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Biomedical subjects

C Quentin

Publications and source records attributed to C Quentin.

At least 19 recordsLinked to original sources
PubMed2000

Impact of an urban effluent on antibiotic resistance of riverine Enterobacteriaceae and Aeromonas spp.

In order to evaluate the impact of an urban effluent on antibiotic resistance of freshwater bacterial populations, water samples were collected from the Arga river (Spain), upstream and downstream from the wastewater discharge of the city of Pamplona. Strains of Enterobacteriaceae (representative of the human and animal commensal flora) (110 isolates) and Aeromonas (typically waterborne bacteria) (118 isolates) were selected for antibiotic susceptibility testing. Most of the Aeromonas strains (72%) and many of the Enterobacteriaceae (20%) were resistant to nalidixic acid. Singly nalidixic acid-resistant strains were frequent regardless of the sampling site for Aeromonas, whereas they were more common upstream from the discharge for enterobacteria. The most common resistances to antibiotics other than quinolones were to tetracycline (24.3%) and beta-lactams (20.5%) for Enterobacteriaceae and to tetracycline (27.5%) and co-trimoxazole (26.6%) for Aeromonas. The rates of these antibiotic resistances increased downstream from the discharge at similar degrees for the two bacterial groups; it remained at high levels for enterobacteria but decreased along the 30-km study zone for Aeromonas. Genetic analysis of representative strains demonstrated that these resistances were mostly (enterobacteria) or exclusively (Aeromonas) chromosomally mediated. Moreover, a reference strain of Aeromonas caviae (CIP 7616) could not be transformed with conjugative R plasmids of enterobacteria. Thus, the urban effluent resulted in an increase of the rates of resistance to antibiotics other than quinolones in the riverine bacterial populations, despite limited genetic exchanges between enterobacteria and Aeromonas. Quinolone resistance probably was selected by heavy antibiotic discharges of unknown origin upstream from the urban effluent.

Aeromonas↗
PubMed1999

Presence of mefA and mefE genes in Streptococcus agalactiae.

Eighteen unrelated clinical isolates of Streptococcus agalactiae with the M phenotype harbored an mef gene. DNA sequencing showed that one of nine strains contained mefA (producing one amino acid substitution), whereas the remaining eight carried mefE (identity, 100%). Restriction analysis of PCR products indicated that the nine other strains also contained mefE.

Bacterial Proteins↗
PubMed1999

Molecular characterization of TEM-59 (IRT-17), a novel inhibitor-resistant TEM-derived beta-lactamase in a clinical isolate of Klebsiella oxytoca.

A clinical isolate of Klebsiella oxytoca (Kox 443) was found to have a low-level resistance to broad-spectrum penicillins (MICs of amoxicillin and ticarcillin, 256 and 32 microg/ml, respectively), without substantial potentiation by 2 microg of clavulanic acid per ml (amoxicillin- and ticarcillin-clavulanate, 128 and 8 microg/ml, respectively), while being fully susceptible to cephalosporins and other beta-lactam antibiotics. These resistances were carried by a ca. 50-kb conjugative plasmid that encodes a single beta-lactamase with a pI of 5.6. Compared to TEM-2, this enzyme exhibited a 3- to 30-fold higher Km and a decreased maximal hydrolysis rate for beta-lactams; higher concentrations of suicide inactivators (5- to 500-fold higher concentrations giving a 50% reduction in hydrolysis) were required for inhibition. Nucleotide sequence analysis revealed identity between the blaTEM gene of Kox 443 and the blaTEM-2 gene, except for a single A-to-G change at position 590, leading to the amino acid change from Ser-130 Gly. This mutation has not been reported previously in the TEM type beta-lactamases produced by clinical strains, and the novel enzyme was called TEM-59 (alternative name IRT-17). This is the first description of an inhibitor-resistant TEM-derived enzyme in the species K. oxytoca.

Aged↗
PubMed1998

Molecular characterization of a TEM-21 beta-lactamase in a clinical isolate of Morganella morganii.

A clinical isolate of Morganella morganii, with reduced susceptibility to expanded-spectrum cephalosporins and aztreonam, was found to produce an extended-spectrum beta-lactamase with a pI of 6.4. The nucleotide sequence of the encoding gene was that of the gene encoding TEM-21. This is the first molecular characterization of an extended-spectrum beta-lactamase in M. morganii.

Base Sequence↗
PubMed1997

Molecular epidemiology of an outbreak due to extended-spectrum beta-lactamase-producing enterobacteria in a French hospital.

Between June 1992 and June 1993, 128 extended-spectrum beta-lactamase-producing enterobacteria (123 Klebsiella pneumoniae, 3 Escherichia coli, 1 Enterobacter aerogenes, and 1 Citrobacter diversus) were collected in a French university hospital. These isolates were recovered mainly from patients hospitalized in intensive care and neurosurgery units. The 128 strains were divided into 14 antibiotypes (ATBs; ATB1 to ATB14); 102 of 103 nonredundant isolates were shown to produce an SHV-4-related extended-spectrum beta-lactamase (pl 7.8, hybridization with a blaSHV probe); the remaining strain (Kp 2108) produced a TEM-3-related extended-spectrum beta-lactamase (pl 6.3, hybridization with a blaTEM probe). For representative isolates, five plasmid profiles (Pl to Pll-4), eight ribotypes (E1 to E8), and seven arbitrarily primed polymerase chain reaction profiles (A1 to A7) were obtained. The results suggest the spread of an epidemic strain of Klebsiella pneumoniae (E1, A1, Pl, various ATBs) from an intensive care unit throughout the hospital. Another epidemic strain (E2, A2, pl, ATB4) was confined to the neurosurgery unit. Other extended-spectrum beta-lactamase-producing Klebsiella pneumoniae of ribotypes distinct from E1 or E2 might result from the spread of an epidemic plasmid, such as reported for isolates of other enterobacterial species. Conversely, they might represent imported cases, such as the strain Kp 2108, which produced a TEM-3-related beta-lactamase.

Cross Infection↗
PubMed1997

In vitro activity of fosfomycin combined with ceftazidime, imipenem, amikacin, and ciprofloxacin against Pseudomonas aeruginosa.

The in vitro activity of fosfomycin in combination with ceftazidime, imipenem, amikacin, or ciprofloxacin was studied by an agar plate checkerboard method against 40 clinical isolates of Pseudomonas aeruginosa with various antibiotic resistance profiles. Fosfomycin/ciprofloxacin appeared to be the most effective combination (synergy 15%, addition 80%, indifference 5%), followed by fosfomycin/amikacin (synergy 7.5%, addition 52.5%, indifference 40%), fosfomycin/imipenem (addition 37%, indifference 63%), and fosfomycin/ceftazidime (addition 20%, indifference 80%). The effects of the combinations were not significantly influenced by the antibiotic susceptibility patterns of the strains.

Amikacin↗
PubMed1997

Molecular epidemiology of a nosocomial outbreak due to SHV-4-producing strains of Citrobacter diversus.

Over a 6-month period, eight strains of Citrobacter diversus (Citrobacter koseri) resistant to extended-spectrum cephalosporins and monobactams were isolated from seven colonized and/or infected patients from the same intensive care unit. All strains harbored a single large conjugative plasmid which mediated an extended-spectrum beta-lactamase of the SHV-4 type (ceftazidimase phenotype; enzyme pI, 7.8; plasmid DNA hybridization with a blaSHV-specific probe). All strains were characterized by antibiotic resistance pattern analysis, beta-lactamase content analysis, plasmid profiling, ribotyping with EcoRI, and arbitrarily primed (AP)-PCR with primers O8 and O12. Among the eight C. diversus strains, strains Cd5 to Cd12, six isolates (isolates Cd6 to Cd11) were identical by all markers; one strain (strain Cd5) differed by two markers (antibiotype and AP-PCR pattern with primer O8), and the remaining strain (strain Cd12) differed by two other markers (ribotype and AP-PCR pattern with primer O12). Our results suggest that six of the eight SHV-4-producing C. diversus strains studied (strains Cd6 to Cd11) were a single epidemic strain. Strain Cd5 could be related to the epidemic strain; the origin of strain Cd12 remains uncertain.

Bacterial Typing Techniques↗
PubMed1997

[Comparative in vitro activity of cefepime: multicenter study in Aquitaine].

Over a 6 month-period (1st January to 30th June 1995), the results of antibiotic susceptibility testing routinely performed for beta-lactams against enterobacteria, Pseudomonas aeruginosa, and Acinetobacter in 7 laboratory hospitals of Aquitaine, have been collected and divided in susceptibility profiles. A total of 9269 strains (7323 enterobacteria, 1667 P. aeruginosa, 279 Acinetobacter) have been examined. On the whole, cefepime (91,5%) and ceftazidime (91,7%) were the most active cephalosporins, followed by cefpirome (87,9%) and cefotaxime (80,4%); imipenem was the most active beta-lactam agent (97,4%). When the strains were divided according to their susceptibility profiles, the advantage of cefepime was shown to be related to its excellent activity against enterobacteria: all strains susceptible to cefotaxime and ceftazidime (CTX/CAZ-S) were susceptible to cefepime, as were most of the strains with an intermediate susceptibility or resistant to these drugs (CTX/CAZ-I/R, approximately 5% of the enterobacteria). The latter strains exhibited a phenotype corresponding either to the overproduction of their chromosomal cephalosporinase (approximately 20% of the species belonging to group 3) or to the synthesis of an extended spectrum beta-lactamase (19% of the strains of Klebsiella pneumoniae). Cefepime was active against 93% of the derepressed mutants of enterobacteria, including 3 imipenem resistant isolates of Enterobacter. CAZ-S strains of P. aeruginosa (84%) were usually susceptible to cefepime (80%), as were 6% of the CAZ-I/R strains. CAZ-S strains of A. baumannii (16.3%) were generally susceptible to cefepime (83%), as were 3.2% of the CAZ-I/R strains.

Acinetobacter↗
PubMed1997

[Vaccines available in France as of 1 January 1997].

The vaccines available in France as of January 1, 1997 are listed. For each one, the nature of the vaccine, indications, efficacy, safety, contraindications, vaccinal calendar have been detailed.

Clinical Protocols↗
PubMed1996

Epidemiological study of an outbreak of infection with Staphylococcus aureus resistant to lincosamides and streptogramin A in a French hospital.

A significant increase in the incidence of isolates of methicillin-resistant Staphylococcus aureus (MRSA), that were also resistant to lincosamides and streptogramin A (LSA-MRSA), was observed in a French university hospital. Twenty-seven isolates from the outbreak were characterised, including 17 isolates from a plastic surgery ward and six control strains of MRSA. The strains were examined by antibiotyping and biotyping, and by three molecular methods: plasmid analysis, ribotyping and insertion sequence (IS) typing with IS256 sequence as a probe. Antibiotyping (five antibiotypes) was discriminatory because of the uncommon resistance phenotype of the epidemic strain. Biotyping (three biotypes), DNA plasmid analysis (four profiles) and ribotyping (two profiles) were poorly sensitive, in contrast to IS-typing (12 profiles). By the latter method, a coefficient of similarity (percentage similarity) compared to the predominant IS profile was calculated. Strains with a coefficient of similarity > or = to 82% were considered as highly related to the epidemic strain, while those with a coefficient of similarity < or = to 40% were regarded as distant. Results obtained with the five markers confirmed that an outbreak of hospital infection had occurred in the plastic surgery ward, with spread of the epidemic strain throughout the hospital.

Adult↗
PubMed1996

Epidemiological study of an outbreak due to multidrug-resistant Enterobacter aerogenes in a medical intensive care unit.

In 1993, 63 isolates of Enterobacter aerogenes were collected from 41 patients in a medical intensive care unit (ICU). During the same period, only 46 isolates from 32 patients were collected in the rest of the hospital. All isolates were analyzed by antibiotic resistance phenotype, and 77 representative isolates were differentiated by plasmid restriction analysis, ribotyping, and arbitrarily primed (AP)-PCR. The extended-spectrum beta-lactamases produced by 22 strains were characterized by determination of their isoelectric points and by hybridization of plasmid DNA with specific probes. The isolates were divided into 25 antibiotic resistance phenotypes, either susceptible (group I) or resistant (group II) to aminoglycosides, and exhibited three phenotypes of resistance to beta-lactams: chromosomally derepressed cephalosporinase alone or associated with either extended-spectrum beta-lactamases (mainly of the SHV-4 type) or imipenem resistance. The results of the tests divided the 77 representative isolates (group I, n = 21; group II, n = 56) into 15 plasmid profiles, 14 ribotypes, and 15 AP-PCR patterns. Although the resistant isolates (group II) exhibited different plasmid profiles, ribotyping and AP-PCR analysis demonstrated an identical chromosomal pattern, indicating an epidemiological relatedness. They were mainly found in the medical ICU and occasionally in other units. The susceptible strains (group I) had various and distinct markers and were mainly isolated in units other than the medical ICU. In conclusion, the presence of a nosocomial outbreak in an ICU and the spread of a multidrug-resistant epidemic strain throughout the hospital was confirmed. Ribotyping and AP-PCR represent discriminatory tools for the investigation of nosocomial outbreaks caused by E. aerogenes.

Disease Outbreaks↗