OBJECTIVES:A multicenter study was implemented in order to determine the distribution and antibiotic susceptibility patterns of strains isolated from 15 to 65 year old female patients with community-acquired urinary tract infections.PATIENTS AND METHODS:From October to December 2003, 11 French private laboratories consecutively collected 420 clinical strains with medical data. Minimal inhibitory concentrations of antibiotics on E. coli were determined using the agar dilution method in a coordinating center and interpretation followed the recommendations of the Comité de l'antibiogramme de la Société française de microbiologie.RESULTS:Escherichia coli was the most prevalent pathogen (80%) followed by Proteus mirabilis (4%), Klebsiella spp (2%), other Enterobacteriaceae (4%), Enterococcus spp (3%), Staphylococcus aureus (2%), Staphylococcus saprophyticus (2%), and Streptococcus agalactiae (2%). The susceptibility of E. coli strains was 61% for amoxicillin (AMX), 93% for nalidixic acid (NAL), 97% for norfloxacin (NOR) and ciprofloxacin (CIP), 77% for cotrimoxazole (SXT), 99% for fosfomycin, gentamicin and cefotaxime. The susceptibility of E. coli was lower in case of previous treatment with beta-lactam antibiotics for AMX (84 vs 95% p=0.02) and SXT (62 vs 81% p=0.02). In the same way, previous treatment with quinolones was associated with decreased susceptibility for NAL (84 vs 95% p=0.02) and SXT (62 vs 81% p=0.02).CONCLUSIONS:In 2003, fluoroquinolones, third generation cephalosporins, aminoglycosides, and fosfomycin kept a good activity on E. coli collected from community-acquired urinary tract infections in 15 to 65 years old female patients in France.

Traveler's diarrhoea (TD) occurs in 20 to 60% of European or North-American travelers in intertropical areas. Following return from endemic zone, malaria must always be evocated in front of febrile diarrhoea. Many causative infectious agents are involved in TD and their frequency may vary according to destination and seasons. The main agents involved in TD are Escherichia coli pathovars (especially enterotoxigenic and enteroaggregative E. coli) followed by enteroinvasive bacteria (Campylobacter spp., Shigella spp., Salmonella enterica), enteric viruses (norovirus, rotavirus) and protozoa (Gardia intestinalis, Cryptosporidium parvum et Entamoeba histolytica). The development of molecular biology methods as PCR may allow us to evaluate the relative frequency of these agents and especially of viral agents in TD. Protozoa and microsporidia are more frequently isolated in persistent and chronic TD, especially in compromised patients. A complete etiological research in routine microbiology laboratories is difficult and time-consuming, related to the high diversity of causative agents and the need for specific methods. Implementation of laboratory diagnosis is highly recommended when diarrhoea is associated with fever or presence of blood in stools, immunosuppression, antibiotic treatment (Clostridium difficile toxins) or in case of persistent/chronic diarrhoea. According to the high frequency of acquired antibiotic-resistance in enteric bacteria, an antibiogram must be performed for all causative bacterial agents.

Vertebral osteomyelitis is a quite rare but severe cause of back pain in adults. Various causative organisms have been reported. Pasteurella species have rarely been isolated. We report here a case of vertebral osteomyelitis and consecutive cauda equina syndrome due to Pasteurella dagmatis in a 60-year-old diabetic man. (c) 2007 Elsevier Masson SAS. Tous droits reserves.

La diarrhée du voyageur (DV) peut toucher entre 20 et 60% des voyageurs européens ou Nord-Américains voyageant en zone intertropicale. Une étiologie palustre doit être évoquée de principe devant une diarrhée fébrile au retour d'une zone d'endémie. Les étiologies microbiennes de la DV sont particulièrement nombreuses et leur répartition varie en fonction des destinations et des saisons. Les agents incriminés dans les DV sont par ordre de fréquence les différents pathovars d'Escherichia coli, et en particulier les E. coli entérotoxinogènes et entéroaggrégants suivis par des bactéries à mécanisme entéro-invasif (Campylobacter spp., Shigella spp., Salmonella enterica), les virus entériques (norovirus, rotavirus) et les protozoaires (Gardia intestinalis, Cryptosporidium parvum et Entamoeba histolytica). Le développement des techniques de biologie moléculaire devrait permettre de mieux apprécier la fréquence relative des différents agents et en particulier des agents viraux dans la DV. Les protozoaires et les microsporidies sont plus fréquents dans les DV persistantes ou chroniques, surtout dans un contexte d'immunodépression. La recherche étiologique est difficile en pratique de routine du fait de la diversité des agents en cause et des techniques parfois spécialisées à mettre en œuvre. Elle devrait être systématique dans les diarrhées fébriles, en cas de présence de sang dans les selles, chez les patients immunodéprimés, à la suite d'un traitement antibiotique (toxines de Clostridium difficile) ou dans un contexte de diarrhée persistante ou chronique. L'isolement d'un agent bactérien pathogène doit entraîner la pratique systématique d'un antibiogramme du fait de la fréquence des résistances acquises.

Introduction. - Septic arthritis caused by Neisseria gonorrhoeae is mono or pauciarticular. They represent a nonrare cause of arthritis in sexually active adults. He is necessary to think of it even in the absence of urethritis.Exegesis. - We report the case of gonococcal arthritis without urethritis in a young man associated with positive synovial fluid culture and negative blood cultures.Conclusion. - Prompt recognition and treatment of this disease results in cure without aftereffects. The finding of penicillin-resistant organisms reinforces recent recommendations that advanced-generation cephalosporin must be used as initial therapy. (C) 2006 Elsevier Masson SAS. Tous droits reserves.

INTRODUCTION Healthy pets contact are able to induce unusual and severe diseases. CLINICAL CASE This case reports the medical history of a dorsal spondylodiscitis in a diabetic patient admitted for a chronic wound of his toes. He had a long-standing history of regular consumption of alcohol and tobacco. Blood bottles and biopsy of intervertebral disc infected discovered Pasteurella dagmatis, commonly colonizing the oropharynx of healthy dogs and cats. In this case, licking of his injured toe by his dog was the likely source of entry of the organism. DISCUSSION We found no identical cases in the medical literature. Diabetes mellitus and other immunocompromised disorders justify to change behaviours toward domestic animals.

INTRODUCTION:Septic arthritis caused by Neisseria gonorrhoeae is mono or pauciarticular. They represent a nonrare cause of arthritis in sexually active adults. He is necessary to think of it even in the absence of urethritis.EXEGESIS:We report the case of gonococcal arthritis without urethritis in a young man associated with positive synovial fluid culture and negative blood cultures.CONCLUSION:Prompt recognition and treatment of this disease results in cure without aftereffects. The finding of penicillin-resistant organisms reinforces recent recommendations that advanced-generation cephalosporin must be used as initial therapy.

BACKGROUND:An outbreak of cutaneous leishmaniasis occurred among 71 soldiers who had participated in various missions during a 4-month's period in French Guiana. The aims of this study were (i) to describe outbreak and (ii) to determine risk factors of cutaneous leishmaniasis.METHODS:All patients were hospitalised. Cutaneous lesions were biopsied and cultured for species identification. Individual information was collected by a physician or a nurse, using on a standardised, anonymous chart. Data were processed with EpiInfo 6.04 and SAS.RESULTS:Mean age of the 71 soldiers was about 25.9 years (19-37 years). Twelve soldiers presented 56 lesions due to Leishmania (Viannia) guyanensis (attack rate = 16.9 for 100). Among 56 lesions, 13 lesions were localized on the trunk, usually an unexposed body area. Logistic regression highlighted military exercises in the forest during a high risk period of leishmaniasis transmission (OR = 11.2; p < 0.01), and the young age (OR = 1.33; p = 0.04). Vector control measures were not statistically significant.CONCLUSION:Military authorities should restrict deep forest activities during periods of high risk transmission. Vector control measures are essential. Officers should motivate their soldiers and supervise vector control measures. As ecotourism is developing, tourists as well as workers staying in deep forest must be informed of the risk and about vector control measures.

The first identification of the Leishmania species responsible for visceral leishmaniasis in Djibouti is described. Four strains, obtained from three autochthonous cases, were identified by starch-gel electrophoresis and iso-enzyme analysis of 15 enzymatic systems. The strains were found to belong to two newly recognized zymodemes of L. donovani: MON-268 and MON-287.

Les bêtalactamines constituent la famille d'antibiotiques la plus importante, aussi bien par le nombre et la diversité des molécules utilisables que par leurs indications en thérapeutique et en prophylaxie des infections bactériennes. Cette famille, qui regroupe les pénicillines, les céphalosporines, les carbapénèmes et les monobactames, est caractérisée par la présence constante du cycle bêtalactame associé à des cycles et des chaînes latérales variables qui expliquent les propriétés pharmacocinétiques et le spectre d'activité des différents produits. La grande variété de leurs modes d'administration, leur large spectre d'activité antibactérien associé à une action bactéricide, une bonne diffusion tissulaire, une bonne tolérance et un faible nombre d'interactions médicamenteuses expliquent leur popularité et l'importance de leur utilisation, seules ou en associations, depuis plus de 60 ans. Ce succès, accompagné d'une utilisation souvent excessive, a contribué à provoquer l'apparition de résistances acquises parmi les principales espèces bactériennes d'intérêt médical pour tous les produits de la famille des bêtalactamines. Le respect des règles de bon usage des antibiotiques et des indications en pratique de ville et à l'hôpital est le meilleur garant du maintien de la pérennité de l'efficacité des produits de cette famille d'intérêt majeur en santé publique.

The determination of an indicating antibiotic for multiresistance, as methicillin in staphylococci, can be useful for Pseudomonas aeruginosa. Until now, the majority of the hygienists used ticarcillin, ceftazidim or imipenem in their investigations as markers of multiresistance for this species. Piperacillin has never been proposed for this purpose. To evaluate this choice, 2098 non-repetitive P. aeruginosa strains collected from 15 teaching hospitals in 1997-1999 were analysed, for eight antibiotics (ticarcillin, piperacillin, ceftazidim, imipenem, tobramycin, amikacin, ciprofloxacin, fosfomycin) according (i) to the results of the minimal inhibiting concentrations obtained by dilution in Mueller-Hinton agar, (ii) to their susceptibility following the criteria of Comité de l'antibiogramme de la Société Française de Microbiologie and (iii) to the determination of the mechanisms of resistance to the beta-lactam antibiotics. The low rates of sensitivity to the beta-lactam antibiotics, aminoglycosides, ciprofloxacin and fosfomycin were more frequent for piperacillin-resistant strains than for ceftazidim-resistant ones. Resistance to the other beta-lactam antibiotics are poor markers of multiresistance. In the light of the presented data, piperacillin seems to be, among the beta-lactam antibiotics, the best candidate as a marker of multiresistance for P. aeruginosa, followed by ceftazidim. This multiresistance is mainly found in strains overproducing AmpC cephalosporinase or transferable beta-lactamases. These mechanisms are well detected by resistance to piperacillin.

Prader-Willi Syndrome (PWS) belong to genetic obesities and we report a caricatural observation.The early onset of (PWS) is characterised by a severe neonatal hypotonia with poor suck reflex--which may lead to tube feeding--and poor weight gain. Later appears insatiable appetite, morbid obesity associated with short stature, dysmorphic syndrome with small hands and behavioural disorders. Although diagnosis is based on clinical features, it must be confirmed by genetic test looking for the characteristic deletion of the chromosome 15q11-q13 region. PWS is the first example in humans of genetic imprinting.Today, the challenge in PWS is it early management which may authorise Growth Hormone administration.

Les infections urinaires nosocomiales (IUN) sont les plus fréquentes des infections nosocomiales, associées dans la grande majorité des cas à un cathétérisme vésical. Les critères de définition actuellement utilisés (définitions des 100 recommandations) reposent sur la présence de symptômes, la présence ou non d’un cathétérisme vésical et le niveau de leucocyturie et de bactériurie déterminés par l’examen cytobactériologique des urines (ECBU). Ces définitions n’envisagent pas toutes les situations et doivent être élargies. Les conditions de prélèvement, de transport et de conservation des urines influent largement sur la leucocyturie et surtout sur le niveau et la nature de la bactériurie retrouvée à l’ECBU. L’interprétation de l’ECBU doit tenir compte de diverses situations épidémiocliniques. Les patients porteurs d’un cathéter urinaire sont souvent asymptomatiques et présentent une leucocyturie non spécifique d’IUN, d’autant plus fréquente que la durée du sondage est longue. Chez ces patients, le diagnostic d’IUN repose donc essentiellement sur le niveau de la bactériurie qui est le plus souvent polymicrobienne et quasi toujours présente après une longue durée de sondage. Chez les patients non sondés et symptomatiques, l’absence d’une leucocyturie a une bonne valeur prédictive négative, et sa présence avec une bactériurie, même peu élevée (103 à 105 ufc mL–1), signe une infection urinaire. Chez les patients symptomatiques ou porteurs de sonde, le dépistage par bandelettes urinaires ne peut se substituer à l’ECBU. Le dépistage systématique d’une infection urinaire (bandelette ou ECBU) n’est justifié que dans certaines situations impliquant la mise en œuvre d’un traitement en cas de dépistage positif.

Nosocomial urinary tract infections (NUTI) are the most frequent nosocomial infections. They are often associated with vesical catheterization. The current criteria of definition are based on the presence of symptoms, of vesical catheterization, and on the level of pyuria and bacteriuria determined by urinalysis. These definitions do not take into account all situations and must be reviewed. The conditions of sampling, transfer to the laboratory, and conservation of urines greatly influence the level of pyuria and the level and nature of bacteriuria. The interpretation of the urinalysis must take into account various clinical and epidemiological situations. Patients harboring an urinary catheter are often asymptomatic; they present a nonspecific pyuria all the more frequent that the duration of catheterization is long. Among these patients, the diagnosis of NUTI is based primarily on the level of the bacteriuria which is generally polymicrobial and always present after long-term catheterization. The absence of pyuria is a good negative predictor for non-catheterized symptomatic patients. Pyuria associated with bacteriuria, even low (10(3) to 10(5) cfu mL(-1)), proves the presence of UTI in these patients. Screening by urinary reagent strips cannot replace urinalysis for either symptomatic or catheterized patients. The systematic screening of UTI (using either a urinary reagent strips or urinalysis) is justified only when treatment is required in case of positive results. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tons droits reserves.

For over a decade, fluoroquinolones have been the standard treatment of non-typhoid salmonella infections. They have also been reported to reduce the occurrence or duration of convalescent carriage [1Sammalkorpi K Lähdevirpa J Mäkelä T Rostila T Treatment of chronic Salmonella carriers with ciprofloxacin.Lancet. 1987; 2: 164-165Abstract PubMed Scopus (27) Google Scholar,2Raymond J Moulin F Badoual J Gendrel D Eradication of convalescent-phase Salmonella carriage in children with two oral doses of pefloxacin.Eur J Clin Microbiol Infect Dis. 1994; 13: 307-310Crossref PubMed Scopus (18) Google Scholar], and consequently to reduce the risk of relapse or dissemination [3Ahmad F Bray G Prescott RW et al.Use of ciprofloxacin to control a Salmonella outbreak in a long-stay psychiatric hospital.J Hosp Infect. 1991; 17: 171-178Abstract Full Text PDF PubMed Scopus (16) Google Scholar]. However, given the extensive use of these drugs in both veterinary and human practice, both in vitro resistance and clinical failures occur, especially with some serotypes (Salmonella Hadar, S. Typhimurium, S. Choleraesuis) [4Threlfall EJ Ward LR Skinner JA et al.Increase in multiple antibiotic resistance in non typhoidal Salmonellas from humans in England and Wales.Microb Drug Resist. 1997; 3: 263-266Crossref PubMed Scopus (132) Google Scholar,5Chiu CH Wu TL Su LH et al.The emergence in Taiwan of fluoroquinolone resistance in Salmonella enterica serotype Choleraesuis.N Engl J Med. 2002; 346: 413-419Crossref PubMed Scopus (239) Google Scholar]. Hitherto, no alternative antibiotics have been available to clear salmonella carriage in cases of fluoroquinolone resistance. Azithromycin is highly effective against intracellular salmonellae [6Chiu CH Lin TY Ou JT In vitro evaluation of intracellular activity of antibiotics against non-typhoid Salmonella.Int J Antimicrob Agents. 1999; 12: 47-52Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar] and has been used successfully in the acute phase of typhoid fever [7Butler T Sridhar CB Daga MK et al.Treatment of typhoid fever with azithromycin versus chloramphenicol in a randomized multicentre trial in India.J Antimicrob Chemother. 1999; 44: 243-250Crossref PubMed Scopus (67) Google Scholar,8Girgis NI Butler T Frenck RW et al.Azithromycin versus ciprofloxacin for treatment of uncomplicated typhoid fever in a randomized trial in Egypt that included patients with multidrug resistance.Antimicrob Agents Chemother. 1999; 43: 1441-1444PubMed Google Scholar], even in cases of multiresistance [7Butler T Sridhar CB Daga MK et al.Treatment of typhoid fever with azithromycin versus chloramphenicol in a randomized multicentre trial in India.J Antimicrob Chemother. 1999; 44: 243-250Crossref PubMed Scopus (67) Google Scholar,8Girgis NI Butler T Frenck RW et al.Azithromycin versus ciprofloxacin for treatment of uncomplicated typhoid fever in a randomized trial in Egypt that included patients with multidrug resistance.Antimicrob Agents Chemother. 1999; 43: 1441-1444PubMed Google Scholar]. It has also cleared S. Typhi from stools [8Girgis NI Butler T Frenck RW et al.Azithromycin versus ciprofloxacin for treatment of uncomplicated typhoid fever in a randomized trial in Egypt that included patients with multidrug resistance.Antimicrob Agents Chemother. 1999; 43: 1441-1444PubMed Google Scholar]. However, the clinical efficacy of azithromycin in non-typhoid infections is not as well documented. We report a case of multiresistant S. Hadar convalescent carriage following an invasive infection in an immunocompetent woman that was cured with a single course of azithromycin. A 31-year-old woman with no significant past medical history presented with three days of diarrhea, fever and abdominal pain. Her admission temperature was 40 °C, her pulse was 110/min, and her blood pressure was 120/60 mmHg. Clinical examination revealed a poor general condition, dehydration, and abdominal tenderness without rebound. The white blood cell count was 12 × 109/L (9800 neutrophils), and the C-reactive protein level was 175 mg/L. Blood and stool cultures grew S. Hadar resistant to amoxicillin, nalidixic acid and pefloxacin, and with low susceptibility to ciprofloxacin (minimal inhibitory concentration (MIC) of 0.5 mg/L). The patient was HIV negative, and other immunodeficiency diseases were ruled out. Abdominal ultrasonography was normal. The presumed source of contamination was chicken eaten at an Asian restaurant the day before the onset of illness. Ciprofloxacin (200 mg twice daily) was given intravenously for 3 days, without clinical effect. Intravenous ceftriaxone was substituted (2 g daily for 8 days), and the patient improved within 24 h. Upon complete clinical recovery, she was discharged, but S. Hadar persisted in semimonthly stool cultures 2 months after discharge. Given the risk of a relapse or exposure of either family or colleagues, azithromycin (500 mg daily for 5 days) was proposed, in spite of the high MICs (2 and 4 mg/L, respectively) of two S. Hadar strains tested by the agar dilution method. However, stool cultures became negative on day 12 and remained free of S. Hadar during a follow-up period of 6 months. Tolerance of azithromycin was excellent. S. Hadar is commonly resistant in vitro to β-lactams, nalidixic acid and fluoroquinolones [4Threlfall EJ Ward LR Skinner JA et al.Increase in multiple antibiotic resistance in non typhoidal Salmonellas from humans in England and Wales.Microb Drug Resist. 1997; 3: 263-266Crossref PubMed Scopus (132) Google Scholar]. Non-Typhi salmonella resistance to fluoroquinolones mainly derives from mass use, in both animals and humans [4Threlfall EJ Ward LR Skinner JA et al.Increase in multiple antibiotic resistance in non typhoidal Salmonellas from humans in England and Wales.Microb Drug Resist. 1997; 3: 263-266Crossref PubMed Scopus (132) Google Scholar,5Chiu CH Wu TL Su LH et al.The emergence in Taiwan of fluoroquinolone resistance in Salmonella enterica serotype Choleraesuis.N Engl J Med. 2002; 346: 413-419Crossref PubMed Scopus (239) Google Scholar]. As a result, treatment of invasive diseases in humans has become more difficult, as shown in our case. Convalescent carriage is well documented in salmonella infections and reaches rates of 20% in non-Typhi strains [10Buchwald DS Blaser MJ A review of human salmonellosis. II. Duration of excretion following infection with nontyphi Salmonella.Rev Infect Dis. 1984; 6: 345-356Crossref PubMed Scopus (208) Google Scholar]. Usually no treatment is required, except in rare epidemiologic or clinical situations, e.g. the institutionalized elderly [3Ahmad F Bray G Prescott RW et al.Use of ciprofloxacin to control a Salmonella outbreak in a long-stay psychiatric hospital.J Hosp Infect. 1991; 17: 171-178Abstract Full Text PDF PubMed Scopus (16) Google Scholar], infants or patients with sickle cell disease or HIV infection. We believe, however, that persistence in stools of multiresistant Salmonella after a severe invasive infection is also an indication for treatment, even in immunocompetent patients. Nevertheless, attempts at eradication are difficult with multiresistant strains. Azithromycin, a drug effective in vitro in eradicating intracellular Salmonella [6Chiu CH Lin TY Ou JT In vitro evaluation of intracellular activity of antibiotics against non-typhoid Salmonella.Int J Antimicrob Agents. 1999; 12: 47-52Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar], produced bacterial cure (negative stool cultures) in 100% of cases of enteric fever [8Girgis NI Butler T Frenck RW et al.Azithromycin versus ciprofloxacin for treatment of uncomplicated typhoid fever in a randomized trial in Egypt that included patients with multidrug resistance.Antimicrob Agents Chemother. 1999; 43: 1441-1444PubMed Google Scholar]. However, in another clinical trial, it was no better than placebo in clearing non-Typhi salmonellae from stools [9Chinh NT Parry CM Ly NT et al.A randomized controlled comparison of azithromycin and ofloxacin for treatment of multidrug-resistant or nalidixic acid-resistant enteric fever.Antimicrob Agents Chemother. 2000; 44: 1855-1859Crossref PubMed Scopus (119) Google Scholar], but most of those patients were lost to follow-up [9Chinh NT Parry CM Ly NT et al.A randomized controlled comparison of azithromycin and ofloxacin for treatment of multidrug-resistant or nalidixic acid-resistant enteric fever.Antimicrob Agents Chemother. 2000; 44: 1855-1859Crossref PubMed Scopus (119) Google Scholar]. Although cut-offs for the MIC of azithromycin were not determined, its clinical efficacy could be explained by very high intracellular concentrations, regardless of the high serum MIC levels in the reported case. In our patient, carriage eradication was attributed to azithromycin, although spontaneous clearance cannot be ruled out [10Buchwald DS Blaser MJ A review of human salmonellosis. II. Duration of excretion following infection with nontyphi Salmonella.Rev Infect Dis. 1984; 6: 345-356Crossref PubMed Scopus (208) Google Scholar]. We therefore suggest that this antibiotic warrants further investigation in the treatment of chronic Salmonella carriers.

OBJECTIVES:Monitor the evolution in France of antibiotic sensitivity of non-typhoid salmonella isolated in fecal cultures conducted in army hospital laboratories.METHODS:A prospective study was performed from January 1998 to December 1999 in all the biology departments of the 11 army hospitals in France. All the non-repetitive strains were sent to an official center for serotyping and determination of the minimum inhibiting concentrations, by dilution in Mueller Hinton's gelose. The antibiotics currently used in treatment were tested and interpretation endpoints followed the recent recommendations of the Antibiogram committee of the French society of microbiology. Identification of beta-lactamase was conducted by iso-electric focalization and polymerization by chain reaction (PCR). For Salmonella Typhimurium, research for the specific resistance locus of the DT104 clone was made using PCR.RESULTS:Two hundred and twenty-two non-repetitive salmonella strains were isolated. The principle serotypes found were: Salmonella Enterididis (23.9%), S. Typhimurium (21.2%) and S. Hadar (10.8%). All the strains were sensitive to ciprofloxacin and cefotaxim, whereas one third exhibited reduced sensitivity to aminopenicillin. Depending on the serotype, Typhimurium and Hadar serotypes exhibited significantly lesser sensitivity to aminopenicillin, nalidixic acid and tetracycline. For S. Typhimurium, resistance is related to the diffusion of the multiresistant DT104 clone, which involves half of the strains of this serotype. For S. Hadar, 18 out of 24 strains (75%) were resistance to nalidixic acid, and 5 of them exhibited reduced resistance to ciprofloxacin. There was no difference in sensitivity to antibiotics between the strains responsible for diarrhea and those isolated in systematic examinations for capacity to work in the food trade (respectively 54 and 46% of strains).CONCLUSION:Non-typhoid salmonella are frequently isolated in diarrhea of infectious origin. The increasing resistance to antibiotics is primarily related to the diffusion of the DT104 clone, regarding S. Typhimurium and to the increase in resistance to quinolone, regarding S. Hadar.

Four human cases of localized cutaneous leishmaniasis caused by Leishmania naiffi are reported. Two of the cases were infected in French Guiana, one in French Guiana or Martinique, and the other in Ecuador or Peru. The geographical distribution of L. naiffi is clearly larger than that initially reported. Three zymodemes were represented by the four isolates, confirming that there is intraspecific polymorphism in L. naiffi.

The OptiMal test is an immuno-chromatographic dipstick test that permits indiscriminate detection of Plasmodium falciparum and other species of human malaria. The purpose of this study was to evaluate the efficacy of the test for diagnosis of imported malaria. A total of 244 patients with a presumptive diagnosis of imported malaria in France were included during the study period. The reference test, i.e., combined thick and thin blood films, demonstrated infection by Plasmodium falciparum in 58 cases, Plasmodium vivax in 12, P. ovale in 8 and Plasmodium malariae in 2. The OptiMal test detected only 46 of the 55 Plasmodium falciparum cases. The sensitivity of the test for diagnosis of that species was 80%, its specificity was 98%, and its positive and negative predictive values were 95 and 93% respectively. Parsitemia studies showed poor test reliability for densities lower than 150/ul. Detection of other species was accurate in 21 out of 22. The results of this study demonstrate that the current version of the OptiMal test should be used with great caution for the diagnosis of malarial infection in hospital practice.