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Sainte-Foy-lès-Lyon, France

Larreche S.,Service de Biologie Medicale | Imbert P.,Service de Maternite pediatrie | Mornand P.,Service de Maternite pediatrie | Andriamanantena D.,Service des Maladies Infectieuses et Tropicales | And 2 more authors.
Travel Medicine and Infectious Disease | Year: 2013

Snakebites are an infrequent but real risk for travelers. We report a case of envenomation by Bothrops atrox in a traveler to Manaus, Brazil. Rapid administration of specific antivenom prevented the expected systemic disorders. This case gives opportunity to review prevention and first aid measures of snakebites in travelers. © 2013 Elsevier Ltd. All rights reserved. Source

Larreche S.,Service de Biologie Medicale | Mion G.,Pole Anesthesie Reanimations Thorax Exploration | Mornand P.,Service de Maternite pediatrie | Imbert P.,Service de Maternite pediatrie
Archives de Pediatrie | Year: 2012

Snake bites are a major public health problem in the tropics but they have a low incidence in Europe and are responsible for few deaths each year. The incidence is higher in children than in adults but no difference in severity seems to be observed between children and adults. In France, snake envenomations are due mainly to . Vipera aspis and . Vipera berus. The clinical presentation is usually limited to a local syndrome with pain and local inflammatory edema, but systemic signs occur in 17% of cases. Clinical grading published by the Institut Pasteur in Paris helps to assess the severity of envenomation and to decide the use of antivenom. Every bitten patient must be transferred in a hospital for medical assessment. Specific treatment is based on antivenom immunotherapy. However, other medical and surgical treatments have limited value. © 2012 Elsevier Masson SAS. Source

Merens A.,Service de Biologie Medicale | Delacour H.,Service de Biologie Medicale | Plesiat P.,Hospitalier University 3 | Cavallo J.-D.,Ecole du Val de Grace | Jeannot K.,Hospitalier University 3
Revue Francophone des Laboratoires | Year: 2011

The development of β-lactam resistance in Pseudomonas aeruginosa results from mutations leading to stable overexpression of intrinsic cephalosporinase AmpC, overexpression of efflux systems, reduced permeability and acquisition of transferable genes. The emerging β-lactam resistance mechanisms that have been reported are spread of extended-spectrum β-lactamases, metallo-carbapenemases and extended spectrum oxacillinases. Resistance to aminoglycosides is also frequent, related to acquisition of aminoglycoside-modifying enzymes or ARN-methylases, and sometimes, in overexpression of efflux pumps. Resistance to fluoroquinolones is related to mutations in the Quinolone Resistance Determining Region of the GyrA subunit of DNA gyrase, but also to overexpression of efflux pumps. The combination of these mechanisms results in multidrug or pandrug resistant Pseudomonas aeruginosa, which are steadily increasing worldwide, particularly in intensive care units. The authors expose the trends in the antibiotic resistance epidemiology in Pseudomonas aeruginosa, the recommendations for in vitro susceptibility testing in the laboratory, and the different tools available for detection of extended-spectrum β-lactamases, metallo-carbapenemases and extended-spectrum oxacillinases. © 2011 Elsevier Masson SAS Tous droits réservés. Source

Hauck Y.,University Paris - Sud | Hauck Y.,French National Center for Scientific Research | Soler C.,Laboratoire Of Biologie Clinique | Jault P.,Laboratoire Of Biologie Clinique | And 11 more authors.
PLoS ONE | Year: 2012

Background: Infections by A. calcoaceticus-A. baumannii (ACB) complex isolates represent a serious threat for wounded and burn patients. Three international multidrug-resistant (MDR) clones (EU clone I-III) are responsible for a large proportion of nosocomial infections with A. baumannii but other emerging strains with high epidemic potential also occur. Methodology/Principal Findings: We automatized a Multiple locus variable number of tandem repeats (VNTR) analysis (MLVA) protocol and used it to investigate the genetic diversity of 136 ACB isolates from four military hospitals and one childrens hospital. Acinetobacter sp other than baumannii isolates represented 22.6% (31/137) with a majority being A. pittii. The genotyping protocol designed for A.baumannii was also efficient to cluster A. pittii isolates. Fifty-five percent of A. baumannii isolates belonged to the two international clones I and II, and we identified new clones which members were found in the different hospitals. Analysis of two CRISPR-cas systems helped define two clonal complexes and provided phylogenetic information to help trace back their emergence. Conclusions/Significance: The increasing occurrence of A. baumannii infections in the hospital calls for measures to rapidly characterize the isolates and identify emerging clones. The automatized MLVA protocol can be the instrument for such surveys. In addition, the investigation of CRISPR/cas systems may give important keys to understand the evolution of some highly successful clonal complexes. © 2012 Hauck et al. Source

Valdes V.,Service de neonatologie | Legagneur H.,Service de Biologie Medicale | Watrin V.,Service de Biologie Medicale | Paris L.,Laboratoire Of Parasitologie Mycologie | Hascoet J.-M.,Service de neonatologie
Archives de Pediatrie | Year: 2011

Reinfection with Toxoplasma gondii is exceptional but can lead to transmission to the fetus when it occurs during pregnancy. We present a case of congenital toxoplasmosis in a young baby born to an immunocompetent mother who had been immunized against toxoplasmosis before pregnancy. The presence of residual IgG-specific antibodies does not always mean an absolute protection against a new toxoplasma infection. During the pregnancy, the patient was advised to follow the hygienic and dietary preventive measures even though the previous test results were consistent with past toxoplasma infection. © 2011 Elsevier Masson SAS. Source

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