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Biomedical subjects

M E Reverdy

Publications and source records attributed to M E Reverdy.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Erythromycin and latamoxef in the initial treatment of diffuse peritonitis with visceral failure].

In a thirty months prospective study, 61 patients treated in an Intensive Care Unit received erythromycin (E) (3 g/24 h) and latamoxef (L) (2 g/24 h) as soon as acute peritonitis was surgically confirmed. Five days later, E + L were stopped and nitro-imidazol (NI) was prescribed while searching for a possible infection. The severity of the illness was assessed by clinical study of organ failures and by use of the Simplified Acute Physiology Score (SAPS). 21 patients died (34%): among them 8 of the 19 with postoperative peritonitis. Average SAPS was 17.8 (+/- 4.1) while it was 13 in 631 ICU treated patients (mortality: 22%). Every patient needed mechanical ventilation; pré or per-operative shock has been noted in 41 (67%) and 27 had developed acute renal failure (44%). During E + L, 6 patients died because of an irreversible shock and twice the treatment was not efficient on the isolated bacteria (Pseudomonas aeruginosa, Staphylococcus). No more shock developed post-operatively. During NI, 11 secondary infections (20%) were diagnosed (bacteremia = 6, urinary tractus infection = 4, reactivated arthritis = 1). The bacteria were Streptococcus (n = 6) with Enterococcus (n = 5), Staphylococcus (n = 3) and Pseudomonas aeruginosa (n = 2): they were still respectively sensitive to ampicillin, methicillin and ticarcillin. The association E + L was clinically and biologically well tolerated.

Acute Disease↗
PubMed1986

[Application of a micromethod to the study of the bactericidal activity of 2 antiseptics based on chlorhexidine gluconate].

Minimal bactericidal concentrations (MBCs) of two antiseptics containing chlorhexidine digluconate (5% for the A solution, 1.5% for the B solution) were determined using a microdilution method. This method is a miniaturization of the Afnor T 72150 standard for antiseptics and disinfectants. 133 hospital isolates were studied, including 68 Enterobacteriaceae, 11 Acinetobacter, 18 Pseudomonas, 1 Achromobacter, 23 Staphylococcus, and 12 S. faecalis. Each microplate was seeded with eleven of these strains and one reference strain (E. coli CIP 54127, P. aeruginosa CIP A22, S. aureus CIP 53154, and S. faecium CIP 5855). Ten microliter of a standardized inoculum (2 to 3 10(8) bacteria/ml) were added to 90 microliters of a solution containing the antiseptic. Each antiseptic was tested in various concentrations (1.95 to 125 mg/l for A and 1.17 to 75 mg/l for B). After five minutes contact at 21 degrees C, 1.5 microliter from each well was seeded on a neutralizing agar plate (letheen agar + 3% tween 80 + 0.3% lecithin + 3% saponin + 0.1% histidine). The neutralizing effectiveness of this plate on the antiseptics in the concentrations used had been ascertained previously. The Afnor T 72150 standard was established for each reference strain. MBCs 90 (in mg/l) found were as follows: 31.2 (A) and 18.8 (B) for Enterobacteriaceae, 15.6 (A) and 9.4 (B) for Acinetobacter, 31.2 (A) and 18.8 (B) for Pseudomonas, 62.5 (A) and 37.7 (B) for Staphylococcus and 125 (A) and 37.5 (B) for S. faecalis.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Infective Agents, Local↗
PubMed1986

[Proposal for a method of studying the activity of soap or antiseptic against the microbial flora of the hands after a single surgical scrub].

The authors, all members of the Antiseptics group of the Societé Française de Microbiologie, propose a standardised method for the evaluation of the activity of antiseptics on the microbial flora of the hands in the context of surgical scrubbing. This paper defines the aims of the method, its field of application and describes the media and materials required. The various phases of the preliminary study and the definitive trial also described.

Anti-Infective Agents, Local↗
PubMed1984

Evaluation of the API 20 STREP system for species identification of streptococci associated with infective endocarditis.

A rapid commercial system (API 20 STREP gallery, API System, France) for the identification of streptococci was compared with conventional biochemical or serological methods. 77 clinical isolates from patients with infective endocarditis and six reference strains were tested. Biochemical tests showing differences between conventional methods and the API gallery were the acidification of inulin and the Voges-Proskauer reaction, but these differences did not affect the final identification of any strain. 75 strains were identified by the API system and 70 by conventional methods. 69 strains (25 groupable and 44 of 51 non-groupable streptococci) were given the same identity by both methods. One S. morbillorum was only identified by the conventional method. Seven S. sanguis I strains were identified only by the API system and confirmed by additional biochemical tests. The API gallery is a useful method for identifying streptococci associated with infective endocarditis, agreeing with conventional methods in 90% of strains. Results are usually available in 24 h.

Bacteriological Techniques↗
PubMed1984

Nosocomial colonization and infection by Achromobacter xylosoxidans.

Achromobacter xylosoxidans, a bacterial species named in 1971, is often isolated from aqueous environments, but little has been reported about its pathogenicity in humans, its epidemiological pattern, and its susceptibility to antibiotics and antiseptics. We were faced with an epidemic caused by this microorganism for 18 months in an intensive care unit. Two patients had fatal infections and 37 others were colonized. The source was the deionized water of the hemodialysis system. The 46 isolates were identified by comparison with the reference strain A. xylosoxidans ATCC 27061. The characteristic cellular fatty acids of this species were demonstrated by gas-liquid chromatography. The minimal inhibitory concentrations of 27 antibiotics were determined. The isolates were susceptible to only two: moxalactam at 4 micrograms/ml and ceftazidime at 8 micrograms/ml. The minimal bactericidal concentrations of one disinfectant and three antiseptics were: sodium hypochloride, 109 micrograms/ml; chlorhexidine digluconate in ethanol solution, 15 to 125 micrograms/ml; polyvinylpyrrolidone iodine, 750 micrograms/ml; and iodine ethanol, 312 to 625 micrograms/ml.

Alcaligenes↗
PubMed1984

[Comparative study of 3 methods for quantifying bacterial flora of the hands: membrane filtration, agar inclusion and plate culture].

We report a study comparing three methods of quantifying bacterial flora on hands: filtration on a 0.22 mu membrane, pour-plate method, and conventional plate culture. Forty samples were taken using Gaschen's bag method with 400 ml of buffer solution. The bacteria in each sample were then counted using each method in duplicate. By adjusting the size of the sample and the number of dilutions, a countable number of colonies was obtained with each method. Culture media, and incubation time and atmosphere were the same for all three methods. Results, expressed as the log 10 of the number of bacteria per hand for aerobic and facultative anaerobic organisms respectively were as follows: membrane filtration 5.65 +/- 0.72 and 6.02 +/- 0.62; pour-plate 5.81 +/- 0.68 and 5.83 +/- 0.62; surface culture 5.80 +/- 0.69 and 5.97 +/- 0.52. None of the differences were statistically significant. The three methods were then compared for manipulation time, cost, volume of sample required and ease of reading and subsequent speciation. Overall, the pour-plate method emerged as the best, especially if speciation is required.

Agar↗
PubMed1984

[Verification of the effectiveness of neutralization in the in vivo study of antiseptics].

Well defined controls of the effectiveness of antiseptic neutralizing agents in vitro already exist (Afnor Standards for antiseptics and disinfectants). Conversely, there is currently no standard method for verifying how effectively such agents neutralize antiseptics which have been applied to the skin. We describe a method in which the neutralizing solution is first applied to the antiseptic-treated skin and then filtered to remove skin flora. The effect of the neutralizing agent is then checked using a test organism (Staphylococcus epidermidis ATCC 14990) in parallel with four controls: viability of the test organism (T1), activity of the untreated antiseptic (T2), non-bactericidal effect of the neutralizing agent (T3) and of skin secretions (4). Skin sampling was carried out using Gaschen's bag method for the hands and the Williamson and Kligman method modified by Fleurette for other sites. Twelve soaps and/or antiseptics were studied. In each case, activity of the antiseptic (T2) was confirmed, except when the product under study was a non-bactericidal soap. Bacterial counts obtained in controls T3 and T4 and in the neutralization test itself were always greater than 80% of the control value (T1). Occasionally, the counts in the neutralization test exceeded 100% of the T1 value, probably because of the dispersal effect of the triton X100 present in the neutralizing solution. This method thus offers a means of standardizing the study of antiseptics in vivo. In addition, the test organism, Staphylococcus epidermidis, is more representative of the skin flora than the bacterial strains recommended by Afnor for in vitro studies.

Anti-Infective Agents, Local↗
PubMed1984

[Effectiveness of 9 soaps and/or antiseptics on hand flora after surgical-type washing].

We studied the effect of nine soaps and/or antiseptics on the bacterial flora of hands 5 minutes after a surgical scrub. Each agent was used by ten healthy volunteers, free of skin lesions. The following agents were used: chlorhexidine gluconate 4% and 1.5%, povidone iodine 4%, ethanol 70 degrees, isopropanol 70 degrees, a non-antiseptic soap, and another soap followed by either ethanol 70 degrees, isopropanol 70 degrees or a preparation containing H2O2. The surgical scrub procedure varied slightly according to whether or not the agent was soapy and required rinsing. Sampling was carried out using Gaschen's bag method with 400 ml of neutralising solution. Counts were made after 48 hours aerobic incubation at 35 degrees C on tryptic soy agar with 1% Tween 80, and after 8 days anaerobic incubation at 35 degrees C on Brewer's yeast agar with 1% Tween 80. Results were expressed as the log 10 to the number of bacteria per hand. Statistical significance was determined using the Student t test. The greatest reduction in aerobic flora was produced by isopropanol 70 degrees C (1.7 log 10). 1.5 to 0.5 log 10 reductions were produced, in the following decreasing order, by ethanol 70 degrees, povidone iodine, chlorhexidine gluconate 4% and 1.5% and a soap with ethanol 70 degrees. A reduction of less than 0.5 log 10 was produced by a soap with isopropanol 70 degrees, and soaps with H2O2. Similar results were obtained with the facultative anaerobes.

Anti-Infective Agents, Local↗
PubMed1983

[Bacteriologic study of 125 cases of infectious streptococcal endocarditis].

Streptococci remain the bacterial group the most frequently associated with microbial endocarditis. This paper points out the ability of the different species to cause endocarditis. 128 streptococci are isolated from patients with microbial endocarditis (127 from blood cultures, 1 from a valve). Isolates are speciated by biochemical tests and the determination of their group antigen. The viridans streptococci most frequently isolated are S. sanguis I (27 p. cent), S. mitis (16,5 p. cent) and S. sanguis II (9,6 p cent). A comparative survey of the results is rather difficult due to the methodological and taxonomical divergences.

Endocarditis, Bacterial↗
PubMed1983

[Growth of Staphylococcus aureus Cowan I in the presence of subbactericidal concentrations of povidone-iodine].

Staphylococcus aureus, strain Cowan I, is cultivated in the presence of povidone iodine (PVP.I) at the concentration of 0, 640, 960 micrograms/ml; growth curves points are platted (OD 640 mm) at 0, 1, 2.50, 3, 4.50, 7 and 24 hours. Growth curves in the presence of povidone alone as well as in the standard without antiseptic are similar and reproducible. A bacteriostatic effect is observed with 640 micrograms/ml PVP.I concentration compared to an incomplete bactericidal effect with 960 micrograms/ml concentration. Proteinee A detected by conditioned hemagglutination method is present in the centrifugation pellet of the standard and only in the supernatant of the test samples during the early phases of the growth. Production of alpha-ribitol-teichoic acid detected by counterimmunoelectrophoresis is not significantly different in the standard and in the presence of antiseptic. Biochemical characteristics studied by Api Staph gallery are identical for the control strain and the strain grown in the presence of PVP.I. Observed by scanning and transmission electronic microscope the bacterial cells do not present structural modification during growth with PVP.I.

Povidone↗
PubMed1982

[Skin flora of the hands, elbow-hollow and fore-arm (author's transl)].

During five years, the values of the skin flora of the hands, fore-arm and elbow-hollow were studied on volunteers, especially five of them. Samples were taken according to the washing method. Results show important quantitative variations of the flora between the differents volunteers and even for a same volunteer. In the five long term followed subjects, the differences were: 2.17 log 10 for aerobic flora and 1.97 log 10 for aeroanaerobic flora of the hands, 3.90 log 10 for aerobic flora and 3.88 log 10 for aero-anaerobic flora of the fore-arm, 2.95 log 10 for aerobic flora and 3.35 log 10 for aero-anaerobic flora of the elbow-hollow. These variations remained independent of the season. According to these variations, already notified by others authors it is suggested first to standardize sampling and bacteriological methods, second to develop multicentric programs in view to increase the number of subjects to be included in the study.

Adult↗
PubMed1982

[Bacteriologic study of 125 cases of streptococcal infectious endocarditis].

Streptococci remain the bacterial group the most frequently associated with microbial endocarditis. This paper points out the ability of the different species to cause endocarditis. 128 streptococci are isolated from patients with microbial endocarditis (127 from blood cultures, 1 from a valve). Isolates are speciated by biochemical tests and the determination of their group antigen. The viridans streptococci most frequently isolated are S. sanguis I (27 p. cent), S. mitis (16.5 p. cent) and S. sanguis II (9.6 p cent). A comparative survey of the results is rather difficult due to the methodological and taxonomical divergences.

Endocarditis, Bacterial↗
PubMed1982

[Skin flora of the hands, elbow-hollow and fore-arm (author's transl)].

During five years, the values of the skin flora of the hands, fore-arm and elbow-hollow were studied on volunteers, especially five of them. Samples were taken according to the washing method. Results show important quantitative variations of the flora between the different volunteers and even for a same volunteer. In the five long term followed subjects, the differences were 2,17 log 10 for aerobic flora and 1,97 log 10 for aero-anaerobic flora of the hands, 3,90 log 10 for aerobic flora and 3,88 log 10 for aero-anaerobic flora of the fore-arm 2,95 log 10 for aerobic flora and 3,35 log 10 for aero-anaerobic flora of the elbow-hollow. These variations remained independent of the season. According to these variations, already notified by others authors it is suggested first to standardize sampling and bacteriological methods, second to develop multicentric programs in view to increase that number of subjects to be included in the study.

Aerobiosis↗