Biomedical subjects
Publications and source records attributed to Y Perol.
The genomes of 17 isolates of the human parvovirus B 19 were compared by restriction with eight endonucleases. All but four isolates proved indistinguishable. A 3.2 kb B 19 DNA fragment was cloned and used as a molecular probe.
The in vitro activities of the new spectinomycin analog U-63366, the new macrolide roxithromycin (RU 28965), and five new quinolone derivatives (pefloxacin, rosoxacin, norfloxacin, ofloxacin, and ciprofloxacin) were studied against 23 multiresistant strains of Haemophilus ducreyi (beta-lactamase producers) isolated in Paris and were compared with the activities of tetracycline, minocycline, chloramphenicol, streptomycin, kanamycin, gentamicin, spectinomycin, erythromycin, and nalidixic acid. All strains were uniformly susceptible to the seven new antibiotics tested. Ciprofloxacin had the greatest inhibitory effect in vitro (the MIC for 90% of the strains tested [MIC90] was 0.016 microgram/ml), and U-63366 was the most active aminoglycoside-aminocyclitol antibiotic (MIC90, 0.25 microgram/ml).
Ofloxacin is a new fluoroquinolone with in vitro activity against the three main urethritis-causing pathogens: i.e. Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. 18 adult males with acute uncomplicated urethritis took 200 mg ofloxacin by mouth twice daily for 7 (non-chlamydial urethritis) or 14 (chlamydial urethritis) days. 12 patients had N. gonorrhoeae; 2 had H. parainfluenzae, 1 had E. coli and 5 had C. trachomatis. Urethral cultures were obtained before treatment and on day 7 (non-chlamydial urethritis) or 28 (chlamydial urethritis). Clinical and microbiological cure was achieved in 17 of the 18 patients. Clinical manifestations failed to resolve in one patient due to the presence of Trichomonas vaginalis recognized on day 7. No side effects were observed. According to these results, ofloxacin is effective and safe against gonococcal and chlamydial urethritis.
Eight Capnocytophaga infections are described: bacteremia in immunodepressed patients (three cases), endocarditis (one case), pneumopathy (one case), buccal infection (two cases) and endometritis during use of an intrauterine contraceptive device (one case). The role of this bacterium in infections presented by immunodepressed patients is discussed in terms of literature data. Identification of the genus posed no problems. Species diagnosis is considered in terms of the use of conventional biochemical tests and the API ZYM collection.
Cytomegalovirus (CMV) viremia was systematically studied in 56 patients having undergone bone marrow transplantation for leukemia or aplastic anemia. Of the patients who survived at least three months, 57% had CMV viremia with a frequency peak between the 7th and the 9th weeks. We describe possible clinical signs associated with viremia, particularly late peripheral and/or central thrombocytopenia. The occurrence of viremia was studied according to the specific preexisting immune status of recipients and donors; granulocyte transfusions and graft-versus-host disease. The relationship between these parameters and viremia provides a basis for the analysis of prophylactic treatments of CMV infection.
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Monoclonal antibody analysis of peripheral blood T-cell subsets was performed in 23 multitransfused haemophiliacs, 5 children and 10 adults. Although none of the patients exhibited symptoms of acquired immune deficiency, 5 of them showed an abnormally low proportion of T-cells with reversal of the OKT4 (helper/inducer) to OKT8 (cytotoxic/suppressor) ratio. No evidence of cytomegalovirus infection was found. A search for antibodies to human leukaemia virus antigen P24 gave negative results. The relationship between this abnormality and transfusions is discussed.
Isolation of cytomegalovirus (CMV) from blood plated on embryonic fibroblasts necessitates a delay of 10-30 days. Using monoclonal antibodies (McAb) we have developed a 96 hour test to diagnose viremia. We produced monoclonal antibodies directed against CMV (strain AD 169). Clone E 13 McAb detected a CMV early antigen in nuclei using indirect immunofluorescence. These monoclonal antibodies recognized reference strains (Davis and Towne) and 20 field isolates of CMV. E 13 McAb were therefore selected for the diagnostic tests. MRC 5 cells grown on coverslips in tubes were inoculated with buffy-coat from 51 blood samples from bone marrow allograft recipients and Guillain Barre polyneuritis, and centrifuged on hour at 4000 g at 36 degrees C. The indirect immunofluorescence test (IIF) was performed using E 13 McAb, 48 and 96 hours post infection. Three viremia were detected within 48 hours and five others within 96 hours. Plasma and buffy-coat were also inoculated onto MRC 5 cells grown in flasks. Flasks were observed daily for CMV cytopathic effect (CPE). CPE appeared within an average of 14 days. When CMV was detected by CPE, the IF tests were always positive within 96 hours after drawing the blood.
Actinomyces israelii was isolated from cervico-facial subacute or chronic infections (9 cases), and abdominal wall abscess (1 case). Two conditions were necessary for successful isolation of A. israelii: properly collected clinical specimen (pus aspirated from abscess or biopsy) and prolongated incubation of anaerobic cultures (at minimum 5 days). Two commercially available micro-method multitest systems (Api 20 anaerobes, Api Zym test) were compared with standard biochemical procedures. The three methods were evaluated as to the reproducibility and help in identifying anaerobic non spore-forming Gram-positive bacilli in a routine clinical laboratory.
Isolation of Chlamydia trachomatis (C. trachomatis) in cell culture is the most reliable method for the diagnosis of chlamydial infections. The results are obtained in 48-72 hours. We have produced anti-chlamydial monoclonal antibodies (McAb) and by means of indirect immunofluorescence (IIF) we have developed a rapid diagnostic test. Sixty-six patients, 34 males seen for subacute urethritis authenticated by the presence of polymorphonuclear cells on urethral smears and 32 females presenting with leucorrhea were included in the study. The specimens obtained from urethra and cervix were inoculated on Hela 229 cells for isolation of C. trachomatis. A similar specimen was placed in normal saline containing 2% fetal calf serum. 50 microliters of the saline solution were then placed in wells in IF slides, dried at 37 degrees C and fixed for 30 minutes in acetone at -20 degrees C. Anti-chlamydial McAb and fluorescein labelled mouse anti IgG were used for the rapid IIF test. From 34 cases, we have isolated C. trachomatis from the urethra of 19 males. In these 19 cases, most of the polymorphonuclear cells demonstrated a brilliant cytoplasma revealing the presence of chlamydial antigens. In 25 other cases without isolation, the rapid diagnostic test was positive twice. From the 32 females, C. trachomatis was isolated 7 times. In these 7 cases, the rapid diagnosis IIF test was positive with the same characteristics as noted in the male population. In the 25 other cases without isolation, the test was positive 3 times.
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Herpes virus hominis infection was observed in 28% (diagnosis ascertained on viral examination) to 33% (clinical suspicion) of 36 adult patients prospectively studied during remission induction chemotherapy for acute leukaemia. Symptoms are non specific so that diagnosis relies upon viral isolation. All infected patients but one survived the viral infection and the prognosis of the underlying acute leukaemia was unaffected.
In a double-blind controlled study, oral acyclovir was compared with placebo in 39 consecutive patients undergoing bone-marrow transplantation. Acyclovir was given at a dose of 200 mg every 6 h from 8 days before to 35 days after bone-marrow transplantation. Pharmacokinetic studies showed good absorption of the drug, despite intestinal damage related to chemoradiotherapy or gut graft-versus-host disease. There was no sign of toxicity. The protection against herpes simplex virus (HSV) infection was complete in the treated group compared with the placebo group even in patients with high anti-HSV antibody titres before transplantation. The same protection was observed against cytomegalovirus (CMV) infection. The frequencies of HSV and CMV infections were the same in both groups after the cessation of treatment.
We have studied the in-vitro susceptibility of 30 strains of Haemophilus ducreyi to 22 antibacterial agents. Twenty-seven strains produced a beta-lactamase that had an isoelectric point similar to the isoelectric point of the TEM 1 type beta-lactamase produced by pSF 2124. Except for cefamandole, the 30 strains had similar susceptibilities to the different cephalosporins, cefotaxime being the most active compound. Twenty-two isolates were resistant to tetracycline and doxycycline; minimal inhibitory concentration (MIC) of minocycline was 4 mg/l for all the strains. One isolate was resistant to chloramphenicol (MIC = 16 mg/l). All strains were relatively resistant to colistin and nalidixic acid, and susceptible to streptomycin, kanamycin, gentamicin, erythromycin, rifampicin and vancomycin.
In a double-blind controlled study, oral acyclovir has been compared to a placebo in a series of 39 consecutive patients undergoing bone marrow transplantation. A dose of 200 mg was given every 6 h from day 8 to day 35 after transplantation. Pharmacokinetic studies have shown the good absorption of the drug despite intestinal damage related to chemoradiotherapy or gut graft-versus-host disease (GVHD); there was no sign of toxicity. The protection against herpes simplex virus (HSV) infection was complete in the treated group when compared to the control group even in patients with high anti-HSV antibody titres. The same protection was observed against cytomegalovirus (CMV) infection. The incidence of HSV and CMV was the same in both groups after treatment ended. This study confirms the efficacy of acyclovir against HSV infection and possibly against CMV infection when it is given prophylactically after bone marrow transplantation.
Herpes virus hominis infection was observed in 28% (diagnosis assessed on viral examination) to 33% (clinical suspicion) of 36 adult patients prospectively studied during remission induction chemotherapy for acute leukaemia. Symptoms are non specific so that diagnosis relies upon viral isolation. All infected patients but one survived the viral infection and the prognosis of the underlying acute leukaemia was unaffected.
Cell fusion of Sp2/0, a murine myeloma derived non-secreting variant, with splenic lymphocytes from Mice immunized against human cytomegalovirus, has originated two stable hybridomas producing monoclonal antibodies (IgG) which react specifically with antigens that appear early in infectious cycle and remain localized in the cell nucleus.