Three specimens from 111 asymptomatic male partners of infertile couples attending the Department of Urology in Amiens, France, were examined by the PCR COBAS AMPLICOR test (Roche Molecular Diagnostics) for the presence of Chlamydia trachomatis. The specimens analysed were: first void urine (FVU), urine obtained after prostatic massage (UPM) and semen specimens. Serum from each patient was also obtained and analysed for the presence of IgG and IgA chlamydial antibodies by in-house microimmunofluorescence (MIF) and pELISA. C. trachomatis was detected by PCR in 5 . 4 % of FVU samples, 2 . 7 % of semen specimens and in 0 . 9 % of UPM samples. Two treatments for processing the samples (storage at À70 8C and heating to 95 8C) were routinely used before initial testing to reduce the effects of inhibitors of PCR. Despite these precautions, the PCR method revealed the presence of inhibitors in 7 . 3 % of semen specimens and 3 . 6 % of FVU samples. C. trachomatis was detected by PCR COBAS AMPLICOR in seven of 111 patients (6 . 3 %) and by serology in five of 111 patients (4 . 5 %). The detection of C. trachomatis in FVU, UPM and semen specimens can serve as a marker for the presence of this organism in the genital tract, and can be used as a reliable way of detecting asymptomatic carriers of infection. INTRODUCTIONChlamydia trachomatis is one of the most common sexually transmitted pathogens of humans, with an estimated 92 million new cases occurring worldwide each year (WHO, 2001). The number of cases is probably underestimated, particularly for men, who are less likely to seek diagnosis than women. C. trachomatis often causes asymptomatic genital tract infections in both men and women, and the high number of unrecognized infected individuals provides a reservoir for spreading the infection to men and women via sexual contact.Chlamydial infection in the male urethra can be complicated by inflammation of the epididymis (Stamm et al., 1984) and the prostate gland (Dan et al., 1991), but the role that C. trachomatis infection plays in male infertility is controversial.C. trachomatis can attach to spermatozoa (Hanssen & Mardh, 1984) and can be present in cytoplasmic droplets of spermatozoa (Villegas et al., 1991). Previous studies have found a correlation between genital chlamydial infection and sperm quality (Custo et al., 1989), although other studies have reported contradictory findings (Eggert- Kruse et al., 1996;Gdoura et al., 2001). It is important to resolve this issue, since chlamydiae present in semen could be transmitted by adhering to spermatozoa, which may serve as vectors, spreading the pathogen to the uterus and Fallopian tubes. In fact, studies have reported finding spermatozoa with adhering chlamydial bodies in the peritoneal fluid of women with salpingitis at laparoscopy (Friberg et al., 1987).The presence of C. trachomatis in semen emphasizes the potential risk of this route of transmission, and underlines the need for sensitive direct detection methods in this group of patients (Dieterle et al., 1995).Sc...

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Between February 1997 and December 2002, 3340 hospitalised patients yielded samples positive for Proteus mirabilis, of whom 45 (1.3%) were colonised/infected by P. mirabilis producing extended-spectrum beta-lactamases (ESBLs). The gross incidence of patients colonised/infected by ESBL-producing P. mirabilis was 1.61/10(5) days of hospitalisation, with 20% of isolates being collected from patients in urology wards, most frequently (53.3%) from urine samples. Seventeen (37.7%) of the 43 isolates were obtained from samples collected within 48 h of hospitalisation, indicating that they were community-acquired. Isoelectric focusing assays and sequencing identified the TEM-24, TEM-92 and TEM-52 ESBLs. Pulsed-field gel electrophoresis revealed eight pulsotypes (I-VIII), with the two most common pulsotypes, IV and VI, comprising ten (23.3%) and 12 (26.6%) isolates, respectively. These pulsotypes were considered to represent epidemic strains and spread in various wards of the hospital.

Background Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. Methods To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). Results 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. Conclusion These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.

Forty nontyphoidal salmonellosis episodes were diagnosed in hospitalized patients (34 episodes of gastroenteritis, two episodes of bacteremia not affecting other organs, one episodes of bacteremia plus urinary infection, one episodes of bacteremia plus gastroenteritis, one episodes of chronic colitis plus gastroenteritis and one episode of peritonitis), and three carriers were observed in outpatients. By means of PFGE, RAPD and antibiotic susceptibility patterns 44 isolates were subdivided into 16 clonally related groups. Two of them were predominantly implicated in the course of these infections, being responsible for two successive waves of infection, while the others were encountered sporadically.