelwala-Guruge J, Ascencio F, Ljungh Å, Wadström T, Ringnér M, Valkonen K, Paulsson M, Ljungh Å, Wadström T, Guldvog I, Tannaes T, Bukholm G, Grav H, Corinaldesi R, Tucci A, Stanghellini V, Gasperoni S, Varoli O, Paparo GF, Gaetani M, Cioffi G, Barbara L, Husson MO, Legrand D, Mazurier J, Caron C, Leclerc H, Spik G, English L, Keane CT, O’Morain CA, Fox JG, Correa P, Taylor NS, Fatela N, Melo Cristino J, Monteiro L, Ramalho F, Saragoça A, Salgado M, Mauch F, Bode G, Ditschuneit H, Malfertheiner P, Nilius M, Pugliese M, Moshkowitz M, Gorea A, Santo M, Berger S, Gilat T, Belluzzi A, Vaira D, Campieri M, Boschi S, Gionchetti P, Mulè P, Brignola C, Rizzello F, Miglioli M, Barbara L, Lamouliatte H, Brugmann D, Cayla R, H. Bernard P, Mégraud F, Quinton A, Bär W, Wagner S, Glen-Calvo E, Koopmann H, Szentmihalyi A, Radnai Z, Molnar G, Bálint A, Ihász M. Microbiology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sirot DL, Goldstein FW, Soussy CJ, Courtieu AL, Husson MO, Lemozy J, Meyran M, Morel C, Perez R, Quentin-Noury C. Resistance to cefotaxime and seven other beta-lactams in members of the family Enterobacteriaceae: a 3-year survey in France. Antimicrob Agents Chemother 1992; 36:1677-81. [PMID: 1416850 PMCID: PMC192029 DOI: 10.1128/aac.36.8.1677] [Citation(s) in RCA: 107] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
During the second quarter each of 1988, 1989, and 1990, a French collaborative study group, including 12 university hospital laboratories, surveyed the resistance to beta-lactams of clinical isolates from hospitalized patients: consecutively, 10,641, 10,692, and 9,382 isolates were tested. The distribution of bacterial species over time was similar in each laboratory. The susceptibilities of microorganisms to amoxicillin, ticarcillin, cephalothin, cefoxitin, cefotaxime (CTX), ceftazidime (CAZ), aztreonam (ATM), and imipenem (IPM) were measured by the disk diffusion method in accordance with the recommendations of the Antibiogram Committee of the French Society for Microbiology. Five reference strains were included for quality control. Extended-spectrum beta-lactamases were detected by the synergistic effect of the combination of clavulanic acid-amoxicillin with CTX, CAZ, and ATM in the double-diffusion test. A synergistic effect with CTX, CAZ, and ATM was detected for 1.5% of all strains, mainly those of Klebsiella pneumoniae (13.3%). For this species, the synergy test enabled the detection of roughly 50% of the resistant strains misclassified as susceptible on the basis of interpretative standards. Extended-spectrum beta-lactamases disseminated in 1990 in most enterobacterial species but at a low frequency. Important variations in the percentages of resistant strains were observed in terms of bacterial species, hospitals, and wards. However, when the total number of strains was considered, the percentages of resistance to newer beta-lactams remained low.
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Affiliation(s)
- D L Sirot
- Laboratoire de Bactériologie, Faculté de Médecine, Clermont-Ferrand, France
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40
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Levasseur S, Husson MO, Leitz R, Merlin F, Laurent F, Peladan F, Drocourt JL, Leclerc H, Van Hoegaerden M. Rapid detection of members of the family Enterobacteriaceae by a monoclonal antibody. Appl Environ Microbiol 1992; 58:1524-9. [PMID: 1622220 PMCID: PMC195635 DOI: 10.1128/aem.58.5.1524-1529.1992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Six monoclonal antibodies directed against enterobacteria were produced and characterized. The specificity of one of these antibodies (CX9/15; immunoglobulin G2a) was studied by indirect immunofluorescence against 259 enterobacterial strains and 125 other gram-negative bacteria. All of the enterobacteria were specifically recognized, the only exception being Erwinia chrysanthemi (one strain tested). Bacteria not belonging to members of the family Enterobacteriaceae were not detected, except for Plesiomonas shigelloides (two strains tested), Aeromonas hydrophila (five strains tested), and Aeromonas sobria (one strain tested). This recognition spectrum strongly suggested that CX9/15 recognized the enterobacterial common antigen. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot (immunoblot) experiments, the six antienterobacteria antibodies presented similar specificities; they all revealed only one band with an apparent molecular weight of about 20,000 from the crude extract of an enterobacterium. The six monoclonal antibodies, and especially CX9/15, can be used to develop new tests for rapid and specific detection of enterobacteria.
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Abstract
Monoclonal antibodies were produced against an acid glycine extract of Helicobacter pylori ATCC 43504T. One of these appeared to be specific for H. pylori; it recognized all H. pylori isolates by an indirect immunofluorescence assay (IIF) but it did not cross-react with the other strains tested, including different species of the genera Helicobacter, Campylobacter, and Wolinella. Different strains of members of the families Enterobacteriaceae and Pseudomonadaceae or other gram-negative bacteria tested also gave negative reactions. Indirect immunofluorescence assay of antral biopsy specimens identified 54 of 56 infected patients (96.4%), and it may be able to detect nonviable organisms after antibiotic therapy.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie A, Faculté de Médecine, Lille, France
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42
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Husson MO, Mielcarek C, Izard D, Leclerc H. Alkaline phosphatase capture test for the rapid identification of Escherichia coli and Shigella species based on a specific monoclonal antibody. J Clin Microbiol 1989; 27:1518-21. [PMID: 2671016 PMCID: PMC267607 DOI: 10.1128/jcm.27.7.1518-1521.1989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A specific monoclonal antibody for Escherichia coli and Shigella sp. alkaline phosphatase was used in an immunocapture assay and allowed identification of E. coli either in culture isolates or directly in clinical specimens. The assay was easy and required only four steps: (i) alkaline phosphatase was released within 10 min by using a gentle lysis procedure, (ii) cell lysates were transferred to antibody-coated tubes for 45 min, (iii) p-nitrophenyl phosphate substrate was added, and (iv) alkaline phosphatase activity was detected in a microsample spectrophotometer at 410 nm. This immunocapture assay was highly specific: only one false-positive reaction was observed with a Klebsiella pneumoniae lysate among the 205 non-E. coli strains tested. The assay was sensitive, detecting 10(7) CFU/ml from culture isolates or 10(5) CFU/ml from urine specimens which had first been grown in phosphate-limiting medium for 2 h. At these bacterial concentrations, the percentages of detected E. coli were high: 91% for blood cultures, 95.4% for culture isolates, and 96.8% for urine specimens.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie, Faculté de Médecine, Lille, France
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Husson MO, Mielcarek C, Gavini F, Caron C, Izard D, Leclerc H. Isolation and characterization of monoclonal antibodies against alkaline phosphatase of Pseudomonas aeruginosa. J Clin Microbiol 1989; 27:1115-8. [PMID: 2501343 PMCID: PMC267497 DOI: 10.1128/jcm.27.5.1115-1118.1989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Monoclonal antibodies against the alkaline phosphatase of Pseudomonas aeruginosa were produced from spleen cells of BALB/c mice primed with purified alkaline phosphatase of P. aeruginosa ATCC 10145 and SP20/Ag-14 myeloma cells. The eight stable clones established produced antibodies that reacted by enzyme-linked immunosorbent and indirect immunofluorescence assays with all bacterial strains of P. aeruginosa, including the 17 serotypes and two nontypable strains. Three of the clones cross-reacted only with some Pseudomonas species of the rRNA homology group I defined by N. J. Palleroni (in N. R. Krieg and J. G. Holt, ed., Bergey's Manual of Systematic Bacteriology, 8th ed., p. 140-218, 1984). The other clones also interacted with other species, including Pseudomonas acidovorans and Xanthomonas maltophilia. Because other species of the genera Aeromonas and Acinetobacter and species of the family Enterobacteriaceae were not detected by these monoclonal antibodies, the antibodies could be used as reagents for routine detection of P. aeruginosa in clinical specimens. Interactions of the antibodies with other Pseudomonas species such as P. fluorescens and P. stutzeri are not important, since these species are susceptible to the same antipseudomonal agents.
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Affiliation(s)
- M O Husson
- Laboratoire de Bactériologie, Faculté de Médecine, Lille, France
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Vincent P, Colombel JF, Husson MO, Izard D, Paris JC, Leclerc H. [Pharmacokinetics of cefotaxime in cirrhotic patients with or without ascites]. Presse Med 1988; 17:2331-4. [PMID: 2974968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Pharmacokinetic values of cefotaxime were measured in 12 cirrhotic male patients (6 without ascites and 6 with ascites) after intravenous injection of a single 2 gram dose of the antibiotic. In patients without ascites elimination of the drug was about the same as in normal subjects or control patients, although clearance was increased. In patients with ascites, the drug elimination half-life was significantly more prolonged (7.5 +/- 3.9 h versus 1.3 +/- 0.4 h, P less than 0.01) and the drug clearance was significantly lower (193.6 +/- 92.4 ml/min versus 475.8 +/- 152.2 ml/min, P less than 0.01) than in the other group. The accumulation of cefotaxime in these patients produced concentration in the ascites fluid that were above the critical therapeutic values for about 20 hours.
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Affiliation(s)
- P Vincent
- Laboratoire de Bactériologie, Faculté de Médecine, Lille
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46
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Husson MO, Galizia JP, Savage C, Fournier L, Pellerin P, Izard D, Leclerc H. [A method of bacterial count by epifluorescence with acridine orange. Application to skin biopsies performed in burnt patients]. Presse Med 1988; 17:1637-9. [PMID: 2460851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Acridine orange was used for staining and counting micro-organisms obtained from 136 skin biopsies performed in burned patients. The number of organisms per gram of tissue was compared to the number of colony-forming-units (CFU) calculated from cultures of the same biopsies. The staining method was positive in 97 per cent of septic samples, and in 25 per cent of these it proved more sensitive than bacterial cultures, with a 100 to 1000-fold greater number of pathogens detected. Acridine orange also demonstrated bacteria in 69 biopsies which remained sterile after culture. In some cases, the same bacterial species was found in other samples taken a few days later.
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Affiliation(s)
- M O Husson
- Faculté de Médecine, CHU, Laboratoire de Bactériologie, Lille
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Abstract
A study was performed to compare the Autoscan-4 (MicroScan, Inc., Mahwah, N.J.) with conventional biochemical methods for identifying clinical isolates of the family Enterobacteriaceae. The Autoscan-4 yielded correct identification of 95.4% of the isolates at the species level and 98.4% at the genus level. Only one misidentification was observed. The identification of both common and less-common isolates of Enterobacteriaceae makes this system highly efficient.
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Affiliation(s)
- F Gavini
- Institut National de la Santé et de la Recherche Médicale, Unité 146, Villeneuve-d'Ascq, Lille, France
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Freney J, Husson MO, Gavini F, Madier S, Martra A, Izard D, Leclerc H, Fleurette J. Susceptibilities to antibiotics and antiseptics of new species of the family Enterobacteriaceae. Antimicrob Agents Chemother 1988; 32:873-6. [PMID: 3415208 PMCID: PMC172298 DOI: 10.1128/aac.32.6.873] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
One hundred and sixty-nine strains of new species of the family Enterobacteriaceae, isolated mainly from the environment, were tested to determine their susceptibilities to 13 antibiotics and 4 antiseptics or disinfectants. All the species were susceptible to aminoglycosides, doxycycline, and trimethoprim but were resistant to chloramphenicol. Susceptibility to beta-lactams varied more among the strains. However, all the strains were cefotaxime susceptible, apart from some Buttiauxella agrestis strains for which MICs were greater than 256 micrograms/ml. The antiseptic MBCs were similar to those published elsewhere for species of the Enterobacteriaceae of clinical origin. No resistance to chlorhexidine was observed. On the other hand, the environmental strains presented a greater resistance to active chlorine than did the reference strains.
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Affiliation(s)
- J Freney
- Laboratoire de Microbiologie, Faculté de Médecine Alexis-Carrel, Lyon, France
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49
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Trinel PA, Husson MO, Gavini F, Bernard C, Izard D. Immunological relationship among glyceraldehyde-3-phosphate dehydrogenases in the genera Enterobacter and Escherichia. Ann Inst Pasteur Microbiol 1988; 139:307-14. [PMID: 3179057 DOI: 10.1016/0769-2609(88)90022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The comparative immunological study of glyceraldehyde-3-phosphate dehydrogenase (G-3-PDH) among Enterobacteriaceae carried out with an anti-Enterobacter cloacae G-3-PDH serum pointed out the large heterogeneity of the genera Enterobacter and Escherichia. The use of two-dimensional maps integrating our new data and previously acquired quantitative data confirmed these results.
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Affiliation(s)
- P A Trinel
- Unité INSERM 146, Villeneuve d'Ascq, France
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Husson MO, Trinel PA, Mielcarek C, Gavini F, Caron C, Izard D, Leclerc H. Specificity of a Monoclonal Antibody for Alkaline Phosphatase in Escherichia coli and Shigella Species. ACTA ACUST UNITED AC 1988. [DOI: 10.1099/00207713-38-2-201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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