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P Balvay

Publications and source records attributed to P Balvay.

11 recordsLinked to original sources

Pseudomonas aeruginosa: antibiotic susceptibility and genotypic characterization of strains isolated in the intensive care unit.

A prospective study was carried out to assess the incidence and the local antibiotic susceptibility of Pseudomonas aeruginosa in intensive care units (ICUs) and to characterize cross-transmission by using pulsed-field gel electrophoresis as an epidemiologic tool. For this purpose, we screened surveillance cultures and routine clinical cultures from patients admitted to two adult ICUs during a 2-year period. Antibiotic susceptibility was determined by a disk diffusion method. The overall incidence of P. aeruginosa was 19.1 cases per 100 patients. Our findings concerning the antibiotic resistance of clinical isolates were concordant with those of other studies. Genotyping revealed that approximately 53.5% of P. aeruginosa colonization was acquired via cross-transmission; the other cases probably originated from endogenous sources. Cross-colonization seems to make a large contribution to the spread of P. aeruginosa in ICUs.

Adult↗

Large outbreak in a surgical intensive care unit of colonization or infection with Pseudomonas aeruginosa that overexpressed an active efflux pump.

During a 30-month survey, 55 patients were colonized or infected by a single clone of Pseudomonas aeruginosa in a surgical intensive care unit (ICU). This clone overexpressed an efflux pump system, and its antibiotic resistance pattern was extremely stable as it spread from patient to patient. Pulsed-field gel electrophoresis showed that isolates from different patients were genetically identical or very similar. We were unable to identify an environmental reservoir, but cultures of hand specimens from 2 health care workers were positive. It was not clear whether this carriage was the source of the epidemic or a consequence of it. However, the propagation of the epidemic clone was probably linked to its transmission by the staff from patient to patient. The outbreak was controlled, with difficulty, by strengthening isolation procedures, replacing the antiseptic soap being used by the staff, and changing the antibiotic prescription policy. This observation emphasizes the importance of compliance with hand washing and universal precautions.

Anti-Bacterial Agents↗

Inhaled nitric oxide in patients with pulmonary embolism.

OBJECTIVE: To describe the use of inhaled nitric oxide (NO) in four patients with severe pulmonary embolism. SETTING: The intensive care unit (ICU) of a university teaching hospital. PATIENTS: Four patients with severe pulmonary embolism on the basis of clinical, haemodynamic or blood-gas parameters received NO by inhalation either during spontaneous respiration (two cases) or while mechanically ventilated (two cases). INTERVENTIONS: Conventional management of pulmonary embolism in addition to the use of inhaled NO. MEASUREMENTS AND RESULTS: Description of clinical course, haemodynamic and gas-exchange data. Dose-response data are also described for three patients. CONCLUSIONS: We reported four cases of pulmonary embolism where the administration of inhaled NO resulted in an improvement in pulmonary haemodynamic and gas-exchange parameters. Two patients were weaned from NO and survived until discharged from the ICU. Inhaled NO might be a useful adjunct in pulmonary embolism to improve stability of the patient prior to thrombolysis or surgery.

Administration, Inhalation↗

[Calorimetric study of enteral low-carbohydrate diet in patients with respiratory insufficiency and decompensation].

Standard artificial feeding is not suitable for patients with acute respiratory failure due to the increase in CO2 production it entails, effect of carbohydrate metabolism. Randomized use of an enteral diet comprising 55% of fats in 10 patients with chronic pulmonary disease during an acute phase, receiving mechanical ventilatory support, achieved a rapid decrease of VCO2 value, 243 to 215 ml.min-1, while it increased to 250 ml.min-1 with the control diet. These variations are metabolic and not ventilatory in origin for they are not accompanied by changes in plasmatic total CO2 rate.

Blood Gas Analysis↗