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Biomedical subjects

S Gros

Publications and source records attributed to S Gros.

7 recordsLinked to original sources
PubMed2001

Molecular analysis of relapse vs re-infection in HIV-positive patients suffering from recurrent Clostridium difficile associated diarrhoea.

Recurrence is a major complication of Clostridium difficile associated diarrhoea, especially in human immunodeficiency virus (HIV) positive patients, and it is important to distinguish between relapse and re-infection in recurrent episodes. The aim of our study was to analyse C. difficile isolates obtained from HIV-positive patients with recurrent diarrhoea in order to distinguish between relapse and re-infection. This analysis was based on the study of DNA similarities among isolates obtained from different episodes within each patient. Relapses occurred in 64% of patients, 32% suffered re-infections and a combination of relapse plus re-infection was seen in 4%. DNA typing methods can be useful tools to characterize recurrent episodes of C. difficile associated disease.

AIDS-Related Opportunistic Infections↗
PubMed1999

Rapid detection of toxigenic Clostridium difficile from stool samples by a nested PCR of toxin B gene.

Toxigenic Clostridium difficile is the aetiologic agent of most cases of antibiotic-associated diarrhoea and pseudomembranous colitis. The present standard method for C. difficile diagnosis is a cytotoxicity assay, performed on human fibroblast cultures. It is time consuming and requires special facilities. A nested-PCR assay detecting toxin B gene within a few hours was designed. One hundred and two stool samples were collected during four months. All samples were processed for toxin B-PCR, cultured for C. difficile and tested for cytotoxicity. This approach achieved 99% concordance with the cytotoxic assay. The sensitivity and specificity for the new PCR assay were 96.3% and 100% respectively. The procedure described is easy to perform, does not require special equipment and has produced excellent results. It deserves serious consideration for routine clinical microbiology laboratory use.

Bacterial Toxins↗
PubMed1998

Improving clinical outcome in bacteremia.

Bacteremia is associated with significant morbidity and mortality. There is wide variation in morbidity and mortality rates according to organism and predisposing conditions. Additionally, prompt administration of appropriate antimicrobial agents is associated with a decrease in mortality. Unfortunately, many bacteremic patients receive inappropriate or no antibiotics. Infectious disease consultation can decrease the number of patients receiving inappropriate initial therapy. 'Quality standard for the treatment of bacteremia' (Gross et al., 1994, Infection Control and Hospital Epidemiology 15, 189-192) is a consensus paper; its purpose is to 'improve the treatment of hospitalized patients with documented bacteremia by ensuring that they receive an antibiotic appropriate in light of the blood-culture susceptibility of the pathogen isolated.' A programme to assess the treatment of bacteremia can improve the quality of care with a modest commitment of additional resources. Many of the activities could be performed by a pharmacist, infection control practitioner, or pathologist. However, physician-to-physician communications are most likely to be successful. This programme should be considered a component of a hospital's quality-improvement programme; either the hospital quality assurance or infection control committee could be responsible for the programme. We encourage adoption of the standard, and recommend prospective monitoring to include the choice of empiric antimicrobial agents.

Anti-Bacterial Agents↗
PubMed1997

Implementation of consensus guidelines for the follow-up of positive blood cultures.

OBJECTIVE: Assess the effect and use of resources associated with implementation of a program for the systematic follow-up of positive blood cultures. DESIGN: Prospective epidemiologic study. SETTING: Tertiary-care military medical center. INTERVENTION: All positive blood cultures (BC) were reported via E-mail to an infectious disease specialist as soon as growth was noted. This individual reviewed all Gram stains, clinical data, and antibiotic information on these patients. RESULTS: From June 26, 1994, through January 25, 1995, there were 3,121 BCs drawn, of which 199 (6.4%) were positive from 145 episodes. Sixty-three episodes involved probable contaminants, and 82 episodes were considered true bacteremias. Six patients with true bacteremia died, two were transferred, and three were discharged within 24 hours of drawing the positive BC. Of the remaining 71 true bacteremias, 9 patients were on inadequate empiric therapy, as judged by the final organism susceptibilities. Changes in empiric therapy were recommended for five of the nine episodes and were implemented by the primary physicians in each case. Each of the changes resulted in improved coverage (as judged by the final identification and susceptibilities). CONCLUSIONS: This program has improved the quality of care at Keesler Medical Center at the cost of one additional hour of consultant time per week.

Adult↗
PubMed1987

Cyclosporine administration decreases liver vitamin A stores in normal and vitamin A-deficient rats.

Thirty-four Wistar rats were fed a marginal or normal vitamin A diet and received daily for 14 days an intragastric intubation of oil supplemented with 0, 20, or 60 mg X kg-1 of cyclosporine A. The hepatic content and concentration of vitamin A were significantly decreased by cyclosporine treatment, whereas no modification occurred in kidney or serum vitamin A levels. No induction of hepatic cytochrome P-450 was observed in treated animals. These results suggest that cyclosporine interferes with vitamin A stores; thus, vitamin A supplementation may be useful in patients receiving cyclosporine therapy. Drug-metabolizing enzymes, which are cytochrome P-450 dependent, did not seem to be involved in the hepatic vitamin A decrease observed.

Animals↗