Service de microbiologie clinique

Paris, France

Service de microbiologie clinique

Paris, France
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Kakkos A.,Service de Gynecologie Obstetrique | Gonne E.,Service dOncologie Medicale | Coimbra C.,Service de Chirurgie Abdominale | Nervo P.,Service de Gynecologie Obstetrique | And 6 more authors.
Revue Medicale de Liege | Year: 2017

Actinomycosis is a rare chronic disease caused by a group of anaerobic Gram positive bacteria. It may mimic a neoplasia at various anatomical levels. A pelvic localization is exceptional but has an increasing incidence since the use of intrauterine devices. In such cases, pelvic actinomycosis may present as a gynecological or a lower colonic malignancy. For all atypical clinical presentation, with a prominent infectious or inflammatory context, the diagnosis of actinomycosis must be suggested and discussed with the pathologist to whom the biopsy will be submitted. In the absence of a preoperative diagnosis, an inadequately aggressive pelvic surgery might be performed and rendered particularly complex due to the adherent and diffusely inflammatory pattern of the disease. The treatment of choice remains a long-term therapy with antibiotics that leads to a complete clinical and radiological response in the majority of cases. We report the case of a 27-year-old woman with a clinical and radiological diagnosis of rectal carcinoma but with limited preoperative biopsy that revealed a pelvic actinomycosis and allowed a conservative and successful antibacterial treatment.


Lepeule R.,Unite transversale de traitement des infections | Leflon-Guibout V.,Hopitaux Universitaires Paris Nord Val Of Seine | Vanjak D.,University Pierre and Marie Curie | Zahar J.-R.,Angers University Hospital Center | And 25 more authors.
Medecine et Maladies Infectieuses | Year: 2014

Objective: We wanted to describe the clinical features associated with urinalysis positive for ESBL-producing Escherichia coli and their impact on antibiotic use. Methods: We performed a prospective observational study in 13French hospitals of the Paris area for 3consecutive months. We included all patients with urine cultures positive for ESBL-producing E. coli. Results: One hundred and seventeen of the 218patients (54%) presented with asymptomatic bacteriuria, 31 (14%) with cystitis, and 70 (32%) with a parenchymal infection. Nineteen patients with asymptomatic bacteriuria (16%) received antibiotics. Forty-one with parenchymal infections (59%) received a carbapenem. A carbapenem alternative could have been used in every patient treated with a carbapenem, according to antibiotic susceptibility testing results. Conclusions: Urinary tract infections accounted for 46% of E. coli ESBL positive urinalysis. Fifty percent of parenchymal infections were treated with a carbapenem. © 2014 Elsevier Masson SAS.


PubMed | Unite transversale de traitement des infections, Hopitaux Universitaires Paris Nord Val Of Seine, Angers University Hospital Center, Service de microbiologie clinique and 3 more.
Type: Journal Article | Journal: Medecine et maladies infectieuses | Year: 2014

We wanted to describe the clinical features associated with urinalysis positive for ESBL-producing Escherichia coli and their impact on antibiotic use.We performed a prospective observational study in 13French hospitals of the Paris area for 3consecutive months. We included all patients with urine cultures positive for ESBL-producing E.coli.One hundred and seventeen of the 218patients (54%) presented with asymptomatic bacteriuria, 31 (14%) with cystitis, and 70 (32%) with a parenchymal infection. Nineteen patients with asymptomatic bacteriuria (16%) received antibiotics. Forty-one with parenchymal infections (59%) received a carbapenem. A carbapenem alternative could have been used in every patient treated with a carbapenem, according to antibiotic susceptibility testing results.Urinary tract infections accounted for 46% of E.coli ESBL positive urinalysis. Fifty percent of parenchymal infections were treated with a carbapenem.

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