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Biomedical subjects

G Dorche

Publications and source records attributed to G Dorche.

32 records · Page 2Linked to original sources

[Activity of ticarcillin combined with different concentrations of clavulanic acid on 137 Gram-negative bacilli resistant to ticarcillin].

The MIC of ticarcillin exclusively or joined with 3 concentrations of clavulanic acid: (2, 4 and 8 mg/l) was determined by agar dilution in relation to 137 bacilli resistant to ticarcillin (MIC greater than or equal to 256 mg/l) detected between 1985 and 1986 in the Bellevue Hospital in Saint-Etienne. We could study 26 Escherichia coli, 30 Klebsiella, 28 Enterobacter, 36 Serratia and 17 Pseudomonas aeruginosa. The concentration of 2 mg/l of clavulanic acid allows to lower the MIC of ticarcillin over the very large majority of strains of Escherichia coli and Klebsiella resistant to ticarcillin. In those conditions, ticarcillin becomes more active than piperacillin over those species. The concentration of 4 and 8 mg/l of clavulanic acid doesn't bring any real advantage to those bacilli. Moreover the concentrations of 2, 4 and 8 mg/l slightly change the MIC of ticarcillin on the strains of Serratia, Enterobacter and Pseudomonas aeruginosa.

Clavulanic Acids↗

[Strategy of the use of immunological tests in the topographical diagnosis of urinary infections].

Assays for bacteria-specific antibodies were performed in 423 hospital patients with urinary tract infection (UTI), 184 of whom also had serodiagnosis by passive haemoagglutination with the strain responsible for the infection. The results of serodiagnosis were expressed as the difference in dilution between the antibody titres found in the patients and those found in pooled sera from healthy subjects. On the basis of this study, a rationale for immunological investigations, particularly in adults, is suggested. When bacteria-specific antibodies are lacking the probability of a lower UTI is 98%; when they are present, the probability of an upper UTI is only 74.5%, but the figure rises to 95% with a positive passive haemoagglutination serodiagnosis. In patients with negative serodiagnosis and positive bacteria-specific antibodies, a topographical diagnosis of UTI by immunological methods becomes impossible. In children, these methods are of little use owing to their poor sensitivity in detecting bacteria-specific antibodies, but the information provided by serodiagnosis is useful for determining the site of infection.

Adolescent↗

[Bacterial flora of 241 patients in an intensive care service].

The investigators performed an epidaemiological study of 260 patients in intensive care and identified the causal organisms by the obtaining of various specimens: tracheobronchial, urinary, blood cultures and catheter samples. By means of these specimens, they attempted to effectuate counts for each patient and the compare each month the patients definitely infected with the infections presented by the new patients. This study attempts to demonstrate the frequency of infections of the same kind when the intensive care unit consists of a single ward without separation of the patients and where the hospital staff treat all the patients in the unit in turn.

Adolescent↗

Prolonged treatment of chronic Pseudomonas aeruginosa osteomyelitis with a combination of two effective antibiotics.

Emergence of Pseudomonas aeruginosa resistant to antibiotic monotherapy is one of the causes of therapeutic failure in chronic P. aeruginosa osteomyelitis. We report 15 cases of chronic (> 3 months of evolution) biopsy culture proven P. aeruginosa osteomyelitis included in an open prospective study evaluating the efficacy of prolonged treatment (> 4 months) with two effective antibiotics in combination. Mean post-treatment follow-up was 38 months. A regimen of cefsulodin in combination with oral ofloxacin was used for six patients, cefsulodin-pefloxacin for three patients, cefsulodin-ciprofloxacin for one patient, piperacillin-pefloxacin for one patient, cefsulodin-fosfomycin for one patient, imipenem-ciprofloxacin for two patients and amoxicillin-ciprofloxacin-fosfomycin for one patient as home therapy. The clinical cure rate of 73% and bacteriological cure rate of 93% are far superior to those previously described in the literature. We did not observe adverse drug reactions. We think that a prolonged use of two effective antibiotics in combination is a safe and improved therapeutic schedule for chronic P. aeruginosa osteomyelitis.

Adolescent↗