References of "Melin, Pierrette"
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See detailKilling kinetics of clinical isolates of group B streptococci isolated in Belgium for penicillin alone or in combination with gentamicin
MELIN, Pierrette ULg; Lorquet, Sophie; HAYETTE, Marie-Pierre ULg et al

Poster (2005, September)

BACKGROUND: Associated with high morbidity and mortality, severe GBS infections should be treated with antimicrobial agents alone or in combination characterized by both a good diffusion at the site of ... [more ▼]

BACKGROUND: Associated with high morbidity and mortality, severe GBS infections should be treated with antimicrobial agents alone or in combination characterized by both a good diffusion at the site of infection and a short bactericidal lag time. Penicillin (P) or another blactam used in combination with an aminoglycoside is usually recommended to start the therapy. MICs to gentamicin (G) of GBS recently isolated in Belgium range from 16 to 256 mg/L (> or = MICs of E.faecalis with low level resistance to G, LLR). OBJECTIVES: To investigate in vitro, the potential synergism of P+G on strains of GBS isolated in Belgium. METHODS: According to Etest-AB Biodisk original procedures, for 6 Belgian strains of GBS (G MICs: 16-128 mg/L), we investigated the potential synergism, MICs and time killing curves, between P and G (ratio1:1). In the killing kinetic assays, surviving organisms were enumerated initially and repeatedly after 2, 4, 8 and 20 hours (T2, T4, T8 and T20) at concentrations of P equal to 4 and 16x MICs. Two strains of E.faecalis (1 HighLR and 1 LLR to G) were used as negative and positive control. Each isolate was tested twice. RESULTS: For GBS the P MICs in the combination were within +/- 1 dilution compared with single drug. As expected, P+G produced enhanced killing at T2 and T4 compared with P alone for G LLR E.faecalis and there was no difference for the G HLR E.faecalis. On the contrary, no accelerated killing was observed for any GBS isolate with the combination even for a concentration of 16xMIC of P; moreover for 3 isolates a reduced killing was observed at T2 in the combination tests compared with P alone. CONCLUSION: This limited in vitro testing of the combination P+G compared with P alone for Belgian GBS isolates did not show any synergism or accelerated killing. Moreover the killing was reduced at T2 for half of the isolates. Further evaluation should be performed on these strains with other ratio or other b-lactams as ampicillin in combination with G. [less ▲]

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See detailLe streptocoque du groupe B en clinique antenatale et en salle de travail: un probleme d'attitude systematique
Lorquet, Sophie ULg; Melin, Pierrette ULg; Minon, Jean-Marc et al

in Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (2005), 34(2), 115-27

OBJECTIVES: We wanted to evaluate the compliance to the local recommendations, similar to the CDC (Centers for Disease Control and prevention) recommendations launched in 1996, for the prevention of ... [more ▼]

OBJECTIVES: We wanted to evaluate the compliance to the local recommendations, similar to the CDC (Centers for Disease Control and prevention) recommendations launched in 1996, for the prevention of perinatal group B streptococcal (GBS) disease in the clinical practice of a academic maternity and to identify the causes of missed screening and antibiotic prophylaxis. MATERIALS AND METHODS: Retrospective study of 1249 consecutive pregnancies between 1st January and 31th August 2002. The screening methods for GBS colonisation were the culture of rectovaginal swabs collected between 35 and 37 weeks and/or a rapid antigenic screening performed on a vaginal swab collected at the patient's admission for labor. RESULTS: Rate of global screening was very high (97.8%): 28.8% of antenatal screening versus 90.3% during labor. An appropriate antibiotic prophylaxis was administered to only one-third of positive women when the screening was performed at admission to the labor room, whereas two-thirds of GBS-positive women screened between 35 and 37 weeks received their antibiotic prophylaxis. 2.4%o of the newborns were infected and 2.9% were colonized. Among the different risk factors, intrapartum fever was more often associated with maternal GBS colonisation. The observed sensitivity of the rapide antigenic test was 20.4%. CONCLUSION: Compliance to guidelines is sometimes difficult in the clinical practice of an academic maternity. In our hands the rapid test for GBS screening had low sensitivity. The analysis of these data led to introducing a computerized algorithm in our maternity to improve the prevention of perinatal group B streptococcal disease. [less ▲]

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See detailPerinatal Group B Streptococcal infections
Melin, Pierrette ULg

Conference (2005, February)

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See detailSusceptibility testing of pseudomonas aeruginosa by the Vitek 2 system: A comparison with Etest results
Saegeman, V.; Huynen, Pascale ULg; Colaert, J. et al

in Acta Clinica Belgica (2005), 60(1, JAN-FEB), 3-9

P aeruginona infections need accurate antimicrobial susceptibility data, as treatment mainly relies on antibiotic efficiency in debilitated patients. Vitek 2, a popular automated susceptibility testing ... [more ▼]

P aeruginona infections need accurate antimicrobial susceptibility data, as treatment mainly relies on antibiotic efficiency in debilitated patients. Vitek 2, a popular automated susceptibility testing method, was compared with Etest to assess its reliability on 150 Belgian P. aeruginonas isolates. Vitek 2 and Etest exhibited a high degree of concordance, but some discrepancies in clinical category were evident for cefepime (high minor and borderline very major error rate) and for piperacillin/tazobactam (high very major error rate). Vitek 2 appears to yield valuable information to the clinician concerning the antimicrobials amikacin, ceftazidime, ciprofloxacin and meropenem, in the setting of pseudomonas infection. For cefepime and piperacillin/tazobactam, a confirmatory testing by means of disk diffusion is worth considering. [less ▲]

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See detailPrevention of perinatal GBS infections: update and guidelines
MELIN, Pierrette ULg

Conference (2004, December 17)

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See detailScreening or not for Group B Streptococci: Screening is necessary
MELIN, Pierrette ULg

Conference (2004, December 09)

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See detailReal-Time PCR detection of group B streptococci from pregnant women's vaginal specimens at time of delivery: clinical evaluation
MELIN, Pierrette ULg; Rodriguez Cuns, Grisel; Lorquet, Sophie et al

in American Society of Microbiology (Ed.) Program and Abstracts of the 44th Intersciences Conference on Antimicrobial Agents and Chemotherapy (2004, November)

Guidelines for prevention recommend intrapartum antimicrobial prohylaxis (IAP) for pregnant women with a positive prenatal culture-based screening for GBS. To improve this strategy, a rapid screening ... [more ▼]

Guidelines for prevention recommend intrapartum antimicrobial prohylaxis (IAP) for pregnant women with a positive prenatal culture-based screening for GBS. To improve this strategy, a rapid screening performed at the onset of labor with the IDI-Strep BTM test (IDI), a real time PCR detection (Infectio Diagnostic), may be used. Objective: To evaluate the performance of the IDI to detect GBS from vaginal specimens collected at time of delivery. Methods: Intrapartum vaginal specimens from 923 pregnant women were tested to determine the status of GBS colonization, by CDC’s recommended culture method (including selective LIM broth) with a Granada agar (GR) added as well as by the IDI and the immunologic StrepB OIATM test (OIA), BioStar. The performance of the different methods was compared. Results: GBS were recovered from 16.8% and 23.6% specimens respectively on primary culture plates and overall. The colonization rate for GBS was 18.6 % by IDI and 15.7 % by OIA testing. The sensitivity of IDI for identifying vaginal colonization status at delivery was 92 % or 77.1 % when compared to GR primary cultures or to overall culture results, and for the OIA, it was respectively 65.1 or 52.1 %. The specificity was 99.1 % for IDI and 95.5 % for OIA. The turnaround time for obtaining results was less than one hour for both IDI and OIA. Conclusions: 1) Strep B-IDI test, performed on intrapartum vaginal specimens, yields relevant results rapidly enough to be used as an efficient diagnostic tool for the identification of GBS colonized women, in order to offer IAP really targeted to GBS carriers. 2) By comparison to the prenatal screening-based strategy, the high sensitivity and specificity of IDI would allow a reduction of useless IAP and of missed opportunities. 3) IDI testing might be implemented “in routine” in some hospitals for further clinical and practical evaluation. [less ▲]

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See detailHow many women can benefit from a full intrapartum antibiotic prphylaxis for prevention of perinatal group B streptococcal disease?
MELIN, Pierrette ULg; Lorquet, Sophie; Rodriguez Cuns, Grisel et al

in American Society of Microbiology (Ed.) Program and Abstracts of the 44th Intersciences Conference on Antimicrobial Agents and Chemotherapy (2004, November)

Background: In Belgium as in many Western countries, GBS are still the leading cause of severe perinatal infections. Current guidelines for prevention recommend intrapartum antimicrobial prohylaxis (IAP ... [more ▼]

Background: In Belgium as in many Western countries, GBS are still the leading cause of severe perinatal infections. Current guidelines for prevention recommend intrapartum antimicrobial prohylaxis (IAP) administered promptly before delivery to pregnant women colonized with GBS. The risk of vertical GBS transmission to the newborn decreases as the duration of prophylaxis increases. The considered threshold for prophylaxis adequacy is the first dose administered at least 4 hours before delivery. Objective: To evaluate the proportion of pregnant women who could benefit from an adequate IAP for the prevention of GBS perinatal infections. Methods: Between June and October 2003, we recorded in two hospitals the elapse time between admission for labor and delivery. We assumed 5 hours represent a useful threshold to allow admission, revision of chart and administration of adequate IAP. The status of vaginal colonization with GBS was determined by CDC’s recommended culture method with Granada agar added. Results: Among 532 women, 27.3 % delivered within 5 hours after admission for labor. The colonization rate for GBS was 25.6 %. The distribution of elapse time between admission and delivery for GBS colonized pregnant women was not significantly different from non colonized women (p <= 1). Conclusions: 1) With the current prevention strategy, 27.3 % of these pregnant women would not have benefit from adequate prophylaxis 2) These results highlight the importance of an efficient organization to warranty prompt administration of IAP as soon as possible when mandatory. 3) If a rapid intrapartum screening test is used, no delay can be afforded “from ward to bench to bed”. [less ▲]

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See detailPlace of PCR methods in malaria diagnosis
Klein, Ségolène; Hayette, Marie-Pierre ULg; Melin, Pierrette ULg et al

Conference (2004, October)

Background: Gold-standard method for malaria diagnosis is microscopic examination of Giemsa stained thick and thin blood smears. This method is cheap and simple but fastidious and requires experienced ... [more ▼]

Background: Gold-standard method for malaria diagnosis is microscopic examination of Giemsa stained thick and thin blood smears. This method is cheap and simple but fastidious and requires experienced microscopists. In recent years, molecular biology techniques have been applied with success in the microbiology field because of their great sensitivity and specificity. The aim of this study is the evaluation of Polymerase Chain Reaction (PCR) in the detection of low parasitaemia and mixed infections. Methods: A total of 191 blood samples were included in the study. They were collected from patients admitted to hospital because of suspicion of malaria infection, and distributed as follows: 105 from Liege (Belgium), 42 from Lubumbashi (Democratic Republic of Congo), and 44 from Cayenne (French Guiana). Two PCR techniques targeting the small sub-unit rRNA gene of Plasmodium were tested in comparison with microscopy. The real-time PCR was specific of Plasmodium sp. and the semi-nested multiplex PCR was able to detect each of the four species. Results: The real-time PCR sensitivity was 97% and 100% for multiplex PCR. The specificity of both techniques was 96%. Multiplex PCR detected 2 mixed infections that were missed by microscopy. In 4 cases, both PCR techniques permit to detect parasitaemia after treatment while microscopy was already negative. In one case, parasite DNA was detected by PCR one day before the microscopy became positive. Conclusions: Both PCR techniques presented the same detection limit. The PCR methods had a better sensitivity than microscopy. They detected P. falciparum and P. vivax respectively 7 and 6 days after beginning of treatment. Multiplex PCR allowed species identification and mixed infection determination that could confirm and complete the microscopic examination. Real-time PCR was quicker than nested PCR and could be used for screening in addition to the gold-standard method [less ▲]

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See detailResistance testing challenges and solutions with emphasis on patient care
Melin, Pierrette ULg

Conference (2004, May 13)

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See detailEvaluation of the group B differential agar for the detection of group B streptococci from vaginal specimens
MELIN, Pierrette ULg; Rodriguez Cuns, Grisel; Lorquet, Sophie et al

in American Society of Microbiology (Ed.) Program and Abstracts of the 104th General Meeting of the American Society for Microbiology (2004, May)

Background Group B streptococci (GBS) are the leading cause of severe perinatal infections. Most current guidelines for the prevention of GBS perinatal disease are based on prenatal screening culture for ... [more ▼]

Background Group B streptococci (GBS) are the leading cause of severe perinatal infections. Most current guidelines for the prevention of GBS perinatal disease are based on prenatal screening culture for vaginal GBS colonisation. Use of selective and differential media could improve the sensitivity of these cultures. Objective To evaluate the GBS-Differential Agar (GBSDA) recently formulated by Becton Dickinson for the selective growth and production of orange colonies of b- hemolytic (b-H) GBS. Methods 283 vaginal swabs (VAG) collected from pregnant women were inoculated in selective Lim broth. After overnight incubation, Lim broth were subcultured on GBSDA, on Granada agar (Biomedics, Spain) and on Columbia blood agar (BA). To evaluate the stability, 99 isolates of GBS (REF) from adult or neonatal infections (Belgian GBS reference laboratory collection) were cultured on GBSDA and Granada at their limit of expiration, and on BA. GBSDA and Granada were incubated anaerobically and BA aerobically + 7% CO2, at 35°C, 24 to 48 h. Positive and negative control strains (GBS ; E. faecalis) were cultured with each run. Specific identification of colonies suggestive of GBS (pale to dark orange on GBSDA and Granada, b-H on BA) was performed. Results b-H GBS were recovered from 63 VAG (22.3 %): 62 were easily identified after overnight incubation on GBSDA and 63 on Granada without requiring any subculture. All GBS were also recovered from BA however it was after many subcultures. All orange colonies were confirmed as GBS. Among REF, 3 strains were non hemolytic ; they grew but were not differentiated as orange colonies on GBSDA or Granada. 96 REF were b-H, 94 (97.9%) produced orange to very dark orange colonies on GBSDA, 2 produced white colonies, and on Granada, 74 (77.1 %) produced pale to dark orange colonies and 22 white to white-orange colonies. Conclusion 1) GBSDA and Granada: a) very high sensitivity and specificity for the detection of b-H GBS, in a single step b) Results available within 48 h after inoculation in Lim broth, low workload 2) Excellent stability up to expiration date for GBSDA 3) Non hemolytic GBS: grown but not differentiated on GBSDA or Granada. [less ▲]

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See detailTowards a Belgian consensus for prevention of perinatal group B streptococcal disease
Melin, Pierrette ULg; Verschraegen, G.; Mahieu, L. et al

in Indian Journal of Medical Research (2004), 119(Suppl. S), 197-200

Background & objectives: In Belgium, as in many other countries, group B Streptococcus (GBS) is still the leading cause of sepsis and meningitis in neonates. In 2001, though no Belgian guidelines for ... [more ▼]

Background & objectives: In Belgium, as in many other countries, group B Streptococcus (GBS) is still the leading cause of sepsis and meningitis in neonates. In 2001, though no Belgian guidelines for their prevention were available, in some hospitals, obstetrical programmes included a GBS prevention policy. With an aim to reach a Belgian consensus for the prevention of perinatal group B streptococcal disease, a national consensum meeting was organized in 2001. We report here our experience and findings of this meeting. Methods: In November 2001, obstetricians, neonatologists, microbiologists and infectious diseases specialists were invited to participate in a GBS symposium. International and Belgian speakers presented epidemiological aspects, argued comparative cost-effectiveness of different approaches for prevention and debated technical and practical problems. Management of neonates with risk factors for GBS disease and progress in GBS vaccines were also included in the programme. Further results about Belgian obstetricians’ practice and compliance to a policy for prevention of neonatal GBS diseases, as answered in two mail surveys, were commented and discussed. In an interactive session at the end, each participant was asked to vote on the key points related to the different steps of the ideal prevention strategy to recommend. Results: For the main questions, 94 per cent of participants choose a screening-based approach and 94 per cent shifted from the current use of ampicillin to penicillin as first choice for antimicrobial prophylaxis. Further, 79 per cent voted for an approach with integrated neonatal prophylaxis for selected neonates at high risk for GBS disease and 47 per cent voted for a strategy based on an intrapartum rapid screening-based approach. Interpretation & conclusion: The state of the question by different speakers, the data from Belgian epidemiology, and the debate about cost-effectiveness of different approaches led to a massive vote in favour of the universal screening-based approach. Based on these results, a working group has been appointed by the Ministry of Health to draft and edit Belgian recommendations for the prevention of perinatal GBS disease. [less ▲]

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See detailL'accréditation en microbiologie
MELIN, Pierrette ULg

Conference (2003, December 18)

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See detailCatheter-related Infections - Belgian epidemiological data
Melin, Pierrette ULg

Conference (2003, November 20)

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See detailEarly onset neonatal sepsis and meningitis in Belgium: a decade review
MELIN, Pierrette ULg; Maquet, Julie; Ducoffre, Geneviève et al

in American Society of Microbiology (Ed.) Program and Abstracts of the 43rd Intersciences Conference on Antimicrobial Agents and Chemotherapy (2003, September)

Background: In the late 1990s, Belgium has reached the era of “group B streptococcal (GBS) prevention” and after 1996, some institutions, but not the majority, had implemented intrapartum ... [more ▼]

Background: In the late 1990s, Belgium has reached the era of “group B streptococcal (GBS) prevention” and after 1996, some institutions, but not the majority, had implemented intrapartum antibioprophylaxis for GBS prevention. Concern exists that one unintended consequence of GBS prevention efforts through chemoprophylaxis may be an increase in the rate of serious neonatal infections due to Gram negative bacteria (GNB). To monitor trends, continued surveillance of neonatal sepsis is needed. Methods: On a weekly basis, laboratories of the Belgian sentinel network notified each case of neonatal bacteremia or meningitis occurring within 28 days after birth. We reviewed on a year-base data collected from 1991-2001 for early–onset diseases (EOD; < 5 days). Results: A yearly mean of 47 cases (24-90) were notified by 28 (16-35) laboratories. Overall GBS remained the leading cause and represented annually 37.9% (25-54.7%) of EOD and did not show significant change. It was followed by E.coli 11.4%, coagulase negative staphylococci (CNS) 11.9%, S.aureus 9.9%, Listeria sp 3.9%, S.pyogenes (GAS) 2.5%, S.pneumoniae 2.7%, H.influenzae 2.7% and others. During the decade, whereas a significant reduction in the rate of E.coli and other GNB EOD occurred (p <0.01), significant increases in the rate of EOD due to GAS (p <0.001), S.aureus (p <0.001), and CNS (p <0.01), were found. For CNS, we did not have data to distinguish definite or possible infections from contaminations. Conclusions: 1) During the last decade, GBS has remained the leading cause of neonatal EOD. 2) A decline in the rate of E.coli and other GNB infections occurred. 3) In the late 1990s, S.aureus and CNS were more frequently reported. 4) An increase in GAS occurrence was found 5) Potential change in pathogens overtime requires confirmation by ongoing surveillance. [less ▲]

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