Toxigenic Corynebacterium ulcerans in human and non-toxigenic Corynebacterium diphtheriae in cat.

Corynebacterium diphtheriae and Corynebacterium ulcerans are rarely isolated from clinical samples in Belgium. A case of toxigenic C. ulcerans in a woman is described, which confirms that this pathogen is still present. During investigation of the patient's cats, only a non-toxigenic toxin-bearing C. diphtheriae strain was detected.

[Antibiotics in pregnancy: importance of rational utilization]. / Antibiothérapie en maternité: importance d'une utilisation rationnelle.

It is now clear that antibiotic treatment in the antenatal period significantly does prolong pregnancy during conservative management of preterm premature rupture of membranes and reduces neonatal infectious diseases as well as neonatal-related morbidities. In the same way, prophylactic intrapartum antibiotherapy reduces the incidence of early-onset group B Streptococcus-induced sepsis. Nevertheless, on the other hand, antibiotics in the perinatal period are associated with an increase of neonatal sepsis by organisms resistant to maternally administered antibiotics. In addition, antibiotic treatment in this period of time is emerging as one of the possible sources of the dramatic increase in atopic disorders in infants and children owing to the interference with the normal process of intestinal microbial colonization. So, guidelines for using antibiotics in the perinatal period can be said as one of the major priority in public health. Antibiotics have therefore to be rightly choosen and must be used in a rational manner. Local microbial epidemiology, period of infection onset, clinical evaluation, all together allow the physician to use antibiotics, always in association, according to the "well-thought-out wager". In addition, the pharmacodynamic/pharmacokinetic relationship of each drug has to be known, in order to increase efficacy, decrease toxicity and reduce microbial resistance. It is especially mandatory in neonatology where the differences in drug distribution and drug elimination are of great concern, as compared to children and adults. The aim of this paper is to point out such very important aspects using antibiotics in the perinatal period.

Ribotyping for use in studying molecular epidemiology of Serratia marcescens: comparison with biotyping.

Ribotyping carried out with a nonradioactive probe (acetylaminofluorene ribosomal RNA kit I from Eurogentec, Seraing, Belgium) was performed for the characterization of 139 hospital strains of Serratia marcescens. These strains, which belonged to 11 biotypes and 1 nontypeable group, were isolated in seven hospitals in Belgium between 1986 and 1992. EcoRI and HindIII were used to obtain cleavage patterns. Analysis of the results produced 27 different patterns with EcoRI and 23 patterns with HindIII. Typeability reached 100%. Combination of the patterns obtained with each enzyme produced 38 distinct ribotypes. Percent similarity values, calculated by using the Dice coefficient and unweighted-pair group average linkage clustering, showed four main clusters and nine subclusters of ribopatterns at a similarity rate of approximately 80% or less. These groups did not coincide with those delimited by biotyping, although a rather good correlation was observed. The simultaneous use of the two methods has potential value in epidemiological studies.

Combination of biotyping and electrophoretic patterns of esterases for differentiation of nosocomial Serratia marcescens strains.

A total of 292 Serratia marcescens strains isolated in seven Belgian hospitals between 1986 and 1992 were submitted to both biotyping by carbon source utilization and esterase electrophoresis typing. The strains were assigned to 11 biotypes (290 isolates) or were auxotrophic (2 isolates), whereas the various electrophoretic patterns of their esterases produced 54 zymotypes. The two typing methods correlate well, since biotypes embraced more than one zymotype, while each zymotype was restricted to a single biotype. Esterase electrophoretic patterns represent a potent marker for delineating outbreaks of nosocomial infections, whereas biotyping appears to be an appropriate method for screening of strains.

[Anesthesia in neuromuscular diseases. Experience in orthopedic and spinal surgery]. / Anesthésie dans les myopathies. Expérience d'un service de chirurgie orthopédique et du rachis.

Anesthesia of patients suffering from one of the various types of myopathy and with a view to orthopedic operation, cannot be univocal. Operating indications, preparation, results, vary according to the type of suffering. The absence of associated cardiopathy allows surgery even with severe respiratory failures. The experiment of an orthopedic surgery department over a 10 years period shows that these patients may be effectively taken charge of by a multidisciplinary group, thus restricting to a maximum their hospital stay for the benefit of at home hospitalization techniques.

[Pseudomonas aeruginosa and surgical intensive care units]. / Pseudomonas aeruginosa et unités de soins intensifs chirurgicaux.

The prevalence of Pseudomonas aeruginosa in intensive care unit (ICU) is 19 per cent although its incidence in blood culture is only 3.5 per cent and remains the same even though the total prevalence of this bacterium increases. A review of the clinical results shows that this germ causes severe complications in only 3 per cent of patients. A study by epidemiological markers reveals the presence of 16 different IATS serotypes in the ICU, this distribution of the serotypes being similar to this observed in ambulatory patients. The serotype 12 of Ps. aeruginosa is multiresistant. In 1984, it represented 22 per cent of the isolated Ps. aeruginosa, its incidence decreases in 1985 and in 1986 (14.5%). Ps. aeruginosa seems weakly pathogenic for the surgical patients in the ICU. On the other hand, the incidence of Klebsiella pneumoniae, Serratia marcescens (014 imm. serotype resistant to tobramycin), Enterobacter aerogenes and Enterobacter cloacae increases in blood cultures proportionally to their total prevalence in ICU. These bacteria are probably responsible for hospital epidemics.

[Separation of pygopagous Siamese twins]. / Séparation de siamois pygopages.

The successful separation of pygopagous twins is described. The sacrum formed a common canal since S 1 to coccyx with two medullary cords side to side and diastematomyelia with, at this level, two dural sacks. In each baby there was small atrophy in one lower limb. There were two opposite vulvovaginal ducts and two recto-perineal fistules.