Résistance au linézolide de Staphylococcus aureus avant inscription au livret du médicament

Resistance to antibiotics is a global problem in geriatric centres.

OBJECTIVE

The aim of this study was to determine the frequency of the resistance to linezolid in Staphylococcus aureus strains before its release in a geriatric centre.

METHOD

From 03-01-01 to 03-04-30 linezolid was included in the panel of antibiotics tested in S. aureus strains. The susceptibilities were estimated by the disk diffusion test in routine clinical microbiology practice.

RESULTS

A total of 213 strains of S. aureus was analysed. All of them were susceptible to the following antibiotics: linezolid, cotrimoxazol, fosfomycin, and glycopeptides. The meticillin-resistant S. aureus (MRSA) represented 67.1% (60.3-73.3) strains. The resistance to pefloxacin, tobramycin and erythromycin concerned 92.3% (86.3-95.9), 73.4% (65.3-80.3) and 31.5% (24.1-39.8) of MRSA strains respectively. The MRSA strains were less resistant to the following antimicrobial drugs: gentamicin 7.0% (3.6-12.8), fusidic acid 2.1% (0.5-6.5) and rifampicin 1.4% (0.2-5.5). The resistance concerning at the same time gentamicin, pefloxacin and fucidic acid represented 2.1% (0.5-6.5) of SARM strains, rifampicin was not interested.

CONCLUSION

Linezolid was effective in vitro in S. aureus strains regardless their susceptibilities in meticillin. According to its effectiveness in vivo, linezolid may be of use for the treatment of infections due to MRSA. However, there has been two reports of resistance of MRSA in clinical infections. The use of linezolid has to follow the instructions and it should be carefully monitored.

[Geriatrics and rehabiliation: role of the hospital in healthcare networks?]

OBJECTIVE

There is no accepted definition of geriatric post-acute or rehabilitation care. The exact role within the healthcare network and the function of units providing such care remain to be clarified. We describe the activity of geriatric post-acute or rehabilitation care units in four French hospitals to identify common features and provide elements of practical interest concerning their role in the healthcare network.

METHODS

Data from 4 healthcare institutions in France recorded in the 1999 Medical Information System were analyzed.

RESULTS

Geriatric post-acute or rehabilitation units generally provided care for patients over 80 years of age in short-stay wards. These patients were dependent and recovering from an acute illness. In addition to rehabilitation and medical care, given according to the patients' needs, the units also provided social counseling and acute care as in other short-stay wards. A wide variety of pathological conditions was observed. At discharge most patients returned to their home or were transferred to a nursing home.

CONCLUSION

Geriatric post-acute or rehabilitation units meet the requirements proposed in French legislation and in addition provide social counseling and acute care services, which is evidence of the deficiencies in the healthcare network in the field of elderly patient care.

Randomized trial of albendazole versus tiabendazole plus flubendazole during an outbreak of human trichinellosis

To determine the therapeutic usefulness of benzimidazoles in trichinellosis, 117 patients from a single outbreak were treated either with albendazole alone (N = 59) or with a regimen including tiabendazole followed by flubendazole (N = 58). The criteria of disease activity were evaluated at days 1, 7, 15, and 45. No difference was found between the two groups with regard to the evolution of myalgia, fever, fatigue, new clinical manifestations, or laboratory and serologic data. Both treatment regimens were well tolerated. In all, 30 patients of the albendazole group and 29 of the tiabendazole-flubendazole group were reevaluated 16 months later. Serology was negative in 70% of the albendazole-treated patients vs 34.5% of the tiabendazole-flubendazole-treated patients (P less than 0.01). The muscle biopsy examination of nine patients suggested less parasitic infection in the albendazole group. In conclusion, no difference was noted during the early therapeutic responses to the drugs used, but albendazole might be more effective than the other regimen in treating residual larval infestation estimated 16 months after the onset of the disease.