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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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See detailAntimicrobial Susceptibilities of recent clinical isolates of group B streptococci agalactiae from Belgium
MELIN, Pierrette ULg; Maquet, Julie; Rodriguez Cuns, Grisel et al

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

Background: : GBS cause severe infections in neonates, pregnant women and other adults. Empiric therapy is usually started before susceptibility results are available. Early neonatal diseases can be ... [more ▼]

Background: : GBS cause severe infections in neonates, pregnant women and other adults. Empiric therapy is usually started before susceptibility results are available. Early neonatal diseases can be prevented with intrapartum antibiotic prophylaxis based on accurate susceptibility surveillance data. A previous Belgian study showed an increase of 3 to 10 % R to erythromycin (EM) through the 1990s. Methods: 187 GBS isolates consecutively received at the reference laboratory between 2001 to March 2003 were from 73 neonates (52 early-onset and 21 late-onset diseases), 52 adults and 62 from pregnant women’s vagina. MICs of penicillin (PG), EM, clindamycin (CM) and gentamicin (GM) were determined with Etest. PG MBCs were also determined by inactivating the drug in MIC plates using betalactamase. EM resistant (R) isolates were tested by the CM + EM double disk to determine macrolide R phenotypes. Results: All strains were susceptible (S) to PG and no tolerance was observed with MBCs falling within 2 dilutions of MICs. 19.2% of isolates were R to EM, with significantly more R isolates from adults (30.8%; p <0.01) and serotype V (46.8%; p <0,001). 80% had the MLSB phenotype (R to EM and CM), 16 were constitutive and 12 inducible. The M phenotype (R to EM and S to CM) was seen in 7 (20%) of isolates. Less than 10% of isolates were inhibited by GM MIC of <=64 mg/L, 83.6% by 128-256 mg/L and 2.9% by >/=512 mg/L. Non typable strains were more R to GM (p <0.01). Conclusions: 1) PG remained active against all isolates and no tolerance was seen. 2) Prevalence of R to macrolides had increased since 1999, particularly in adult isolates and serotype V. 3) Intermediate to high level R to GM was seen and potential synergy of PG + GM should be investigated. 4) R surveillance is mandatory to guide prophylaxis and treatment of serious GBS infections. [less ▲]

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See detailPrevention of Perinatal Group B Streptococcal Infections - Guidelines from the Belgian Health Council, 2003 (SHC.7721)
Working party of experts, Superior Health Concil; Dubois, J. J.; MELIN, Pierrette ULg et al

Book published by Superior Health Council (2003)

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See detailPrévention des Infections Périnatales à Streptocoquues du groupe B - Recommandations du Conseil Supérieur d'Hygiène, N° 7721
Groupe de travail d'experts, Conseil Supérieur de la Santé; Dubois, J. J.; MELIN, Pierrette ULg et al

Book published by Conseil Supérieur d'Hygiène (2003)

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See detailInfection néonatale tardive à streptocoques B
MELIN, Pierrette ULg

in Ministère de la Communauté Française, Direction générale de la Santé (Ed.) Stratégies de contrôle de maladies transmissibles (2003)

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See detailInfection néonatale précoce à Streptocoques B
MELIN, Pierrette ULg

in Ministère de la Communauté Française, Direction Générale de la Santé (Ed.) Stratégies de contrôle de maladies transmissibles (2003)

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See detailContrôle de qualité interne et assurance de qualité en bactériologie
MELIN, Pierrette ULg

Scientific conference (2003, May)

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See detailInfections et grossesse
MELIN, Pierrette ULg

Conference (2003, April 04)

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See detailLa problématique de la résistance des pneumocoques aux antibiotiques
Marchal, Valérie; Melin, Pierrette ULg; Hayette, Marie-Pierre ULg et al

in Revue Médicale de Liège (2003), 58(11), 675-680

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia and it is also a common cause of sinusitis, otitis media, bacteremia and meningitis. The increasing resistance to ... [more ▼]

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia and it is also a common cause of sinusitis, otitis media, bacteremia and meningitis. The increasing resistance to antimicrobial agents, now endemic in many countries, reflects an uncontrolled use of antibiotics. A good antibiotics policy and vaccination are at the moment the only way to control efficaciously the increasing antibiotic resistance of Streptococcus pneumoniae [less ▲]

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See detailPerinatal Group B Streptococcal Disease Prevention, Interactive session
Melin, Pierrette ULg

Conference (2002, November 23)

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See detailProceeds from the European workshop: GBS neonatal disease prevention
MELIN, Pierrette ULg

in de la Rosa, Manuel (Ed.) Proceedings from the European workshop: GBS neonatal disease prevention (2002)

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