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M Delmée

Publications and source records attributed to M Delmée.

68 records · Page 4Linked to original sources
PubMed1988

Serotyping of Clostridium difficile.

A total of 246 live Clostridium difficile cultures were serotyped by a slide agglutination technique. Fifteen grouping antisera were produced which serotyped 98% of the cultures (241 of 246). Our results indicated that certain serogroups may have specific pathogenicity. Strains of serogroups A, G, H, K, S1, and S4 were cytotoxigenic and were isolated mainly from adult patients with pseudomembranous colitis or antibiotic-associated diarrhea. Nontoxigenic strains of serogroups D and Cd-5 were isolated mainly from asymptomatic neonates and small children. Some cross-reactions occurred among some strains of serogroups A, Cd-5, G, and K. These strains were further examined by analysis of protein profiles and restriction endonuclease patterns to elucidate their serology. Typing of C. difficile by using slide agglutination is a simple technique suitable for routine examination. Serogrouping may be a useful epidemiological marker and could help in elucidating the medical relevance of some C. difficile isolates.

Adult↗
PubMed1987

Epidemiology and prevention of Clostridium difficile infections in a leukemia unit.

A 29-month prospective study was carried out in a leukemia unit with the aim of investigating the epidemiology of Clostridium difficile infections and limiting their spread. Systematic cultures of stools and assays for cytotoxin were performed on patient admission and at weekly intervals, yielding 1,355 cultures and assays. The study period was divided in period A, before total unit renovation, and period B, afterwards. During period B all patient carriers of Clostridium difficile received vancomycin. A comparison of the two periods showed that the percentage of positive cultures fell from 16.6% to 3.6% and the positive toxin assays from 9.9% to 1.2%. It was concluded that colonization by Clostridium difficile can be prevented in hospital wards with generally high rates of infection by a combination of decontamination of the environment, introduction of preventive measures and treatment of Clostridium difficile carriage with vancomycin.

Carrier State↗
PubMed1986

Comparison of serogrouping and polyacrylamide gel electrophoresis for typing Clostridium difficile.

A typing scheme for Clostridium difficile based on slide agglutination with rabbit antisera was previously described. It allows the differentiation of 10 serogroups designated A, B, C, D, F, G, H, I, K, and X. We studied the correlation between serogrouping and polyacrylamide gel electrophoresis (PAGE) of whole-cell proteins. A total of 202 isolates from different sources were analyzed by PAGE after ultrasonic disintegration of cells from an 18-h liquid culture and treatment with sodium dodecyl sulfate and 2-mercaptoethanol. A total of 21 different patterns were observed. The reference strains from the 10 serogroups showed different profiles. For each serogroup except A, the patterns obtained with the clinical isolates were identical to the patterns obtained with the reference strains. For the 48 strains belonging to serogroup A, 12 different profiles were observed. Five of these involved strains isolated from patients with antibiotic-associated diarrhea. Typing by sodium dodecyl sulfate-PAGE thus correlates with serogrouping. In addition, it allows discrimination within the heterogeneous serogroup A.

Agglutination Tests↗
PubMedDate not supplied

Clostridium difficile infection in a geriatric ward.

In a prospective, longitudinal study we searched for the presence of Clostridium difficile in the stools of 100 consecutively hospitalized elderly patients (mean age: 82; SD: 9.5 years). C. difficile was found on admission in 6 patients, 3 of whom were asymptomatic carriers. Ten patients acquired C. difficile during hospitalization. Four different types of C. difficile were isolated. The various types were clustered in time, indicating that the infection was acquired from the environment.

Journal Article↗
PubMedDate not supplied

Antimicrobial therapy for intra-abdominal infections: guidelines from the Infectious Disease Advisory Board (IDAB).

Intra-abdominal infection is a common cause of severe sepsis in a hospital setting and remains associated with a significant morbidity, mortality and resource use. Early adequate surgery or drainage remain the cornerstones of intra-abdominal infection management and impact on patients outcome. Concomitant early and adequate empiric antimicrobial therapy further influences patients morbidity and mortality. Multiple empirical regimens have been proposed in this setting, but rarely supported by well designed, randomized-controlled studies. The current manuscript summarizes the recommendations of the Infection Disease Advisory Board on the management of intra-abdominal infections. Empiric antimicrobial therapy for the most common causes of abdominal infections is proposed. In addition, particular attention has been paid on antibiotic treatment duration.

Abdominal Abscess↗
PubMedDate not supplied

Distribution and prevalence of antimicrobial resistance among gram-negative isolates in intensive care units (ICU) in Belgian hospitals between 1996 and 1999.

OBJECTIVE: To assess the distribution and prevalence of resistance rates among Gram-negative isolates in Belgian intensive care units (ICUs) between 1996 and 1999. METHODS: During 1996-1997 and 1998-1999, over a total period of 10 and 9 months respectively, members of the NPRS Belgian Study group collected, on clinical indications, 3029 consecutive initial isolates of Gram-negative bacteria from patients admitted to 26 Belgian hospitals and performed minimal inhibitory concentration (MIC) determinations by means of the E-test. Break-points were defined according to the criteria of the NCCLS. RESULTS: The overall distribution of bacterial species was, in decreasing order of frequency: Pseudomonas aeruginosa > E. coli > E. aerogenes > K. pneumoniae > P. mirabilis > S. marcescens > E. cloacae > K. oxytoca > M. morganii > Stenotrophomonas maltophilia > Acinetobacter spp. All together these species and genera constituted about 90% of all isolates. The frequency of resistance for all the initial Gram-negative isolates in 1998-9 were: amoxicillin-clavulanic acid 60%, piperacillin 31%, piperacillin-tazobactam 20%, cefuroxime 58%, ceftriaxone 31%, ceftazidime 17%, aztreonam 23%, cefepime 10%, imipenem 13%, gentamicin 12%, amikacin 12% and ciprofloxacin 21%. Apart for an increase in multiple drug resistance among P. aeruginosa isolates, no significant trends were observed neither in species distribution nor in the overall prevalence of antimicrobial resistance among Gram-negative isolates from Belgian ICUs between 1996-7 and 1998-9. CONCLUSIONS: Among Gram-negative isolates in Belgian ICUs, a very high frequency of resistance was seen to amoxicillin-clavulanic acid and cefuroxime, and rather high frequencies of resistance to piperacillin, ceftriaxone and aztreonam. Taking into account the species distribution and the prevalence of resistance, cefepime, imipenem, amikacin and gentamicin appeared generally suitable for empirical therapeutic use in severe ICU-acquired Gram-negative infections in Belgium. However, the therapeutic strategy should be adapted according to the local ecology of resistance.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Campylobacter pylori gastritis: review of diagnostic methods].

The presence of Campylobacter pylori in gastric mucosa is a proof of active gastritis. Diagnostic methods are based on endoscopy: culture--histology--cytology--urease test, or on noninvasive tests: C14 urea breath test and serology. The principles, results (sensitivity--specificity), advantages and problems of each test are discussed as well as the choice of a diagnostic method. In practice, we recommend the use of two methods, a morphological one (histology or cytology) and another based on bacterial activity (urease test or culture).

Bacteriological Techniques↗
PubMedDate not supplied

[An original method of bacteriological sampling for studying Campylobacter pylori in duodenal ulcer].

The presence of Campylobacter pylori in duodenal ulcer was investigated in 26 patients. The method used was a sterile endoscopic sampling technique which forcasted and checked for contamination of the samples. A sterile catheter was introduced through the endoscope and then an infusion of saline was instituted. Once the catheter was in the intestinal lumen, the infused solution was aspirated for control of sterility. Semi-quantitative cultures of gastric and duodenal juices and of biopsies of the duodenal ulcer, the bulbar mucosa close to the ulcer and prepyloric antral mucosa were compared. Only two contaminations were detected with this method. C. pylori was isolated in one gastric and one duodenal sample only. It was isolated in 14 of 26 duodenal ulcers, 12 of 26 bulbar mucosa and 20 of 26 mucosal specimens. Our study established that the presence of C. pylori was very uncommon in gastric and duodenal juices even when the bacterium was present in the mucosal membrane in large quantities.

Adult↗
PubMedDate not supplied

Clostridium difficile colitis: recent therapeutical and immunological considerations.

Clostridium difficile is the main etiological agent of antibiotic associated diarrhoea and pseudomembranous colitis (PMC). It is considered as the most frequent agent of infectious diarrhoea occurring in hospitalized patients, in whom it is responsible for a high morbidity and occasional mortality even when the diagnosis and the treatment are pursued aggressively (1). The pathology is due to the production of at least two toxins: toxin A is an enterotoxin which induces intestinal tissue damage and a fluid response and toxin B is a cytotoxin which lacks any enterotoxic activity but is believed to exert an additive effect in vivo (2).

Clostridioides difficile↗