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Biomedical subjects

N Desplaces

Publications and source records attributed to N Desplaces.

At least 19 recordsLinked to original sources

In vivo selection during pefloxacin therapy of a mutant of Staphylococcus aureus with two mechanisms of fluoroquinolone resistance.

Staphylococcus aureus BM4626 (ciprofloxacin MIC, 0.5 microgram/ml) and BM4627 (ciprofloxacin MIC, 32 microgram/ml) were isolated from the same patient before and during pefloxcin therapy for septic tibial nonunion, respectively. The two strains had similar serotypes and indistinguishable phage types and SmaI-generated restriction fragment length polymorphisms. Portions of the gyrA (codons 60 to 120) and the gyrB (codons 420 to 480) genes of each clinical isolate were amplified by PCR and sequenced. Strain BM4627 had a serine-to-leucine substitution resulting from a cytosine-to-thymidine mutation at codon 84 of gyrA relative to the sequence of the gyrA gene of BM4626. Norfloxacin accumulation, measured in a whole-cell uptake assay, was significantly lower in BM4627 than BM4626. These data indicate that double mutants can be selected in vivo under fluoroquinolone therapy.

Anti-Infective Agents

[BCG osteoarthritis on knee prosthesis after intra-vesical BCG therapy].

A case of Calmette-Guérin bacillus (BCG) infection of a knee implant during intravesical BCG-therapy is reported. The course was favorable after replacement of the implant and administration of antituberculous agents. This case of septic osteoarthritis due to the BCG is different from cases of reactive polyarthritis reported after intravesical instillations of BCG. It probably resulted from diffusion of the BCG via the bloodstream.

Administration, Intravesical

Monoclonal antibody reactivity as a virulence marker for Legionella pneumophila serogroup 1 strains.

Using a panel of nine monoclonal antibodies, we subgrouped 85 environmental and 129 clinical Legionella pneumophila serogroup 1 isolates from Paris, France. Patients were unlikely to be epidemiologically linked either with each other or with the 44 sampled environmental sites (14 air conditioning systems and 30 buildings) that were selected at random in the Paris area. According to their monoclonal antibody patterns, isolates belonged to 14 subgroups. Monoclonal antibody 2 recognized 121 (93.8%) of 129 clinical isolates and 30 (35.3%) of 85 environmental isolates (P less than 10(-9)). Of the eight patients infected with L. pneumophila not recognized with monoclonal antibody 2, seven were immunocompromised; only 46.3% of the 121 patients infected with L. pneumophila reactive with monoclonal antibody 2 were immunocompromised (P = .02). We conclude that monoclonal antibody 2 can be used as a marker for the more virulent strains of L. pneumophila serogroup 1.

Antibodies, Monoclonal

Urease-positive thermophilic Campylobacter (Campylobacter laridis variant) isolated from an appendix and from human feces.

Urease-positive thermophilic campylobacters were isolated for the first time from the feces of two adults with diarrheal disease and from the appendix of a child with appendicitis. They were identified as Campylobacter laridis by a hybridization dot blot assay. Urease testing should be included in the tests used for the identification of campylobacters at the species level, even for those strains which are not of gastric origin.

Appendix

[Chlamydia trachomatis perityphlitis, an anatomo-clinical entity? Study of 3 cases].

The authors describe three cases of perityphlitis secondary to Chlamydia trachomatis infection and revealed at laparotomy. Clinically, the symptoms invariably mimicked acute appendicitis. The pathogen was identified by a direct immunofluorescent assay with specific monoclonal antibodies (Microtrak). Prompt cure was achieved by doxycycline therapy. Thus, peroperatively, the discovery of an isolated perityphlitis with a normal appendix should raise the possibility of a C. trachomatis infection, even if there is no salpingitis.

Adult

The new quinolones and their combinations with other agents for therapy of severe infections.

New quinolones are very potent compounds against Gram-negative bacteria, including Pseudomonas, and staphylococci. They are particularly interesting because of their oral availability and their pharmacokinetic properties. When combined with other common antibiotics they appear to have mostly indifferent effects in vitro. Clinical results have shown their efficacy when used alone for the treatment of osteomyelitis, complicated urinary tract infections and prostatitis. Nevertheless, in 6% of cases resistant strains were selected (Klebsiella, Enterobacter, Serratia, P. aeruginosa and staphylococci). The use of combinations of quinolones with other antibiotics was successful in the treatment of osteomyelitis and severe nosocomial infections including bacteraemia, and seems to prevent emergence of resistant strains.

Anti-Bacterial Agents