Acinetobacter baumannii outbreak isolates characterized by three typing methods.

Forty-two strains of Acinetobacter baumannii were isolated from 15 patients hospitalized in a French intensive care unit. An epidemiological study based on the typing of these isolates was carried out using biotyping, antibiotyping, and ribotyping to recognize the transmission of multiresistant strains by transfer of a patient from one hospital to another. Fifteen strains from the outbreak (1 strain for each patient), five Acinetobacter baumannii strains isolated before the outbreak in Bellevue Hospital (St. Etienne), and five strains isolated in Cochin Hospital (Paris) were included. The three methods gave a good correlation: the epidemic strains had the same antibiotic resistance pattern, the same biotype, and the same ribotypes obtained with three different endonucleases.

[Evaluation of three automated blood culture systems. Bio Argod, Bact T/Alert, bactec NR-860]. / Evaluation de trois systèmes automatisés pour hémocultures. Bio Argos, BacT/Alert, Bactec NR-860.

In 1991 and 1992, three automated blood culturing systems were successively assessed ("Diagnostics Pasteur" Bio Argos: 1,120 Vials, "Organon Teknika" BacT/Alert: 1,400 vials and "Becton Dickinson" bactec NR-860: 2,146 standard vials 6 and 7 and 2,360 resin vials 26 and 27), and compared with the conventional system (C) (Roche aerobic BHI-S Liquoîd, and Diagnostics Pasteur anaerobic prereduced Shaedler). Duplicate blood cultures were collected in various hospital services. They were processed over a 7-day period by the automated instruments and were incubated for 10 days using conventional techniques. The percentage of positivity (clinically significant results) obtained with the automated instruments was similar to that obtained with conventional techniques. Bio Argos: 3.4 p. cent vs 3.8 p. cent with C, BacT/Alert: 3.9 p. cent vs 3.5 p. cent, Bactec standard 6 and 7 vials: 5.6 p. cent vs 6.4 p. cent, and resin 26 and 27: 4.2 p. cent vs 3.1 p. cent. A better sensitivity was found with Bactec resin 26 and 27 vials when compared to C for Staphylococcus aureus (22 p. cent of S. aureus strains were isolated only with resin vials 26 and 27). False positives were as follow: 0.36 p. cent for BacT/Alert, 2.1 p. cent for Bio Argos and 3.5 p. cent for Bactec. The fastest detection rate was observed with the instrument which shakes the vials continuously (BacT/Alert): 73.6 p. cent of positive vials were detected on the day the vials were received at the laboratory. Ninety-four percent of the Bactec resin 26 and 27 positive vials, 90.6 p. cent of the BacT/Alert positive vials, 84 p. cent of the Bactec 6 and 7 positive vials and 73.7 p. cent of the Bio Argos positive vials were detected within twenty-four hours.

Treatment of vulvovaginal candidiasis with boric acid powder.

A double-blind comparison was made of the use of 14 daily intravaginal gelatin capsules containing 600 mg of boric acid powder versus the use of identical capsules containing 100,000 U nystatin diluted to volume with cornstarch for the treatment of vulvovaginal candidiasis albicans. Cure rates for boric acid were 92% at 7 to 10 days after treatment and 72% at 30 days, whereas the nystatin cure rates were 64% at 7 to 10 days and 50% at 30 days. The speed of alleviation of signs and symptoms was similar for the two drugs. There were no untoward side effects, and cervical cytologic features were not affected. In vitro studies found boric acid to be fungistatic and its effectiveness to be unrelated to pH. Blood boron analyses indicated little absorption from the vagina and a half-life of less than 12 hours. Acceptance by the patients was better than for "messy" vaginal creams, and self-made capsules containing boric acid powder are inexpensive (31 cents for fourteen) compared with the costly medication commonly prescribed.