Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency.

(18)F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB.

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cThe Xpert GBS real-time PCR assay for the detection of group B streptococci (GBS) in antepartum screening samples was evaluated on amniotic fluid samples collected from 139 women with premature rupture of membrane at term. When any intrapartum positive result from the Xpert GBS or culture was considered a true positive, the sensitivities of the Xpert GBS and culture were 92.3% and 84.6%, respectively. This assay could enhance exact identification of candidates for intrapartum antibiotic prophylaxis. Streptococcus agalactiae, also known as group B streptococcus (GBS), is the leading infectious cause of neonatal morbidity and mortality. Maternal GBS colonization is one of the most important risk factors for early onset GBS disease (EO-GBSD). Mother-child transmission can occur during membrane rupture or delivery. The reported rate of GBS vaginal colonization among pregnant women ranges from 4% to 36% in Europe (1). The risk of EO-GBSD increases in cases of preterm delivery, maternal fever, and premature rupture of membrane (PROM) more than 12 h before delivery. Intrapartum antibiotic prophylaxis (IAP) reduces significantly the incidence of EO-GBSD (2). It is still debated whether this IAP will favor colonization by antibiotic-resistant bacteria (3, 4). In France, the strategy to identify women for targeted IAP is based on universal antenatal screening with vaginal culture at 35 to 37 weeks gestation (5). GBS culture remains the gold standard for the detection of GBS colonization. However, its turnaround time (TAT) varies from 18 to 72 h, which makes it not adapted for intrapartum screening.Term PROM is defined as the spontaneous rupture of membranes more than 12 h at term before the onset of regular uterine contractions. PROM at term affects 8 to 10% of pregnant women (6). When PROM is confirmed, active management with labor induction or expectant management is possible. One criterion for expectant management is GBS-negative status while pregnant women with GBS-positive term PROM should be offered antibiotic prophylaxis and induction of labor (6). However, it has been well documented that results of antepartum GBS screening culture do not always accurately predict intrapartum GBS status (7,8). A nucleic acid amplification test (NAAT) may be able to identify women who are positive at the time of delivery. The Xpert GBS (Cepheid) has shown to be an accurate and easy-to-use PCR for the detection of GBS DNA from vaginal or rectal specimens (8, 9). With Xpert GBS intrapartum screening, significant decreases in neonatal infections and the length of stay (LOS) were demonstrated (47% fewer hospitalization days in neonatology/90% fewer days in the intensive care unit [ICU]) (10).The objective of our study was to validate the Xpert GBS assay directly on amniotic fluids collected from pregnant women with rupture of membranes at term gestation before the onset of labor.Our prospective study was conducted at Antoine Béclère Hospital (Clamart, France), a university hospital with a level III maternity center, from May 2011 thro...

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Objectives: The aim was to assess the incidence of sink contamination by multidrug-resistant (MDR) Pseudomonas aeruginosa and Enterobacteriaceae, risk factors for sink contamination and splashing, and their association with clinical infections in the intensive care setting. Methods: A prospective French multicentre study (1 January to 30 May 2020) including in each intensive care unit (ICU) a point-prevalence study of sink contamination, a questionnaire of risk factors for sink contamination (sink use, disinfection procedure) and splashing (visible plashes, distance and barrier between sink and bed), and a 3-month prospective infection survey. Results: Seventy-three ICUs participated in the study. In total, 50.9% (606/1191) of the sinks were contaminated by MDR bacteria: 41.0% (110/268) of the sinks used only for handwashing, 55.3% (510/923) of those used for waste disposal, 23.0% (62/269) of sinks daily bleached, 59.1% (126/213) of those daily exposed to quaternary ammonium compounds (QACs) and 62.0% (285/460) of those untreated; 459 sinks (38.5%) showed visible splashes and 30.5% (363/1191) were close to the bed (<2 m) with no barrier around the sink. MDR-associated bloodstream infection incidence rates 0.70/1000 patient days were associated with ICUs meeting three or four of these conditions, i.e. a sink contamination rate 51%, prevalence of sinks with visible splashes 14%, prevalence of sinks close to the patient's bed 21% and no daily bleach disinfection (6/30 (20.0%) of the ICUs with none, one or two factors vs. 14/28 (50.0%) of the ICUs with three or four factors; p 0.016). Discussion: Our data showed frequent and multifactorial infectious risks associated with contaminated sinks in ICUs.

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This review focuses on the role of new tools in the "modern" microbiological diagnosis of tuberculosis. Traditional techniques of microscopy and culture remain essential to diagnostic certainty, but some innovations replace daily the older techniques such as the identification of Mycobacterium tuberculosis complex by immunochromatography or mass spectrometry MALDI-TOF type from positive cultures, or susceptibility testing in liquid medium. New tools that use molecular techniques have become important. They all have in common to optimize the fight against tuberculosis by reducing diagnostic delay. They also allow rapid detection of drug resistance. However, the techniques of gene amplification directly from clinical samples are still less sensitive than culture. Bacteriological diagnosis of tuberculosis disease therefore still relies on the complementarities of different phenotypic and molecular techniques.