Journal des agents antimicrobiens

Urogenital mycoplasmas Ureaplasma urealyticum, Ureaplasma parvum and Mycoplasma hominis have long been considered commensals of human urogenital microflora. Several studies have recently clarified whether these bacteria could cause or be associated with various obstetric complications. Epidemiologic studies have found high prevalence of Ureaplasma spp. and M. hominis among otherwise healthy population. On the other hand, U. urealyticum, U. parvum and M. hominis have increasingly been linked to adverse pregnancy outcomes such as spontaneous pre-term labor, pre-term premature rupture of fetal membranes, miscarriage, stillbirth and low birth weight. However, no convincing causal relationship has been shown. Studies have shown that antibiotics resistance is on the rise and differs considerably by regions. Screening of asymptomatic patients for M. hominis, U.urealyticum and U. parvum is currently still not indicated.

Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii characterized by fever, maculo-papular rash and a black eschar at the site of the tick bite (tache noire). Acute pancreatitis is a rare complication of MSF. We report a 45 year old man admitted with fever, maculopapular rash, and eschar (tache noire). The working diagnosis at admission was MSF. Five day after admission, the patient developed signs of an acute abdomen, amylase and lipase elevation, and ultrasound hypoechoic pancreas. CT scan revealed a stage B pancreatitis. An immunofluorescence antibody test confirmed Rickettsia conorii infection. Diagnosis of MSF was made and treatment with oral doxycycline was started. After five days of therapy, there was completed remission of epigastric pain and fever. Gastrointestinal and hepatic complications are described in association with MSF. Much rarer is pancreatic involvement. Inflammation may play a role in the pathogenesis of pancreatitis. This suggests that pancreas should be explored in MSF patients even in the absence of underlying risk factors.

We here describe the implementation of a program for optimizing the use of antibiotics (PROA) in a 128-bed regional hospital in Barakaldo, Spain, and the results obtained at 6 months. The study was a quasi-experimental prospective intervention study using a historical control group. A non-restrictive intervention model to help prescription, with a direct and bidirectional intervention was developed. The program consisted of an optimization audit of the use of antibiotics without pre-established personalized guidelines. Variables assessed included antibiotic consumption and costs, cost per process, mean hospital stay, and percentage of hospital readmissions. Data obtained during the 6-month study period (November 2013-April 2014) were compared with data collected between November 2012 and April 2013. A total of 307 audits were performed. In 65.8% of cases, treatment was discontinued between the 7th and the 10th day. The main reasons of treatment discontinuation were completeness of treatment (43.6%) and lack of indication (14.7%). The reduction of pharmaceutical expenditure was 8.59% (P=0.049) and 5.61% of the consumption in defined daily dose (DDD)/100 stays (P=0.180). The costs by processes in general surgery showed a 3.14% decrease (P=0.001). These results confirm the efficiency of implementing programs for optimizing the use of antibiotics in medium-sized hospitals with limited resources.

The cellulosic fabrics bearing the porphyrin as a photo-sensitizer were done in order to prepare efficient polymeric materials for antimicrobial applications. The obtained porphyrin-grafted cellulosic fabrics were characterized by ATRFTIR, DRUV spectroscopy, TG and SEM image. The antimicrobial activity of the products was tested under visible light irradiation against Staphylococcus aureus, Pseudomunas aeroginosa and Escherichia coli.