[Five years follow-up of infections with extended-spectrum beta-lactamase producing enterobacteriaceae]. / Évolution sur cinq ans des infections à germes produisant une ß-lactamase à spectre étendu.

INTRODUCTION: Actually, epidemiology of extended-spectrum ß-lactamase (ESBL) producing enterobacteriaceae is increasing worldwide, especially in urinary tract infections (UTI). The objective of the study was to investigate the epidemiology of ESBL producers in a department of urology. PATIENTS AND METHODS: This was a retrospective, monocentric study, which included all patients with positive culture showing an ESBL producing enterobacteriaceae in a department of urology between 2005 and 2009 included. RESULTS: The prevalence of ESBL producers in UTI was 2/113 (1.8%) in 2005 and 3/196 (1.5%) in 2009 (P=0.87). Twenty-seven isolates were included: 66.7% of Escherichia coli, 11.1% of Klebsiella pneumoniae, 11.1% of Enterobacter cloacae. ESBL producers were resistant to another antibiotic family in 24 cases (88.8%). The mean age in this study was 70.4 years, 70% of patients had another antibiotherapy in the past 6 months, 87% an hospitalization within 90% had surgery. Among the patients, 56.5% had a material. The infection was community-acquired in three cases only. Thirty-five percent of patients had no symptoms, 26% presented with severe sepsis. CONCLUSION: This report was a five-year retrospective study of BLSE-positive bacteria showing the nosocomial infection with ESBL producers and their multiresistance to usual antibiotics without any increase of their prevalence.

[Prevalence of extended-spectrum beta-lactamases of the CTX-M type producing Escherichia coli and Klebsiella pneumoniae in Bretonneau hospitals (CHRU Tours)]. / Prévalence des souches de Escherichia coli et de Klebsiella pneumoniae productrices de beta-lactamases à spectre étendu de type CTX-M à l'hôpital Bretonneau (CHRU de Tours).

The CTX-M type extended spectrum beta-lactamases constitute a rapidly growing cluster of enzymes that have disseminated geographically. This study evaluates the prevalence of these enzymes in the university hospital in Tours, in 2007. Twenty-eight strains were studied: 21 Escherichia coli and seven Klebsiella pneumoniae. The gene bla(CTX-M) was detected by real-time PCR for 27 strains. The CTX-M-1 group, including CTX-M-15, was the most frequent CTX-M-type enzyme.

[Pediatric osteoarticular infections caused by Kingella kingae from 1995 to 2006 at CHRU de Tours]. / Infections ostéo-articulaires pédiatriques à Kingella kingae de 1995 à 2006 au CHRU de Tours.

Use of molecular biology shows that Kingella kingae is a pathogen frequently involved in osteoarticular infections in young children. This study describes the cases of osteoarticular infections due to K. kingae which happened from 1995 to 2006 in the CHRU of Tours. The description is based on clinical and biological features. A K. kingae specific polymerase chain reaction was performed in our laboratory in order to improve K. kingae osteoarticular infections diagnosis, and is detailed here.

Blood pressure cuff as a potential vector of pathogenic microorganisms: a prospective study in a teaching hospital.

OBJECTIVE: To investigate the potential role of blood pressure (BP) cuffs in the spread of bacterial infections in hospitals. DESIGN: A comprehensive, prospective study quantitatively and qualitatively evaluating the bacterial contamination on BP cuffs of 203 sphygmomanometers in use in 18 hospital units from January through March 2003. SETTING: A university hospital with surgical, medical, and pediatric units. RESULTS: A level of contamination reaching 100 or more colony-forming units per 25 cm(2) was observed on 92 (45%) of inner sides and 46 (23%) of outer sides of 203 cuffs. The highest rates of contamination occurred on the inner side of BP cuffs kept in intensive care units (ICUs) (20 [83%] of 24) or on nurses' trolleys (27 [77%] of 35). None of the 18 BP cuffs presumed to be clean (ie, those that had not been used since the last decontamination procedure) had a high level of contamination. Potentially pathogenic microorganisms were isolated from 27 (13%) of the 203 BP cuffs: 20 of these microorganisms were Staphylococcus aureus, including 9 methicillin-resistant strains. The highest rates of contamination with potentially pathogenic microorganisms were observed on cuffs used in ICUs and those kept on nurses' trolleys. For 4 patients with a personal sphygmomanometer, a genetic link was found between the strains isolated from the BP cuffs and the strains isolated from the patients. CONCLUSIONS: The results of this survey highlight the importance of recognizing BP cuffs as potential vectors of pathogenic bacteria among patients and as a source of reinfection when dedicated to a single patient, emphasizing the urgent need for validated procedures for their use and maintenance.

[Molecular identification of species within the Mycobacterium tuberculosis complex using regions of difference]. / Identification moléculaire des espèces de mycobactéries du groupe de la tuberculose par étude des régions de différence.

The differentiation within the Mycobacterium tuberculosis complex (MTBC) based on phenotypic methods is long and does not give an unambiguous result in every case whereas the advance in genetic knowledge leads to new views. Thus, regions of difference (RD), that seem to characterize the species of the MTBC, have been identified. Amplification methods, targeted on these zones, have been developed then. The study of four regions (RD1, RD5, RD9, RD10) has been done on 64 isolates formerly identified thanks to phenotypic methods. Genotypic results confirm phenotypic identifications except in one case. This strain initially identified as M. tuberculosis and isolated from a Gabonese patient, corresponds, according to genotypic identification, to M. africanum. Since phenotypic characterization of M. africanum is difficult, this method would allow to accurately determine the true prevalence of this specie. Moreover, the study of RD10 doesn't seem to be informative. The amplification of only two RD, RD1 and RD9 carries out the identification of all M. tuberculosis and M. bovis BCG isolates. M. bovis and M. africanum will be then identified thanks to RD5. Thus, this easy and rapid method of identification of the major species of MTBC seems to be appropriated for a routine use.

[Peritoneal benign polycystic mesothelioma]. / Le mésothéliome polykystique péritonéal bénin.

BACKGROUND: Benign multicystic peritoneal mesothelioma (BMPM) is an uncommon condition. CASE REPORT: We observed a typical case of BMPM occurring in a 57-year-old man who presented with a painful mass of the lower right quadrant. The pathology using immunostaining gave the diagnosis. DISCUSSION: The diagnosis of BMPM can be suspected on the basis of imaging findings, but is usually confirmed by pathology. The only treatment for BMPM is surgical resection. Prognosis is good despite frequent recurrences. Two main hypotheses based on etiopathology can be discussed: does BMPM consist of a mesothelioma proliferative and reactional lesion or is it a real mesothelioma tumor?