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Ferreira MAM, Pires PPA, Dos Santos KV. Staphylococcus aureus nasal colonization and susceptibility profile to antimicrobials in hemodialysis patients using a protocol of seven collections. Diagn Microbiol Infect Dis 2024; 109:116295. [PMID: 38579431 DOI: 10.1016/j.diagmicrobio.2024.116295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/09/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Patients colonized with Staphylococcus aureus in their nasal passages have a higher risk of acquiring infection, especially if they are immunocompromised or have comorbidities such as chronic renal failure undergoing hemodialysis (HD). OBJECTIVE This study aimed to report the prevalence of nasal carriage of S. aureus among HD patients utilizing a seven-week sampling protocol and to assess the susceptibility of these isolates to various antimicrobial agents. METHODS Over seven consecutive weeks, nasal swab samples were collected from 47 HD patients, resulting in a total of 329 samples. The microorganisms were identified using biochemical methods and subjected to antimicrobial susceptibility testing via disk diffusion and microdilution techniques. RESULTS Out of all the patients analyzed, 25 individuals (53.19%) were found to be colonized by S. aureus, with 21 of them displaying intermittent colonization. Additionally, 38% showed positive results for S. aureus in only the 6th or 7th week of sampling. Within the 58 isolates, 17.2% (n=10) exhibited methicillin (oxacillin)-resistance and 25.86% (n=15) displayed elevated vancomycin MIC values (2 µg/ml). Based on the results, daptomycin and gentamicin were found to be effective treatment options. However, 31% of the isolates (n=18) exhibited a MIC of 1 µg/ml for daptomycin. CONCLUSION Over half of the patients were colonized by S. aureus, but mostly on an intermittent basis. The identification of oxacillin resistance and high vancomycin and daptomycin MICs serve as warnings for possible future complications in managing bacteremia caused by S. aureus in these patients.
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Affiliation(s)
- Mariana Abou Mourad Ferreira
- Department of Pathology, Health Sciences Center, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, Espírito Santo 29040-090, Brazil
| | - Pamella Plass Andrade Pires
- Department of Pathology, Health Sciences Center, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, Espírito Santo 29040-090, Brazil
| | - Kênia Valéria Dos Santos
- Department of Pathology, Health Sciences Center, Universidade Federal do Espírito Santo (UFES), Av. Marechal Campos, 1468, Vitória, Espírito Santo 29040-090, Brazil.
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Fayolle M, Epercieux A, Haddar CH, Pillet S, Berthelot P, Pozzetto B, Carricajo A, Grattard F, Verhoeven PO. Prospective Evaluation of the BD MAX StaphSR Assay for the Screening of Methicillin-Susceptible and -Resistant Staphylococcus aureus from Nasal Swabs Taken in Intensive Care Unit Patients. Int J Mol Sci 2023; 24:13881. [PMID: 37762183 PMCID: PMC10531305 DOI: 10.3390/ijms241813881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/02/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Screening patients for S. aureus nasal carriage has proved effective in preventing cross-contamination and endogenous infection with this bacterium. The aim of this study was to assess the performance of the BD MAX StaphSR assay with liquid Amies elution swabs, taken during routine care of intensive care unit patients. Direct and pre-enriched cultures were used as reference methods to screen for S. aureus and methicillin-resistant S. aureus (MRSA). Discrepant results between the BD MAX StaphSR assay and cultures were resolved by using the Xpert SA Nasal Complete assay. A total of 607 nasal swabs taken from 409 patients were included in this study. Compared to culture methods, the sensitivity and specificity of the BD MAX StaphSR assay were 92.5% and 91.7% for S. aureus screening, and 94.7% and 98.3% for MRSA screening, respectively. In 52 (8.6%) specimens, there was a discrepancy between the results of cultures and the BD MAX StaphSR assay, including 13 (25%) where the results of the BD MAX StaphSR assay were confirmed by the Xpert SA Nasal Complete test. This prospective study showed that the BD MAX StaphSR assay is reliable for S. aureus and MRSA detection from nasal samples taken with liquid Amies elution swabs.
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Affiliation(s)
- Martin Fayolle
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Amélie Epercieux
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
| | - Cyrille H. Haddar
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
| | - Sylvie Pillet
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Philippe Berthelot
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Infection Control Unit, Department of Infectious Diseases, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Bruno Pozzetto
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Anne Carricajo
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Florence Grattard
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
| | - Paul O. Verhoeven
- CIRI, Centre International de Recherche en Infectiologie, GIMAP Team, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Claude Bernard Lyon 1 University, 69007 Lyon, France
- Faculty of Medicine, Jean Monnet St-Etienne University, 42023 St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne, France
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Rigaill J, Gavid M, Fayolle M, Morgene MF, Lelonge Y, Grattard F, Pozzetto B, Crépin A, Prades JM, Laurent F, Botelho-Nevers E, Berthelot P, Verhoeven PO. Staphylococcus aureus nasal colonization level and intracellular reservoir: a prospective cohort study. Eur J Clin Microbiol Infect Dis 2023; 42:621-629. [PMID: 36964269 DOI: 10.1007/s10096-023-04591-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
Staphylococcus aureus is a major pathogen in humans. The nasal vestibule is considered as the main reservoir of S. aureus. However, even though the nasal cavity may also be colonized by S. aureus, the relationships between the two sites are still unclear. We conducted a prospective study in humans to assess the S. aureus colonization profiles in the vestibule and nasal cavity, and to investigate the presence of intracellular S. aureus in the two sites. Patients undergoing ear, nose, and throat surgery were swabbed during endoscopy to determine S. aureus nasal load, genotype, and presence of intracellular S. aureus. Among per-operative samples from 90 patients, the prevalence of S. aureus carriage was 32.2% and 33.3% in the vestibule and the nasal cavity, respectively. The mean S. aureus load was 4.10 and 4.25 log10 CFU/swab for the nasal vestibule and nasal cavity, respectively (P > 0.05). Genotyping of S. aureus revealed that all nasal strains isolated from a given individual belong to the same clonal complex and spa-type. An intracellular carriage was observed in 5.6% of the patients, all of whom exhibited a S. aureus vestibule load higher than 3 log10 CFU/swab. An intracellular niche was observed in the vestibule as well as in the nasal cavity. In conclusion, the nasal cavity was also found to be a major site of S. aureus carriage in humans and should draw attention when studying host-pathogen interactions related to the risk of infection associated with colonization.
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Affiliation(s)
- Josselin Rigaill
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Marie Gavid
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Martin Fayolle
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Mohamed Fedy Morgene
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
| | - Yann Lelonge
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Florence Grattard
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Bruno Pozzetto
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Adeline Crépin
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
| | - Jean-Michel Prades
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Frédéric Laurent
- CIRI - Centre International de Recherche en Infectiologie, Staphylococcal Pathogenesis team, Université de Lyon, Inserm, U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Department of Bacteriology, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Elisabeth Botelho-Nevers
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Diseases, University Hospital of St-Etienne, St-Etienne, France
| | - Philippe Berthelot
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Diseases, University Hospital of St-Etienne, St-Etienne, France
| | - Paul O Verhoeven
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.
- Faculty of Medicine, University Jean Monnet, St-Etienne, France.
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France.
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Techasupaboon T, Vasikasin V, Varothai N, Raknaisil N, Nasomsong W. Staphylococcus aureus nasal carriage and bloodstream infection among conventional hemodialysis patients in Thailand: a prospective multicenter cohort study. BMC Res Notes 2022; 15:290. [PMID: 36068640 PMCID: PMC9450322 DOI: 10.1186/s13104-022-06185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Staphylococcus aureus nasal carriage screening among hemodialysis patients is not standard practice in Thailand, because of data lacking regarding prevalence and correlation with subsequent infection. We aimed to investigate the prevalence of S. aureus nasal carriage and its association with bloodstream infection among hemodialysis patients. In this prospective multicenter cohort study, participants were screened for S. aureus nasal carriage over 2 consecutive weeks. Incidence of S. aureus bloodstream infection over the next 12 months was observed. Results The prevalence of S. aureus nasal carriage was 11.67%. Incidence of S. aureus bacteremia among participants with and without S. aureus nasal carriage were 7.1% and 3.8%, respectively. The odds ratio for nasal carriage and subsequent bacteremia was 1.96 (95% CI 0.04–21.79; p = 0.553). Survival analysis showed that time to bacteremia among participants in the two groups did not significantly differ (p = 0.531). Prevalence of S. aureus nasal carriage among hemodialysis patients in Thailand was low. Patients presenting with S. aureus nasal carriage did not have increased risk of S. aureus bacteremia after 12-month follow-up. Nasal S. aureus screening and decolonization should not be encouraged in this setting. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06185-y.
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Affiliation(s)
- Tanyanop Techasupaboon
- Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Vasin Vasikasin
- Department of Internal Medicine, Ananda Mahidol Hospital, Lopburi, Thailand.,Division of Infectious Disease, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Narittaya Varothai
- Division of Nephrology, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Navee Raknaisil
- Department of Internal Medicine, Ananda Mahidol Hospital, Lopburi, Thailand
| | - Worapong Nasomsong
- Division of Infectious Disease, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, 10400, Thailand.
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Hong Q, Li X, Lin Q, Shen Z, Feng J, Hu C. Resveratrol Improves Intestinal Morphology and Anti-Oxidation Ability in Deoxynivalenol-Challenged Piglets. Animals (Basel) 2022; 12:ani12030311. [PMID: 35158635 PMCID: PMC8833336 DOI: 10.3390/ani12030311] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Deoxynivalenol (DON)-contaminated feed may cause anorexia, vomiting, immunosuppression, and intestinal dysfunction in pigs, which would lead to growth retardation and great losses in the pig industry. In this study, the effects of resveratrol (RES) on growth performance, the intestinal barrier, antioxidant capacity, and mitochondrial function in weaned pigs fed with DON-contaminated diets were investigated. Dietary supplementation with resveratrol increased the average daily feed intake of piglets. Diets supplemented with resveratrol increased the villus height and the ratio of the jejunum villus height to crypt depth, increased the activities of superoxide dismutase (SOD), and increased the total antioxidant capacity in the jejunum mucosa. After being supplemented with RES, the level of reactive oxygen species (ROS) in mitochondria was decreased, while the mitochondrial membrane potential in the jejunum was increased. In conclusion, these results suggested that resveratrol effectively relieved DON-induced oxidative stress in weaned piglets, improved intestinal barrier function, enhanced mitochondrial function, and improved the growth performance of piglets. Abstract This study aimed to investigate the potential effects of resveratrol (RES) on intestinal function and oxidative stress in deoxynivalenol (DON)-challenged piglets. Twenty-four healthy Duroc × Yorkshire × Landrace weaned piglets at the age of 28 ± 1 days were randomly divided into four groups with six repetitions per group. The four groups were as follows: the control group (CON), fed with a basic diet; the RES group, fed with a basal diet + 300 mg/kg RES; the DON group, fed with a basal diet containing 2.65 mg/kg DON; and the DON + RES group, fed with a basal diet containing 2.65 mg/kg DON + 300 mg/kg RES. The results showed that the growth performance and intestinal function of DON-challenged piglets were significantly decreased (p < 0.05). Compared with the DON group, the average daily feed intake of piglets in the DON + RES group was significantly increased (p < 0.05). Additionally, dietary RES ameliorated DON-induced intestinal morphology impairment, as indicated by the increased (p < 0.05) jejunal villi height and the ratio of the jejunal villi height/crypt depth. Furthermore, after the addition of RES, the activities of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the jejunum mucosa were significantly increased, and the content of malondialdehyde (MDA) was significantly declined (p < 0.05). In addition, the level of reactive oxygen species (ROS) in the mitochondria was significantly reduced by RES, while the mitochondrial membrane potential in jejunum was significantly increased by RES (p < 0.05). However, there was no obvious difference between DON + RES and DON groups on average daily gain and the ratio of feed togain, except for the significant inhibition of average daily feed intake (p < 0.05). In conclusion, RES could effectively alleviate the DON-induced oxidative stress on weaned piglets, and reduce the damage to mitochondria and intestinal morphology, so as to improve the growth performance of piglets.
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Affiliation(s)
- Qihua Hong
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
- Correspondence: (Q.H.); (C.H.)
| | - Xin Li
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
| | - Qian Lin
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
| | - Zhuojun Shen
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
| | - Jie Feng
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
| | - Caihong Hu
- College of Animal Sciences, Zhejiang University, Hangzhou 310058, China; (X.L.); (Q.L.); (Z.S.); (J.F.)
- Key Laboratory of Animal Nutrition and Feed Science (Eastern of China), Ministry of Agriculture and Rural Affairs, Hangzhou 310058, China
- Key Laboratory of Animal Feed and Nutrition of Zhejiang Province, Hangzhou 310058, China
- Key Laboratory of Molecular Animal Nutrition, Ministry of Education, Zhejiang University, Hangzhou 310058, China
- Correspondence: (Q.H.); (C.H.)
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Nicolas R, Carricajo A, Morel J, Rigaill J, Grattard F, Guezzou S, Audoux E, Campisi S, Favre JP, Berthelot P, Verhoeven PO, Botelho-Nevers E. Evaluation of effectiveness and compliance with the mupirocin nasal ointment part of Staphylococcus aureus decolonization in real life using UPLC-MS/MS mupirocin quantification. J Antimicrob Chemother 2021; 75:1623-1630. [PMID: 32097475 DOI: 10.1093/jac/dkaa025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preoperative decolonization is recommended in Staphylococcus aureus nasal carriers scheduled for cardiac surgery. We aimed to evaluate the effectiveness of and compliance with mupirocin use in nasal S. aureus carriers in a real-life setting. METHODS Prospective study including consecutive patients scheduled for cardiac surgery screened for S. aureus nasal carriage at preoperative consultation. Carriers were prescribed mupirocin nasal ointment, chlorhexidine shower and mouthwash. Effectiveness of decolonization was evaluated with a postoperative nasal sample. Compliance was evaluated objectively by determination of nasal mupirocin concentration using UPLC-MS/MS and self-reported by questionnaire. RESULTS Over 10 months, 361 patients were included, 286 had preoperative screening, 75 (26.2%) were S. aureus nasal carriers and 19 of them (25.3%) failed to be effectively decolonized. No resistance to mupirocin was documented. Preoperative and postoperative strains were identical in all cases. Declared good compliance was associated with decolonization success (OR = 24; 95% CI 4-143, P < 0.0001). Mupirocin detection was significantly associated with the level of compliance. Mupirocin was detected in 52.2% (24/46) of patients effectively decolonized and in 12.5% (2/16) of patients with decolonization failure (P < 0.01). In 2/19 patients, failure of decolonization was not associated with a compliance issue. Postoperative carriage was associated with an increased risk of S. aureus infection (OR = 9.8; 95% CI 1.8-53, P < 0.01). CONCLUSIONS In real life, decolonization is not always effective, hence there is a persisting risk of S. aureus endogenous infection. Mupirocin concentration measurement may help to understand compliance issues and failures in decolonization.
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Affiliation(s)
- Roxane Nicolas
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France.,GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France
| | - Anne Carricajo
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Jérôme Morel
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Josselin Rigaill
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Florence Grattard
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Salim Guezzou
- Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Estelle Audoux
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France
| | - Salvatore Campisi
- Cardiac Surgery Department, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Jean-Pierre Favre
- Cardiac Surgery Department, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Philippe Berthelot
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France.,Infectious Diseases Department, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Paul O Verhoeven
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
| | - Elisabeth Botelho-Nevers
- GIMAP (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, 42055 St-Etienne Cedex 02, France
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7
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Vanegas JM, Salazar-Ospina L, Roncancio GE, Jiménez JN. Staphylococcus aureus colonization increases the risk of bacteremia in hemodialysis patients: a molecular epidemiology approach with time-dependent analysis. Am J Infect Control 2021; 49:215-223. [PMID: 32485274 DOI: 10.1016/j.ajic.2020.05.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Bacteremia is the second cause of death in hemodialysis patients and colonization may be a risk factor. We analyzed the association between Staphylococcus aureus or multidrug-resistant Gram-negative bacteria colonization and bacteremia in hemodialysis patients. METHODS A prospective cohort study was conducted. Colonization status was determined at baseline, 2, and 6 months later. The time-to-first-bacteremia was analyzed using the baseline status and time-dependent nature of colonization. The recurrence of bacteremia given colonization status was evaluated using a Poisson regression model. The genetic relatedness between isolates that colonized and caused bacteremia were established by molecular typing methods. RESULTS Seventy-one patients developed bacteremia over the course of follow-up, with the majority of cases being caused by S aureus (n = 28; 39.4%) and only three caused by multidrug-resistant Gram-negative bacteria. S aureus colonization was associated with an increased risk of bacteremia in time-dependent analysis (HR:4.64; 95%CI: 1.72-12.53) and with recurrence of infection in Poisson model (IRR:5.90, 95%CI: 2.29-15.16). Molecular methods revealed that 77.8% of patients with S aureus bacteremia were colonized with the same strain that caused the infection. CONCLUSIONS S aureus is a cause of endogenous infection in hemodialysis patients. Colonization is associated with both time-to-first-bacteremia and the recurrence of infection. The prompt identification of colonized patients and the evaluation of decolonization protocols are needed.
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Gagnaire J, Botelho-Nevers E, Martin-Simoes P, Morel J, Zéni F, Maillard N, Mariat C, Haddar CH, Carricajo A, Fonsale N, Grattard F, Pozzetto B, Laurent F, Berthelot P, Verhoeven PO. Interplay of nasal and rectal carriage of Staphylococcus aureus in intensive care unit patients. Eur J Clin Microbiol Infect Dis 2019; 38:1811-1819. [PMID: 31273646 DOI: 10.1007/s10096-019-03613-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/11/2019] [Indexed: 12/22/2022]
Abstract
The aim of this study was to investigate the relationship between nasal and rectal Staphylococcus aureus carriage in intensive care unit (ICU) patients and the occurrence of ICU-acquired infections related to S. aureus carriage. Three hundred and ninety-five patients admitted in ICU were screened for S. aureus nasal and rectal carriages and followed to record S. aureus infections during their stay. S. aureus strains were genotyped by arbitrarily primed PCR, spa-typing, microarray and whole genome sequencing. At ICU admission, 112 of 363 (30.9%) patients carried S. aureus including 61 (16.8%) exclusive nasal carriers, 40 (11.0%) combined nasal and rectal carriers and 11 (3.0%) exclusive rectal carriers. The 152 S. aureus isolates from nasal and rectal swabs belonged to 19 clonal complexes (CCs). Patients colonized in both nose and rectum harboured different strains in at least 40% of cases according to arbitrarily primed PCR data. Nasal carriers of CC5 S. aureus had an increased risk of rectal carriage (RR = 1.85, P < .05). S. aureus nasal and rectal carriage was a risk factor of S. aureus ICU-acquired infection (RR = 4.04; 95%CI [1.38-11.76]). Incidence rates of endogenous ICU-acquired infections in exclusive nasal carriers, exclusive rectal carriers and in both nasal and rectal carriers were 0.08 (5/61), 0.09 (1/11) and 0.03 (1/40), respectively (p = 0.47). Rectal swabbing increased the detection of S. aureus carriage and revealed an important diversity of S. aureus strains in ICU patients. Further studies are needed to understand how S. aureus rectal carriage increases the risk of endogenous ICU-acquired infections.
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Affiliation(s)
- Julie Gagnaire
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France
| | - Elisabeth Botelho-Nevers
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France
| | - Patricia Martin-Simoes
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Université de Lyon, Lyon, France.,Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Morel
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of St-Etienne, St-Etienne, France
| | - Fabrice Zéni
- Medical Intensive Care Unit, University Hospital of St-Etienne, St-Etienne, France
| | - Nicolas Maillard
- Nephrology, Dialysis and Renal Transplantation Department, University Hospital of St-Etienne, St-Etienne, France
| | - Christophe Mariat
- Nephrology, Dialysis and Renal Transplantation Department, University Hospital of St-Etienne, St-Etienne, France
| | - Cyrille H Haddar
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Anne Carricajo
- Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Nathalie Fonsale
- Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Florence Grattard
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Bruno Pozzetto
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Frédéric Laurent
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Université de Lyon, Lyon, France.,Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Philippe Berthelot
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Paul O Verhoeven
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France. .,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France.
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9
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Gagneux-Brunon A, Lucht F, Launay O, Berthelot P, Botelho-Nevers E. Vaccines for healthcare-associated infections: present, future, and expectations. Expert Rev Vaccines 2018; 17:421-433. [DOI: 10.1080/14760584.2018.1470507] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Amandine Gagneux-Brunon
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
| | - Frédéric Lucht
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
| | - Odile Launay
- Inserm CIC 1417, I-REIVAC, University of Paris-Descartes, University Hospital of Cochin-Broca-Hôtel-Dieu, Paris, France
| | - Philippe Berthelot
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
- Infection control unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, Saint-Etienne, France
- GIMAP EA 3064, University of Lyon, Saint-Etienne, France
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10
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Gagneux-Brunon A, Lucht F, Launay O, Berthelot P, Botelho-Nevers E. Les vaccins dans la prévention des infections associées aux soins. JOURNAL DES ANTI-INFECTIEUX 2017. [PMCID: PMC7148680 DOI: 10.1016/j.antinf.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Les infections associées aux soins (IAS) constituent un véritable problème de santé publique. Escherichia coli, Staphylococcus aureus, Clostridium difficile sont les plus souvent à l’origine des IAS. L’antibiorésistance fréquente complique encore la prise en charge et des impasses thérapeutiques existent à présent. Les mesures d’hygiène hospitalière bien qu’essentielles sont insuffisantes pour diminuer drastiquement les IAS. Ainsi, des stratégies alternatives à l’antibiothérapie s’avèrent nécessaires pour prévenir et traiter les IAS. Parmi celles-ci, la vaccination et l’immunisation passive sont probablement les plus prometteuses. Nous avons fait une mise au point sur les vaccins disponibles et en développement clinique pour lutter contre les IAS, chez les patients à risque d’IAS et les soignants. L’intérêt de la vaccination grippale et rotavirus chez les patients pour prévenir ces IAS virales a été examiné. Le développement d’un vaccin anti-S. aureus, déjà émaillé de 2 échecs est complexe. Toutefois, ces échecs ont permis d’améliorer les connaissances sur l’immunité anti-S. aureus. La mise à disposition d’un vaccin préventif anti-C. difficile semble plus proche. Pour les autres bactéries gram négatif responsables d’IAS, le développement est moins avancé. La vaccination des patients à risques d’IAS pose également des problèmes de réponse vaccinale qu’il faudra résoudre pour utiliser cette stratégie. Ainsi, la vaccination des soignants, de par l’effet de groupe permet également de prévenir les IAS. Nous faisons ici le point sur l’intérêt de la vaccination des soignants contre la rougeole, la coqueluche, la grippe, la varicelle, l’hépatite B pour réduire les IAS avec des vaccins déjà disponibles.
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11
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Gagnaire J, Verhoeven PO, Grattard F, Rigaill J, Lucht F, Pozzetto B, Berthelot P, Botelho-Nevers E. Epidemiology and clinical relevance of Staphylococcus aureus intestinal carriage: a systematic review and meta-analysis. Expert Rev Anti Infect Ther 2017; 15:767-785. [PMID: 28726558 DOI: 10.1080/14787210.2017.1358611] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Recent data highlight the importance of screening more than one site for improving the detection of S. aureus colonization. Intestinal carriage is frequently under-investigated and its clinical impact ought to be defined a better way. Areas covered: This review and meta-analysis provide an updated overview of prevalence, characteristics and clinical significance of S. aureus intestinal carriage in different populations, both for methicillin-susceptible and -resistant S. aureus strains. Expert commentary: Intestinal S. aureus carriage is documented with higher prevalence in children and in patients with S. aureus skin and soft tissue infections. This site of colonization was shown to be associated with a high risk of dissemination in the environment and with S. aureus infection. Intestinal carriage is frequently retrieved in nasal carriers, reflecting probably an association with a high bacterial load. Exclusive intestinal carriage present in one third of intestinal carriers can be associated with infection. Comparative genotyping analysis of different strains from nasal and extra-nasal sites of carriage, including the intestinal ones, in the same individuals, would allow a better comprehension of the pathophysiology of S. aureus endogenous infection. It could also permit to improve the prevention of these infections by decolonization of sites implicated in infection genesis.
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Affiliation(s)
- Julie Gagnaire
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Paul O Verhoeven
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Florence Grattard
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Josselin Rigaill
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Frédéric Lucht
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Bruno Pozzetto
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Philippe Berthelot
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
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12
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Botelho-Nevers E, Gagnaire J, Verhoeven PO, Cazorla C, Grattard F, Pozzetto B, Berthelot P, Lucht F. Decolonization of Staphylococcus aureus carriage. Med Mal Infect 2016; 47:305-310. [PMID: 27856080 DOI: 10.1016/j.medmal.2016.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 04/25/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
Staphylococcus aureus nasal colonization is a well-known independent risk factor for infection caused by this bacterium. Screening and decolonization of carriers have been proven effective in reducing S. aureus infections in some populations. However, a gap remains between what has been proven effective and what is currently done. We aimed to summarize recommendations and current knowledge of S. aureus decolonization to answer the following questions: Why? For whom? How? When? And what are the perspectives?
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Affiliation(s)
- E Botelho-Nevers
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France.
| | - J Gagnaire
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - P O Verhoeven
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - C Cazorla
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France
| | - F Grattard
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - B Pozzetto
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - P Berthelot
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - F Lucht
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France
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