Direct antimicrobial susceptibility testing method for analysis of sputum collected from patients with cystic fibrosis

AbstractBackgroundChronic Pseudomonas aeruginosa colonisation and subsequent exacerbations in patients with cystic fibrosis (CF) require antimicrobial treatment. But since multiple morphotypes and other Gram-negative bacteria with different antibiotic susceptibilities are often isolated inside the same sputum sample, bacteriological analysis is difficult.MethodsTo simplify this analysis, we explored a direct sputum antimicrobial susceptibility testing (DSST) method by applying E test directly on plates inoculated with the sputum. A total of 316 samples collected from CF patients were analysed and compared with standard procedures (SP) for the identification and antimicrobial susceptibility testing of all Gram-negative bacterial species.ResultsDSST was as efficient as SP to detect P. aeruginosa including the mucoid morphotype in monomicrobial specimen, but was less sensible to detect all Gram-negative bacteria present in the same sample. It allowed the direct reading of the MIC inhibiting all Gram-negative bacteria. Agreements between these global MICs with the cumulative antibiotics susceptibility of all Gram-negative bacteria measured by SP were excellent for tobramycin and imipenem (>96%) and satisfactory for ticarcillin, ceftazidime, aztreonam and ciprofloxacin (90.4% to 94.3%).In conclusion, the DSST method is an efficient and easy antibiotic susceptibility testing method

Spread of OXA-48-Encoding Plasmid in Turkey and Beyond

WOS: 000274733300064PubMed ID: 20086157Eighteen carbapenem-resistant, OXA-48-positive enterobacterial isolates recovered from Turkey, Lebanon, Egypt, France, and Belgium were analyzed. In most isolates, similar 70-kb plasmids carrying the carbapenemase gene bla(OXA-48) were identified. That gene was located within either transposon Tn1999 or transposon Tn1999.2, which was always inserted within the same gene. This work highlights the current plasmid-mediated dissemination of the OXA-48 carbapenemase worldwide.Ministere de l'Education Nationale et de la Recherche [UPRES-EA3539]; European communityEuropean Community (EC) [LSHM-CT-2005-018705]; INSERMInstitut National de la Sante et de la Recherche Medicale (Inserm)This work was funded by a grant from the Ministere de l'Education Nationale et de la Recherche (UPRES-EA3539), Universite Paris XI, Paris, France, and mostly by a grant from the European community (LSHM-CT-2005-018705) and by the INSERM, Paris, France

Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency.

International audienceABSTRACT: BACKGROUND: Mycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization. Cases presentation: We report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient. CONCLUSION: Clinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status