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M Vergnaud

Publications and source records attributed to M Vergnaud.

At least 19 recordsLinked to original sources
PubMed2005

[Legionella pneumonia in an immunocompetent child].

We report a case of Legionella pneumonia in an immunocompetent child. Legionella pneumonia is a rare pathology among children, and even rarer when they are immuno-competent; a few cases have been reported in the literature. This is explained by the fact that infection occurs primarily to immuno-suppressed patients. Legionella bacteria are not systematically sought for in front of child's atypical pneumonia, contrary to Mycoplasma or Chlamydiae. In addition, a number of cases are probably not even noticed because either not serious (Pontiac fever), spontaneously cured, or cured with macrolides prescribed in the case of suspected pneumonia with Mycoplasma.

Anti-Bacterial Agents↗
PubMed2003

Clinical and microbiological epidemiology of Streptococcus pneumoniae bacteremia in eight French counties.

OBJECTIVE: To describe the incidence of pneumococcal bacteremia not associated with infection of the central nervous system, investigate the susceptibility of bacterial isolates to beta-lactams, evaluate risk factors for antibiotic resistance, and determine factors predicting patient outcome. METHODS: Over a period of 1 year, 919 Streptococcus pneumoniae isolates were collected from 919 patients with bacteremia in eight French counties. Their clinical and microbiological features were recorded. Univariate and multivariate analyses were used to determine risk factors for penicillin-non-susceptible pneumococcal bacteremia and predictors of fatal outcome. RESULTS: Of the 919 patients in the study, 27% were infected with penicillin-non-susceptible pneumococci (PNSP): 17.8% of the isolates were intermediate to penicillin, 7.2% were resistant to penicillin, 16% were intermediate to amoxicillin, and 11% were intermediate to cefotaxime; no PNSP were resistant to either of the last two antibiotics. The most common PNSP serotypes isolated were 14 (41%) and 23 (24%). A statistically significant relationship between PNSP infection and age below 5 years or above 60 years in the different counties was observed by univariate and multivariate analysis. Gender, origin of bacteremia, co-morbidity, immunodeficiency, previous hospitalization and nosocomial infection were not predisposing factors associated with PNSP. The mortality rate was 20.6%: there was no increase in mortality among patients with PNSP bacteremia. Age was the strongest risk factor for mortality, but immunodeficiency also seemed to have had an impact on mortality. Clinical outcome was more closely related to clinical conditions than to the susceptibility status of S. pneumoniae. CONCLUSION: Among cases of bacteremia, 27% were caused by PNSP, but this level varies according to the counties and the age of the patients. Infection-related mortality was high, but there was no increase related to penicillin G non-susceptibility of the infecting strain.

Adolescent↗
PubMed2001

[Pneumococcal antibiotic resistance. Results from 21 regional registries for 1999].

IN ADULTS: The prevalence of reduced susceptibility to penicillin was an estimated 40% with rates of 23% for amoxicillin and 15% for cefotaxime. For resistant strains, the rates were 11% for penicillin, 1.3% for amoxicillin and 0.3% for cefotaxime. For respiratory tract samples grouped together, pneumococcal resistance to antibiotics, erythromycin excepted, has increased little in France since 1997. For lung samples, beta-lactam activity has remained stable with only rare strains exhibiting amoxicillin and cefotaxime resistance. IN CHILDREN: The prevalence of reduced susceptibility to penicillin was 53%, 32% for amoxicillin and 22% for cefotaxime. Despite a high rate of penicillin-G resistant strains (16%), amoxicillin and cefotaxime resistant strains remain rare, 2.8% and 1.2% respectively. For all samples grouped together, pneumococcal resistance to antibiotics, erythromycin excepted, has increased little in France since 1997. There has however been an alarming rise in resistance of strains isolated from blood cultures. Globally, beta-lactam activity has remained stable and only rare amoxicillin and cefotaxime resistant strains have been isolated, including middle ear fluid sample. SEROTYPE DISTRIBUTION: Among the strains with reduced susceptibility to penicillin isolated in 1999, the more frequent serotypes were serotypes 6, 9, 14, 15, 19 or 23.

Adult↗
PubMed2000

Macrolide resistance phenotypes and genotypes in French clinical isolates of Streptococcus pneumoniae. Observatoire de Normandie du Pneumocoque.

The aim of this study was to analyze the mechanisms of macrolide resistance in French clinical isolates of Streptococcus pneumoniae. A total of 838 strains of pneumococci were isolated in 1997 in Normandy, a region of western France, by 19 microbiology laboratories. Fifty-three percent had displayed diminished susceptibility to penicillin G and 50% were resistant to erythromycin. From this collection, 92 penicillin-intermediate or -resistant and 18 penicillin-susceptible strains resistant to erythromycin were studied. The presence of erm genes coding for ribosomal methylases and of mefE-like genes responsible for macrolide efflux was screened by a multiplex polymerase chain reaction and confirmed by DNA/DNA hybridization. Of the 110 strains studied, 108 were cross-resistant to erythromycin, spiramycin and clindamycin, including 105 strains containing ermB-related genes and three strains that contained a combination of ermB- and mefE-related genes. Two strains apparently susceptible to clindamycin but resistant to spiramycin also contained ermB-related genes. No strain was resistant to erythromycin alone or contained only a mef-like gene. Therefore, resistance to erythromycin is mostly related to ribosomal methylation in this region of France.

Anti-Bacterial Agents↗
PubMed2000

In vitro activity of fusidic acid against streptococci isolated from skin and soft tissue infections.

The in vitro activity of fusidic acid was evaluated against 242 strains of streptococci isolated from skin and soft tissue infections during a prospective multicentre study. Nearly 90% of strains were isolated from dermatology, emergency and medicine units. Groups A, B, C and G streptococci represented, respectively, 41.9, 20.6, 4.4 and 27.8% of the strains. The activity of fusidic acid was dependent on the media used. MICs were generally one dilution lower with heart infusion agar than with Mueller-Hinton agar supplemented with 5% horse blood (MIC(90) for the whole streptococcal population = 8 mg/L and 16 mg/L, respectively). The distribution of MICs was unimodal and only two strains displayed MICs of fusidic acid >/= 64 mg/L. In both media, fusidic acid was moderately active against streptococci. However, antibiotic concentrations obtained in the skin exceed the MIC(90) of fusidic acid for streptococci, possibly explaining its clinical efficacy in the treatment of common cutaneous infections.

Anti-Bacterial Agents↗
PubMed1996

Molecular study of nosocomial nocardiosis outbreak involving heart transplant recipients.

Randomly amplified polymorphic DNA analysis and rRNA gene restriction patterns (ribotyping) were compared as methods of investigating a nosocomial outbreak of nocardiosis involving three heart transplant recipients. No clear distinctions between three clinically related isolates and four unrelated strains were obtained by ribotyping. On the contrary, randomly amplified polymorphic DNA analysis with two selected primers, primers 2650 and DKU49, showed one pattern for the three related isolates and four patterns for the unrelated strains.

Adult↗
PubMed1994

[Endocarditis caused by Cardiobacterium hominis].

The incidence of endocarditis due to Cardiobacterium hominis is probably underestimated because clinical presentations vary greatly and culture of this Gram negative germ is difficult. A 48-year-old man with a past history of post-streptococcic aortic regurgitation was hospitalized twice within 1 week for fever (38 degrees C) and junctional tachycardia which responded to amiodarone. Subsequently, infero-apical necrosis was documented. Based on the result of the laboratory tests, coronary embolism was suspected although 12 blood cultures were negative. The patient recovered well with a standard antibiotic treatment. Fifteen days later, the blood cultures revealed Cardiobacterium hominis. Antibiotic therapy was adapted and aortic valve replacement was programmed. Two months later the patient died from uncontrollable left heart failure. A 63-year-old man who had had mitral valve replacement 10 years earlier for Streptococcus mitis endocarditis was hospitalized for fever (38 degrees C) and a painful left calf. Phlebocavography eliminated deep vein thrombosis and a complete cardiac work-up was inconclusive. Endocarditis was suspected although blood cultures were negative. The patient was given oral penicillin and discharged after one week. Three months later, the patient was again febrile (38 degrees C) and suffered a cerebral vascular event. Fourteen days after blood sampling, cultures revealed Cardiobacterium hominis. The patient's haemodynamic status worsened and valve replacement with atrioplasty was performed. Outcome after 4 years follow-up has been favourable. Endocarditis due to Cardiobacterium hominis, a saprophitic germ of the upper airway and the female genital tract, has been reported in 64 cases in the literature. The clinical picture is often limited to fever and a heart murmur and laboratory tests show an accelerated erythrocyte sedimentation rate and hyperleukocytosis. Inflammatory type anaemia is often found due to the latency of the endocarditis. Complications are frequent and can be fatal due to massive pulmonary emboli, cerebral vascular events or irreversible heart failure. C. hominis is sensitive to amoxycillin and netilmicin. Surgical treatment of the valvulopathy is indicated.

Anti-Bacterial Agents↗
PubMed1994

[Clostridium perfringens septicemia in drug-induced aplasia].

Septicemia due to Clostridium perfringens during the course of acute leukemia is rare and often lethal particularly in childhood. Antibiotherapy is necessary but polymorphonuclear activity recovery is helpful. This can be done through transfusion or administration of colony stimulating factors. Here is a new case of such a septicemia in a 12 year-old female treated for acute lymphoblastic leukemia. Of particular interest is the favourable outcome despite a high risk situation.

Anemia, Aplastic↗
PubMed1991

[Resistance of hospital flora to imipenem. Experience in two intensive care units].

Imipenem is a beta-lactam antibiotic active against most Gram-negative bacilli. Between July 1, 1987 and September 30, 1989 (9 semesters), the activity of imipenem against 6 micro-organisms was tested in two intensive care units attached to the university hospital of Caen (Normandy). During the same period, the consumption of imipenem was evaluated from the number of vials drawn by each of these two units from the central pharmacy. Imipenem was found to be 100 percent effective against 5 of the 6 micro-organisms tested, but transient falls in sensitivity and an increase in imipenem consumption were observed when Pseudomonas aeruginosa was the pathogen. The most probable cause of these transient decreases of imipenem activity against Ps. aeruginosa was the existence of a resistant strain which showed a protein abnormality in its outer membrane by temporary selection pressure.

Acinetobacter↗
PubMed1991

[Prospective study of routine screening for cirrhosis and colonic tumors associated with Streptococcus bovis bacteremia].

Between 1987 and 1990, seven patients hospitalized in our hospital had bacteremia caused by Streptococcus bovis. Complete gastrointestinal evaluation was routinely carried out for digestive portal of entry and liver disease screening. In four cases (2 bacteremia, 2 endocarditis), a colonic growth was detected: sigmoid adenoma (n = 1) and rectosigmoid carcinoma (n = 4); in one case (endocarditis), several rectosigmoid carcinomas were associated with alcoholic cirrhosis; in one case (bacteremia), alcoholic cirrhosis was diagnosed; in one case (endocarditis), no gastrointestinal or hepatic portal of entry was found. These cases emphasize the need for simultaneous detection of endocarditis and gastrointestinal portal of entry such as colonic tumor and/or cirrhosis, in case of Streptococcus bovis bacteremia.

Adenocarcinoma↗
PubMed1990

[In vitro antibacterial activity of RU 51746 (sodium salt of cefpodoxime). Results of a multicenter study].

Cefpodoxime proxetil, a new oral cephalosporin, is the prodrug ester of cefpodoxime. Minimal inhibitory concentrations (MIC) of RU 51746 (sodium salt of cefpodoxime: CPD) were evaluated by agar dilution for 1 696 bacterial strains isolated in 5 hospitals. For Enterobacteriaceae, MIC 50 and 90% were respectively (micrograms/ml): (1) naturally non bêtalactamase producing species: E. coli, Shigella and Salmonella 0.25-0.5; P. mirabilis 0.06-0.12. (II) chromosomal penicillinase producing species: Klebsiella 0.12-1. (III) chromosomal cephalosporinase producing species: E. cloacae and C. freundii 2-greater than 128; S. marcescens 2-64; indole + Proteus 0.25-64; P. stuartii 0.25-16. Activity of CPD was not modified on plasmid mediated penicillinase producing strains, but CPD was inactive on cephalosporinase hyperproducing strains, and on broad spectrum bêtalactamases producing strains. CPD was inactive on P. aeruginosa (MIC greater than or equal to 64) and on A. baumannii (16-pi 128). Haemophilus, regardless on bêtalactamase production status, were very susceptible to CPD (MIC less than or equal to 0.25) and B. catarrhalis was generally inhibited by 0.12 to 1. CPD was poorly active on methicillin susceptible Staphylococci (MIC 50 and 90%: 2-4) and inactive on methicillin resistant strains. Enterococci and Listeria monocytogenes were generally resistant; Streptococci A, B, C, G and Pneumococci were inhibited by low concentration: 0.002 to 0.25 (MIC 50 and 90%: 0.016-0.032) whereas MIC for other Streptococci were 0.004 to 32 (MIC 50 and 90%: 0.25-4). These antibacterial properties placed CPD in excellent position among oral cephalosporins.

Anti-Bacterial Agents↗
PubMed1989

[In vitro antibacterial effect of a new oral cephalosporin, cefixime. Results of a multicenter study].

Minimal inhibitory concentrations (MIC) of cefixime (CXM) were evaluated by agar dilution against 2,469 bacterial strains isolated in 10 hospitals. For Enterobacteriaceae, MIC 50 and 90% micrograms/ml were respectively: (I) naturally non beta lactamase producing species: E. coli and Shigella 0.25-0.5; Salmonella 0.06-0.25; P. mirabilis 0.008-0.032. (II) chromosomal penicillinase producing species: Klebsiella 0.06-2. (III) chromosomal cephalosporinase producing species: E. cloacae and C. freundii 1-greater than 128; S. marcescens 0.25-16; indole + Proteus 0.06-4; P. stuartii 0.032-0.5. Activity of CXM was not modified against plasmid-mediated penicillinase producing strains, but CXM was inactive on cephalosporinase hyperproducing strains and on broad spectrum beta lactamases producing strains. CXM was inactive on P. aeruginosa (MIC 50 and 90%: 64-128) and on A. baumannii (16-128). Haemophilus and Gonococci, regardless of beta-lactamase production status, and Meningococci were very susceptible to CXM (MIC 0.008-0.12). B. catarrhalis was generally inhibited by 0.03 to 0.5. CXM was poorly active on methicillin susceptible Staphylococci (MIC 50 and 90%: 1-64) and inactive on methicillin resistant strains. Enterococci were generally resistant whereas Streptococci and Pneumococci were inhibited by low concentrations: 0.008 to 1. These antibacterial properties place CXM in excellent position among oral cephalosporins.

Cefixime↗