[Endometriosis in teenagers]. / Endométriose et adolescente.

Endometriosis has long been considered as a disease of women over 30 years old. However, recent data from the literature demonstrated its high incidence in teenagers. Endometriosis in teenagers is generally associated with chronic pelvic pains and cyclical signs are less common than in adults. The persistence of the pain despite an estroprogestative contraception associated with non-steroidal anti-inflammatory drugs is a strong argument for the diagnosis and justifies a laparoscopic exploration. During this laparoscopy, the search for atypical lesions, which are much more common than typical ones, is essential. Biopsies of these lesions is mandatory in every patient to rule out false positives and false negatives which are common in atypical lesions. The aim of the treatment is to improve the pain. The first line of medical treatment is based on the estroprogestative contraception and non-steroidal anti-inflammatory drugs. The prescription of GnRH should be the ultimate solution because the bone reserve increases until the age of 18 to 20. The laparoscopic treatment, when required, should be as complete as possible. Early diagnosis and medical management may prevent the development of the disease. However, further studies in the teenager are essential to improve the current empirical management.

In vitro susceptibility of Escherichia coli O157 to several antimicrobial agents.

We evaluated the antimicrobial susceptibility of six strains of Escherichia coli O157 (E. coli O157) isolated from patients in Yamaguchi Prefecture between June and July, 1996. Seven antimicrobial agents that were expected to retain a high concentration in the intestine were selected. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of ciprofloxacin, polymyxin B, cefoperazone, and kanamycin for each strain were < or = 6.25 microg/ml. However, the MIC of fosfomycin was 3.13-100 microg/ml, and its MBC was > or = 100 microg/ml. The MIC of ampicillin and tetracycline was > 100 mcirog/ml in some strains. In a time-kill study of E. coli O157 at a drug concentration of 12.5 microg/ml, about 10(4) colony forming units/ml of E. coli O157 were eradicated within 10 min by ciprofloxacin, within 30 min by polymyxin B, within 4 h by cefoperazone, and within 16 h by kanamycin. These results suggest that the new quinolones with a poor absorption rate in the intestine (such as ciprofloxacin and norfloxacin) are effective against E. coli O157. When oral administration is impossible, bile excreting cephem antibiotics (such as cefoperazone, ceftriaxone, and cefotetan) may be useful.

The salting-out test to identify virulent Yersinia pseudotuberculosis.

A total of 54 strains including 8 serotypes of Yersinia pseudotuberculosis were examined to find out about their cell surface hydrophobicity and virulence plasmid-associated properties. All the strains which aggregated in 0.9% saline expressed the properties of calcium-dependent growth and autoagglutination. However, the hydrophilic strains did not possess virulence plasmid-associated properties. The above results suggest that the salting-out test with 0.9% saline could be an effective measure to differentiate the virulence plasmid-carrying strains of Y. pseudotuberculosis from those of plasmidless virulence.