Annales françaises d'anesthèsie et de rèanimation
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Research efforts to discover new compounds active against staphylococci are more than ever justified today. The incidence of methicillin-resistant staphylococci remains very high in hospitals, and the solution provided by glycopeptides is far from being satisfactory. ⋯ Finally, strains with diminished sensitivity to these antibiotics are beginning to appear. This article examines the opportunities offered by two new anti-staphylococcal agents: quinupristine-dalfopristine (Synercid) and linezolide (not marketed in France).
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Ann Fr Anesth Reanim · May 2002
Review[Antibiotic combinations in Staphylococcus aureus infections: arguments in favour].
More than 40% of Staphylococcus aureus strains isolated in hospitals are methicillin-resistant, thus posing daily problems regarding therapy. The treatment of these infections is principally based on glycopeptides. The need or not to combine them, first-line or second-line, with another antibiotic, remains a subject for debate. In this article, we have endeavoured to demonstrate the validity of arguments which plead in favour of using glycopeptides in combination, and not as single-drug therapy.
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Increasing frequency in antibiotic resistance in Staphylococcus aureus is worrying. In this review, we briefly describe the mechanisms of resistance to antibiotics in staphylococci and we report the current incidence of antibiotic resistance in France. Methicillin-resistance is mostly confined to hospitals. ⋯ By contrast, incidence of multiply resistance in hospitals remains high. After a recent decrease, incidence of oxacillin resistance seems to be stabilized. A new and recent feature is the great variety of resistance phenotypes which can be found in methicillin-resistant strains, in particular with gentamicin susceptibility.
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Ann Fr Anesth Reanim · May 2002
Review[The importance of detecting methicillin-resistant Staphylococcus aureus in an intensive care setting].
In recent years, the fight against nosocomial infections has constituted a major public health challenge. Measures aimed at preventing the spread of multiresistant bacteria (MRB) through carriage combine the more or less systematic detection of carriers and precautions concerning isolation. In the light of published data, elements for the evaluation of a cost-efficiency ratio for measures concerning detection and isolation in intensive care are presented. ⋯ Although isolation precautions appear to be effective, the value of detecting MRSA remains a subject of debate. Such detection has several objectives: the identification of carriers, assistance in the implementation of isolation precautions, the eradication of carriage and the evaluation of strategy. These different objectives are discussed.
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Ann Fr Anesth Reanim · May 2002
Clinical Trial[Value of cervical plain radiography in unconscious trauma patient].
The aim of this study was to evaluate the diagnostic value of cervical spine standard radiographs, performed in emergency, and compared with entire cervical helical CT with multiplanar reconstructions as reference. ⋯ The diagnostic value of standard radiographs was weak whatever the physician. Therefore, helical CT of the entire cervical spine is absolutely necessary and must be performed during the initial evaluation, if the haemodynamic conditions are required.