[1997-2007, 10 years of monitoring the evolution of resistance of Streptococcus pneumoniae to antibiotics in the region Centre; review of the Pneumococcus network]. / 1997-2007, dix ans de suivi de l'évolution de la résistance de Streptococcus pneumoniae aux antibiotiques en région Centre; bilan de l'observatoire du pneumocoque.

Regional pneumococcal observatories in region Centre, created in 1997, participate with the others pneumococcal observatories alongside the National Reference Center for Pneumococci and the Institut de Veille Sanitaire at the monitoring of the evolution of resistance of pneumococci to antibiotics in France. Between 1997 and 2007, 2427 strains of Streptococcus pneumoniae were isolated in part from cerebrospinal fluids, blood and middle ear fluid, from children and adults. The prevalence of pneumococci with a decreased susceptibility to penicillin (PDSP) decreased strongly in region Centre: 56.8 % in 2001, 39.6 % en 2007. These data are similar to the French national data over the same period.

[Use of BioRad plating agar MRSASelect for the daily detection of methicillin resistant staphylococci isolated from samples taken from blood culture bottles]. / Apport de l'utilisation de la gélose MRSASelect BioRad pour la détection de routine de la résistance à la méticilline des staphylocoques isolés de flacons d'hémoculture.

Within a medium size general biology laboratory, it is not always easy to set up rapid methods for detection of methicillin-resistant staphylococci (detection of the mecA gene or PLP2a). Since we already use BioRad chromogenic plating agar MRSASelect for the detection of carriers of methicillin resistant Staphylococcus aureus, we wanted to test its use on samples taken from blood culture bottles. Between December 2004 and October 2005, all the blood bottle cultures that detected positive by direct examination for Gram positive cocci and suspected to be staphylococci, that is 45 pairs of blood cultures and 3 joint aspirations, were inoculated on quarter plates of both MRSASelect and standard non-selective agar. After culture, they were screened by the disc method. No mismatch was observed between the cultures themselves or the highlighting of methicillin resistance in either Staphylococcus aureus isolates or for coagulase-negative staphylococci, regardless of species. Furthermore, the red colour of Staphylococcus aureus on the medium allowed visualisation of the colonies after only about ten hours incubation, thus giving the clinician rapid warning of suspected methicillin resistant Staphylococcus aureus. In addition, in polymicrobial cultures the different colour of the colonies of Staphylococcus aureus (red) and coagulase-negative staphylococci (white) is extremely useful.

[The Pneumococcal Observatory for the Central Region, 1 April 1999 to 31 March 2000]. / Observatoire du Pneumocoque de la Région Centre, du 1er avril 1999 au 31 mars 2000.

Seven hundred and ninety six strains of pneumococcus were collected in the Centre region, from 15 laboratories, between 1st April 1999 and 31st of March 2000. Data were processed, using 4th dimension software, and concerned age, file number, consultation/hospitalisation, sample type, susceptibility to oxacillin (5 micrograms), results of the E-test for benzylpenicillin, amoxicillin, cefotaxime and results of the routine disc diffusion test. Strains with reduced susceptibility to benzylpenicillin (PRSP) were collected by the co-ordinating centre to perform MICs by the reference agar dilution test and serotyping. Out of 796 strains, 450 strains (56.7%) were categorised as PRSP and 400 of them were studied by the co-ordinating centre. Forty two percent of the samples originated from lungs, followed by 19.5% from blood samples, 15% from ear pus (85.7% PRSP) and 2.5% from CSF. Thirty nine percent of the patients were female. 36.6% were children under sixteen (70.1% PRSP) and 62.4% were adults (49.2% PRSP). Out of 400 PRSP 106 (26.5%) were characterised as resistant and 294 (73.5%) as intermediate to benzylpenicillin. Compared to the agar dilution test, 90% of the PRSP studied by E-test had a MIC value for benzylpenicillin within +/- 1 dilution. Thirty six strains of PRSP were resistant to amoxicillin (9% of the PRSP) and 10 (2.5% of the PRSP) to cefotaxime. Serotyping was done on 375 strains. The serotypes encountered were the following: 23 (26.9%), 14 (22.1%), 19 (19.5%), 6 (12.8%), 9 (9.9%) and 15 (5.1%).

Capnocytophaga ochracea: characterization of a plasmid-encoded extended-spectrum TEM-17 beta-lactamase in the phylum Flavobacter-bacteroides.

A plasmid-encoded extended-spectrum TEM beta-lactamase with a pI of 5.5 was detected in a Capnocytophaga ochracea clinical isolate. The bla gene was associated with a strong TEM-2 promoter and was derived from bla(TEM-1a) with a single-amino-acid substitution: Glu(104)-->Lys, previously assigned to TEM-17, which is thus the first TEM beta-lactamase to be reported in the phylum Flavobacter-Bacteroides.

[The Pneumococcus Observatory of the Central Region, from June 1, 1997 to May 31, 1998]. / Observatoire du pneumocoque de la région Centre, du 1er juin 1997 au 31 mai 1998.

714 pneumococcus were listed from 14 laboratories between the 1 June 1997 and the 31 May 1998. Data capture was done on Epi info software and concerned age, file number, consultation/hospitalization, sample type, susceptibility to oxacilline (5 micrograms), the results of the E-test for penicillin G, amoxicillin, cefotaxime and the results of the routine disk diffusion susceptibility method. Strains with reduced susceptibility to penicillin G (PRSP) were collected by the coordinating center to perform MICs by the reference method of agar dilution and serotyping. Over 714 strains, 45.7% of the samples originated from lungs, followed by 22% for blood samples, 14% for ear pus and 2.3% for CSF. 34% of the patients were female. 36.7% were children under 16 (57.8% PRSP) and 63.3% were adults (41% PRSP). 338 strains (47.3%) were determined as PRSP and 293 of them were studied by the coordinating center. 81 of the 293 PRSP (27.7%) were resistant et 212 (72.3%) were intermediate to penicillin G. 81% of the PRSP studied had a CMI value for penicillin G within +/- 1 log2 dilution. 20 strains of PRSP were resistant for amoxicillin (6.8% of the PRSP) and two (0.7% of the PRSP) for cefotaxime. 289 serotyping were done, most met serotypes were 23 (25%), 14 (23%). The least met was 15 (2.4%). These results let assess the epidemiology of pneumococcus in our region.

Characterization of Streptococcus agalactiae strains by randomly amplified polymorphic DNA analysis.

A collection of 54 unrelated Streptococcus agalactiae strains isolated from cerebrospinal fluid samples from neonates and 60 unrelated strains isolated from carriers that had been previously studied by multilocus enzyme electrophoresis (R. Quentin, H. Huet, F.-S. Wang, P. Geslin, A. Goudeau, and R. K. Selander, J. Clin. Microbiol. 33:2576-2581, 1995) were characterized by randomly amplified polymorphic DNA (RAPD) assay. Four primers, 5'AGGGGGTTCC3', 5'AACGCGCAAC3', 5'GCATCAATCT3', and 5'AGTCGGGTGG3', named OPS16, AP42, A4, and OPS11, respectively, were selected from 29 primers tested. This investigation identified 71 RAPD types. The three families of strains defined by multilocus enzyme electrophoresis analysis, which contain most of the cerebrospinal fluid isolates, were also identified by clustering analysis of RAPD data. Each of these three groups exhibits specific RAPD patterns or fragments. The discriminatory power of the RAPD typing method was also evaluated. The simplest typing scheme was obtained by the combination of RAPD typing done with primers AP42 and OPS11 and serotyping (index of discrimination, 0.97).

Endocervical infection in a pregnant woman caused by Neisseria meningitidis: evidence of associated oropharyngeal colonization of the male partner.

A case of premature birth associated with an endocervical infection caused by Neisseria meningitidis is reported. Treatment of the mother with amoxycillin eradicated the bacteria from the endocervix and avoided newborn colonization or infection. Epidemiological investigation identified meningococcal oropharyngeal colonization of the male partner. The two strains were of the same antigenic formula B:4:P1.14 and exhibited identical rDNA restriction fragment patterns and outer membrane protein profiles. This phenotypic and genomic identity of strains is the first clear evidence for cross-colonization between sexual partners.

Use of a DNA typing method to investigate a fatal perinatal infection due to Staphylococcus aureus.

The aim of this study was to determine, by random amplified polymorphic DNA analysis, the origin of a fatal Staphylococcus aureus perinatal infection which occurred after multiple cervical examinations before induction of labor for patient convenience. This DNA typing method was able to demonstrate that this infection originated from S. aureus genital carriage and urinary tract infection of the mother, and was not acquired in the hospital. This observation argues for the systematic screening of genital flora for highly virulent strains before induction of labor for non medical reasons. In addition, the DNA typing method used demonstrates that one neonate was subsequently infected by the strain responsible for the chorioamnionitis. This shows that molecular typing methods can help determine hospital staff responsibility.