[Prevention of Listeria infections]. / La prophylaxie des listérioses.

Listeriosis is a rare but very serious foodborne disease. The non-contamination of food products is the best prevention of listeriosis. In spite of notable efforts to improve the microbiologic quality of food products through surveillance and control of food contaminations, the prevention has still to be based upon the information of consumers. This information can take different forms. When a food product is found to be contaminated with Listeria monocytogenes, if the withdrawal of this product does not occur as early as to prevent its commercialisation, a consumers alert is necessary to avoid any subsequent human case and to allow a rapid medical care of exposed persons in case of occurrence of symptoms of the disease. A specific information from health professionals to persons with risk factors of contracting listeriosis is a point of debate. Immunocompromised persons, for instance do not represent an easily defined group. On the other hand, pregnant women that are specially at risk of developing listeriosis, with potentially life threatening consequences for their foetus, represent a well identified population. They are medically monitored, and, because they feel concerned, most of them accept, during their pregnancy, to follow some simple rules that, sometimes, change their habits. At present, information is given to pregnant women by different ways: documents, leaflets, posters. The health authorities have decided to reinforce this information. They are also working on a special advisory meeting, specially targeted at foodborne diseases (including listeriosis), that could take place, for pregnant women, during the first months of their pregnancy.

[Gram-negative bacteria in a medical resuscitation unit. Distribution of species and antibiotic sensitivity]. / Les bacilles à Gram négatif en réanimation médicale. Répartition des espèces et sensibilité aux antibiotiques.

The distribution of Gram-negative bacilli species and their susceptibility to various antibiotics were surveyed over a 18-month period in an intensive care unit. Gram-negative bacilli were isolated from blood cultures (65), urine cultures (191), respiratory tract samples (176) or miscellaneous samples (69). The bacilli most frequently isolated from blood cultures were enterobacteriaceae (95%), including Escherichia coli (46%), Proteus (22%) and Klebsiella pneumoniae (12%). Pseudomonas aeruginosa was predominant in respiratory tract samples, and Serratia marcescens was more frequently isolated from urine cultures than from other samples. Antibiotic susceptibility testing was performed using a standard disc diffusion method. In view of the susceptibility of blood isolates to the second-generation cephalosporins we consider that these are preferable to third-generation cephalosporins for first-line antibiotic therapy of septicaemia due to Gram-negative bacilli, except for hospital-acquired infections. More than 50% of the bacilli were resistant to ampicillin; ticarcillin and mezlocillin were not very active against Klebsiella. Nalidixic acid was very active on urine isolates and therefore seems to be a good first-line antibacterial for lower urinary tract infections.