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B Clavier

Publications and source records attributed to B Clavier.

12 recordsLinked to original sources

[One case report of anti-JK1 antibody undetected on plasma sample].

The sensitivity of the detection of irregular antibodies (DIA) is one of the fundamental bases of transfusion safety. Its implementation is specified in accordance with a very specific framework that allows the use of serum or plasma. The case reported here points out a failure to detect irregular antibodies in plasma sample. Thus a low intensity anti-JK1 antibody detected and identified in serum slipped through unnoticed in plasma. The difficulties to detect and identify this antibody, well-known as a deceptive and dangerous one, are being discussed in order to better assess the limitations of DIA.

Aged, 80 and over↗

[Transfusional record and blood grouping methods: essential factors of transfusion safety].

The clinical and biological control of the whole transfusion process is a major preoccupation for everyone dealing with blood transfusion. Specially when the patient is a female recipient or belongs to a group with a high prevalence of alloimmunisation. This case report points out the outstanding importance of the immune compatibility, which must be strongly maintained to prevent any harmful consequences. The transfusional record transmission and a simple and sensitive blood grouping test are essential to increase transfusion safety.

Blood Group Antigens↗

[Evaluation of 7 endoscope washer-disinfectors: bactericidal activity of the disinfectants, antibacterial efficacity of paired washer-disinfector products].

The authors studied seven automatic washer disinfectors for flexible endoscopes with two methods. The first method, a microdilution method, studied the bactericidal activity of the seven disinfectants against 21 strains: four reference strains, 14 hospital strains reported in the literature as nosocomial strains responsible for infections transmitted by flexible endoscopes and three vancomycin-resistant Enterococci. The ability of the seven automatic washer disinfectors to decontaminate flexible endoscopes following inoculation with four reference strains was studied with the second method. There were three kinds of results: the results of three automatic washer disinfectors in conformity with both methods; the results of three automatic washer disinfectors conformity with 1 method only; the results of one automatic washer disinfector without conformity with any methods. Both methods should be used for evaluation of automatic washer disinfector. Then, these results emphasize the necessity to modify the use of disinfectants and/or the systems of some automatic washer disinfectors.

Anti-Bacterial Agents↗

[Pneumococcus observatory data in the Rhône-Alps region. Results from 1996].

Throughout 1996, 22 hospital-based laboratories in the Rhône-Alpes region of France collected pneumococcal strains and used a standardized protocol to record the following data; patient age and sex; type of specimen; and determination of susceptibility to at least the following antibiotics: oxacillin 1 microgram and 5 micrograms, erythromycin (Ery), tetracycline (Tet), chloramphenicol (Chl), rifampin (Rmp), and loracarbef. For penicillin-nonsusceptible strains (PNSSs), which were identified based on results with oxacillin, MICs for penicillin G, amoxicillin (Amx), and cefotaxime (Ctx) were determined using the E Test, at the study site and agar dilution at the coordinating center. Of the 1153 strains, 65.5% were from adults and 31.8% from children; patient age was unknown in 2.7% of cases. PNSPs (MIC > 0.06 mg/l) contributed 32.9% of strains (I: 23.3%; R: 9.6%) and were more common in children (41.1%) than in adults (28.1%). The frequency of PNSSs varied across specimen types: 27.9% in blood cultures (305 strains), 15.6% in cerebrospinal fluid (32), 38.7% in protected bronchopulmonary specimens (31), 31.5% in unprotected bronchopulmonary specimens (434), 50.8% in acute otitis media (118), and 34.4% in other specimens (221). Among PNSSs, nonsusceptibility (I + R) to other antibiotics was variable: Ery, 62.1%; Tet, 41.5%; Chl, 40.4%; Rmp, 1.1%. Corresponding figures for the overall strain population were Ery, 33.3%; Tet, 22.7%; Chl, 22.8%; Rmp, 0.9%. In addition, 56.5% of PNSSs exhibited multiple drug resistance. Resistance to amoxicillin (MIC > 2 mg/l) was demonstrated for only 5 strains. No strains were resistant to loracarbef or cefotaxime. Serotypes of the 379 PNSSs were as follows: 23F, 26.6%; 14 (25.6%); 9V (18.2%), 6 (8.7%), 15 (5%), 19 (4.5%).

Adult↗

Full-term delivery following intracytoplasmic sperm injection with frozen-thawed immotile testicular spermatozoa.

We present one of the very few deliveries occurring following intracytoplasmic sperm injection of thawed immotile testicular spermatozoa from a testicular biopsy of a man with bilateral congenital absence of the vas deferens. A first attempt in the 33 year old woman with fresh testicular biopsy extracted spermatozoa was unsuccessful. The supernumerary spermatozoa were cryopreserved for later use. After thawing, testicular spermatozoa were immotile. From 11 intact oocytes injected with frozen-thawed immotile testicular spermatozoa, a two pronuclear fertilization rate of 27% and a cleavage rate of 100% were obtained. A total of three embryos was transferred resulting in a singleton pregnancy and the birth of a normal female baby.

Adult↗

[Comparison of the results of the Etest and the method for determining minimum inhibitory concentrations in solid media for penicillin G, amoxicillin, and cefotaxime for S. pneumoniae. A multicenter study].

In 1996-1997 a multicentre study was carried out on 450 Streptococcus pneumoniae strains to compare the MICs and susceptibility categories obtained with the Etest (AB Biodisk) used under routine conditions in 22 hospital laboratories in the Rhône-Alpes region, France, with those obtained by the reference technique of agar dilution performed in a single coordinating centre. Each laboratory detected penicillin resistant pneumococci (PRP) by the oxacillin disk method (1 microgram and 5 micrograms) and determined the MICs of penicillin G (PG), amoxycillin (AMX) and cefotaxime (CTX) by the Etest. All the PRP strains were collected in the coordinating centre where MICs were carried out. The strains were classified as susceptible (S), intermediate (I) and resistant (R) according to the CASFM criteria (Comité de l'Antibiogramme de la Société Française de Microbiologie). The concordance results based on susceptibility categories are as follows: PG = 67.6%, AMX = 63.6%, CTX = 71.5%. Minor errors are as follows: PG = 31.2%, AMX = 36%, CTX = 28.5%. Major and very major errors are rare (0% to 0.6%). Agreement within 1 log2 dilution was obtained for about 80% of the strains. The minor errors results from strains clustering near the breakpoints 1 mg/l (PG) and 0.5 mg/l (AMX, CTX), and from practical difficulties in routine use of the Etest. These discrepancies may result in severe therapeutic problems. This study confirms the limits of the Etest. The authors insist on standardization and rigorous use of the Etest under routine conditions.

Amoxicillin↗

[Is the quantitative antibiogram a reliable epidemiological marker for Pseudomonas aeruginosa infections? Comparison with pulsed field electrophoresis].

Epidemiologic supervision of P. aeruginosa infections is a daily care for microbiologists. The aim of this study is to evaluate quantitative antibiogram, which compare strains by calculation of euclidian distances from inhibition zone diameters on agar, compared with pulse field gel electrophoresis (PFGE) results. 53 isolates of P. aeruginosa obtained from bronchial secretions of 26 patients in intensive care unit are typed by conventional disk diffusion test on agar with 11 usual antibiotics. Dendrogram of euclidian distances is performed by Taxotron computer program (P.A.D. Grimont, Institute Pasteur, Paris); results are compared with 53 PFGE patterns after restriction with Spe I (Genepath system, BIO-RAD). Quantitative antibiogram has a high discriminatory power for beta-lactamin resistant strains: 27 isolates from 11 patients clustered in 5 types where PFGE discerned 5 patterns. The discriminatory power is low for beta-lactamin sensible strains: 26 isolates from 15 patients clustered in 8 types where PFGE discerned 19 patterns, but serotyping method combined with quantitative antibiogram restore a high disriminatory power for beta-lactamin sensible strains.

Bronchoalveolar Lavage Fluid↗

The Centre H. Becquerel studies in inflammatory non metastatic breast cancer. Combined modality approach in 178 patients.

One hundred and seventy-eight patients with non metastatic inflammatory breast cancer (IBC) have been treated at the Centre H. Becquerel. Median follow up is 67 months (6-178). Every patient received neoadjuvant chemotherapy (mean number of cycles = 4; range: 2-8), followed by a loco regional treatment (radiotherapy = XRT or modified radical mastectomy = S), followed by adjuvant chemotherapy. During this period, the types of chemotherapy and locoregional treatment have been the following: Study I: 64 patients treated with CMF or AVCF and XRT; Study II: 83 patients, treated with either AVCF, FAC or VAC followed by S (n = 38) or XRT (n = 22) in case of complete or partial response, or followed by XRT (23) in case of initial supraclavicular lymph node involvement or lack of response after chemotherapy; Study III: 31 patients treated with FEC-HD + Estrogenic recruitment followed by S and XRT after adjuvant chemotherapy, except seven patients who received XRT (refusal of surgery). Although objective response rates (= 56.2, 73.5 and 93.5% for study I, II and III respectively) are statistically better in the 3rd study, this does not translate in dramatically different disease free survival (median = 16.7, 19 and 22.2 months respectively for study I, II and III) or overall survival (median = 25, 45.7 and 32.6 months respectively for study I, II and III). Analysis of subset of patients without supra clavicular lymph node involvement where neoadjuvant chemotherapy obtained at least a 50% response reveals a median disease free survival and median overall survival of respectively 38.3 and 60.1 months for patients who underwent S vs 19 and 38.3 months for those who received XRT (P = 0.15). These studies suggest that surgery has no deleterious effect on outcome of IBC. Advantage on disease free survival or overall survival from intensive chemotherapy in IBC remains to be proven with appropriate randomised trials.

Adult↗

[Specificity of immunofluorescent methods detecting malarial antibodies: comparative study in the screening of blood donations].

UNLABELLED: In France, no case of transfusion-transmitted malaria has been reported since 1994, reflecting the efficiency of the blood donations screening. However, an insufficiently specific serological assay leads to an unjustified loss of red cell units. MATERIALS AND METHODS: A retrospective study included 55 sera previously disqualified for the presence of malarial antibodies. We used different assays detecting these antibodies: Paludix, Falciparum-Spot without or with the elimination of natural antiglobulins by two different methods. RESULTS: Using Paludix, 87% of sera were negative (P < 0.001). With the sera treated for the elimination of natural antiglobulins by neutralisation or absorption, Falciparum-Spot(TM) gave respectively 87% and 94.5% of negative results. CONCLUSION: When using assays avoiding non-specific fluorescence, the number of false positive results significantly decreased. Because the number of blood donors travelling in at-risk countries is continuously rising, a sufficiently specific method to detect malarial antibodies should save a lot of red cell units.

Antibodies, Protozoan↗

[Blood transfusion security: one train may conceal another!].

The discovery of antibodies with specificities that are directed toward antigens of high prevalence is a difficult situation to manage in emergency blood transfusion. The reactions they produce interfere with the identification of reactions due to other, clinically significant antibodies. We report a case which illustrates this problem in terms of transfusion safety and time to carry out the tests.

Aged↗