1
|
Akroum S, Tubiana S, de Broucker T, Dournon N, Varon E, Ploy MC, Mourvillier B, Oziol E, Lacassin F, Laurichesse H, Hoen B, Duval X, Burdet C. Long-term neuro-functional disability in adult patients with community-acquired bacterial meningitis. Infection 2022; 50:1363-1372. [PMID: 35657529 DOI: 10.1007/s15010-022-01855-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence of neuro-functional disability and its determinants 12 months after community-acquired bacterial meningitis (CABM) in adult patients. METHODS In a prospective multicenter cohort study (COMBAT), all consecutive cases of CABM were enrolled and followed up for 12 months. Neuro-functional disability at 12 months was evaluated using a combination of the Glasgow Outcome Scale (functional disability), and the modified Rankin Disability Scale (physical disability). Factors associated with neuro-functional disability were identified by multivariate logistic regression. RESULTS Among 281 patients, 84 (29.9%) patients exhibited neuro-functional disability at 12 months: 79 (28.1%) with functional disability and 51 (18.1%) with physical disability. Overall, 6 patients (2.1%) died during the follow-up. The most common pathogen identified was Streptococcus pneumoniae (131/272, 48.2%); 77/268 patients (28.7%) had a physical disability at hospital discharge. Factors independently associated with 12-month neuro-functional disability were a pneumococcal meningitis (adjusted OR = 2.8; 95% confidence interval (CI) = [1.3; 6.7]), the presence of a physical disability at hospital discharge (aOR = 2.3; 95%CI = [1.2; 4.4]) and the presence of behavioral disorders at hospital-discharge (aOR = 5.9; 95%CI = [1.6; 28.4]). Dexamethasone use was not significantly associated with neuro-functional disability (OR = 0.2; 95%CI = [< 0.1;1.3]). CONCLUSION Neuro-functional disability is frequently reported 12 months after CABM. Detailed neurological examination at discharge is needed to improve the follow-up. TRIAL REGISTRATION NCT01730690.
Collapse
Affiliation(s)
- Souade Akroum
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France
| | - Sarah Tubiana
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Centre de Ressources Biologiques, AP-HP, Hôpital Bichat, 75018, Paris, France
| | | | - Nathalie Dournon
- Service de maladies infectieuses et tropicales, dermatologie, médecine interne, Centre Hospitalier Universitaire de Pointe-à-Pitre, 97159, Pointe-à-Pitre, France
| | - Emmanuelle Varon
- Centre Hospitalier Intercommunal de Créteil, Centre National de Référence des Pneumocoques, 94010, Créteil, France
| | - Marie Cécile Ploy
- Centre Hospitalier Universitaire de Limoges, Observatoire Régional des Pneumocoques, 87000, Limoges, France
| | - Bruno Mourvillier
- Service de Médecine Intensive et Réanimation Polyvalente, CHU Reims, 51100, Reims, France
| | - Eric Oziol
- Service de Médecine Interne, Centre Hospitalier de Béziers, 34500, Béziers, France
| | - Flore Lacassin
- Service de Médecine Interne, Centre Hospitalier Territorial de Nouméa, 98849, Nouméa, France
| | - Henri Laurichesse
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Bruno Hoen
- Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, 54511, Vandoeuvre-lès-Nancy, France
| | - Xavier Duval
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France. .,Université Paris Cité, IAME, INSERM, 75018, Paris, France.
| | - Charles Burdet
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Département d'Epidémiologie, Biostatistique et Recherche, AP-HP, Hôpital Bichat, 75018, Paris, France
| | | |
Collapse
|
2
|
Danis K, Ploy MC, Varon E, Levy-Bruhl D, Gaillat J. Severe outcomes following invasive pneumococcal disease in adults in France. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Pneumococcal vaccine serotypes and host factors may increase the risk of severe invasive pneumococcal disease (IPD). In France, pneumococcal vaccination in adults is recommended for at-risk groups (immunosuppression or at-risk conditions/diseases). In 2014-2017, we conducted a study of IPD in adults to identify factors/serotypes associated with disease severity.
We included IPD cases, excluding meningitis, in adults from 25 acute-care sentinel hospitals in six regions. Severe cases were IPD patients either admitted to an ICU or under mechanical ventilation or with severe sepsis or shock. Infectious disease specialists collected clinical/microbiological data on all cases. We calculated adjusted risk ratios (aRR) using binomial regression.
In 2014-2017, 908 cases (median age 71 (range 18-101) years) were diagnosed; 48%(431/908) were severe and 84%(764/908) were at-risk. Compared with non-risk individuals, the risk of severe disease increased from 20% (aRR 1.2; 95%CI 1.0-1.4) in cases with 1-2 chronic diseases to 30% (aHR 1.3; 95%CI 1.0-7.0) in those with >2 chronic diseases. The risk of severe disease was 42% (aRR 1.4; 95%CI 1.2-1.6) higher for PCV13 serotypes compared with non-vaccine serotypes. Among cases infected with PCV13 serotypes, the risk of severe disease did not differ (aRR 0.96; 95%CI 1.2-23) between no-risk or at-risk cases. However, among cases infected with non-vaccine serotypes, the risk increased 49% (aRR 1.5; 95%CI 2.1-22) in at-risk compared with no-risk cases (homogeneity test p = 0.03).
We observed a cumulative effect of concurrent comorbidities on severe IPD outcomes. The risk of severe IPD increased for vaccine serotypes regardless of risk status. However, non-vaccine serotypes increased the risk of severe outcomes only in risk groups, suggesting a different interplay between host factors and the pathogen in vulnerable groups. We recommend enhancing vaccination among risk groups and especially in those most at risk for poor IPD-related outcomes.
Key messages
Cumulative effect of concurrent comorbidities on severe invasive pneumococcal disease outcomes. Non-vaccine serotypes increase the risk of severe invasive pneumococcal disease outcomes only in vulnerable groups.
Collapse
Affiliation(s)
- K Danis
- Department of Infectious Diseases, Santé Publique France, Saint Maurice, France
| | - M C Ploy
- CHU de Limoges, University of Limoges, Limoges, France
| | - E Varon
- National Centre for Pneumococci, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - D Levy-Bruhl
- Department of Infectious Diseases, Santé Publique France, Saint Maurice, France
| | - J Gaillat
- Centre Hospitalier Annecy Genevois, Annecy, France
| | | |
Collapse
|
3
|
Yugueros-Marcos J, Barraud O, Iannello A, Ploy MC, Ginocchio C, Rogatcheva M, Alberti-Segui C, Pachot A, Moucadel V, François B. New molecular semi-quantification tool provides reliable microbiological evidence for pulmonary infection. Intensive Care Med 2018; 44:2302-2304. [PMID: 30350171 DOI: 10.1007/s00134-018-5417-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Javier Yugueros-Marcos
- Medical Diagnostic Discovery Department (MD3), bioMérieux S.A., Grenoble, France
- bioMérieux S.A./BioFire LLC Research and Development, Grenoble, France
| | - Olivier Barraud
- Univ. Limoges, Inserm, CHU Limoges, RESINFIT, U1092, Limoges, France
| | - Alexandra Iannello
- Medical Diagnostic Discovery Department (MD3), bioMérieux S.A., Grenoble, France
| | - Marie Cécile Ploy
- Univ. Limoges, Inserm, CHU Limoges, RESINFIT, U1092, Limoges, France
| | - Christine Ginocchio
- BioFire Diagnostics, LLC, Salt Lake City, UT, USA
- bioMérieux Inc., Durham, NC, USA
| | | | | | - Alexandre Pachot
- Medical Diagnostic Discovery Department (MD3), bioMérieux S.A., Grenoble, France
| | - Virginie Moucadel
- Medical Diagnostic Discovery Department (MD3), bioMérieux S.A., Grenoble, France
| | - Bruno François
- Univ. Limoges, Inserm, CHU Limoges, RESINFIT, U1092, Limoges, France.
- Réanimation Polyvalente, CHU Dupuytren, Limoges, France.
- Inserm CIC1435, CHU Dupuytren, Limoges, France.
| |
Collapse
|
4
|
Couvé-Deacon E, Postil D, Barraud O, Duchiron C, Chainier D, Labrunie A, Pestourie N, Preux PM, François B, Ploy MC. Staphylococcus Aureus Carriage in French Athletes at Risk of CA-MRSA Infection: a Prospective, Cross-sectional Study. Sports Med Open 2017; 3:28. [PMID: 28815486 PMCID: PMC5559403 DOI: 10.1186/s40798-017-0094-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022]
Abstract
Background Staphylococcus aureus (SA) is a leading cause of infectious diseases in sports teams. In recent decades, community-associated SA (CA-SA) strains have emerged worldwide and have been responsible for outbreaks in sports teams. There are very few data on the prevalence of these strains in France, and none on the carriage among athletes. Methods We conducted a cross-sectional study to determine the SA carriage proportion among athletes practicing sports at risk for CA-SA infection in a French county, and determined the methicillin-resistant and/or CA-SA proportion. We also analyzed SA carriage according to risks factors and studied the SA clonality in a sample of our population. Results We included 300 athletes; SA carriage proportion was 61% (n = 183) and one was MRSA carrier (0.33%). The MRSA strain belonged to the clonal complex ST5. None of the strain produced Panton Valentine Leucocidin, and we did not find clonal distribution within the teams. Interestingly, we found a high throat-only carriage (n = 57), 31.1% of the SA carriers. Conclusion We found a high SA carriage with a local epidemiology quite different than that reported in a similar population in the USA. Further studies on SA carriage should include throat sampling. Trial registration The approved protocol was registered on ClinicalTrial.gov, NCT01148485.
Collapse
Affiliation(s)
- E Couvé-Deacon
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - D Postil
- INSERM, CIC-1435, F-87000, Limoges, France
| | - O Barraud
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - C Duchiron
- INSERM, CIC-1435, F-87000, Limoges, France
| | - D Chainier
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - A Labrunie
- CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - N Pestourie
- CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France
| | - P M Preux
- CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - B François
- University Limoges, UMR, 1092, Limoges, France.,INSERM, UMR, 1092, Limoges, France.,INSERM, CIC-1435, F-87000, Limoges, France
| | - M C Ploy
- University Limoges, UMR, 1092, Limoges, France. .,INSERM, UMR, 1092, Limoges, France. .,CHU Limoges, Laboratory of Bacteriology-Virology-Hygiene, 2 avenue Martin Luther King, 87042, Limoges, cedex, France.
| |
Collapse
|
5
|
Barraud O, Isnard C, Lienhard R, Guérin F, Couvé-Deacon E, Martin C, Cattoir V, Ploy MC. Sulphonamide resistance associated with integron derivative Tn6326 in Actinotignum schaalii. J Antimicrob Chemother 2016; 71:2670-1. [PMID: 27261268 DOI: 10.1093/jac/dkw197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- O Barraud
- INSERM, U1092, Limoges F-87000, France Université de Limoges, UMR-S1092, Faculté de Médecine, 2 rue du Dr Marcland, Limoges F-87025, France CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, 2 Av. Martin Luther King, Limoges F-87042, France
| | - C Isnard
- CHU de Caen, Service de Microbiologie, Caen, France Université de Caen Normandie, EA 4655 (équipe 'Antibiorésistance'), Caen, France
| | - R Lienhard
- ADMED Microbiologie, La-Chaux-de-Fonds, Switzerland
| | - F Guérin
- CHU de Caen, Service de Microbiologie, Caen, France Université de Caen Normandie, EA 4655 (équipe 'Antibiorésistance'), Caen, France CNR de la Résistance aux Antibiotiques (laboratoire associé 'Entérocoques et résistances particulières des bactéries à Gram positif'), Caen, France
| | - E Couvé-Deacon
- INSERM, U1092, Limoges F-87000, France Université de Limoges, UMR-S1092, Faculté de Médecine, 2 rue du Dr Marcland, Limoges F-87025, France CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, 2 Av. Martin Luther King, Limoges F-87042, France
| | - C Martin
- INSERM, U1092, Limoges F-87000, France Université de Limoges, UMR-S1092, Faculté de Médecine, 2 rue du Dr Marcland, Limoges F-87025, France CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, 2 Av. Martin Luther King, Limoges F-87042, France
| | - V Cattoir
- CHU de Caen, Service de Microbiologie, Caen, France Université de Caen Normandie, EA 4655 (équipe 'Antibiorésistance'), Caen, France CNR de la Résistance aux Antibiotiques (laboratoire associé 'Entérocoques et résistances particulières des bactéries à Gram positif'), Caen, France
| | - M C Ploy
- INSERM, U1092, Limoges F-87000, France Université de Limoges, UMR-S1092, Faculté de Médecine, 2 rue du Dr Marcland, Limoges F-87025, France CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, 2 Av. Martin Luther King, Limoges F-87042, France
| |
Collapse
|
6
|
Gault J, Ferber M, Machata S, Imhaus AF, Malosse C, Charles-Orszag A, Millien C, Bouvier G, Bardiaux B, Péhau-Arnaudet G, Klinge K, Podglajen I, Ploy MC, Seifert HS, Nilges M, Chamot-Rooke J, Duménil G. Neisseria meningitidis Type IV Pili Composed of Sequence Invariable Pilins Are Masked by Multisite Glycosylation. PLoS Pathog 2015; 11:e1005162. [PMID: 26367394 PMCID: PMC4569582 DOI: 10.1371/journal.ppat.1005162] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/20/2015] [Indexed: 12/27/2022] Open
Abstract
The ability of pathogens to cause disease depends on their aptitude to escape the immune system. Type IV pili are extracellular filamentous virulence factors composed of pilin monomers and frequently expressed by bacterial pathogens. As such they are major targets for the host immune system. In the human pathogen Neisseria meningitidis, strains expressing class I pilins contain a genetic recombination system that promotes variation of the pilin sequence and is thought to aid immune escape. However, numerous hypervirulent clinical isolates express class II pilins that lack this property. This raises the question of how they evade immunity targeting type IV pili. As glycosylation is a possible source of antigenic variation it was investigated using top-down mass spectrometry to provide the highest molecular precision on the modified proteins. Unlike class I pilins that carry a single glycan, we found that class II pilins display up to 5 glycosylation sites per monomer on the pilus surface. Swapping of pilin class and genetic background shows that the pilin primary structure determines multisite glycosylation while the genetic background determines the nature of the glycans. Absence of glycosylation in class II pilins affects pilus biogenesis or enhances pilus-dependent aggregation in a strain specific fashion highlighting the extensive functional impact of multisite glycosylation. Finally, molecular modeling shows that glycans cover the surface of class II pilins and strongly decrease antibody access to the polypeptide chain. This strongly supports a model where strains expressing class II pilins evade the immune system by changing their sugar structure rather than pilin primary structure. Overall these results show that sequence invariable class II pilins are cloaked in glycans with extensive functional and immunological consequences. During infection pathogens and their host engage in a series of measures and counter-measures to promote their own survival: pathogens express virulence factors, the immune system targets these surface structures and pathogens modify them to evade detection. Like numerous bacterial pathogens, Neisseria meningitidis express type IV pili, long filamentous adhesive structures composed of pilins. Intriguingly the amino acid sequences of pilins from most hypervirulent strains do not vary, raising the question of how they evade the immune system. This study shows that the pilus structure is completely coated with sugars thus limiting access of antibodies to the pilin polypeptide chain. We propose that multisite glycosylation and thus variation in the type of sugar mediates immune evasion in these strains.
Collapse
MESH Headings
- Amino Acid Sequence
- Bacterial Adhesion
- Cell Line
- Cells, Cultured
- Conserved Sequence
- Endothelium, Vascular/cytology
- Endothelium, Vascular/immunology
- Endothelium, Vascular/microbiology
- Endothelium, Vascular/pathology
- Fimbriae Proteins/chemistry
- Fimbriae Proteins/genetics
- Fimbriae Proteins/metabolism
- Fimbriae, Bacterial/immunology
- Fimbriae, Bacterial/metabolism
- Fimbriae, Bacterial/ultrastructure
- Gene Deletion
- Glycosylation
- Host-Pathogen Interactions
- Human Umbilical Vein Endothelial Cells/cytology
- Human Umbilical Vein Endothelial Cells/immunology
- Human Umbilical Vein Endothelial Cells/microbiology
- Human Umbilical Vein Endothelial Cells/pathology
- Humans
- Immune Evasion
- Meningococcal Infections/immunology
- Meningococcal Infections/metabolism
- Meningococcal Infections/microbiology
- Meningococcal Infections/pathology
- Microscopy, Electron, Transmission
- Models, Molecular
- Neisseria meningitidis/immunology
- Neisseria meningitidis/metabolism
- Neisseria meningitidis/ultrastructure
- Protein Processing, Post-Translational
- Sequence Homology, Amino Acid
- Species Specificity
- Surface Properties
Collapse
Affiliation(s)
- Joseph Gault
- Structural Mass Spectrometry and Proteomics Unit, Institut Pasteur, CNRS UMR 3528, Paris, France
| | - Mathias Ferber
- Institut Pasteur, Unité de Bioinformatique Structurale, CNRS UMR 3528, Département de Biologie Structurale et Chimie, Paris, France
| | - Silke Machata
- INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France
| | - Anne-Flore Imhaus
- INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France
| | - Christian Malosse
- Structural Mass Spectrometry and Proteomics Unit, Institut Pasteur, CNRS UMR 3528, Paris, France
| | - Arthur Charles-Orszag
- INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France
| | - Corinne Millien
- INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France
| | - Guillaume Bouvier
- Institut Pasteur, Unité de Bioinformatique Structurale, CNRS UMR 3528, Département de Biologie Structurale et Chimie, Paris, France
| | - Benjamin Bardiaux
- Institut Pasteur, Unité de Bioinformatique Structurale, CNRS UMR 3528, Département de Biologie Structurale et Chimie, Paris, France
| | | | - Kelly Klinge
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Isabelle Podglajen
- Service de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Marie Cécile Ploy
- INSERM UMR1092, Faculté de Médecine, Université de Limoges, Limoges, France
| | - H. Steven Seifert
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Michael Nilges
- Institut Pasteur, Unité de Bioinformatique Structurale, CNRS UMR 3528, Département de Biologie Structurale et Chimie, Paris, France
| | - Julia Chamot-Rooke
- Structural Mass Spectrometry and Proteomics Unit, Institut Pasteur, CNRS UMR 3528, Paris, France
| | - Guillaume Duménil
- INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France
- * E-mail:
| |
Collapse
|
7
|
Lacroix M, Barraud O, Clavel M, Filiputti D, Prudent S, François B, Ploy MC, Jestin MA, Rodrigue M, Pachot A, Yugueros-Marcos J, Moucadel V. Rapid quantification of Staphylococcus aureus from endotracheal aspirates of ventilated patients: a proof-of-concept study. Diagn Microbiol Infect Dis 2015; 83:117-20. [PMID: 26227327 DOI: 10.1016/j.diagmicrobio.2015.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 06/05/2015] [Accepted: 06/07/2015] [Indexed: 11/30/2022]
Abstract
Major concern for intubated patients is ventilator-associated pneumonia (VAP). Early detection of VAP and its causative microorganism(s) is a key challenge for clinicians. Diagnosis is based on clinical, radiological, and microbiological elements, the latter being provided 24-48h after sampling. According to practices, clinicians can sample endotracheal aspirates (ETAs) so as to check for patient colonization or perform ETA in case of VAP suspicion. In this proof-of-concept study, we report the evaluation of a semiautomated molecular method to rapidly quantify Staphylococcus aureus, one of the most involved microorganisms in VAP, directly from raw ETA samples. After evaluation using artificial ETA samples, our method was applied on 40 clinical ETA samples. All S. aureus-positive samples were successfully detected and quantified. Our method can provide an efficient sample preparation protocol for all raw ETA samples, combined with an accurate quantification of the bacterial load, in less than 3h 30min.
Collapse
Affiliation(s)
- Morgane Lacroix
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Olivier Barraud
- Inserm, UMR 1092, Limoges, Univ. Limoges, UMR 1092, CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, Limoges, France
| | - Marc Clavel
- Intensive Care Unit/Inserm CIC1435, CHU Limoges, 2 avenue Martin Luther King, 87042 Limoges Cedex, France
| | - Delphine Filiputti
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Sandrine Prudent
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Bruno François
- Intensive Care Unit/Inserm CIC1435, CHU Limoges, 2 avenue Martin Luther King, 87042 Limoges Cedex, France
| | - Marie Cécile Ploy
- Inserm, UMR 1092, Limoges, Univ. Limoges, UMR 1092, CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, Limoges, France
| | | | - Marc Rodrigue
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Alexandre Pachot
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Javier Yugueros-Marcos
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France
| | - Virginie Moucadel
- Medical Diagnostic Discovery Department, bioMérieux SA, Centre Christophe Mérieux, 5 rue des berges, 38024 Grenoble cedex 1, France.
| |
Collapse
|
8
|
Clavel M, Barraud O, Moucadel V, Ploy MC, Karam E, Meynier F. Concordance between a new molecular real-time approach and traditional culture in suspected VAP patients. Crit Care 2015. [PMCID: PMC4472708 DOI: 10.1186/cc14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
9
|
Rizzo L, Manaia C, Merlin C, Schwartz T, Dagot C, Ploy MC, Michael I, Fatta-Kassinos D. Urban wastewater treatment plants as hotspots for antibiotic resistant bacteria and genes spread into the environment: a review. Sci Total Environ 2013; 447:345-60. [PMID: 23396083 DOI: 10.1016/j.scitotenv.2013.01.032] [Citation(s) in RCA: 1198] [Impact Index Per Article: 108.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/08/2013] [Accepted: 01/08/2013] [Indexed: 05/20/2023]
Abstract
Urban wastewater treatment plants (UWTPs) are among the main sources of antibiotics' release into the environment. The occurrence of antibiotics may promote the selection of antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB), which shade health risks to humans and animals. In this paper the fate of ARB and ARGs in UWTPs, focusing on different processes/technologies (i.e., biological processes, advanced treatment technologies and disinfection), was critically reviewed. The mechanisms by which biological processes influence the development/selection of ARB and ARGs transfer are still poorly understood. Advanced treatment technologies and disinfection process are regarded as a major tool to control the spread of ARB into the environment. In spite of intense efforts made over the last years to bring solutions to control antibiotic resistance spread in the environment, there are still important gaps to fill in. In particular, it is important to: (i) improve risk assessment studies in order to allow accurate estimates about the maximal abundance of ARB in UWTPs effluents that would not pose risks for human and environmental health; (ii) understand the factors and mechanisms that drive antibiotic resistance maintenance and selection in wastewater habitats. The final objective is to implement wastewater treatment technologies capable of assuring the production of UWTPs effluents with an acceptable level of ARB.
Collapse
Affiliation(s)
- L Rizzo
- Department of Civil Engineering, University of Salerno, 84084, Fisciano (SA), Italy.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Barraud O, Baclet MC, Denis F, Ploy MC. Quantitative multiplex real-time PCR for detecting class 1, 2 and 3 integrons. J Antimicrob Chemother 2010; 65:1642-5. [PMID: 20542899 DOI: 10.1093/jac/dkq167] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Integrons are bacterial genetic elements that can capture and express genes contained in mobile cassettes. Integrons have been described worldwide in Gram-negative bacteria and are a marker of antibiotic resistance. We developed a specific and sensitive Taqman probe-based real-time PCR method with three different primer-probe pairs for simultaneous detection of the three main classes of integron. METHODS Sensitivity was assessed by testing mixtures of the three targets (intI integrase genes of each integron class) ranging from 10 to 10(8) copies. Specificity was determined with a panel of integron-containing and integron-free control strains. The method was then applied to clinical samples. RESULTS The PCR method was specific and had a sensitivity of 10(2) copies for all three genes, regardless of their respective quantities. The method was quantitative from 10(3) to 10(7) copies, and was able to detect integrons directly in biological samples. CONCLUSIONS We have developed a rapid, quantitative, specific and sensitive method that could prove useful for initial screening of Gram-negative isolates, or clinical samples, for likely multidrug resistance.
Collapse
Affiliation(s)
- O Barraud
- EA3175, Univ Limoges, Faculté de Médecine, 2 rue du Dr Marcland, 87025 Limoges, France
| | | | | | | |
Collapse
|
11
|
Gassama Sow A, Aïdara-Kane A, Barraud O, Gatet M, Denis F, Ploy MC. High prevalence of trimethoprim-resistance cassettes in class 1 and 2 integrons in Senegalese Shigella spp isolates. J Infect Dev Ctries 2010; 4:207-12. [PMID: 20440057 DOI: 10.3855/jidc.583] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 02/01/2010] [Accepted: 02/17/2010] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Integrons have a well-established role in the dissemination of resistance among Gram-negative pathogens and are thus a useful marker of antibiotic resistance. Shigellae are noteworthy for their multiple drug resistance, having gradually acquired resistance to most widely use and inexpensive antimicrobial drugs. METHODOLOGY A total of 32 Shigella strains belonging to serotypes flexneri, dysenteriae, and boydii 20, a new Shigella serovar, resistant to at least four antibiotics were analyzed by molecular techniques. RESULTS Class 1 integrons were the most prevalent (92.8%); class 2 integrons were found in 16 strains (57.1%). Fifty percent of the strains harboured both class 1 and 2 integrons (intI1 and intI2 genes); this combination of integrase genes was most prevalent in S. boydii 20 and S. dysenteriae strains. The class 1 integrons detected contained dfr and aadA cassettes, alone or in combination (dfrA5/dfrA15, or dfrA15-aadA1, dfrA1-aadA2), and an atypical cassette array with an insertion sequence (oxa30-aadA1-IS1). For class 2 integrons, we detected either the same cassettes as those found in Tn7 (dfrA1-sat1-aadA1-orfX) or truncated class 2 integrons without aadA1 or orfX. The tns genes were absent from all class 2 integrons.The distribution of integrons among RAPD profiles and serotypes revealed a clonal spread of integrons into serotypes and a transfer of integrons between different serotypes. CONCLUSIONS The detection of integrons in a new Shigella serovar, in addition with a high integron prevalence among Shigella strains, confirms the propensity of shigellae to acquire and disseminate resistance determinants.
Collapse
Affiliation(s)
- Amy Gassama Sow
- Unité de Bactériologie Expérimentale, Institut Pasteur, Dakar, Senegal.
| | | | | | | | | | | |
Collapse
|
12
|
Desachy A, Lina G, Vignon P, Hashemzadeh A, Denis F, Etienne J, Francois B, Ploy MC. Role of superantigenic strains in the prognosis of community-acquired methicillin-susceptible Staphylococcus aureus bacteraemia. Clin Microbiol Infect 2007; 13:1131-3. [PMID: 17727671 DOI: 10.1111/j.1469-0691.2007.01810.x] [Citation(s) in RCA: 11] [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: 01/31/2023]
Abstract
Methicillin-susceptible Staphylococcus aureus (MSSA) strains can produce superantigenic toxins that may trigger a massive release of pro-inflammatory cytokines, which are involved in the onset of septic shock. This 1-year prospective pilot study assessed the role of the production of superantigenic toxins in the outcome of immunocompetent patients hospitalised for community-acquired MSSA bacteraemia. Thirty-seven patients were enrolled, of whom 14 died in hospital. Fourteen patients had septic shock, and the mortality rate in this subgroup was 56%. Twenty-seven (73%) isolates produced at least one superantigenic toxin, but this did not influence the rate of occurrence of septic shock or death.
Collapse
Affiliation(s)
- A Desachy
- Dupuytren Teaching Hospital, Medical-Surgical Intensive Care Unit, Limoges, France.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Rogues AM, Placet-Thomazeau B, Parneix P, Vincent I, Ploy MC, Marty N, Merillou B, Labadie JC, Gachie JP. Use of antibiotics in hospitals in south-western France. J Hosp Infect 2004; 58:187-92. [PMID: 15501332 DOI: 10.1016/j.jhin.2004.07.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [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: 07/02/2003] [Accepted: 07/26/2004] [Indexed: 11/17/2022]
Abstract
Data on the use of antibiotics were collected by means of a questionnaire from 49 hospitals in south-western France. Use was expressed as a usage density rate: number of defined daily doses (DDDs) per 1000 patient-days. The average use of antibiotics amounted to 402 DDDs per 1000 patient-days and varied between 60 and 734. In acute-care wards, the amount of antibiotic use increased with the size of the hospital: 461 DDDs per 1000 patient-days for group A (<100 beds), 510 DDDs per 1000 patient-days for group B (more than 100 and less then 300 beds) and 676 DDDs per 1000 patient-days for group C (>300 beds). The rate of use differed among different types of hospital areas and varied from 58 for psychiatry departments to more than 1273 DDDs per 1000 patient-days for the infectious diseases departments. Broad-spectrum penicillins were the most frequently prescribed antibiotics. Fluoroquinolone and third-generation cephalosporin use were relatively uniform in the three size categories. This study shows that it is possible for a hospital to benchmark its consumption with other hospitals that are similar in size. In this way, surveillance of antibiotic use can aid hospitals in targeting infection control efforts.
Collapse
Affiliation(s)
- A M Rogues
- Service d'Hygiène Hospitalière, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Bezanahary H, Loustaud-Ratti V, Ploy MC, Vidal E. Baisse de l'acuité visuelle et lésions hépatospléniques, ce ne serait pas un mystère … à Istanbul! Rev Med Interne 2004; 25 Suppl 2:S281-2. [PMID: 15460479 DOI: 10.1016/s0248-8663(04)80032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- H Bezanahary
- Service de médecine interne A, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | | | | | | |
Collapse
|
15
|
Trividic M, Gauthier ML, Sparsa A, Ploy MC, Mounier M, Boulinguez S, Bedane C, Bonnetblanc JM. [Methi-resistant Staphylococcus aureus in dermatological practice: origin, risk factors and outcome]. Ann Dermatol Venereol 2002; 129:27-9. [PMID: 11937926] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND Increased frequency of methiresistant Staphylococcus aureus (MRSA) in inpatients is a day to day problem. OBJECTIVE To determine the origin of MRSA, the causes for contamination, and potential complications in a department of Dermatology. PATIENTS AND METHODS A retrospective study of patients hospitalized in a dermatology department with cutaneous MRSA during 1997-1998. We considered age, type and duration of dermatitis, geographic origin of patients on admission, previous hospitalizations, time between arrival in the ward and positive MRSA, and complications requiring systemic antibiotics. RESULTS Out of 4579 of our patients, 53 (0.011 p. 100) had positive MRSA. They were on average 70.86 years-old (26 to 97). The most common underlying dermatitis was leg ulcers (30) and foot sores (4). Dermatitis had lasted for more than 1 month in 48 patients. Most of the patients (40) had their MRSA on admission to our ward. Twenty six patients admitted from home had MRSA; only 9 had never been in an hospital. Six patients had diabetes mellitus. Thirty two patients healed with local treatment for their dermatitis. Thirteen patients have had some complications (erysipela 1, osteoarthritis 3, septicemia 2, febrile syndrome 9). DISCUSSION Most patients with MRSA had leg ulcers or foot sores, confirming liability of chronic wounds to MRSA colonizing. Thirty one out of 40 patients with MRSA at arrival had been previously hospitalized. Hospitalization increases the risk of MRSA contamination. Treatment of MRSA is essentially that of the underlying dermatitis. However, it is still necessary to monitor the lesion for complications.
Collapse
Affiliation(s)
- M Trividic
- Service de Dermatologie, CHU Dupuytren Limoges, France
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Ploy MC, Francois B, Mounier M, Vignon P, Denis F. Nasal carriage of vancomycin-intermediate Staphylococcus aureus among intensive care unit staff. Clin Infect Dis 2001; 33:1951. [PMID: 11692314 DOI: 10.1086/323561] [Citation(s) in RCA: 7] [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: 11/04/2022] Open
|
17
|
Leclercq R, Nicolas-Chanoine MH, Nordmann P, Philippon A, Marchais P, Buu-Ho A, Chardon H, Dabernat H, Doucet-Populaire F, Grasmick C, Legrand P, Muller-Serieys C, Nguyen J, Ploy MC, Reverdy ME, Weber M, Courcol RJ. Multicenter evaluation of an automated system using selected bacteria that harbor challenging and clinically relevant mechanisms of resistance to antibiotics. Eur J Clin Microbiol Infect Dis 2001; 20:626-35. [PMID: 11714043 DOI: 10.1007/s100960100574] [Citation(s) in RCA: 10] [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: 11/27/2022]
Abstract
A multicenter study was carried out to evaluate the performance of a new commercial automated system in comparison with that of the reference agar dilution method. Ten clinical microbiology laboratories tested a collection of 61 strains of gram-negative bacilli (49 Enterobacteriaceae and 12 Pseudomonas aeruginosa), and 6 other laboratories tested a collection of 55 strains of gram-positive cocci (10 enterococci and 45 staphylococci) against 10-20 antimicrobial agents. The strains were selected on the basis that they harbored challenging and characterized mechanisms of resistance. In comparison with the agar reference method, the automated system gave an overall essential agreement (+/-1 dilution) of 94.5%, 93.5%, and 97% for the gram-negative bacilli, enterococci, and staphylococci, respectively. According to the interpretive standards of the National Committee for Clinical Laboratory Standards, the category agreement ranged from 96 to 96.4% for the three sets of organisms. The accuracy of the automated system, as determined by the kappa test, ranged from 0.80 to 0.88, reflecting an almost perfect agreement with the reference technique. Very major, major, and minor errors obtained with the automated system were 0.3%, 2.9%, and 6.6% for gram-negative bacilli, 3.4%, 0%, and 5% for enterococci, and 1%, 1.6%, and 2.7% for staphylococci, respectively. The high rate of very major errors in enterococci was mostly due to a single strain of multidrug-resistant Enterococcus faecium, which was found susceptible to several antibiotics in a majority of participant laboratories. The use of a heavy inoculum and of a broth test medium by the automated system might account for a better expression of certain resistance mechanisms, including beta-lactamases, as compared to the agar dilution reference method. The interlaboratory reproducibility was acceptable, as shown by the narrow dispersion of MICs and by the results of quality control.
Collapse
|
18
|
Gambarotto K, Ploy MC, Dupron F, Giangiobbe M, Denis F. Occurrence of vancomycin-resistant enterococci in pork and poultry products from a cattle-rearing area of France. J Clin Microbiol 2001; 39:2354-5. [PMID: 11376091 PMCID: PMC88145 DOI: 10.1128/jcm.39.6.2354-2355.2001] [Citation(s) in RCA: 33] [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: 11/20/2022] Open
Abstract
Meat products were collected from public retail outlets and tested for the presence of vancomycin-resistant enterococci (VRE) in an area with a high prevalence of VRE reported in human fecal samples. VRE were detected in 66% of the samples, and a predominance of VanC strains was found, which is also true for human fecal samples.
Collapse
Affiliation(s)
- K Gambarotto
- Department of Microbiology and Virology, Limoges University Teaching Hospital, 2 av. Martin Luther King, 87000 Limoges, France
| | | | | | | | | |
Collapse
|
19
|
Denis F, Martin C, Ploy MC. [Erysipelas: microbiological and pathogenic data]. Ann Dermatol Venereol 2001; 128:317-25. [PMID: 11319358] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Streptococcus pyogenes is considered as the primary cause of erysipelas and the virulence factors of this species are reviewed. The role of Staphylococcus aureus alone or associated with Streptococcus pyogenes remains unclear. Other etiologies are infrequent. Several techniques were used to detect bacteria (direct examination, culture, antigen or genome assay) in local samples (needle aspiration, swab.), in others sites (throat, blood cultures), or specific antibodies. The performance of the various diagnosis methods is evaluated. Despite the combination of 2 or more methods, the etiology remains unknown in almost 20 p. 100 of the cases.
Collapse
Affiliation(s)
- F Denis
- Département de Bactériologie, Virologie, Hygiène, CHU Dupuytren, 87042 Limoges, France
| | | | | |
Collapse
|
20
|
Ploy MC, Denis F, Courvalin P, Lambert T. Molecular characterization of integrons in Acinetobacter baumannii: description of a hybrid class 2 integron. Antimicrob Agents Chemother 2000; 44:2684-8. [PMID: 10991844 PMCID: PMC90135 DOI: 10.1128/aac.44.10.2684-2688.2000] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.5] [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: 12/15/1999] [Accepted: 07/01/2000] [Indexed: 11/20/2022] Open
Abstract
Twenty Acinetobacter baumannii strains resistant to various antibiotics were analyzed for integron content and sequences of the amplification products. Sixteen clinical isolates had a class 1 integron, 2 contained an additional class 1 or class 2 integron, but no class 3 integron was detected. Thirteen strains had integrons with a single cassette: aac(3)-Ia (9 strains), ant(2")-Ia (2 strains), or aac(6')-Ib (2 strains); 1 had aac(6')-Ib and oxa20 cassettes and an unknown gene; and 1 had an integron containing ant(2")-Ia and an oxa3 cassette truncated by IS6100. The remaining strains harbored class 1 integrons with gene cassettes previously found in Enterobacteriaceae. One integron had a hybrid structure composed of intI2 and the 3' conserved segment of class 1 integrons. These data indicate that integrons play a major role in multidrug resistance in Acinetobacter.
Collapse
Affiliation(s)
- M C Ploy
- Laboratoire de Bactériologie-Virologie-Hygiène, CHU Dupuytren, 87042 Limoges, France.
| | | | | | | |
Collapse
|
21
|
Ploy MC, Lambert T, Gassama A, Denis F. [The role of integrons in dissemination of antibiotic resistance]. Ann Biol Clin (Paris) 2000; 58:439-44. [PMID: 10932044] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Bacteria can transfer genetic information to get protection against most antibiotics. The acquisition of resistance genes involves genetic mobile elements such as plasmids and transposons. Another genetic structures, named integrons, have been described and contain one or more gene cassettes located at a specific site. Integrons contain an intI gene encoding a site-specific recombinase belonging to the integrase family and a recombination site attI. A gene cassette includes an open reading frame and, at the 3'-end, a recombination site attC. Integration or excision of cassettes occurs by a site-specific recombination mechanism catalyzed by the integrase. However, insertion can rarely occur, at non-specific sites leading to a stable situation for the cassette. Cassettes are transcribed from a common promoter located in the 5'-conserved segment and expression of distal genes is reduced by the presence of upstream cassettes. Most gene cassettes encode antibiotic resistant determinants but antiseptic resistant genes have also been described. Integrons seem to have a major role in the spread of multidrug resistance in Gram-negative bacteria but integrons in Gram-positive bacteria have been recently described. Moreover, the finding of super-integrons with gene cassettes coding for other determinants (biochemical functions, virulence factors) in different Gram negative bacteria suggests that integrons are probably implied in bacterial genome evolution.
Collapse
Affiliation(s)
- M C Ploy
- Laboratoire de bactériologie-virologie-hygiène, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex
| | | | | | | |
Collapse
|
22
|
Abstract
Bacteria can transfer genetic information to provide themselves with protection against most antibiotics. The acquisition of resistance gene arrays involves genetic mobile elements like plasmids and transposons. Another class of genetic structures, termed integrons, have been described and contain one or more gene cassettes located at a specific site. Integrons are defined by an intl gene encoding an integrase, a recombination site attl and a strong promoter. At least six classes of integrons have been determined according to their intl gene. Classes 1, 2 and 3 are the most studied and are largely implicated in the dissemination of antibiotic resistance. A gene cassette includes an open reading frame and, at the 3'-end, a recombination site attC. Integration or excision of cassettes occur by a site-specific recombination mechanism catalyzed by the integrase. However, insertion can occur, albeit rarely, at non-specific sites leading to a stable situation for the cassette. Cassettes are transcribed from the common promoter located in the 5'-conserved segment and expression of distal genes is reduced by the presence of upstream cassettes. Most gene cassettes encode antibiotic resistant determinants but antiseptic resistant genes have also been described. Integrons seem to have a major role in the spread of multidrug resistance in gram-negative bacteria but integrons in gram-positive bacteria were described recently. Moreover, the finding of super-integrons with gene-cassettes coding for other determinants (biochemical functions, virulence factors) in Vibrio isolates dating from 1888 suggests the likely implication of this multicomponent cassette-integron system in bacterial genome evolution before the antibiotic era and to a greater extent than initially believed.
Collapse
Affiliation(s)
- M C Ploy
- Laboratoire de Bactériologie-Virologie-Hygiène, CHU Dupuytren, Limoges, France
| | | | | | | |
Collapse
|
23
|
Denis F, Martin C, Ploy MC. [Role of soluble antigens in rapid diagnosis of bacterial infections]. Arch Pediatr 2000; 7 Suppl 2:328s-329s. [PMID: 10904761 DOI: 10.1016/s0929-693x(00)80088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F Denis
- Service de bactériologie-virologie-hygiène, CHU Dupuytren, Limoges, France
| | | | | |
Collapse
|
24
|
Gambarotto K, Ploy MC, Turlure P, Grélaud C, Martin C, Bordessoule D, Denis F. Prevalence of vancomycin-resistant enterococci in fecal samples from hospitalized patients and nonhospitalized controls in a cattle-rearing area of France. J Clin Microbiol 2000; 38:620-4. [PMID: 10655356 PMCID: PMC86160 DOI: 10.1128/jcm.38.2.620-624.2000] [Citation(s) in RCA: 75] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Vancomycin-resistant enterococci (VRE) have emerged as nosocomial pathogens over the last decade, but little is known about their epidemiology. We report on the prevalence of VRE fecal colonization on the basis of a prospective study among patients hospitalized in a hematology intensive care unit and among nonhospitalized subjects living in the local community. A total of 243 rectal swabs from hematology patients and 169 stool samples from the control group were inoculated onto bile-esculin agar plates with and without 6 mg of vancomycin per liter and into an enrichment bile-esculin broth supplemented with 4 mg of vancomycin per liter. A total of 37% of the hospitalized patients and 11.8% of the subjects from the community were found to be VRE carriers. A total of 65 VRE strains were isolated: 12 (18.5%) E. faecium, 46 (70.7%) E. gallinarum, and 7 (10.8%) E. casseliflavus strains. No E. faecalis strains were detected. All the E. faecium strains were of the vanA genotype. Molecular typing by pulsed-field gel electrophoresis revealed a different pattern for each vanA VRE strain that originated from an individual subject. To our knowledge, this is the first study to be carried out in a cattle-rearing region of France. It reports a higher VRE prevalence than that reported in previous European or U.S. studies. A partial explanation is the use of an enrichment broth step which enabled detection of strains which would otherwise have been missed, but the fact that subjects and patients were recruited from a predominantly agricultural area where vancomycin-related antibiotics have recently been used in animal husbandry could also contribute to the high levels of VRE in patients and subjects alike.
Collapse
Affiliation(s)
- K Gambarotto
- Department of Microbiology and Virology, EP CNRS 118, Limoges University Teaching Hospital, France
| | | | | | | | | | | | | |
Collapse
|
25
|
Ploy MC, Denis F, Lambert T. Les intégrons : un système original de capture de gènes chez les bactéries. Med Sci (Paris) 2000. [DOI: 10.4267/10608/1631] [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: 11/30/2022] Open
|
26
|
Lambert T, Ploy MC, Denis F, Courvalin P. Characterization of the chromosomal aac(6')-Iz gene of Stenotrophomonas maltophilia. Antimicrob Agents Chemother 1999; 43:2366-71. [PMID: 10508008 PMCID: PMC89484 DOI: 10.1128/aac.43.10.2366] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [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: 11/20/2022] Open
Abstract
The aac(6')-Iz gene of Stenotrophomonas maltophilia BM2690 encoding an aminoglycoside 6'-N-acetyltransferase was characterized. The gene was identified as a coding sequence of 462 bp corresponding to a protein with a calculated mass of 16,506 Da, a value in good agreement with that of ca. 16,000 found by in vitro coupled transcription-translation. Analysis of the deduced amino acid sequence indicated that the protein was a member of the major subfamily of aminoglycoside 6'-N-acetyltransferases. The enzyme conferred resistance to amikacin but not to gentamicin, indicating that it was an AAC(6') of type I. The open reading frame upstream from the aac(6')-Iz gene was homologous to the fprA gene of Myxococcus xanthus (61% identity), which encodes a putative pyridoxine (pyridoxamine) 5'-phosphate oxidase. Pulsed-field gel electrophoresis of total DNA from BM2690 and S. maltophilia ATTC 13637 digested with XbaI, DraI, and SpeI followed by hybridization with rRNA and aac(6')-Iz-specific probes indicated that the gene was located in the chromosome. The aac(6')-Iz gene was detected by DNA-DNA hybridization in all 80 strains of S. maltophilia tested. The MICs of gentamicin against these strains of S. maltophilia were lower than those of amikacin, netilmicin, and tobramycin, indicating that production of AAC(6')-Iz contributes to aminoglycoside resistance in S. maltophilia.
Collapse
Affiliation(s)
- T Lambert
- Unité des Agents Antibactériens, Institut Pasteur, 75724 Paris Cedex 15, France.
| | | | | | | |
Collapse
|
27
|
Denis F, Ploy MC, Rogez S, Martin C, Mounier M, Gambarotto K, Venot C, Robert PY, Adenis JP. [Ocular bacterial infections : present and prospective methods of diagnosis]. Ann Biol Clin (Paris) 1999; 57:401-8. [PMID: 10432362] [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] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Bacteriological samples and tests are essentiel for the diagnosis of superficial ocular infections and endophtalmitis. The direct examination and the traditional culture of the samples can be in the futur associated with new diagnostic approach using antigen detection (immunofluorescence, enzyme immunosorbent assays) and genome research by hybridation or better by amplification for Chlamydia and for the most frequent species responsible of endophtalmitis. An original genomic strategy of bacterial endophtalmitis diagnosis was developped.
Collapse
Affiliation(s)
- F Denis
- Département de bactériologie-virologie-hygiène, CHU Dupuytren, 87042 Limoges
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Soussy CJ, Cluzel M, Ploy MC, Kitzis MD, Morel C, Bryskier A, Courvalin P. In-vitro antibacterial activity of levofloxacin against hospital isolates: a multicentre study. J Antimicrob Chemother 1999; 43 Suppl C:43-50. [PMID: 10404337 DOI: 10.1093/jac/43.suppl_3.43] [Citation(s) in RCA: 9] [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: 11/14/2022] Open
Abstract
The objective of this study was to evaluate the activity of the fluoroquinolone, levofloxacin, against hospital isolates of bacteria. MICs of levofloxacin were determined for 2154 strains by agar dilution. Breakpoints for susceptibility testing were calculated using the agar diffusion technique with 5 micrograms discs. The activity of levofloxacin against nalidixic acid- and pefloxacin-susceptible Enterobacteriaceae (n = 668) was higher (MIC50/90 0.06-0.12 mg/L) than previously reported for ofloxacin. As seen with other fluoroquinolones, this activity was reduced against nalidixic acid-resistant and pefloxacin-intermediate and -resistant strains (MIC 1-8 mg/L). MICs for Pseudomonas aeruginosa (n = 104) were between 0.12 and 128 mg/L. Levofloxacin had good activity against nalidixic acid- and pefloxacin-susceptible Acinetobacter baumannii (n = 12; MIC 0.06-0.25 mg/L), but the activity was reduced against nalidixic acid- and pefloxacin-resistant strains (n = 80; MIC 1-32 mg/L). Haemophilus influenzae (n = 70), Haemophilus parainfluenzae (n = 47) and Moraxella catarrhalis (n = 64) were inhibited by low concentrations of levofloxacin (MICs 0.016-0.03 mg/L, 0.03-0.12 mg/L) and 0.03-0.12 mg/L, respectively). Clostridium perfringens (n = 23; MIC 0.25-1 mg/L) was more susceptible than Bacteroides fragilis (n = 60; MIC 0.5-4 mg/L). Levofloxacin showed superior activity compared with ofloxacin against methicillin-susceptible staphylococci (n = 107; MIC 0.03-0.5 mg/L); the resistant strains (MICs 2-32 mg/L) were usually also resistant to methicillin. Levofloxacin was less effective against enterococci (n = 105; MIC 1-32 mg/L), but streptococci (n = 192) and pneumococci (n = 129), including 58 penicillin-non-susceptible strains, were inhibited by low concentrations (MICs 0.5-2 mg/L). According to the regression curve, zone diameters were usually 20-22 mm, 17-19 mm and 15-16 mm for MICs of 1, 2 and 4 mg/L, respectively. In conclusion, this study, performed on a large number of strains, confirms the superior anti-bacterial activity of levofloxacin compared with ofloxacin, especially against pathogens isolated from respiratory tract infections.
Collapse
Affiliation(s)
- C J Soussy
- Service de Bacteriologie, Hôpital Henri Mondor, Créteil, France
| | | | | | | | | | | | | |
Collapse
|
29
|
Ploy MC, Courvalin P, Lambert T. Characterization of In40 of Enterobacter aerogenes BM2688, a class 1 integron with two new gene cassettes, cmlA2 and qacF. Antimicrob Agents Chemother 1998; 42:2557-63. [PMID: 9756755 PMCID: PMC105892 DOI: 10.1128/aac.42.10.2557] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Enterobacter aerogenes BM2688, which is resistant to multiple antibiotics, and its aminoglycoside-susceptible derivative BM2688-1 were isolated from the same clinical sample. Strain BM2688 harbored plasmid pIP833, which carries a class 1 integron, In40, containing (in addition to qacEDelta1 and sul1, which are characteristic of class 1 integrons) four gene cassettes: aac(6')-Ib, qacF, cmlA2, and oxa-9. The cmlA2 gene had 83.7% identity with the previously described nonenzymatic chloramphenicol resistance cmlA1 gene. The qacF gene conferred resistance to quaternary ammonium compounds and displayed a high degree of similarity with qacE (67.8% identity) which, however, has been found as part of a cassette with a very different 59-base element. The oxa-9 gene was not expressed due to a lack of promoter sequences. Study of the antibiotic-susceptible derivative BM2688-1 indicated that a 3,148-bp deletion between the 3' end of the aac(6')-Ib gene and the 3' conserved segment of In40 was responsible for the loss of resistance. The occurrence of this DNA rearrangement, which did not involve homologous sequences, suggests that the In40 integrase could promote recombination at secondary sites.
Collapse
Affiliation(s)
- M C Ploy
- Unité des Agents Antibactériens, Institut Pasteur, 75724 Paris Cedex 15, France
| | | | | |
Collapse
|
30
|
|
31
|
Penot JP, Lagrange P, Darodes N, Ploy MC, Violet T, Virot P, Mansour L, Bensaid J. [Lactobacillus acidophilus endocarditis]. Presse Med 1998; 27:1009-12. [PMID: 9767820] [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: 02/09/2023] Open
Abstract
BACKGROUND Lactobacillus is a commensal germ found in the buccal cavity, the digestive tract and the vagina. Usually non-pathogenic except in case of dental caries, it can occasionally be the causal agent in severe endocarditis. CASE REPORT A 70-year-old woman developed endocarditis on an aortic valve bioprosthesis. Lactobacillus acidophilus was isolated from blood cultures of the valve after surgery. COMMENTS Forty-four cases of Lactobacillus endocarditis have been reported in the literature to date. Mortality is high (26%). The main difficulty in treatment is germ tolerance to penicillin and aminosides found in all cases. Cure requires high dose parenteral antibiotics and surgery in many cases (26%).
Collapse
Affiliation(s)
- J P Penot
- Service de Cardiologie, CHU Dupuytren, Limoges
| | | | | | | | | | | | | | | |
Collapse
|
32
|
|
33
|
Denis F, Barrière E, Venot C, Ranger-Rogez S, Durepaire N, Martin C, Ploy MC. [Virus and gastrointestinal infections]. Ann Biol Clin (Paris) 1997; 55:275-87. [PMID: 9309226] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Numerous viruses found in the gut are not associated with primary infection or disease of the gastrointestinal tract. Other groups or viruses are not classically associated with infection of the gut but can infect the gastrointestinal tract in immunocompromised individuals (herpes simplex virus, cytomegalovirus, papillomavirus ....). The viruses associated with gastroenteritis represent a large number of taxonomic group. Because these viruses have in general been difficult to cultivate, most members of this group were firstly detected by electron microscopic examination (adenovirus, astrovirus, calicivirus, coronavirus, rotavirus ....). The most widely used diagnostic techniques for adenovirus (40/41), rotavirus and astrovirus detection in faecal samples include immunoassays such as Elisa and latex agglutination. Nucleic acid hybridization techniques have generally not proven to be substantially sensitive and the more sensitive techniques recently developed use the polymerase chain reaction (adenovirus) or the reverse transcription/polymerase chain reaction (astrovirus, calicivirus, coronavirus, rotavirus). Special efforts have been made in the search for efficient procedures to extract viral nucleic acids, and to establish the optimal conditions for the amplification and identification of PCR products but the candidate viruses were very different, consensus procedures were not determined, and amplification kits were not actually commercialized.
Collapse
Affiliation(s)
- F Denis
- Département de bactérologie-virologie-hygiène, CHU Dupuytren, Limoges
| | | | | | | | | | | | | |
Collapse
|
34
|
Ploy MC, Grelaud C, Martin C, Denis F. [Emergence of Enterobacter aerogenes strains producing derepressed cephalosporinase at CHU in Limoges: molecular epidemiology by the RAPD technique]. Pathol Biol (Paris) 1997; 45:404-8. [PMID: 9296093] [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
From the beginning of the year 1996, an increase of multiresistant Enterobacter aerogenes isolates was observed. These strains overproduced their chromosomally cephalosporinase. From February to September 1996, we studied the genotypic diversity of multiresistant E. aerogenes isolates. Fifty-seven strains were analysed with the RAPD technique. These strains were isolated from 38 patients in 25 different units. These isolates were collected from urines (37), respiratory tracts (14) and wounds (6). We have observed two distinct profiles. The predominant profile (A) was recovered from 55 strains (36 patients) and the second profile (B) from 2 strains (2 patients). The clonal relatedness of strains isolated (profile A) showed an epidemic spread in our hospital. The RAPD technique is easy to perform and gives results in less than 48 h with a good discriminatory power.
Collapse
Affiliation(s)
- M C Ploy
- Service de Bactériologie-Virologie-Hygiène, CHU Dupruyten, 2, LIMOGES, France
| | | | | | | |
Collapse
|
35
|
Durepaire N, Pradie MP, Ploy MC, Mounier M, Ranger-Rogez S, Martin C, Denis F. [Adenoviruses from stool samples in hospital units. Comparison with main pathogens in gastroenteritis (rotavirus, Campylobacter, Salmonella)]. Pathol Biol (Paris) 1995; 43:601-10. [PMID: 8570265] [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: 01/31/2023]
Abstract
During a six-years period (1988-1993), a total of 14,644 stool samples from in-patients of Limoges University Hospital were examined for the presence of principal enteric pathogens, such as adenovirus, rotavirus, Campylobacter, Salmonella, Shigella and others. Stools were processed for identification of bacteria by standard methods and viruses were detected in fecal specimens using antigen detection methods: ELISA (Enzyme Linked Immunosorbent Assay) and latex agglutination test. The decreasing rates of presence of enteric agents were respectively 6% for rotavirus, 3.2% for Salmonella, 2% for adenovirus, 1.6% for Campylobacter and 0.2% for Shigella, but according to the lack of sensibility of latex agglutination test, adenovirus prevalence was probably underestimated. Concerning the distribution of enteric pathogens throughout the year, our data demonstrate that rotavirus were rather shed during the months from January to April, adenovirus between April and August, Campylobacter during summer and Salmonella from July to October. The two thirds of Campylobacter and rotavirus infections and the half of adenovirus and Salmonella infections were identified during the ten first years of life. The highest prevalence occurs before 5 years old, during the 2nd year of life for adenovirus (4.4%) and rotavirus (22.3%) and during the 3rd year of life for Campylobacter (6.84%) and Salmonella (8.6%).
Collapse
Affiliation(s)
- N Durepaire
- Service de Bactériologie-Virologie-Hygiène, CHU Dupuytren, Limoges, France
| | | | | | | | | | | | | |
Collapse
|
36
|
Ploy MC, Beaudouin CM, Mounier M, Denis F. [Evolution of the susceptibility to penicillin G of Streptococcus pneumoniae at the Limoge University Hospital Center]. Pathol Biol (Paris) 1995; 43:241-4. [PMID: 7567108] [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
A systematic detection of Streptococcus pneumoniae strains with reduced susceptibility to penicillin has been realized at Limoges Hospital during two years half. Of 302 strains isolated, 27 had reduced susceptibility to penicillin (8,9%), and, for 15 strains (5%), the MIC of penicillin G reached at least 2 mg/l. The frequency of strains with reduced susceptibility to penicillin increased from 1992 to 1994: 8,2% in 1992, 8,7% in 1993 and 12,2% in 1994. The resistance level exhibited by pneumococcus strains increased since 1992: the percentage of resistant strains (MIC mg/l > 1) was 2,7% in 1992, 6,9% in 1993 and 7,3% in 1994. Most of the strains with reduced susceptibility to penicillin belonged to serotype 23 (52%) and were isolated from blood cultures, cerebral-spinal or pleural fluids (41%).
Collapse
Affiliation(s)
- M C Ploy
- Service de Bactériologie-Virologie-Hygiène, CHU Dupuytren, Limoges, France
| | | | | | | |
Collapse
|
37
|
Mounier M, Ploy MC, François B, Delaire L, Denis F, Gastinne H. [Dynamics of the nasal colonization by methicillin resistant Staphylococcus aureus in patients hospitalized in an intensive care unit]. Pathol Biol (Paris) 1995; 43:329-35. [PMID: 7567125] [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
Prospective study on MRSA nasal cariage was done during two months in an intensive care unit in Limoges University Hospital. Nasal swab specimens were taken daily and cultured on selective and non selective media. Sixty eight patients were included in this study (878 swab collected, 575 MRSA isolated). Patients mean âge was 62 years and stay period mean was 12.3 days (median: 7 days). Among these patients, 16 were already carrying MRSA when entering in the unit and 26 became positive for MRSA during their stay. The mean colonisation delay was 5.5 days (median 4 days). All patients, except one, have shown a nasal carriage during all their stay. During the study period, 17 patients became infected and only two patients neither carried nasal MRSA before and during infection. In all cases, glycopeptide treatment did not affect nasal carriage. Colonisation and infection risk factors were discussed.
Collapse
Affiliation(s)
- M Mounier
- Service de Bactériologie-Virologie-Hygiène, CHU Dupuytren, Limoges, France
| | | | | | | | | | | |
Collapse
|
38
|
Ploy MC, Giamarellou H, Bourlioux P, Courvalin P, Lambert T. Detection of aac(6')-I genes in amikacin-resistant Acinetobacter spp. by PCR. Antimicrob Agents Chemother 1994; 38:2925-8. [PMID: 7695286 PMCID: PMC188310 DOI: 10.1128/aac.38.12.2925] [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] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The distribution of aac(6')-I genes in 62 strains of Acinetobacter spp. resistant to amikacin, netilmicin, and tobramycin and susceptible to gentamicin, a phenotype compatible with synthesis of an AAC(6')-I enzyme, was studied by PCR and by DNA hybridization. Both methods gave similar results. Among the 51 Acinetobacter baumannii strains, aac(6')-Ib was found in 19 isolates and aac(6')-Ih was found in the remaining strains. The aac(6')-Ig gene was present in all 10 A. haemolyticus strains studied and was detected only in this species. A pair of degenerate oligonucleotides complementary to conserved regions of aac(6')-Ic, -Id, -If, -Ig, and -Ih enabled detection of these genes and also of aac(6')-Ij, recently recognized in Acinetobacter sp. strain 13.
Collapse
Affiliation(s)
- M C Ploy
- Unité des Agents Antibactériens, Institut Pasteur, Centre National de la Recherche Scientifique, Paris, France
| | | | | | | | | |
Collapse
|
39
|
Ploy MC, Mounier M, Denis F. [Antibacterial activity of clarithromycin and its hydroxylated derivative and two other macrolides against thirty strains of Streptococcus pneumoniae]. Pathol Biol (Paris) 1994; 42:379-384. [PMID: 7824300] [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: 05/22/2023]
Abstract
Macrolides are widely used in the treatment of respiratory infections. Here, the authors compared the activity of different 14-membered macrolides: erythromycin (Ery), roxithromycin (Rox), clarithromycin (Cla) and its 14-hydroxy metabolite 14-OH clarithromycin (14-OH) against 30 strains of Streptococcus pneumoniae isolated at the Dupuytren hospital (Limoges, France) from upper respiratory tract sputum, ophthalmic sputum, blood samples and CSF. Twenty strains were susceptible to macrolides and 10 were resistant. Three strains from the susceptible and 7 from the resistant were resistant to penicillin. Furthermore, for all the macrolides except Rox and 14-OH, susceptibility tests were performed by the disk diffusion method on Mueller-Hinton agar. MICs50 of Cla and Ery were 0.06 mg/l. They were two-fold increased for 14-OH (0.125 mg/l) and four-fold increased for Rox (0.25 mg/l). We noted that for 3 resistant strains, MICs of Cla were four-fold decreased than MICs of Ery. Ery, Cla and 14-OH had bactericidal activity against pneumococcus strains susceptible to these antibiotics at 4 and 8 times the MIC after 6 or 18 h. The difference between MIC and MBC was small (1 or 2 two-fold dilutions) for Ery, Rox and Cla. For 14-OH, this difference was within 2 to 4 two-fold dilutions. The bactericidal activity is similar to that of amoxicillin and cefotaxim. A microdilution chequeboard technique was used against 3 strains and the FIC index did not show synergistic effect of combining Cla and 14-OH. The activity of Cla and 14-OH against 5 strains was not modified in the presence of 50% fresh pooled human serum inactivated at 56 degrees C or not.
Collapse
Affiliation(s)
- M C Ploy
- Laboratoire de Bactériologie-Virologie, CHU Dupuytren, Limoges, France
| | | | | |
Collapse
|
40
|
Lambert T, Ploy MC, Courvalin P. A spontaneous point mutation in the aac(6')-Ib' gene results in altered substrate specificity of aminoglycoside 6'-N-acetyltransferase of a Pseudomonas fluorescens strain. FEMS Microbiol Lett 1994; 115:297-304. [PMID: 8138142 DOI: 10.1111/j.1574-6968.1994.tb06654.x] [Citation(s) in RCA: 30] [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: 01/29/2023] Open
Abstract
The aac(6')-Ib' gene from Pseudomonas fluorescens BM2687, encoding an aminoglycoside 6'-N-acetyltransferase type II which confers resistance to gentamicin but not to amikacin, was characterized. Nucleotide sequence determination indicated total identity between aac(6')-Ib' and the aac(6')-Ib gene from Pseudomonas aeruginosa BM2656 [1] with the exception of a C-to-T transition that results in a serine to leucine substitution at position 83 of the deduced polypeptide. The aac(6')-Ib gene specifies a type I enzyme which confers resistance to amikacin but not to gentamicin [2]. It thus appears that the point mutation detected is responsible for enzymic altered substrate specificity.
Collapse
Affiliation(s)
- T Lambert
- Chatenay-Malabry, Centre d'Etudes Pharmaceutiques, France
| | | | | |
Collapse
|
41
|
Denis F, Mounier M, Ploy MC, Adenis JP, Maes S. [Diffusion of piperacillin in the eye]. Pathol Biol (Paris) 1992; 40:534-7. [PMID: 1495840] [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: 12/27/2022]
Abstract
Intraocular diffusion of piperacillin was studied in 42 patients scheduled for cataract surgery (n = 35) or vitrectomy (n = 7). Piperacillin was administered intravenously (4 g/injection). Thirty-four patients were given a single dose and 8 were given two doses 12 hours apart. Peak piperacillin levels in the aqueous (7.3 mg/l) occurred one hour after the injection; levels in the vitreous were low (less than 0.6 mg/l). Intraocular diffusion of piperacillin was also studied in rabbits with an experimental Staphylococcus epidermidis infection of one eye; the other eye served as the control. In pigmented rabbits (6 Fauve de Bourgogne animals), increased diffusion and decreased elimination of piperacillin were seen in the aqueous, iris and cornea of the infected eyes, as compared with uninfected control eyes. In albino rabbits (6 New Zealand animals), results were less conclusive, with a difference between the infected and healthy eyes appearing only during the second hour following the injection. The good diffusion of piperacillin in the aqueous, especially in infected eyes (at least in rabbits), suggests that this drug may be useful for the treatment of ocular infections provided it is initiated early and given in combination with another antimicrobial exhibiting good intraocular diffusion.
Collapse
Affiliation(s)
- F Denis
- Service de Bactériologie-Virologie, CHU Dupuytren, Limoges
| | | | | | | | | |
Collapse
|
42
|
Mounier M, Ploy MC, Chauvin M, Adenis JP, Denis F. [Study of intraocular diffusion of ofloxacin in humans and rabbits]. Pathol Biol (Paris) 1992; 40:529-33. [PMID: 1495839] [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: 12/27/2022]
Abstract
The diffusion of ofloxacin in infected and healthy human and rabbit eyes was investigated. In the human study, cataract surgery patients were given intravenous ofloxacin either as a single 200 or 400 mg dose or as two 400 mg infusions 12 hours apart. Samples of aqueous humor and plasma were collected between 1 and 12 hours after the end of the infusion. Levels in the anterior chamber increased with the dose; peak levels, which occurred after three hours, were 0.33 mg/l after 200 mg and 1.24 mg/l after two 200 mg doses given 12 hours apart. In the rabbit study, 16 hours after experimental infection of the left eye by injection of S. epidermidis into the vitreous, animals were given an intraperitoneal injection of 20 or 50 mg/kg ofloxacin. Dosages in the various ocular tissues showed that penetration into the eye varied with race (albinos greater than pigmented) and dose. Intraocular ofloxacin levels, including in the vitreous, increased two fold when the eye was infected; however, penetration into the sclera, choroid, and retina was comparable in infected and noninfected eyes. These findings in humans and animals suggest that ofloxacin in a dose of a least 400 mg is a useful agent for the treatment of prophylaxis of ocular infections.
Collapse
Affiliation(s)
- M Mounier
- Laboratoire de Bactériologie-Virologie, CHU Dupuytren, Limoges
| | | | | | | | | |
Collapse
|