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Clinical isolates of methicillin-resistant Staphylococcus aureus (n = 1070) collected from 63 French general hospitals during June 2000 (n = 1070) were screened initially for reduced susceptibility to glycopeptides (GISA) on brain-heart infusion agar containing teicoplanin 6 mg/L. Glycopeptide MICs were determined for the 145 isolates that grew on the screening plates. Of the 1070 isolates, 1.4% were GISA on Mueller-Hinton agar, and 2.9% by Etest with a high inoculum, while 0.7% and 2.9% were GISA by vancomycin and teicoplanin population analysis profiles, respectively. Most isolates were resistant to gentamicin and rifampicin or fosfomycin or fusidic acid, as determined by disk diffusion. Pulsed-field gel electrophoresis of the 31 GISA isolates identified four clones, with dissemination of one predominant clone. In these French hospitals there was a low incidence of GISA and hetero-GISA.

We describe the first fatal evolution of cellulitis due to Neisseria meningitidis serogroup Y involving an 85-year-old woman. She presented with an extensive cellulitis of the left side of the face, neck, and thorax and septic shock. In spite of active antibiotic therapy, evolution was rapidly fatal. CASE REPORTAn 85-year-old woman was admitted to the Intensive Care Unit of Saint-Germain-en-Laye Hospital with cellulitis of the face and neck and septic shock. She had been bedridden since 1998 following a traumatic vertebral compression (fourth lumbar vertebra) and right cerebral ischemia. She was undergoing corticosteroid therapy (0.5 mg of oral prednisone/kg of body weight/day for 2 years) for polymyalgia rheumatica. She had chronic heart and renal failure. Asthenia associated with pain on the left side of her neck began 8 days before admission. At the time of admission, her temperature was 38.3°C, her pulse rate was 120 (tachyarrhythmia), and her blood pressure was 80/50 mm Hg. She was conscious and alert. There were no symptoms of meningitis. The left side of the neck, the left shoulder, and the upper anterior part of the chest showed a painful erythema and edema and were swollen and warm. Clinical examination showed no angina and the recent partial loss of a left premolar. Otorhinolaryngologic evaluation showed a normal larynx, hypopharynx, and oropharynx and no phlegmon. A tumefaction of the submandibular space was observed; thus, submandibular sialadenitis was suspected. Laboratory findings included a white blood cell count of 2.71 ϫ 10 9 /liter with 46% neutrophils, a hemoglobin level of 7

A newborn baby was admitted to the Neonatal Intensive Care Unit (NICU) of St Germain en Laye Hospital (France) because of premature birth. On day 12, he contracted gastroenteritis due to Salmonella brandenbourg. The salmonellosis led to a septic shock syndrome with a brief cardiopulmonary arrest. He was treated with intravenous ceftriaxone and gentamicin, and the evolution was favorable. Microbiological investigations revealed that the mother was the vector for this nosocomial infection. S. brandenbourg was isolated from the feces of the baby, despite recent recommendations on managing stool specimens from patients hospitalized for more than three days: according to these recommendations, these stools should be processed for viruses and Clostridium difficile toxin only.

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