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Blez D, Bronnimann D, Rammaert B, Zeller V, Delhaes L, Hustache L, Grenouillet F, Traversier N, Bonhomme J, Chouaki T, Perpoint T, Persat F, Bougnoux ME, Bayle S, Quaesaet L, Nevez G, Boutoille D, Morio F, Pougnet L, Queyrel-Moranne V, Heym BE, Guillemain R, Dannaoui É, Roux A, Garcia-Hermoso D, Lanternier F. Invasive bone and joint infections from the French Scedosporiosis/lomentosporiosis Observational Study (SOS) cohort: no mortality with long-term antifungal treatment and surgery. Med Mycol 2023; 61:7051228. [PMID: 36813259 DOI: 10.1093/mmy/myad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Little is known about localized osteoarticular Scedosporiosis (LOS). Most data come from case reports and small case series. Here we present an ancillary study of the nationwide French Scedosporiosis Observational Study (SOS), describing 15 consecutive cases of LOS diagnosed between January 2005 and March 2017. Adult patients diagnosed with LOS defined by osteoarticular involvement without distant foci reported in SOS were included. Fifteen LOS were analyzed. Seven patients had underlying disease. Fourteen patients had prior trauma as potential inoculation. Clinical presentation was arthritis (n = 8), osteitis (n = 5), and thoracic wall infection (n = 2). The most common clinical manifestation was pain (n = 9), followed by localized swelling (n = 7), cutaneous fistulization (n = 7), and fever (n = 5). The species involved were Scedosporium apiospermum (n = 8), S. boydii (n = 3), S. dehoogii (n = 1), and Lomentospora prolificans (n = 3). The species distribution was unremarkable except for S. boydii, which was associated with healthcare-related inoculations. Management was based on medical and surgical treatment for 13 patients. Fourteen patients received antifungal treatment for a median duration of 7 months. No patients died during follow-up. LOS exclusively occurred in the context of inoculation or systemic predisposing factors. It has a non-specific clinical presentation and is associated with an overall good clinical outcome, provided there is a prolonged course of antifungal therapy and adequate surgical management.
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Affiliation(s)
- Damien Blez
- Service de Maladies Infectieuses et Tropicales, Hôpital universitaire Necker-Enfants malades, Paris, France
| | - Didier Bronnimann
- Service des pathologies infectieuses et tropicales, Université de Paris, Paris, Île-de-France, France
- Médecine interne et maladies infectieuses, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, Aquitaine, France
| | - Blandine Rammaert
- Service de médecine interne et maladies infectieuses et tropicales, CHU Poitiers, Poitiers, France
- Université de Poitiers, INSERM U1070, Poitiers, Nouvelle-Aquitaine, France
| | - Valérie Zeller
- Osteoarticular Reference Center, GH Diaconesses Croix St Simon, Paris, Île-de-France, France
| | - Laurence Delhaes
- INSERM U1045, Bordeaux, Aquitaine, France
- Service de parasitologie-mycologie, Université de Bordeaux, Talence, France
| | - Laurent Hustache
- Service de Maladies Infectieuses et Tropicales, Hôpital Jean Minjoz, Besancon, France
| | - Frédéric Grenouillet
- Chrono-Environment, UFR Santé-Pharmacie et UMR 6249 UBFC-CNRS, Besancon, Bourgogne-Franche-Comté, France
- Mycology Parasitology, University Hospital Centre Besancon, Besancon, France
| | - Nicolas Traversier
- Microbiology Saint-Denis, Felix Guyon University Hospital Center, La Réunion, France
| | - Julie Bonhomme
- Microbiology Laboratory, University Hospital Centre Caen, ToxEMAC-ABTE, Unicaen, Caen, Basse-Normandie, France
| | - Taieb Chouaki
- Mycology, University Hospital Centre Amiens-Picardie, Amiens, Hauts-de-France, France
| | - Thomas Perpoint
- Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Florence Persat
- Service de Parasitologie et Mycologie Médicale, Hospices Civils de Lyon, Lyon, France
- EA7426 PI3-Inflammation and Immunity of the Respiratory Epithelium, Université Claude Bernard Lyon 1, Pierre-Bénite, France
| | - Marie Elisabeth Bougnoux
- Mycology, Hopital universitaire Necker-Enfants malades, Paris, Île-de-France, France
- National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Institut Pasteur, Université Paris Cité, Paris, France
| | - Sophie Bayle
- Medecine interne et infectiologie aiguë polyvalente, Hospital Centre Avignon, Avignon, Provence-Alpes-Côte d'Azu, France
| | - Luc Quaesaet
- Service de Maladies Infectieuses et Tropicales, Cavale Blanche Hospital, Brest, Bretagne, France
| | - Gilles Nevez
- Parasitologie et Mycologie, Centre Hospitalier Universitaire de Brest, Brest, Bretagne, France
- Infections Respiratoires Fongiques (IRF), UFR Médecine science de la santé, Brest, France
| | - David Boutoille
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France
- Centre d'Investigation Clinique-Unité d'Investigation Clinique 1413 INSERM, CHU Nantes, France
| | - Florent Morio
- Centre d'Investigation Clinique-Unité d'Investigation Clinique 1413 INSERM, CHU Nantes, France
- Laboratory of Parasitology and Medical Mycology, Cibles et médicaments des infections et de l'immunité, University Hospital Centre Nantes, IICiMed, UR1155, F-44000, Nantes, Pays de la Loire, France
| | - Laurence Pougnet
- Laboratoire de biologie médicale, HIA Clermont-Tonnerre, CC41, Brest, Bretagne, France
| | - Viviane Queyrel-Moranne
- Service de rhumatologie, Hôpital Pasteur 2, CHU Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - B Eate Heym
- Osteoarticular Reference Center, GH Diaconesses Croix St Simon, Paris, Île-de-France, France
| | | | - Éric Dannaoui
- Service de parasitologie-mycologie, Hopital Européen Georges Pompidou, Paris,Île-de-France, France
- CRCM-Centre de Transplantation Pulmonaire, Service de pneumologie, Hôpital Foch, Suresnes, France
| | - Antoine Roux
- Service de parasitologie-mycologie, Hopital Européen Georges Pompidou, Paris,Île-de-France, France
| | - Dea Garcia-Hermoso
- National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Institut Pasteur, Université Paris Cité, Paris, France
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, Hôpital universitaire Necker-Enfants malades, Paris, France
- National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Institut Pasteur, Université Paris Cité, Paris, France
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Rammaert B, Bochud PY, Brunel AS, Wojtowicz A, Candon S, Gallego Hernanz MP, Lortholary O. A Functional Polymorphism in IL-1B Is Associated With Immune Reconstitution Inflammatory Syndrome of Chronic Disseminated Candidiasis. Open Forum Infect Dis 2023; 10:ofad078. [PMID: 36879623 PMCID: PMC9984983 DOI: 10.1093/ofid/ofad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
We investigated single nucleotide polymorphisms (SNPs) possibly involved in immune reconstitution inflammatory syndrome of chronic disseminated candidiasis (IRIS-CDC) through a candidate gene approach and a prospective matched-control study. We found that an SNP located in interleukin-1B at rs1143627 was significantly associated with the risk of developing IRIS-CDC.
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Affiliation(s)
- Blandine Rammaert
- Université de Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, Paris, France
| | - Pierre-Yves Bochud
- Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, CHUV, Lausanne, Switzerland
| | - Anne-Sophie Brunel
- Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, CHUV, Lausanne, Switzerland
| | - Agnieszka Wojtowicz
- Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, CHUV, Lausanne, Switzerland
| | - Sophie Candon
- INSERM U1234, CHU de Rouen Normandie, Université de Rouen Normandie, Rouen, France
| | | | - Olivier Lortholary
- Université de Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, Paris, France.,Institut Pasteur, CNRS, Département de Mycologie, UMR 2000, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France
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Delaye T, Torregrosa Diaz JM, Vallée M, Gallego Hernanz MP, Gyan E, Lanotte P, Roblot F, Rammaert B. Outcome of febrile neutropenic patients treated for bacteriuria in hematology. Support Care Cancer 2023; 31:102. [PMID: 36622445 DOI: 10.1007/s00520-022-07522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 11/02/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Positive urine sample is a frequent finding in post-chemotherapy febrile neutropenia (FN) and can lead to prolonged antibiotic therapy. The aim of this study was to assess the outcome of bacteriuria episodes in FN patients receiving targeted antibiotic therapy. MATERIALS AND METHODS A multi-centric retrospective study was conducted over a four-year period (2014-2019) on systematic urinalysis. All consecutive first bacteriuria episodes (≤ 2 bacteria with at least ≥ 103 CFU/mL) during FN in hospitalized adult patients for hematological malignancies were included. Relapse and recurrence were defined by fever or urinary tract symptoms (UTS) with the same bacterial subspecies in urine occurring ≤ 7 days and ≤ 30 days, respectively, after antibiotic discontinuation. Mortality rate was determined at 30 days. Targeted antibiotic therapy ≤ 10 days for women and ≤ 14 for men was considered as short course. RESULTS Among 97 patients, 105 bacteriuria episodes on systematic urinalysis were analyzed; 67.6% occurred in women, 41.9% in AML patients, 17.1% were bacteremic, 14.2% presented with UTS, and 61.9% were treated with short-course antibiotic treatment. One death was reported. In men, no relapse/recurrence was noted, even in the short-course antibiotic group. In women, 2.8% of episodes treated with short-course antibiotic led to relapse or recurrence. CONCLUSIONS Relapse, recurrence, and mortality were uncommon events in FN patients experiencing bacteriuria episode, whatever the antibiotic duration. To distinguish asymptomatic bacteriuria from infection remained challenging in women. In men, systematic urinalysis at onset of FN could be useful.
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Affiliation(s)
- Thomas Delaye
- Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.,CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, Poitiers, France
| | | | - Maxime Vallée
- Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.,CHU de Poitiers, Service de Chirurgie Urologique et de Transplantations Rénales, Poitiers, France.,INSERM U1070, Poitiers, France
| | | | - Emmanuel Gyan
- CHU de Tours, Service d'Hématologie Et Thérapie Cellulaire, Equipe LNOx CNRS ERL 7001, Tours, France
| | - Philippe Lanotte
- CHU de Tours, Service de Bactériologie Département des Agents Infectieux Tours, Poitiers, France
| | - France Roblot
- Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.,CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, Poitiers, France.,INSERM U1070, Poitiers, France
| | - Blandine Rammaert
- Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France. .,CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, Poitiers, France. .,INSERM U1070, Poitiers, France. .,Service de Médecine Interne et Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, CS 90577, Cedex, 86021, Poitiers, France.
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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5
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Rammaert B, Maunoury C, Rabeony T, Correas JM, Elie C, Alfandari S, Berger P, Rubio MT, Braun T, Bakouboula P, Candon S, Montravers F, Lortholary O. Does 18F-FDG PET/CT add value to conventional imaging in clinical assessment of chronic disseminated candidiasis? Front Med (Lausanne) 2022; 9:1026067. [PMID: 36606049 PMCID: PMC9807873 DOI: 10.3389/fmed.2022.1026067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Chronic disseminated candidiasis (CDC) classically occurs after profound and prolonged neutropenia. The aim of the CANHPARI study was to assess the clinical value of adding 18F-fluorodeoxyglucose PET/CT to conventional radiology for initial and subsequent evaluations of CDC. Materials and methods A pilot prospective study was conducted in 23 French onco-hematological centers from 2013 to 2017 (NCT01916057). Patients ≥ 18 y.o. suspected for CDC on abdominal conventional imaging (CT or MRI) were included. PET/CT and conventional imaging were performed at baseline and month 3 (M3). Follow-up was assessed until M12. The primary outcome measure was the global response at M3, i.e., apyrexia and complete response to PET/CT. The secondary outcome measure consists in comparison between responses to PET/CT and conventional imaging at diagnosis and M3. Results Among 52 included patients, 44 were evaluable (20 probable and 24 possible CDC); 86% had acute leukemia, 55% were male (median age 47 years). At diagnosis, 34% had fever and conventional imaging was always abnormal with microabscesses on liver and spleen in 66%, liver in 25%, spleen in 9%. Baseline PET/CT showed metabolic uptake on liver and/or spleen in 84% but did not match with lesion localizations on conventional imaging in 32%. M3 PET/CT showed no metabolic uptake in 13 (34%) patients, 11 still having pathological conventional imaging. Global response at M3 was observed in eight patients. Conclusion Baseline PET/CT does not replace conventional imaging for initial staging of CDC lesions but should be performed after 3 months of antifungal therapy. Clinical trial registration [www.clinicaltrials.gov], identifier [NCT01916057].
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Affiliation(s)
- Blandine Rammaert
- Université de Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d’Infectiologie Necker-Pasteur, Institut Imagine, Paris, France,*Correspondence: Blandine Rammaert,
| | - Christophe Maunoury
- Université de Paris, APHP, Hôpital Européen Georges Pompidou, Service de Médecine Nucléaire, Paris, France
| | | | - Jean-Michel Correas
- Université de Paris Cité, APHP, Service de Radiologie Adulte, Hôpital Necker-Enfants Malades, Paris, France
| | | | - Serge Alfandari
- Centre Hospitalier Tourcoing, Service de Réanimation et Maladies Infectieuses, Tourcoing, France
| | - Pierre Berger
- Institut Paoli-Calmettes, Infectiologie Transversale, Marseille, France
| | | | - Thorsten Braun
- Université de Paris Nord, APHP, Hôpital Avicenne, Service d’Hématologie, Bobigny, France
| | | | - Sophie Candon
- Université de Rouen Normandie, INSERM U1234, CHU de Rouen Normandie, Rouen, France
| | - Françoise Montravers
- Sorbonne Université, APHP, Service de Médecine Nucléaire, Hôpital Tenon, Paris, France
| | - Olivier Lortholary
- Université de Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d’Infectiologie Necker-Pasteur, Institut Imagine, Paris, France,Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR 2000, Paris, France
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6
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Deroche L, Buyck J, Cateau E, Rammaert B, Marchand S, Brunet K. Draft Genome Sequence of Kazachstania bovina Yeast Isolated from Human Infection. Mycopathologia 2022; 187:413-415. [PMID: 35829847 DOI: 10.1007/s11046-022-00639-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/18/2022] [Indexed: 11/26/2022]
Abstract
Kazachstania bovina is a yeast species from the K. telluris complex that has been recently involved in bloodstream infections. While yeast genomes from this complex have already been sequenced, K. bovina genome has not been published yet. Here is the first draft genome of K. bovina (CBS 16326).
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Affiliation(s)
- Luc Deroche
- INSERM U1070, Poitiers, France
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Département des Agents Infectieux, Service de Virologie, CHU de Poitiers, Poitiers, France
| | - Julien Buyck
- INSERM U1070, Poitiers, France
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
| | - Estelle Cateau
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Département des Agents Infectieux, Service de Mycologie-Parasitologie, CHU de Poitiers, Poitiers, France
- Laboratoire Écologie et Biologie des Interactions, UMR CNRS 7267, Université de Poitiers, Poitiers, France
| | - Blandine Rammaert
- INSERM U1070, Poitiers, France
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, Poitiers, France
| | - Sandrine Marchand
- INSERM U1070, Poitiers, France
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Service de Toxicologie et de Pharmacocinétique, CHU de Poitiers, Poitiers, France
| | - Kévin Brunet
- INSERM U1070, Poitiers, France.
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.
- Département des Agents Infectieux, Service de Mycologie-Parasitologie, CHU de Poitiers, Poitiers, France.
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7
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Petit S, Puyade M, Pichon M, Wangermez M, Velasco S, Roblot F, Isambert N, Evrard C, Rammaert B. Risk factors for biliary stent infections in malignant biliary obstruction secondary to unresectable malignancies. Support Care Cancer 2022; 30:6937-6946. [PMID: 35543817 DOI: 10.1007/s00520-022-07106-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/29/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Palliative biliary drainage in patients with unresectable malignant biliary obstruction (MBO) frequently leads to biliary stent infection (BI), which could impact medical care. The aim of this study was to assess the risk factors for BI occurrence in patients after stenting procedure and the impact of BI on patient survival. METHODS All consecutive patients hospitalized from 2014 to 2018 for MBO and biliary stenting were retrospectively included. Demographic, clinical, and microbiological characteristics of each BI episode during a 1-year follow-up were described. Documented BI was defined as the association of BI episode and confirmed blood stream infection (BSI). Univariate and multivariate analyses were performed to evaluate risk factors for the first BI occurrence. RESULTS Among 180 patients, 56% were men (mean age of 69±12), and 54% have pancreatic cancer, 16% biliary cancer, 2% hepatic cancer, and 28% lymph node or metastatic compression; metallic stent was placed in 92%. A total of 113 BI episodes occurred in 74 patients, 55% of the first episodes occurring within 3 months after stenting. BI was documented in 56% of the episodes. Enterobacteriaceae were the most frequent pathogens found, while no yeasts were documented. Mortality rate in patients with BI was 64%. Multivariate analysis showed a significant difference in BI occurrence for two criteria: WHO score 3-4 (OR=8.79 [1.79-42.89]; p=0.007) and transpapillary stenting location (OR=3.72 [1.33-10.44]; p=0.013). CONCLUSION Since transpapillary stenting is a risk factor for BI, preserving the papilla as much as possible is a priority so as to avoid BI.
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Affiliation(s)
- Sébastien Petit
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
| | - Mathieu Puyade
- Service de Médecine Interne et Maladies Infectieuses et Tropicales, CHU Poitiers, 2 rue de la Milétrie, CS 90577, 86021, Poitiers Cedex, France
| | - Maxime Pichon
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Laboratoire de Bactériologie et Hygiène Hospitalière, Département des Agents Infectieux, CHU Poitiers, Poitiers, France
- INSERM U1070, Poitiers, France
| | - Marc Wangermez
- Service d'Hépato Gastro-Entérologie, CHU Poitiers, Poitiers, France
| | - Stéphane Velasco
- Service de Radiologie Interventionnelle, CHU Poitiers, Poitiers, France
| | - France Roblot
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Service de Médecine Interne et Maladies Infectieuses et Tropicales, CHU Poitiers, 2 rue de la Milétrie, CS 90577, 86021, Poitiers Cedex, France
- INSERM U1070, Poitiers, France
| | - Nicolas Isambert
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
- Service d'Oncologie Médicale, Pôle Régional de Cancérologie, CHU Poitiers, Poitiers, France
| | - Camille Evrard
- Service d'Oncologie Médicale, Pôle Régional de Cancérologie, CHU Poitiers, Poitiers, France
| | - Blandine Rammaert
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.
- Service de Médecine Interne et Maladies Infectieuses et Tropicales, CHU Poitiers, 2 rue de la Milétrie, CS 90577, 86021, Poitiers Cedex, France.
- INSERM U1070, Poitiers, France.
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Brunet K, Martellosio JP, Tewes F, Marchand S, Rammaert B. Inhaled Antifungal Agents for Treatment and Prophylaxis of Bronchopulmonary Invasive Mold Infections. Pharmaceutics 2022; 14:pharmaceutics14030641. [PMID: 35336015 PMCID: PMC8949245 DOI: 10.3390/pharmaceutics14030641] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
Pulmonary mold infections are life-threatening diseases with high morbi-mortalities. Treatment is based on systemic antifungal agents belonging to the families of polyenes (amphotericin B) and triazoles. Despite this treatment, mortality remains high and the doses of systemic antifungals cannot be increased as they often lead to toxicity. The pulmonary aerosolization of antifungal agents can theoretically increase their concentration at the infectious site, which could improve their efficacy while limiting their systemic exposure and toxicity. However, clinical experience is poor and thus inhaled agent utilization remains unclear in term of indications, drugs, and devices. This comprehensive literature review aims to describe the pharmacokinetic behavior and the efficacy of inhaled antifungal drugs as prophylaxes and curative treatments both in animal models and humans.
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Affiliation(s)
- Kévin Brunet
- Institut National de la Santé et de la Recherche Médicale, INSERM U1070, Pôle Biologie Santé, 1 rue Georges Bonnet, 86022 Poitiers, France; (J.-P.M.); (F.T.); (S.M.)
- Faculté de Médecine et Pharmacie, Université de Poitiers, 6 rue de la Milétrie, 86073 Poitiers, France
- Laboratoire de Mycologie-Parasitologie, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France
- Correspondence: (K.B.); (B.R.)
| | - Jean-Philippe Martellosio
- Institut National de la Santé et de la Recherche Médicale, INSERM U1070, Pôle Biologie Santé, 1 rue Georges Bonnet, 86022 Poitiers, France; (J.-P.M.); (F.T.); (S.M.)
- Faculté de Médecine et Pharmacie, Université de Poitiers, 6 rue de la Milétrie, 86073 Poitiers, France
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France
| | - Frédéric Tewes
- Institut National de la Santé et de la Recherche Médicale, INSERM U1070, Pôle Biologie Santé, 1 rue Georges Bonnet, 86022 Poitiers, France; (J.-P.M.); (F.T.); (S.M.)
- Faculté de Médecine et Pharmacie, Université de Poitiers, 6 rue de la Milétrie, 86073 Poitiers, France
| | - Sandrine Marchand
- Institut National de la Santé et de la Recherche Médicale, INSERM U1070, Pôle Biologie Santé, 1 rue Georges Bonnet, 86022 Poitiers, France; (J.-P.M.); (F.T.); (S.M.)
- Faculté de Médecine et Pharmacie, Université de Poitiers, 6 rue de la Milétrie, 86073 Poitiers, France
- Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France
| | - Blandine Rammaert
- Institut National de la Santé et de la Recherche Médicale, INSERM U1070, Pôle Biologie Santé, 1 rue Georges Bonnet, 86022 Poitiers, France; (J.-P.M.); (F.T.); (S.M.)
- Faculté de Médecine et Pharmacie, Université de Poitiers, 6 rue de la Milétrie, 86073 Poitiers, France
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France
- Correspondence: (K.B.); (B.R.)
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Hennebique A, Caspar Y, Maurin M, Boisset S, Pelloux I, Gallego-Hernanz MP, Burucoa C, Cazenave-Roblot F, Plouzeau C, Rammaert B. Ulceroglandular Infection and Bacteremia Caused by Francisella salimarina in Immunocompromised Patient, France. Emerg Infect Dis 2022; 28:465-467. [PMID: 35076000 PMCID: PMC8798692 DOI: 10.3201/eid2802.211380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Although Francisella tularensis is a well-known, highly virulent bacterium that causes tularemia in humans, other Francisella species have been associated with sporadic human infections. We describe a human cutaneous infection with bacteremia caused by F. salimarina, a Francisella species recently identified from seawater and fishes, in an immunocompromised patient in France.
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E, Bakakos A, Bakar NA, Bal A, Balakrishnan M, Balan V, Bani-Sadr F, Barbalho R, Barbosa NY, Barclay WS, Barnett SU, Barnikel M, Barrasa H, Barrelet A, Barrigoto C, Bartoli M, Bartone C, Baruch J, Bashir M, Basmaci R, Basri MFH, Bastos D, Battaglini D, Bauer J, Bautista Rincon DF, Bazan Dow D, Bedossa A, Bee KH, Behilill S, Beishuizen A, Beljantsev A, Bellemare D, Beltrame A, Beltrão BA, Beluze M, Benech N, Benjiman LE, Benkerrou D, Bennett S, Bento L, Berdal JE, Bergeaud D, Bergin H, Bernal Sobrino JL, Bertoli G, Bertolino L, Bessis S, Betz A, Bevilcaqua S, Bezulier K, Bhatt A, Bhavsar K, Bianchi I, Bianco C, Bidin FN, Bikram Singh M, Bin Humaid F, Bin Kamarudin MN, Bissuel F, Biston P, Bitker L, Blanco-Schweizer P, Blier C, Bloos F, Blot M, Blumberg L, Boccia F, Bodenes L, Bogaarts A, Bogaert D, Boivin AH, Bolze PA, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho-Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau 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Auger C, Chapplain JM, Chas J, Chaudary M, Chávez Iñiguez JS, Chen A, Chen YS, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Chin-Tho L, Chirouze C, Chiumello D, Cho HJ, Cho SM, Cholley B, Chopin MC, Chow TS, Chow YP, Chua HJ, Chua J, Cidade JP, Cisneros Herreros JM, Citarella BW, Ciullo A, Clarke E, Clarke J, Claure Del Granado R, Clohisey S, Cobb JP, Coca N, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connolly J, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cormican S, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin-Cadiergues S, Courtois R, Cousse S, Cregan R, Crepy D'Orleans C, Croonen S, Crowl G, Crump J, Cruz C, Cruz Berm JL, Cruz Rojo J, Csete M, Cucino A, Cullen A, Cullen C, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz AA, Dagens A, Dahly D, Dalton H, Dalton J, Daly S, D'Amico F, Daneman N, Daniel C, Dankwa EA, Dantas J, D’Aragon F, de Boer M, de Loughry G, de Mendoza D, De Montmollin E, de Oliveira França RF, de Pinho Oliveira AI, De Rosa R, de Silva T, de Vries P, Deacon J, Dean D, Debard A, DeBenedictis B, Debray MP, DeCastro N, Dechert W, Deconninck L, Decours R, Defous E, Delacroix I, Delaveuve E, Delavigne K, Delfos NM, Deligiannis I, Dell'Amore A, Delmas C, Delobel P, Delsing C, Demonchy E, Denis E, Deplanque D, Depuydt P, Desai M, Descamps D, Desvallée M, Dewayanti S, Diallo A, Diamantis S, Dias A, Diaz P, Diaz R, Diaz Diaz JJ, Didier K, Diehl JL, Dieperink W, Dimet J, Dinot V, Diop F, Diouf A, Dishon Y, Dixit D, Djossou F, Docherty AB, Doherty H, Dondorp AM, Dong A, Donnelly CA, Donnelly M, Donohue C, Donohue S, Donohue Y, Doran C, Doran P, Dorival C, D'Ortenzio E, Douglas JJ, Douma R, Dournon N, Downer T, Downey J, Downing M, Drake T, Driscoll A, Dryden M, Duarte Fonseca C, Dubee V, Dubos F, Ducancelle A, Duculan T, Dudman S, Duggal A, Dunand P, Dunning J, Duplaix M, Durante-Mangoni E, Durham III L, Dussol B, Duthoit J, Duval X, Dyrhol-Riise AM, Ean SC, Echeverria-Villalobos M, Egan S, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito-Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre I, Fabre M, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Faria P, Farooq A, Farrar JJ, Farshait N, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes M, Fernandes S, Ferrand FX, Ferrand Devouge E, Ferrão J, Ferraz M, Ferreira B, Ferreira S, Ferrer-Roca R, Ferriere N, Ficko C, Figueiredo-Mello C, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn B, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher DM, Franch-Llasat D, Fraser C, Fraser JF, Freire MV, Freitas Ribeiro A, Friedrich C, Fritz R, Fry S, Fuentes N, Fukuda M, Gaborieau V, Gaci R, Gagliardi M, Gagnard JC, Gagné N, Gagneux-Brunon A, Gaião S, Gail Skeie L, Gallagher P, Gallego Curto E, Gamble C, Gani Y, Garan A, Garcia R, García Barrio N, Garcia-Diaz J, Garcia-Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Gerbaud Morlaes L, Germano N, ghisulal PK, Ghosn J, Giani M, Giaquinto C, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Gitahi J, Giwangkancana G, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard JC, Goh JY, Golob J, Gomes R, Gomez K, Gómez-Junyent J, Gominet M, Gonzalez A, Gordon P, Gordon A, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Grazioli L, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Grosse Lordemann A, Gruner H, Gu Y, Guarracino F, Guedj J, Guego M, Guellec D, Guerguerian AM, Guerreiro D, Guery R, Guillaumot A, Guilleminault L, Guimarães de Castro M, Guimard T, Haalboom M, Haber D, Habraken H, Hachemi A, Hadri N, Haidash O, Haider S, Haidri F, Hakak S, Hall A, Hall M, Halpin S, Hamer A, Hamers R, Hamidfar R, Hammond T, Han LY, Haniffa R, Hao KW, Hardwick H, Harrison EM, Harrison J, Harrison SBE, Hartman A, Hashmi J, Hashmi M, Hayat M, Hayes A, Hays L, Heerman J, Heggelund L, Hendry R, Hennessy M, Henriquez A, Hentzien M, Herekar F, Hernandez-Montfort J, Herr D, Hershey A, Hesstvedt L, Hidayah A, Higgins D, Higgins E, HigginsOKeeffe G, Hinchion R, Hinton S, Hiraiwa H, Hitoto H, Ho A, Ho YB, Hoctin A, Hoffmann I, Hoh WH, Hoiting O, Holt R, Holter JC, Horby P, Horcajada JP, Hoshino K, Hoshino K, Houas I, Hough CL, Houltham S, Hsu JMY, Hulot JS, Hussain I, Ijaz S, Illes HG, Imbert P, Imran M, Imran Sikander R, Inácio H, Infante Dominguez C, Ing YS, Iosifidis E, Ippolito M, Isgett S, Ishani PGPI, Isidoro T, Ismail N, Isnard M, Itai J, Ito A, 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M, Lepiller Q, Lescure FX, Lesens O, Lesouhaitier M, Lester-Grant A, Levy B, Levy Y, Levy-Marchal C, Lewandowska K, L'Her E, Li Bassi G, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina B, Lina L, Lind A, Lingas G, Lion-Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez-Colon D, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace-Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Lumbreras Bermejo C, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, MacDonald S, MacDonald S, Machado M, Macheda G, Macias Sanchez J, Madhok J, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandei JM, Mandelbrot L, Manetta F, Mangal K, Mankikian J, Manning E, Manuel A, Maria Sant`Ana Malaque C, Marino D, Marino F, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, 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Plantier L, Plotkin D, Png HS, Poissy J, Pokeerbux R, Pokorska-Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Post AM, Postma DF, Povoa P, Póvoas D, Powis J, Prapa S, Preau S, Prebensen C, Preiser JC, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Puéchal O, Pujo Semedi B, Pulicken M, Puntoni M, Purcell G, Quesada L, Quinones-Cardona V, Quirós González V, Quist-Paulsen E, Quraishi M, Rabaa M, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Ragazzo G, Rahman AKHA, Rahman RA, Rahutullah A, Rainieri F, Rajahram GS, Rajapakse N, Ralib A, Ramakrishnan N, Ramanathan K, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Reeve B, Rehan A, Rehman A, Reid L, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Resende L, Resseguier AS, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Richardson D, Richardson D, Richier L, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Rivera Nuñez MA, Rizer N, Robb D, Robba C, Roberto A, Roberts S, Robertson DL, Robineau O, Roche-Campo F, Rodari P, Rodeia S, Rodriguez Abreu J, Roessler B, Roger C, Roger PM, Roilides E, Rojek A, Romaru J, Roncon-Albuquerque Jr R, Roriz M, Rosa-Calatrava M, Rose M, Rosenberger D, Rossanese A, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Ryckaert S, Rygh Holten A, Saba I, Sadaf S, Sadat M, Sahraei V, Saint-Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Saleem J, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sánchez Choez X, Sanchez de Oliveira K, Sanchez-Miralles A, Sancho-Shimizu V, Sandhu G, Sandhu Z, Sandrine PF, Sandulescu O, Santos M, Sarfo-Mensah S, Sarmento Banheiro B, Sarmiento ICE, Sarton B, Satyapriya S, Satyawati R, Saviciute E, Savio R, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Scott JT, Scott-Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Sepulveda C, Sequeira F, Sequeira T, Serpa Neto A, Serrano Balazote P, Shadowitz E, Shahidan SA, Shahnaz Hasan M, Shamsah M, Shankar A, Sharjeel S, Sharma P, Shaw CA, Shaw V, Shi H, Shiban N, Shiekh M, Shiga T, Shime N, Shimizu H, Shimizu K, Shimizu N, Shindo N, Shrapnel S, Shum HP, Si Mohammed N, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Silva MJ, Silva R, Sim Lim Heng B, Sin WC, Singh BC, Singh P, Sitompul PA, Sivam K, Skogen V, Smith S, Smood B, Smyth C, Smyth M, Smyth M, Snacken M, So D, Soh TV, Solis M, Solomon J, Solomon T, Somers E, Sommet A, Song MJ, Song R, Song T, Song Chia J, Sonntagbauer M, Soom AM, Sotto A, Soum E, Sousa AC, Sousa M, Sousa Uva M, Souza-Dantas V, Sperry A, Spinuzza E, Sri Darshana BPSR, Sriskandan S, Stabler S, Staudinger T, Stecher SS, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu-Cercel A, Streinu-Cercel A, Strudwick S, Stuart A, Stuart D, Subekti D, Suen G, Suen JY, Sukumar P, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Suwarti S, Svistunov AA, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Talarek E, Taleb S, Talsma J, Tampubolon ML, Tan KK, Tan LV, Tan YC, Tanaka C, Tanaka H, Tanaka T, Taniguchi H, Tanveer H, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Tellier MC, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier-Grenier H, Tey A, Thabit AAM, Tham ZD, Thangavelu S, Thibault V, Thiberville SD, Thill B, Thirumanickam J, Thompson S, Thomson D, Thomson EC, Thurai SRT, Thuy DB, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit JF, Tirupakuzhi Vijayaraghavan BK, Tissot N, Toh JZY, Toki M, Tolppa T, Tonby K, Tonnii SL, Torres A, Torres M, Torres Santos-Olmo RM, Torres-Zevallos H, Towers M, Trapani T, Traynor D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
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Lemaigre C, Suarez F, Martellosio JP, Barbarin C, Brunet K, Chomel JC, Hainaut E, Rammaert B, Roblot F, Torregrosa-Diaz JM. Late Onset of Chronic Granulomatous Disease Revealed by Paecilomyces lilacinus Cutaneous Infection. J Clin Immunol 2021; 42:60-63. [PMID: 34596815 PMCID: PMC8821496 DOI: 10.1007/s10875-021-01140-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022]
Abstract
Chronic granulomatous disease (CGD) is an inherited immunodeficiency due to defective leukocyte NADPH responsible for recurrent infections and aberrant inflammation. Mutations in the CYBB gene are responsible for the X-linked CGD and account for approximately 70% of the cases. CGD is diagnosed during childhood in males. Female carriers may have biased X-inactivation and may present with clinical manifestations depending on the level of residual NADPH oxidase activity. We report the case of a previously asymptomatic female carrier who was diagnosed at age 67 with a skin infection with the rare fungus Paecilomyces lilacinus as the first manifestation of CGD. Dihydrorhodamine 123 (DHR) activity was below 10%. Next-generation sequencing (NGS) revealed mutations in DNMT3A, ASXL1, and STAG2 suggesting that clonal hematopoiesis could be responsible for a progressive loss of NADPH oxidase activity and the late onset of X-linked CGD in this patient. Long-term follow-up of asymptomatic carrier women seems to be essential after 50 years old.
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Affiliation(s)
- Clément Lemaigre
- Service de Maladies Infectieuses Et Tropicales, CHU Poitiers, Poitiers, France.,University of Poitiers, Poitiers, France
| | - Felipe Suarez
- Necker - Enfants Malades, APHP - Centre Université de Paris, Institut Imagine, INSERM UMR 1163 & CNRS ERL 8254, Université de Paris, Paris, France
| | - Jean-Philippe Martellosio
- Service de Maladies Infectieuses Et Tropicales, CHU Poitiers, Poitiers, France.,University of Poitiers, Poitiers, France
| | - Cindy Barbarin
- University of Poitiers, Poitiers, France.,Service de Dermatologie, CHU Poitiers, Poitiers, France
| | - Kévin Brunet
- University of Poitiers, Poitiers, France.,INSERM U1070, Poitiers, France.,Département Des Agents Infectieux, CHU Poitiers, Poitiers, France
| | - Jean Claude Chomel
- Service d'Oncologie Hématologique Et Thérapie Cellulaire, INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, 86021, Poitiers Cedex, France.,Service de Cancérologie Biologique, Poitiers, France
| | - Ewa Hainaut
- Service de Dermatologie, CHU Poitiers, Poitiers, France
| | - Blandine Rammaert
- Service de Maladies Infectieuses Et Tropicales, CHU Poitiers, Poitiers, France.,University of Poitiers, Poitiers, France.,INSERM U1070, Poitiers, France
| | - France Roblot
- Service de Maladies Infectieuses Et Tropicales, CHU Poitiers, Poitiers, France.,University of Poitiers, Poitiers, France.,INSERM U1070, Poitiers, France
| | - José Miguel Torregrosa-Diaz
- Service d'Oncologie Hématologique Et Thérapie Cellulaire, INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, 86021, Poitiers Cedex, France.
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Candon S, Rammaert B, Foray AP, Moreira B, Gallego Hernanz MP, Chatenoud L, Lortholary O. Chronic Disseminated Candidiasis During Hematological Malignancies: An Immune Reconstitution Inflammatory Syndrome With Expansion of Pathogen-Specific T Helper Type 1 Cells. J Infect Dis 2021; 221:1907-1916. [PMID: 31879764 DOI: 10.1093/infdis/jiz688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Chronic disseminated candidiasis (CDC) is a rare disease that mostly occurs after chemotherapy-induced prolonged neutropenia in patients with hematological malignancies. It is believed to ensue from Candida colonization, breach of the intestinal epithelial barrier, and venous translocation to organs. Fungal blood or liver biopsy cultures are generally negative, suggesting the absence of an ongoing invasive fungal disease. METHODS To unravel the contribution of the immune system to CDC pathogenesis, we undertook a prospective multicentric exploratory study in 44 CDC patients at diagnosis and 44 matched controls. RESULTS Analysis of Candida-specific T-cell responses using enzyme-linked immunospot assays revealed higher numbers of interferon (IFN)γ-producing T cells reactive to mp65 or candidin in 27 CDC cases compared with 33 controls. Increased plasma levels of soluble CD25, interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and IL-10 and lower levels of IL-2 were observed in CDC patients versus controls. Neutrophilia and higher levels of CD4 and CD8 T-cell activation were found in CDC patients as well as increased proportions of CXCR3-expressing TCRγδ +Vδ2+ cells. CONCLUSIONS The expansion of Candida-specific IFNγ-producing T cells together with features of T-cell activation and systemic inflammation identified here support the view that CDC belongs to the broad spectrum of fungal-associated immune reconstitution inflammatory syndromes.
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Affiliation(s)
- Sophie Candon
- Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France.,Université de Rouen Normandie, INSERM U1234, CHU de Rouen Normandie, Rouen, France
| | - Blandine Rammaert
- Université Paris Descartes, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France.,Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.,CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, Poitiers, France
| | - Anne Perrine Foray
- Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France
| | - Baptiste Moreira
- Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France
| | | | - Lucienne Chatenoud
- Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France
| | - Olivier Lortholary
- Université Paris Descartes, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Paris, France
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Abstract
New Candida species such as Candida auris have emerged recently as important invasive fungal diseases. We report a case of C. bovina bloodstream infection in a 94-year-old patient in France. The species led to identification issues because it was misidentified by phenotypic and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry methods.
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14
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Seidel D, Cornely O, Zarrouk M, Koehler P, Meis JF, Salmanton-García J, Vehreschild JJ, Christner M, Gräfe SK, Falces-Romero I, Lagrou K, Maertens J, Reséndiz- Sharpe A, Racil Z, Weinbergerová B, Valerio M, Muñoz P, Blennow O, Rammaert B, Ostojic A, Govic YL, Lass-Flörl C, Rössler S, van Dijk K, de Jong N, Steinmann J, Desoubeaux G, Alakel N, Klimko N, Schalk E, Brenier-Pinchart MP, Garcia-Vidal C, Bergeron A, Cho SY, Melchers WJG, Vehreschild MJGT, Verweij PE. 1598. Clinical implications of azole-resistant vs. azole-susceptible invasive aspergillosis in hematological malignancy (CLARITY) – a multicenter study. Open Forum Infect Dis 2020. [PMCID: PMC7778089 DOI: 10.1093/ofid/ofaa439.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Advances in the survival of patients with invasive aspergillosis (IA) are jeopardized by the emergence of azole resistance in Aspergillus fumigatus, which has been associated with high probability of azole treatment failure. The clinical implications of azole-resistant IA compared to azole-susceptible IA remain unclear. Thus, we seek to describe the epidemiology and to determine the efficacy of antifungal therapy in patients with documented azole-resistant IA compared to azole-susceptible IA in patients with hematological malignancy.
Methods
For proven and probable IA (EORTC/MSG 2019) caused by A. fumigatus in patients with hematological malignancies retrospective data were documented, comprising demographics, diagnosis, treatment, response, and outcome. Sites provided susceptibility results or respective isolates for analysis in a central laboratory.
Results
Sites in 16 countries worldwide enrolled 187 cases diagnosed with IA between 2010 and 2019; 31 (16.6%) were resistant to at least one of the clinical azoles. Fungal isolates were available from 42 cases. A mixed fungal infection was reported for 32 patients (17.1%), most were related to non-fumigatus Aspergillus and non-Aspergillus molds (n=22, 69%). Most patients were male (66.8%) and overall the majority of patients were in the age groups between 50 and 89 years (71%). Amphotericin B was used for treatment in 24 (77%) patients with azole-resistant IA, compared to 76 (49%) in the azole-susceptible group (lipid-based formulation in 98%); only five (16%) patients with azole-resistant IA were treated with an azole alone vs. 57 (36%) of those with azole-susceptible IA. Overall, all-cause mortality rate was higher for patients with azole-resistant compared to azole-susceptible IA (74.2% vs. 53.8%, log rank P=0.004), the 8 patients with an azole-resistant IA treated in the intensive care unit died within 1 month (Figure 1). Details on underlying disease and survival are given in Table 1.
Table 1. Underlying hematological malignancy and clinical outcome of patients with azole-resistant and azole-susceptible invasive aspergillosis
Figure 1. Intensive care unit 1-year survival probability for patients with azole-resistant and azole-susceptible invasive aspergillosis
Conclusion
Azole-resistance in IA is associated with worse outcome, especially in critically ill patients. Susceptibility testing should be considered in patients with a suspected azole-resistant IA to support treatment decisions.
Disclosures
Danila Seidel, PhD, Basilea (Other Financial or Material Support, travel grant) Oliver Cornely, Prof., Actelion (Grant/Research Support)Actelion (Other Financial or Material Support, Personal fees)Al Jazeera Pharmaceuticals (Consultant)Allecra Therapeutics (Other Financial or Material Support, Personal fees)Amplyx (Other Financial or Material Support, Personal fees)Amplyx (Grant/Research Support)Astellas (Grant/Research Support)Astellas (Other Financial or Material Support, Personal fees)Basilea (Other Financial or Material Support, Personal fees)Basilea (Grant/Research Support)Biosys UK Limited (Other Financial or Material Support, Personal fees)Cidara (Other Financial or Material Support, Personal fees)Cidara (Grant/Research Support)Da Volterra (Grant/Research Support)Da Volterra (Other Financial or Material Support, Personal fees)Entasis (Other Financial or Material Support, Personal fees)F2G (Other Financial or Material Support)F2G (Grant/Research Support)Gilead (Grant/Research Support)Gilead (Other Financial or Material Support, Personal fees)Grupo Biotoscana (Other Financial or Material Support, Personal fees)Janssen Pharmaceuticals (Grant/Research Support)Matinas (Other Financial or Material Support, Personal fees)Medicines Company (Grant/Research Support)MedPace (Grant/Research Support)MedPace (Other Financial or Material Support, Personal fees)Melinta Therapeutics (Grant/Research Support)Menarini Ricerche (Other Financial or Material Support, Personal fees)Merck/MSD (Other Financial or Material Support, Personal fees)Merck/MSD (Grant/Research Support)Mylan Pharmaceuticals (Consultant)Nabriva Therapeutics (Other Financial or Material Support, Personal fees)Octapharma (Other Financial or Material Support, Personal fees)Paratek Pharmaceuticals (Other Financial or Material Support, Personal fees)Pfizer (Other Financial or Material Support, Personal fees)Pfizer (Grant/Research Support)PSI (Other Financial or Material Support, Personal fees)Rempex (Other Financial or Material Support, Personal fees)Roche Diagnostics (Other Financial or Material Support, Personal fees)Scynexis (Other Financial or Material Support, Personal fees)Scynexis (Grant/Research Support)Seres Therapeutics (Other Financial or Material Support, Personal fees)Tetraphase (Other Financial or Material Support, Personal fees) Philipp Koehler, MD, Akademie für Infektionsmedizin e.V., (Other Financial or Material Support, Personal fees)Astellas Pharma GmbH (Other Financial or Material Support, Personal fees)Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany (Other Financial or Material Support, Other)Gilead Sciences GmbH (Other Financial or Material Support, Personal fees)GPR Academy Ruesselsheim (Speaker’s Bureau)Miltenyi Biotec GmbH (Other Financial or Material Support, Non-financial support)MSD Sharp & Dohme GmbH (Other Financial or Material Support, Personal fees)Noxxon N.V. (Speaker’s Bureau)University Hospital, LMU Munich (Other Financial or Material Support, Personal fees) Katrien Lagrou, n/a, FUJIFILM WAKO (Speaker’s Bureau)Gilead (Consultant, Speaker’s Bureau)MSD (Consultant, Speaker’s Bureau, Other Financial or Material Support, travel grant)Pfizer (Speaker’s Bureau, travel grant)SMB Laboratoires Brussels (Consultant) Zdenek Racil, n/a, Astellas (Grant/Research Support, Speaker’s Bureau, travel grant) Blandine Rammaert, n/a, Gilead (Speaker’s Bureau, Other Financial or Material Support, travel grant)Merck/MSD (Speaker’s Bureau)Pfizer (Other Financial or Material Support, travel grant) Nikolay Klimko, n/a, Astellas (Speaker’s Bureau)Gilead (Speaker’s Bureau)Merck/MSD (Speaker’s Bureau)Pfizer (Speaker’s Bureau) Sung-Yeon Cho, MD, Gilead (Grant/Research Support, Speaker’s Bureau)Merck Sharp & Dohme (Grant/Research Support, Speaker’s Bureau)Pfizer (Grant/Research Support, Speaker’s Bureau)
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Affiliation(s)
- Danila Seidel
- University Hospital of Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Oliver Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Marouan Zarrouk
- University Hospital of Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Philipp Koehler
- University Hospital of Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Jacques F Meis
- Canisius Wilhelmina Hospital, Nijmegen, The Netherlands, Nijmegen, Gelderland, Netherlands
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, NRW
| | - Jörg Janne Vehreschild
- University Hospital of Cologne, ECMM Excellence Center, Cologne, Germany, Cologne, Nordrhein-Westfalen, Germany
| | - Martin Christner
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Hamburg, Germany
| | - Stefanie K Gräfe
- University Hospital of Cologne, ECMM Excellence Center, Cologne, Germany, University of Hamburg, Faculty of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Cologne, Nordrhein-Westfalen, Germany
| | | | - Katrien Lagrou
- KU Leuven, Leuven, Belgium, Leuven, Vlaams-Brabant, Belgium
| | - Johan Maertens
- KU Leuven, Leuven, Belgium, Leuven, Vlaams-Brabant, Belgium
| | | | - Zdenek Racil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic, Prague, Hlavni mesto Praha, Czech Republic
| | - Barbora Weinbergerová
- Faculty Hospital Brno, Brno, Czech Republic, Brno, Hlavni mesto Praha, Czech Republic
| | - Maricela Valerio
- Hospital General Universitario Gregorio Marañón. Clinical Microbiology and Infectious Diseases Department. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Madrid, Spain
| | - Patricia Muñoz
- Hospital General Universitario Gregorio Marañón. Clinical Microbiology and Infectious Diseases Department, Madrid, Spain, Madrid, Madrid, Spain
| | - Ola Blennow
- Karolinska University Hospital, Stockholm, Stockholms Lan, Sweden
| | - Blandine Rammaert
- CHU Poitiers, Infectious Disease, Poitiers, France, Poitier, Poitou-Charentes, France
| | - Alen Ostojic
- University Hospital Centre Zagreb, Zagreb, Croatia, Zagreb, Zagrebacka, Croatia
| | - Yohann Le Govic
- University Hospital Angers, Angers, France, Angers, Nord-Pas-de-Calais, France
| | | | - Susann Rössler
- Technische Universität Dresden, Institute of Medical Microbiology and Hygiene, Dresden, Germany, Dresden, Sachsen, Germany
| | - Karin van Dijk
- Amsterdam UMC, location VUmc, The Netherlands, Amsterdam, Noord-Holland, Netherlands
| | - Nick de Jong
- Amsterdam UMC, location VUmc, The Netherlands, Amsterdam, Noord-Holland, Netherlands
| | - Jörg Steinmann
- Paracelsus Medical University, Nuremberg, Bayern, Germany
| | | | - Nael Alakel
- University Hospital Dresden, Dresden, Sachsen, Germany
| | - Nikolay Klimko
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Adygeya, Russia
| | - Enrico Schalk
- Otto-von-Guericke University, Magdeburg, Thuringen, Germany
| | | | - Carolina Garcia-Vidal
- Hospital Clinic, Department of Hematology, Barcelona, Spain, Barcelona, Catalonia, Spain
| | - Anne Bergeron
- Université Paris Diderot, APHP Saint-Louis Hospital, Paris, France, Paris, Ile-de-France, France
| | - Sung-Yeon Cho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Seoul-t’ukpyolsi, Republic of Korea
| | - Willem J G Melchers
- Radboud University Medical Center, Nijmegen, The Netherlands, Nijmegen, Noord-Holland, Netherlands
| | | | - Paul E Verweij
- Radboud University Medical Center, Nijmegen, The Netherlands, Nijmegen, Noord-Holland, Netherlands
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Brunet K, Arrivé F, Martellosio JP, Lamarche I, Marchand S, Rammaert B. Corticosteroids alter alveolar macrophage control of Lichtheimia corymbifera spores in an ex vivo mouse model. Med Mycol 2020; 59:694-700. [PMID: 33369666 DOI: 10.1093/mmy/myaa104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/23/2020] [Accepted: 12/02/2020] [Indexed: 11/12/2022] Open
Abstract
Alveolar macrophages (AM) are the first-line lung defense against Mucorales in pulmonary mucormycosis. Since corticosteroid use is a known risk factor for mucormycosis, the aim of this study was to describe the role of corticosteroids on AM capacities to control Lichtheimia corymbifera spore growth using a new ex vivo model. An in vivo mouse model was developed to determine the acetate cortisone dose able to trigger pulmonary invasive infection. Then, in the ex vivo model, male BALB/c mice were pretreated with the corticosteroid regimen triggering invasive infection, before AM collection through bronchoalveolar lavage. AMs from corticosteroid-treated mice and untreated control AMs were then exposed to L. corymbifera spores in vitro (ratio 1:5). AM control of fungal growth, adherence/phagocytosis, and oxidative burst were assessed using optical densities by spectrophotometer, flow cytometry, and 2', 7'-dichlorofluoresceine diacetate fluorescence, respectively. Cortisone acetate at 500 mg/kg, at D-3 and at D0, led to pulmonary invasive infection at D3. Co-incubated spores and AMs from corticosteroid-treated mice had significantly higher absorbance (fungal growth) than co-incubated spores and control AMs, at 24 h (P = .025), 36 h (P = .004), and 48 h (P = .001). Colocalization of spores with AMs from corticosteroid-treated mice was significantly lower than for control AMs (7.6 ± 1.9% vs 22.3 ± 5.8%; P = .003), reflecting spore adherence and phagocytosis inhibition. Finally, oxidative burst was significantly increased when control AMs were incubated with spores (P = 0.029), while corticosteroids hampered oxidative burst from treated AMs (P = 0.321). Corticosteroids enhanced fungal growth of L. corymbifera through AM phagocytosis inhibition and burst oxidative decrease in our ex vivo model. LAY SUMMARY The aim of this study was to describe the impact of corticosteroids on alveolar macrophage (AM) capacities to control Mucorales growth in a new murine ex vivo model. Corticosteroids enhanced fungal growth of L. corymbifera through AM phagocytosis inhibition and burst oxidative decrease.
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Affiliation(s)
- Kévin Brunet
- INSERM U1070, Poitiers, France.,Université de Poitiers, Faculté de médecine et pharmacie, Poitiers, France.,Centre Hospitalo-Universitaire de Poitiers, service de Mycologie-Parasitologie, Département des agents infectieux, Poitiers, France
| | - François Arrivé
- INSERM U1070, Poitiers, France.,Université de Poitiers, Faculté de médecine et pharmacie, Poitiers, France.,Centre Hospitalo-Universitaire de Poitiers, service de Maladies infectieuses et tropicales, Poitiers, France
| | - Jean-Philippe Martellosio
- INSERM U1070, Poitiers, France.,Université de Poitiers, Faculté de médecine et pharmacie, Poitiers, France.,Centre Hospitalo-Universitaire de Poitiers, service de Maladies infectieuses et tropicales, Poitiers, France
| | | | - Sandrine Marchand
- INSERM U1070, Poitiers, France.,Université de Poitiers, Faculté de médecine et pharmacie, Poitiers, France.,Centre Hospitalo-Universitaire de Poitiers, service de Toxicologie et Pharmacocinétique, Poitiers, France
| | - Blandine Rammaert
- INSERM U1070, Poitiers, France.,Université de Poitiers, Faculté de médecine et pharmacie, Poitiers, France.,Centre Hospitalo-Universitaire de Poitiers, service de Maladies infectieuses et tropicales, Poitiers, France
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Abstract
Due to the low level of resistance observed with daptomycin, this antibiotic has an important place in the treatment of severe Gram-positive infections. It is the first-in-class of the group of calcium-dependent, membrane-binding lipopeptides, and is a cyclic peptide constituted of 13 amino acids and an n-decanoyl fatty acid chain. The antibacterial action of daptomycin requires its complexation with calcium. Daptomycin is not absorbed from the gastrointestinal tract and needs to be administered parenterally. The distribution of daptomycin is limited (volume of distribution of 0.1 L/kg in healthy volunteers) due to its negative charge at physiological pH and its high binding to plasma proteins (about 90%). Its elimination is mainly renal, with about 50% of the dose excreted unchanged in the urine, justifying dosage adjustment for patients with renal insufficiency. The pharmacokinetics of daptomycin are altered under certain pathophysiological conditions, resulting in high interindividual variability. As a result, therapeutic drug monitoring of daptomycin may be of interest for certain patients, such as intensive care unit patients, patients with renal or hepatic insufficiency, dialysis patients, obese patients, or children. A target for the ratio of the area under the curve to the minimum inhibitory concentration > 666 is usually recommended for clinical efficacy, whereas in order to limit the risk of undesirable muscular effects the residual concentration should not exceed 24.3 mg/L.
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Affiliation(s)
- Nicolas Gregoire
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France
- Laboratoire de Toxicologie-Pharmacocinétique, CHU of Poitiers, 2 rue de la Miletrie, 86000, Poitiers, France
| | - Alexia Chauzy
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France
| | - Julien Buyck
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France
| | - Blandine Rammaert
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France
- Service de maladies infectieuses et tropicales, CHU of Poitiers, 2 rue de la Miletrie, 86000, Poitiers, France
| | - William Couet
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France.
- Laboratoire de Toxicologie-Pharmacocinétique, CHU of Poitiers, 2 rue de la Miletrie, 86000, Poitiers, France.
| | - Sandrine Marchand
- INSERM, U1070, UFR de Médecine Pharmacie, Université de Poitiers, 1 rue Georges Bonnet, TSA 51106, 86073, Poitiers Cedex 9, France
- Laboratoire de Toxicologie-Pharmacocinétique, CHU of Poitiers, 2 rue de la Miletrie, 86000, Poitiers, France
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17
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Beuvon C, Rammaert B, Torregrossa J, Gallego Hernanz M, Roblot F, Roblot P, Puyade M. Impact du seuil de fièvre dans l’initiation de l’antibiothérapie empirique chez les patients atteints de neutropénie fébrile : étude FLAM. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Brunet K, Arrivé F, Martellosio J, Lamarche I, Couet W, Marchand S, Rammaert B. Les corticoïdes altèrent la réponse des macrophages alvéolaires contre Lichtheimia corymbifera dans un modèle murin ex vivo. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Ouahnich A, Grosset M, Wierzbicka-Hainaut E, Marechaud R, Paccalin M, Depas N, Males S, Ngo Bell E, Riché A, Rammaert B. Dermohypodermite bactérienne non nécrosante du patient diabétique neuropathique : la place de l’amoxicilline dans la prise en charge curative. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Rammaert B, Maunoury C, Rabeony T, Alfandari S, Berger P, Rubio M, Braun T, Correas J, Montravers F, Lortholary O. Intérêt de la TEP-TDM dans le suivi des patients d’hématologie atteints de candidose chronique disséminée. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Pichon M, Guenezan J, Drugeon B, Rammaert B, Burucoa C, Roblot F, Mimoz O. Supériorité de la chlorhexidine-alcoolique à 2 % et d’un ensemble de dispositifs innovant pour prévenir les complications liées à l’utilisation des cathéters veineux périphériques. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Lauda-Maillen M, Lemaignen A, Puyade M, Catroux M, Le Moal G, Beraud G, El Hajj H, Michaud A, Destrieux C, Bernard L, Rammaert B, Cazenave-Roblot F. Feasibility of early switch to oral antibiotic in brain abscesses and empyema: a multicentre retrospective study. Eur J Clin Microbiol Infect Dis 2020; 40:209-213. [PMID: 32671654 DOI: 10.1007/s10096-020-03904-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
Affiliation(s)
- M Lauda-Maillen
- Université de Poitiers, Poitiers, France.
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France.
| | - A Lemaignen
- Université de Tours, Tours, France
- Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, Hôpital Bretonneau, Tours, France
| | - M Puyade
- Service de Médecine Interne, CHU de Poitiers, Poitiers, France
| | - M Catroux
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - G Le Moal
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - G Beraud
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - H El Hajj
- Service de Neurochirurgie, CHU de Poitiers, Poitiers, France
| | - A Michaud
- Service de Microbiologie, CHU de Poitiers, Poitiers, France
| | - C Destrieux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - L Bernard
- Université de Tours, Tours, France
- Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, Hôpital Bretonneau, Tours, France
| | - B Rammaert
- Université de Poitiers, Poitiers, France
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
- INSERM U1070, Poitiers, France
| | - F Cazenave-Roblot
- Université de Poitiers, Poitiers, France
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
- INSERM U1070, Poitiers, France
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23
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Brunet K, Rammaert B. Mucormycosis treatment: Recommendations, latest advances, and perspectives. J Mycol Med 2020; 30:101007. [PMID: 32718789 DOI: 10.1016/j.mycmed.2020.101007] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
Abstract
Mucormycosis are life-threatening fungal infections especially affecting immunocompromised or diabetic patients. Despite treatment, mortality remains high (from 32 to 70% according to organ involvement). This review provides an update on mucormycosis management. The latest recommendations strongly recommend as first-line therapy the use of liposomal amphotericin B (≥5mg/kg) combined with surgery whenever possible. Isavuconazole and intravenous or delayed-release tablet forms of posaconazole have remained second-line. Many molecules are currently in development to fight against invasive fungal diseases but few have demonstrated efficacy against Mucorales. Despite in vitro efficacy, combinations of treatment have failed to demonstrate superiority versus monotherapy. Adjuvant therapies are particularly complex to evaluate without prospective randomized controlled studies, which are complex to perform due to low incidence rate and high mortality of mucormycosis. Perspectives are nonetheless encouraging. New approaches assessing relationships between host, fungi, and antifungal drugs, and new routes of administration such as aerosols could improve mucormycosis treatment.
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Affiliation(s)
- K Brunet
- INSERM U1070, Poitiers, France; Faculté de médecine et pharmacie, université de Poitiers, Poitiers, France; Service de mycologie-parasitologie, département des agents infectieux, CHU de Poitiers, Poitiers, France.
| | - B Rammaert
- INSERM U1070, Poitiers, France; Faculté de médecine et pharmacie, université de Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France
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24
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Djenontin E, Lebeaux D, Acikgoz H, Rammaert B, Bougnoux ME, Rouzaud C, Bouyer B, Champigneulle B, Dannaoui E. Post-traumatic Curvularia sp. arthritis in an immunocompetent adult. J Mycol Med 2020; 30:100967. [PMID: 32321676 DOI: 10.1016/j.mycmed.2020.100967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/08/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
A 44-year-old woman, victim of a road accident in Mali was diagnosed with left knee arthritis. Joint effusion aspiration and subcutaneous surgical biopsies were positive for a melanized asexual ascomycete. Using microscopy and molecular biology, the fungus was identified as Curvularia sp. In vitro antifungal susceptibility was determined by the EUCAST broth microdilution reference technique and by E-test. The patient was treated with liposomal amphotericin B before posaconazole relay. Mycological samples obtained 10 days after starting the antifungal therapy by liposomal amphotericin B were negative in culture. Curvularia spp. are environmental fungi which can under certain conditions be pathogenic for humans.
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Affiliation(s)
- E Djenontin
- Unité de parasitologie-mycologie, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - D Lebeaux
- Unité mobile de microbiologie clinique, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - H Acikgoz
- Service d'anesthésie-réanimation, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - B Rammaert
- Inserm U1070, service de maladies infectieuses et tropicales, faculté de médecine et pharmacie, université Poitiers, CHU de Poitiers, Poitiers, France
| | - M-E Bougnoux
- Unité de parasitologie-mycologie, service de microbiologie, hôpital Necker-Enfants-Malades, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - C Rouzaud
- Centre d'infectiologie Necker-Pasteur and Institut Imagine, hôpital Necker-Enfants-Malades, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - B Bouyer
- Service d'orthopédie et de traumatologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France
| | - B Champigneulle
- Service d'anesthésie-réanimation, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - E Dannaoui
- Unité de parasitologie-mycologie, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Faculté de médecine, université Paris Descartes, Paris, France.
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25
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Monier A, Puyade M, Hernanz MPG, Bouchaert P, Leleu X, Tourani JM, Roblot F, Rammaert B. Observational study of vaccination in cancer patients: How can vaccine coverage be improved? Med Mal Infect 2019; 50:263-268. [PMID: 31848105 DOI: 10.1016/j.medmal.2019.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 03/04/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Chemotherapy increases the risk of infections, often severe, and some of them are vaccine-preventable infections. We aimed to assess vaccination coverage and associated factors in oncology and hematology patients. METHODS Consecutive adult patients followed in a French university hospital for hematological malignancy or solid cancer voluntarily completed an anonymous questionnaire in September and October 2016. It included questions on underlying disease, chemotherapy, flu, and pneumococcal vaccination uptakes, and attitudes toward vaccination. Factors associated with vaccination uptake were assessed by multivariate logistic regression. RESULTS The response rate was 41.9% (N=671) among 1,600 questionnaires distributed; 232 patients had underlying hematological malignancy and 439 had solid cancer. Half of the patients were aged over 65 years. Chemotherapy was ongoing or discontinued for less than one year in 74.7% of patients. In patients aged <65 years undergoing chemotherapy, flu vaccination rate was 19.9% whereas patients aged >65 years had coverage of 47%. Pneumococcal vaccine uptake was 7.3%. However, 64.7% of patients were favorable to vaccination. Vaccine uptake was associated with age >65 years (OR 4.5 [2.9-7.0]), information about vaccination delivered by the family physician (OR 12.9 [5.5-30.1]), follow-up in hematology unit (OR 2.0 [1.3-3.1]), and positive opinion about vaccination (OR 2.0 [1.3-3.1]). CONCLUSION Despite specific recommendations regarding immunocompromised patients, anti-pneumococcal and flu vaccinations were rarely conducted, even in elderly patients. Targeted information campaigns to family physicians, oncologists, and patients should be implemented to improve vaccine coverage in patients with underlying malignancies.
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Affiliation(s)
- A Monier
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France
| | - M Puyade
- Service de médecine interne, CHU de Poitiers, Poitiers, France
| | - M P Gallego Hernanz
- Service d'hématologie et thérapie cellulaire, CHU de Poitiers, Poitiers, France
| | - P Bouchaert
- Service d'oncologie médicale, CHU de Poitiers, Poitiers, France
| | - X Leleu
- Service d'hématologie et thérapie cellulaire, CHU de Poitiers, Poitiers, France; Inserm CIC 1402, Poitiers, France
| | - J M Tourani
- Service d'oncologie médicale, CHU de Poitiers, Poitiers, France
| | - F Roblot
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France; Inserm U1070, Poitiers, France
| | - B Rammaert
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France; Inserm U1070, Poitiers, France.
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26
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Barbarin C, Cales S, Boutin D, Cormerais M, Edouard C, Regnault MM, Rodier MH, Rammaert B, Hainaut E, Cazenave-Roblot F. Infection cutanée à Paecilomyces lilacinus. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Joncour A, Puyade M, Michaud A, Tourani JM, Cazenave-Roblot F, Rammaert B. Is current initial empirical antibiotherapy appropriate to treat bloodstream infections in short-duration chemo-induced febrile neutropenia? Support Care Cancer 2019; 28:3103-3111. [DOI: 10.1007/s00520-019-05113-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 10/06/2019] [Indexed: 11/28/2022]
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28
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Glavier M, Puyade M, Roblot F, Rammaert B. Vaccination of cancer patients treated with chemotherapy: A survey among general practitioners. Med Mal Infect 2019; 49:586-592. [PMID: 31551165 DOI: 10.1016/j.medmal.2019.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/13/2018] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Despite specific recommendations issued by the French Public Health Council (Haut Conseil de Santé Publique), the vaccination coverage of patients with cancer or malignant blood disease remains insufficient. The aim of this study was to assess the vaccination of chemotherapy patients by their general practitioner (GP). METHODS A survey was conducted between March and July 2017 in 4 French departments to describe the immunization practices of GPs for their chemotherapy patients and provide solutions to help to increase the vaccination rate. RESULTS Of the 1610 GPs who received the questionnaire, 287 (17.8%) returned a usable form; 92.6% were globally pro-vaccine. One third of GPs (37.3%) declared that they vaccinated all their chemotherapy patients. The GPs (n=180) who never or only sometimes vaccinated their chemotherapy patients mainly voiced concerns about not being properly trained (45.6%) and the lack of easily available information on vaccination (35.0%). Three-quarters (n=212; 74%) of the GPs wanted to improve their level of medical knowledge via continuing education (52.4%) or by reading guidelines available on-line (39.6%). GPs suggested that a specific vaccination schedule be included in the letter they receive from the cancer specialist (72.8%) and that patient awareness be increased (50.5%). CONCLUSIONS GPs are in favor of the vaccination of cancer patients. The main obstacles stated are the lack of education and the lack of easily available information. Vaccination coverage could be increased by improving the doctor-to-doctor relation between GPs and cancer specialists.
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Affiliation(s)
- M Glavier
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; Service de maladies infectieuses et tropicales et médecine interne, CHU de Poitiers, 86000 Poitiers, France
| | - M Puyade
- Service de maladies infectieuses et tropicales et médecine interne, CHU de Poitiers, 86000 Poitiers, France
| | - F Roblot
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; INSERM U1070, 86000 Poitiers, France
| | - B Rammaert
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; INSERM U1070, 86000 Poitiers, France.
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29
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Périer A, Puyade M, Revest M, Tattevin P, Bernard L, Lemaignen A, Boutoille D, Allal J, Roblot F, Rammaert B. Prognosis of Streptococcus pneumoniae endocarditis in France, a multicenter observational study (2000-2015). Int J Cardiol 2019; 288:102-106. [PMID: 31056415 DOI: 10.1016/j.ijcard.2019.04.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/18/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Streptococcus pneumoniae is responsible for <2% of infective endocarditis (IE). The aim of this study was to assess the prognosis of pneumococcal IE. METHODS This multicentric observational retrospective study included adult patients presenting with definite S. pneumoniae IE according to modified Dukes criteria from four French university hospitals over a 15-year period, January 2000-December 2015. Survival rate at 90 days and 2 years after diagnosis, appropriateness of antibiotherapy, and pneumococcal vaccination status were determined. Risk factors for mortality were studied by univariate analysis. RESULTS Of 3886 patients admitted with IE during the study period, 50 (1.3%) had pneumococcal IE, mostly males (n = 38, 76%), with a mean age of 60 ± 14 years. Predisposing conditions for IE or for invasive pneumococcal disease (IPD) involved 24% and 78% of the cases, respectively. Only 2 patients were vaccinated against pneumococcus before IE and 13 (26%) after IE. Antimicrobial strategy was in accordance with the 2015 ESC Guidelines in 28%. Cardiac surgery was performed in 56%, and was associated with better survival (p = 0.012). In the 40 patients followed until 2 years, the survival rate was 67%, deaths occurring mostly before 90 days. Age ≥ 65 was a risk factor for mortality (p = 0.011). CONCLUSION Pneumococcal IE remains rare but with a poor prognosis. Resort to surgery is yet to be determined. Predisposing conditions for IPD are the main factors leading to pneumococcal IE. They could be prevented by vaccine coverage improvement.
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Affiliation(s)
- Amandine Périer
- Université de Poitiers, Poitiers, France; CHU de Poitiers, Service de Médecine Interne, Poitiers, France
| | - Mathieu Puyade
- Université de Poitiers, Poitiers, France; CHU de Poitiers, Service de Médecine Interne, Poitiers, France
| | - Matthieu Revest
- Université de Rennes, Rennes, France; CHU de Pontchaillou, Service de Maladies Infectieuses, Rennes, France
| | - Pierre Tattevin
- Université de Rennes, Rennes, France; CHU de Pontchaillou, Service de Maladies Infectieuses, Rennes, France
| | - Louis Bernard
- Université de Tours, Tours, France; CHRU de Tours, Hôpital Bretonneau, Service de Médecine Interne et Maladies Infectieuses, Tours, France
| | - Adrien Lemaignen
- Université de Tours, Tours, France; CHRU de Tours, Hôpital Bretonneau, Service de Médecine Interne et Maladies Infectieuses, Tours, France
| | - David Boutoille
- Université de Nantes, Nantes, France; CHU de Nantes, Service de Maladies Infectieuses, Nantes, France
| | - Joseph Allal
- Université de Poitiers, Poitiers, France; CHU de Poitiers, Service de Cardiologie, Poitiers, France
| | - France Roblot
- Université de Poitiers, Poitiers, France; CHU de Poitiers, Service de maladies infectieuses et tropicales, Poitiers, France; Inserm U1070, Poitiers, France
| | - Blandine Rammaert
- Université de Poitiers, Poitiers, France; CHU de Poitiers, Service de maladies infectieuses et tropicales, Poitiers, France; Inserm U1070, Poitiers, France.
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Rammaert B, Puyade M, Cornely OA, Seidel D, Grossi P, Husain S, Picard C, Lass-Flörl C, Manuel O, Le Pavec J, Lortholary O. Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology. Transpl Infect Dis 2019; 21:e13141. [PMID: 31283872 DOI: 10.1111/tid.13141] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung transplant recipients. METHODS We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a large number of lung transplant centers through an international practice survey from October 2016 to March 2017. RESULTS A total of 51 respondents from 45 lung transplant centers (17 countries, 4 continents) answered the survey (response rate 58%). S/L colonization was estimated to be detected in candidates by 48% of centers. Only 18% of the centers used a specific medium to detect S/L colonization. Scedosporium spp. colonization was a contraindication to transplantation in 10% of centers whereas L prolificans was a contraindication in 31%; 22% of centers declared having had 1-5 recipients infected with S/L in the past 5 years. CONCLUSIONS This survey gives an overview of the current practices regarding S/L colonization and infection in lung transplant centers worldwide and underscores the need of S/L culture procedure standardization before implementing prospective studies.
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Affiliation(s)
- Blandine Rammaert
- Faculté de médecine et pharmacie, Univ Poitiers, Poitiers, France.,Service de maladies infectieuses et tropicales, CHU Poitiers, Poitiers, France.,INSERM U1070, Poitiers, France
| | - Mathieu Puyade
- Service de médecine interne, CHU Poitiers, Poitiers, France
| | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, Clinical Trials Centre Cologne (ZKS), German Centre for Infection Research (DZIF), Partner site Bonn-Cologne, University of Cologne, Cologne, Germany
| | - Danila Seidel
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, Clinical Trials Centre Cologne (ZKS), German Centre for Infection Research (DZIF), Partner site Bonn-Cologne, University of Cologne, Cologne, Germany
| | - Paolo Grossi
- Department of Medicine & Surgery, Infectious and Tropical Diseases Unit, University of Insubria, Varese, Italy
| | - Shahid Husain
- Multi-Organ Transplant Program, Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Canada
| | | | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Oriol Manuel
- Transplantation Center and Infectious Diseases Service, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jérôme Le Pavec
- Université Paris-Sud, Faculté de Médecine, Université Paris Saclay, Le Kremlin Bicêtre, France.,Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.,UMR-S 999, Universite Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olivier Lortholary
- Université de Paris, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, CNRS UMR 2000, Paris, France
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31
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Loubet P, Tubiana S, Claessens YE, Epelboin L, Ficko C, Le Bel J, Rammaert B, Garin N, Prendki V, Stirnemann J, Leport C, Yazdanpanah Y, Varon E, Duval X. Community-acquired pneumonia in the emergency department: an algorithm to facilitate diagnosis and guide chest CT scan indication. Clin Microbiol Infect 2019; 26:382.e1-382.e7. [PMID: 31284034 DOI: 10.1016/j.cmi.2019.06.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim was to create and validate a community-acquired pneumonia (CAP) diagnostic algorithm to facilitate diagnosis and guide chest computed tomography (CT) scan indication in patients with CAP suspicion in Emergency Departments (ED). METHODS We performed an analysis of CAP suspected patients enrolled in the ESCAPED study who had undergone chest CT scan and detection of respiratory pathogens through nasopharyngeal PCRs. An adjudication committee assigned the final CAP probability (reference standard). Variables associated with confirmed CAP were used to create weighted CAP diagnostic scores. We estimated the score values for which CT scans helped correctly identify CAP, therefore creating a CAP diagnosis algorithm. Algorithms were externally validated in an independent cohort of 200 patients consecutively admitted in a Swiss hospital for CAP suspicion. RESULTS Among the 319 patients included, 51% (163/319) were classified as confirmed CAP and 49% (156/319) as excluded CAP. Cough (weight = 1), chest pain (1), fever (1), positive PCR (except for rhinovirus) (1), C-reactive protein ≥50 mg/L (2) and chest X-ray parenchymal infiltrate (2) were associated with CAP. Patients with a score below 3 had a low probability of CAP (17%, 14/84), whereas those above 5 had a high probability (88%, 51/58). The algorithm (score calculation + CT scan in patients with score between 3 and 5) showed sensitivity 73% (95% CI 66-80), specificity 89% (95% CI 83-94), positive predictive value (PPV) 88% (95% CI 81-93), negative predictive value (NPV) 76% (95% CI 69-82) and area under the curve (AUC) 0.81 (95% CI 0.77-0.85). The algorithm displayed similar performance in the validation cohort (sensitivity 88% (95% CI 81-92), specificity 72% (95% CI 60-81), PPV 86% (95% CI 79-91), NPV 75% (95% CI 63-84) and AUC 0.80 (95% CI 0.73-0.87). CONCLUSION Our CAP diagnostic algorithm may help reduce CAP misdiagnosis and optimize the use of chest CT scan.
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Affiliation(s)
- P Loubet
- INSERM, IAME, UMR 1137, Paris, France; AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris, France.
| | - S Tubiana
- INSERM, IAME, UMR 1137, Paris, France
| | - Y E Claessens
- Service des urgences, Hôpital Princesse Grace, Monaco
| | - L Epelboin
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana; Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT) EA3593, Université de la Guyane, Cayenne, French Guiana; Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, 47-83 bd de l'hôpital, Paris, France
| | - C Ficko
- Service de Maladies Infectieuses et Tropicales, Hôpital Inter-armées de Bégin, Saint-Mandé, France
| | - J Le Bel
- INSERM, IAME, UMR 1137, Paris, France; Département de Médecine Générale, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - B Rammaert
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, Poitiers, France; Université de Poitiers, Poitiers, France; Inserm U1070, Poitiers, France
| | - N Garin
- Service de Médecine Interne Générale, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - V Prendki
- Service de Médecine Interne de l'âgé, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - J Stirnemann
- Service de Médecine Interne Générale, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - C Leport
- INSERM, IAME, UMR 1137, Paris, France; Université Paris-Diderot, Paris, France; AP-HP, Unité de Coordination du Risque Épidémique et biologique, Paris, France
| | - Y Yazdanpanah
- INSERM, IAME, UMR 1137, Paris, France; AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris, France
| | - E Varon
- Centre National de Référence des Pneumocoques, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - X Duval
- INSERM, IAME, UMR 1137, Paris, France; Université Paris-Diderot, Paris, France; Inserm CIC 1425, Hôpital Bichat-Claude Bernard, Paris, France
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Inghammar M, Borand L, Goyet S, Rammaert B, Te V, Lorn Try P, Guillard B, Buchy P, Vong S, Tek Chheng E, Cavailler P, Mayaud C, Tarantola A. Community-acquired pneumonia and Gram-negative bacilli in Cambodia-incidence, risk factors and clinical characteristics. Trans R Soc Trop Med Hyg 2019; 112:57-63. [PMID: 29579302 PMCID: PMC6018679 DOI: 10.1093/trstmh/try022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background In Western settings, community-acquired pneumonia (CAP) due to Gram-negative bacilli (GNB) is relatively rare. Previous studies from Asia, however, indicate a higher prevalence of GNB in CAP, but data, particularly from Southeast Asia, are limited. Methods This is a prospective observational study of 1451 patients ≥15 y of age with CAP from two hospitals in Cambodia between 2007 and 2010. The proportion of GNB was estimated. Risk factors and clinical characteristics of CAP due to GNB were assessed using logistic regression models. Results The prevalence of GNB was 8.6% in all CAP patients and 15.8% among those with a valid respiratory sample. GNB infection was independently associated with diabetes, higher leucocyte count and CAP severity. Mortality was higher in patients with CAP due to GNB. Conclusions We found a high proportion of GNB in a population hospitalized for CAP in Cambodia. Given the complex antimicrobial sensitivity patterns of certain GNBs and the rapid emergence of multidrug-resistant GNB, microbiological laboratory capacity should be strengthened and prospective clinical trials comparing empiric treatment algorithms according to the severity of CAP are needed.
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Affiliation(s)
- Malin Inghammar
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia.,Lund University, Department of Clinical Sciences Lund, Section for Infection Medicine, Lund, Sweden
| | - Laurence Borand
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Sophie Goyet
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Blandine Rammaert
- Université de Poitiers, Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France.,INSERM U1070, Pôle Biologie Santé, Poitiers, France
| | - Vantha Te
- Takeo Provincial Hospital, Takeo, Cambodia
| | | | - Bertrand Guillard
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Philippe Buchy
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia.,GlaxoSmithKline Vaccines R&D Asia-Pacific, Scientific Affairs and Public Health, Singapore
| | - Sirenda Vong
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Eap Tek Chheng
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Philippe Cavailler
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
| | - Charles Mayaud
- Service de Pneumologie, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Paris VI, France
| | - Arnaud Tarantola
- Institut Pasteur du Cambodge, Reseau International des Instituts Pasteur, Phnom Penh, Cambodia
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Dellière S, Guery R, Candon S, Rammaert B, Aguilar C, Lanternier F, Chatenoud L, Lortholary O. Understanding Pathogenesis and Care Challenges of Immune Reconstitution Inflammatory Syndrome in Fungal Infections. J Fungi (Basel) 2018; 4:E139. [PMID: 30562960 PMCID: PMC6308948 DOI: 10.3390/jof4040139] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 12/16/2022] Open
Abstract
Immune deficiency of diverse etiology, including human immunodeficiency virus (HIV), antineoplastic agents, immunosuppressive agents used in solid organ recipients, immunomodulatory therapy, and other biologics, all promote invasive fungal infections. Subsequent voluntary or unintended immune recovery may induce an exaggerated inflammatory response defining immune reconstitution inflammatory syndrome (IRIS), which causes significant mortality and morbidity. Fungal-associated IRIS raises several diagnostic and management issues. Mostly studied with Cryptococcus, it has also been described with other major fungi implicated in human invasive fungal infections, such as Pneumocystis, Aspergillus, Candida, and Histoplasma. Furthermore, the understanding of IRIS pathogenesis remains in its infancy. This review summarizes current knowledge regarding the clinical characteristics of IRIS depending on fungal species and existing strategies to predict, prevent, and treat IRIS in this patient population, and tries to propose a common immunological background to fungal IRIS.
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Affiliation(s)
- Sarah Dellière
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Romain Guery
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Sophie Candon
- Medical School, Paris-Descartes University, INSERM U1151-CNRS UMR 8253APHP, Necker-Enfants Malades Hospital, APHP, Clinical Immunology, 75015 Paris, France.
| | - Blandine Rammaert
- Medical School, Poitiers University, Poitiers, France; Poitiers University Hospital, Infectious Disease Unit, Poitiers, France; INSERM U1070, 86022 Poitiers, France.
| | - Claire Aguilar
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Fanny Lanternier
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
- Pasteur Institute, Molecular Mycology Unit, National Reference Center for Invasive Fungal Disease and Antifungals, CNRS UMR 2000, 75015 Paris, France.
| | - Lucienne Chatenoud
- Medical School, Paris-Descartes University, INSERM U1151-CNRS UMR 8253APHP, Necker-Enfants Malades Hospital, APHP, Clinical Immunology, 75015 Paris, France.
| | - Olivier Lortholary
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
- Pasteur Institute, Molecular Mycology Unit, National Reference Center for Invasive Fungal Disease and Antifungals, CNRS UMR 2000, 75015 Paris, France.
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Flateau C, Le Bel J, Tubiana S, Blanc FX, Choquet C, Rammaert B, Ray P, Rapp C, Ficko C, Leport C, Claessens YE, Duval X. High heterogeneity in community-acquired pneumonia inclusion criteria: does this impact on the validity of the results of randomized controlled trials? BMC Infect Dis 2018; 18:607. [PMID: 30509278 PMCID: PMC6276130 DOI: 10.1186/s12879-018-3515-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/14/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is no consensus on the most accurate combination of diagnostic criteria to define community acquired pneumonia (CAP). We describe inclusion criteria in randomized controlled trials (RCT) of CAP and assess their performance for the diagnosis of formally identified CAP. METHODS RCTs related to CAP recorded on ClinicalTrials.gov were analysed. Due to high heterogeneity, we divided close CAP inclusion criteria into patterns (i.e. combinations of inclusion criteria). To assess their diagnostic performances, these CAP definition patterns were applied to a reference population of 319 suspected CAP patients, in whom the CAP diagnosis had been confirmed (n = 163) or excluded (n = 156) by an adjudication committee after a systematic thoracic CT-scan and a 28-day follow-up period. RESULTS In the 47 RCTs included in the analysis, 42 different CAP inclusion criteria combinations were identified and 8 patterns created. This heterogeneity was not explained either by the trials' methodology or by their objectives. When applied to the reference population, the performance ranges of the 8 definition patterns were 9.8-56.4% for sensitivities, 56.4 97.4% for specificities, 63.6 83.6% for positive predictive values and 50.8-66.7% for negative predictive values. None of the CAP definitions had both sensitivity and specificity superior to 65%. Depending on the CAP definition, the rate of included patients without CAP ("false positives") ranged from 1 to 21%. CONCLUSIONS CAP diagnostic criteria within RCTs are heterogeneous, which may have far-reaching consequences on validity of RCT results.
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Affiliation(s)
- Clara Flateau
- Service de Maladies Infectieuses, Centre Hospitalier de Melun, Melun, France
| | - Josselin Le Bel
- Département de Médecine Générale, Université Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- IAME – UMR 1137, Université Paris Diderot, Paris, France
| | - Sarah Tubiana
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- IAME – UMR 1137, Université Paris Diderot, Paris, France
- Inserm CIC 1425, Paris, France
- Hôpital Bichat Claude Bernard, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - François-Xavier Blanc
- Service de Pneumologie, Institut du Thorax, CHU Nantes, Nantes, France
- Inserm, UMR1087, Institut du Thorax, Nantes, France
- CNRS, UMR 6291, Nantes, France
- Université de Nantes, Nantes, France
| | - Christophe Choquet
- Hôpital Bichat Claude Bernard, Assistance Publique des Hôpitaux de Paris, Paris, France
- Service d’Accueil des Urgences, Hôpital Bichat Claude Bernard, Paris, France
| | - Blandine Rammaert
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, Université de Poitiers, Poitiers, France
- Inserm U1070, Poitiers, France
| | - Patrick Ray
- Service d’Accueil des Urgences, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique des Hôpitaux de Paris, Paris, France
- DHU “Fighting against ageing and stress” (FAST), UPMC Paris 6, Paris, France
| | - Christophe Rapp
- Service des Maladies Infectieuses, Hôpital d’Instruction des Armées Bégin, Saint-Mandé, France
| | - Cécile Ficko
- Service des Maladies Infectieuses, Hôpital d’Instruction des Armées Bégin, Saint-Mandé, France
| | - Catherine Leport
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- IAME – UMR 1137, Université Paris Diderot, Paris, France
- Hôpital Bichat Claude Bernard, Assistance Publique des Hôpitaux de Paris, Paris, France
- Unité de Coordination du Risque Epidémique et Biologique (COREB), Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Yann-Erick Claessens
- Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Principality of Monaco, France
| | - Xavier Duval
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- IAME – UMR 1137, Université Paris Diderot, Paris, France
- Inserm CIC 1425, Paris, France
- Hôpital Bichat Claude Bernard, Assistance Publique des Hôpitaux de Paris, Paris, France
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Brunet K, Alanio A, Lortholary O, Rammaert B. Reactivation of dormant/latent fungal infection. J Infect 2018; 77:463-468. [DOI: 10.1016/j.jinf.2018.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 12/18/2022]
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36
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Meriglier E, Sunder A, Elsendoorn A, Canoui E, Rammaert B, Million M, Raoult D, Roblot F. Osteoarticular manifestations of Q fever: a case series and literature review. Clin Microbiol Infect 2018; 24:912-913. [DOI: 10.1016/j.cmi.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/26/2018] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
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37
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Glavier M, Puyade M, Roblot F, Rammaert B. Vaccination des patients atteints de cancer sous chimiothérapie : enquête de pratique auprès de médecins généralistes. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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38
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Roger M, Petrov L, Catroux M, Garcia M, Rammaert B, Meurice J, Roblot F. Étude observationnelle des infections à Métapneumovirus humain chez les patients adultes suivis pour une maladie respiratoire chronique. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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39
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Loubet P, Tubiana S, Leport C, Yazdanpanah Y, Duval X, Claessens Y, Epelboin L, Ficko C, Rammaert B. Algorithme diagnostique des pneumonies aiguës communautaires : le « PACSCAN score ». Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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40
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Inghammar M, By Y, Farris C, Phe T, Borand L, Kerleguer A, Goyet S, Saphonn V, Phoeung C, Vong S, Rammaert B, Mayaud C, Guillard B, Yasuda C, Kasper MR, Ford G, Newell SW, An US, Sokhal B, Touch S, Turner P, Jacobs J, Messaoudi M, Komurian-Pradel F, Tarantola A. Serotype Distribution of Clinical Streptococcus pneumoniae Isolates before the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in Cambodia. Am J Trop Med Hyg 2018; 98:791-796. [PMID: 29313476 PMCID: PMC5930902 DOI: 10.4269/ajtmh.17-0692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Childhood vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in Cambodia in January 2015. Baseline data regarding circulating serotypes are scarce. All microbiology laboratories in Cambodia were contacted for identification of stored isolates of Streptococcus pneumoniae from clinical specimens taken before the introduction of PCV13. Available isolates were serotyped using a multiplex polymerase chain reaction method. Among 166 identified isolates available for serotyping from patients with pneumococcal disease, 4% were isolated from upper respiratory samples and 80% were from lower respiratory samples, and 16% were invasive isolates. PCV13 serotypes accounted for 60% (95% confidence interval [CI] 52–67) of all isolates; 56% (95% CI 48–64) of noninvasive and 77% (95% CI 57–89) of invasive isolates. Antibiotic resistance was more common among PCV13 serotypes. This study of clinical S. pneumoniae isolates supports the potential for high reduction in pneumococcal disease burden and may serve as baseline data for future monitoring of S. pneumoniae serotypes circulation after implementation of PCV13 childhood vaccination in Cambodia.
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Affiliation(s)
- Malin Inghammar
- Section for Infection Medicine, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.,Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Youlet By
- University of Health Science, Phnom Pen, Cambodia.,Fondation Mérieux, Phnom Penh, Cambodia
| | | | - Thong Phe
- Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
| | | | | | - Sophie Goyet
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | | | - Sirenda Vong
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Blandine Rammaert
- CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, INSERM U1070, Université de Poitiers, Poitiers, France
| | | | | | | | | | - Gavin Ford
- Naval Medical Research Unit No. 2, Phnom Penh, Cambodia
| | | | - Ung Sam An
- Cambodian National Laboratory of Public Health, Phnom Penh, Cambodia
| | - Buth Sokhal
- Cambodian National Laboratory of Public Health, Phnom Penh, Cambodia
| | - Sok Touch
- Cambodian Communicable Disease Control Department, Phnom Penh, Cambodia
| | - Paul Turner
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
| | - Jan Jacobs
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Sihanouk Hospital Center of Hope, Phnom Penh, Cambodia
| | - Mélina Messaoudi
- Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France
| | - Florence Komurian-Pradel
- Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France
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Taj-Aldeen SJ, Gamaletsou MN, Rammaert B, Sipsas NV, Zeller V, Roilides E, Kontoyiannis DP, Henry M, Petraitis V, Moriyama B, Denning DW, Lortholary O, Walsh TJ. Bone and joint infections caused by mucormycetes: A challenging osteoarticular mycosis of the twenty-first century. Med Mycol 2017; 55:691-704. [PMID: 28053147 PMCID: PMC6251651 DOI: 10.1093/mmy/myw136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/06/2016] [Accepted: 11/29/2016] [Indexed: 12/15/2022] Open
Abstract
Osteomyelitis and arthritis caused by mucormycetes are rare diseases that rank among the most challenging complications in orthopedic and trauma surgery. The aim of this work is to review the epidemiological, clinical, diagnostic, and therapeutic aspects of the osteoarticular mucormycosis with particular emphasis on high-risk patients. A systematic review of osteoarticular mucormycosis was performed using PUBMED and EMBASE databases from 1978 to 2014. Among 34 patients with median age 41 (0.5-73 years), 24 (71%) were males. While 12 (35%) were immunocompromised patients, 14 (41%) had prior surgery, and seven (21%) suffered trauma. Other underlying conditions included diabetes mellitus, hematological malignancies, transplantation, and corticosteroid therapy. The median diagnostic delay from onset of symptoms and signs was 60 (10-180) days. The principal mechanism of the infection was direct inoculation (n = 19; 56%), and in immunocompromised patients was usually hematogenous disseminated. The long bones were infected by trauma or surgery, while a wide variety of bones were involved by hematogenous dissemination. Combined surgery and amphotericin B treatment were implemented in 28 (82%) and eight (23%) had an unfavorable outcome. Osteoarticular mucormycosis occurs most frequently after trauma or surgical procedures. These infections are progressively destructive and more virulent in individuals with impaired immune systems. Early diagnosis, timely administration of amphotericin B, control of underlying conditions, and surgical debridement of infected tissue are critical for successful management of osteoarticular mucormycosis.
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Affiliation(s)
- Saad J. Taj-Aldeen
- Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Weill Cornell Medicine, Doha, Qatar
| | - Maria N. Gamaletsou
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University, New York, NY, USA
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
| | - Blandine Rammaert
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University, New York, NY, USA
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
| | - Nikolaos V. Sipsas
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
- National and Kapodistrian University of Athens, Athens, Greece
| | - Valerie Zeller
- Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Emmanuel Roilides
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University, School of Health Sciences, and Hippokration Hospital, Thessaloniki, Greece
| | | | - Michael Henry
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University, New York, NY, USA
| | - Vidmantas Petraitis
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University, New York, NY, USA
| | - Brad Moriyama
- Department of Pharmacy, NIH Clinical Center, Bethesda, MD, USA
| | - David W. Denning
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
| | - Olivier Lortholary
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- Université Paris-Descartes, Sorbonne Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d’Infectiologie Necker-Pasteur, Institut Imagine, Paris, France
- Institut Pasteur, Mycology Molecular Unit, Paris, France
- Departments of Pediatrics, and Microbiology and Immunology, Weill Cornell Medical Center of Cornell University, New York, NY, USA
| | - Thomas J. Walsh
- Center for Osteoarticular Mycoses, Hospital for special Surgery, New York, NY, USA
- International Osteoarticular Mycoses Study Consortium, New York, NY, USA and Paris, France
- Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University, New York, NY, USA
- Departments of Pediatrics, and Microbiology and Immunology, Weill Cornell Medical Center of Cornell University, New York, NY, USA
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Monier A, Puyade M, Bouchaert P, Tourani J, Leleu X, Roblot F, Rammaert B. Enquête sur la vaccination des patients d’onco-hématologie dans un pôle régional de cancérologie. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pouget-Abadie X, Roncato-Sabéran M, Bernard L, Sunder S, Turmel JM, Rammaert B, Roblot F. Caractéristiques épidémiologiques et cliniques de la tularémie. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gamaletsou MN, Rammaert B, Bueno MA, Sipsas NV, Moriyama B, Kontoyiannis DP, Roilides E, Zeller V, Taj-Aldeen SJ, Henry M, Petraitis V, Denning DW, Lortholary O, Walsh TJ. Aspergillus arthritis: analysis of clinical manifestations, diagnosis, and treatment of 31 reported cases. Med Mycol 2017; 55:246-254. [PMID: 27609563 PMCID: PMC6251616 DOI: 10.1093/mmy/myw077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/15/2016] [Accepted: 04/24/2016] [Indexed: 11/14/2022] Open
Abstract
Aspergillus arthritis is a debilitating form of invasive aspergillosis. Little is known about its epidemiology, clinical manifestations, laboratory features, treatment, and prognosis. Cases of Aspergillus arthritis were reviewed in the English literature from 1967 through 2015 for variables of arthritis with Aspergillus spp. recovered from joint and/or adjacent bone, underlying conditions, symptoms, signs, inflammatory biomarkers, diagnostic imaging, management, and outcome. Among 31 evaluable cases, 87% were males and 13% pediatric. Median age was 50 y (range 1-83 y). Seventeen (55%) patients were immunosuppressed with such conditions as hematological malignancies (26%), corticosteroids (39%), and/or transplantation (26%). Approximately one-half (52%) of patients had hematogenous seeding of the joint, and more than 80% had de novo infection with no prior antifungal therapy. Oligoarticular infection (2-3 joints) occurred in 45% and contiguous osteomyelitis was present in 61%. Clinical manifestations included pain (87%), edema (26%), and limited function (23%), with knees (35%), intervertebral discs (26%), and hips (16%) being most commonly infected. Aspergillus fumigatus constituted 77% of cases followed by Aspergillus flavus in 13%, Aspergillus niger in 3%, and not specified in 7%. Median ESR was 90 mm/hr and median CRP was 3.6 mg/dl. Median synovial fluid WBC was 17,200/μL (7,300-128,000) with 72% PMNs (range 61-92). Osteolysis occurred in 35%, and soft-tissue extension 47%. Nineteen patients (61%) were managed with combined medical and surgical therapy, 10 (32%) with medical therapy only, and 2 (6%) surgery only. Amphotericin B and itraconazole were the most frequently used agents with median duration of therapy of 219 days (range 30-545). Surgical interventions included debridement in 61%, drainage 19%, and amputation 6%. Complete or partial response was achieved in 71% and relapse occurred in 16%. Medical therapy was reinstituted with successful outcome in these patients. Overall survival was 65%. Aspergillus arthritis mainly develops as a de novo infection involving knees and intervertebral disks in immunocompromised patients with localizing symptoms. Contiguous osteomyelitis is frequently observed. Diagnosis is established by synovial fluid culture. Aspergillus arthritis is therapeutically challenging with most patients undergoing surgery and protracted antifungal therapy.
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Affiliation(s)
- Maria N. Gamaletsou
- Weill Cornell Medicine of Cornell University, New York, NY, USA
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
- National Aspergillosis Centre, University of South Manchester, Manchester, UK
| | - Blandine Rammaert
- Université Paris-Descartes, Sorbonne Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d’Infectiologie Necker-Pasteur, Institut Imagine, Paris
- Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France
| | | | - Nikolaos V. Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
| | - Brad Moriyama
- Department of Pharmacy, NIH Clinical Center, Bethesda, MD, USA
| | | | - Emmanuel Roilides
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
- Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University, Thessaloniki, Greece
| | - Valerie Zeller
- Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Saad J. Taj-Aldeen
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar
| | - Michael Henry
- Weill Cornell Medicine of Cornell University, New York, NY, USA
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
- Hospital for Special Surgery, New York, NY, USA
| | - Vidmantas Petraitis
- Weill Cornell Medicine of Cornell University, New York, NY, USA
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
| | - David W. Denning
- The National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
| | - Olivier Lortholary
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
- Institut Pasteur, Unité de mycologie moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, CNRS URA3012, Paris, France
- Université Paris Descartes, APHP, Hopital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France
| | - Thomas J. Walsh
- Weill Cornell Medicine of Cornell University, New York, NY, USA
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, NY, USA
- Hospital for Special Surgery, New York, NY, USA
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Rammaert B, Candon S, Maunoury C, Bougnoux ME, Jouvion G, Braun T, Correas JM, Lortholary O. Thalidomide for steroid-dependent chronic disseminated candidiasis after stem cell transplantation: A case report. Transpl Infect Dis 2016; 19. [PMID: 27862711 DOI: 10.1111/tid.12637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 07/09/2016] [Accepted: 08/14/2016] [Indexed: 01/05/2023]
Abstract
Chronic disseminated candidiasis (CDC) is a rare and difficult-to-treat invasive fungal disease occurring mainly after prolonged and profound neutropenia. We describe the case of a 59-year-old man successfully treated with thalidomide for CDC recurrences after an autologous transplantation. We add evidence of the effectiveness of immunomodulatory drugs to manage inflammatory reconstitution immune syndrome-related refractory CDC.
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Affiliation(s)
- Blandine Rammaert
- Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, APHP, Sorbonne Paris Cité, Institut Hospitalo-Universitaire Imagine, Paris, France
| | - Sophie Candon
- Hôpital Necker-Enfants Malades, Immunologie Biologique, APHP, Paris, France.,PRES Sorbonne-Paris-Cité, Université Paris Descartes, Paris, France
| | - Christophe Maunoury
- Hôpital Européen Georges Pompidou, Service de Médecine Nucléaire, APHP, Paris, France
| | - Marie-Elisabeth Bougnoux
- PRES Sorbonne-Paris-Cité, Université Paris Descartes, Paris, France.,Hôpital Necker-Enfants Malades, Laboratoire de Microbiologie, Unité de Mycologie-Parasitologie, APHP, Paris, France
| | - Grégory Jouvion
- PRES Sorbonne-Paris-Cité, Université Paris Descartes, Paris, France.,Institut Pasteur, Unité d'histopathologie Humaine et Modèles Animaux, Paris, France
| | - Thorsten Braun
- Hôpital Avicenne, Service d'hématologie, APHP, Bobigny, France
| | - Jean-Michel Correas
- Hôpital Necker-Enfants Malades, Service de Radiologie Adulte, APHP, Paris, France
| | - Olivier Lortholary
- Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker Pasteur, APHP, Sorbonne Paris Cité, Institut Hospitalo-Universitaire Imagine, Paris, France.,PRES Sorbonne-Paris-Cité, Université Paris Descartes, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France.,CNRS, URA 3012, Paris, France
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46
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Fadlallah J, Rammaert B, Laurent S, Lanternier F, Pol S, Franck N, Mamzer M, Dupin N, Lortholary O. Mycobacterium aviumcomplex disseminated infection in a kidney transplant recipient. Transpl Infect Dis 2016; 18:105-11. [DOI: 10.1111/tid.12478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/28/2015] [Accepted: 09/20/2015] [Indexed: 01/20/2023]
Affiliation(s)
- J. Fadlallah
- Université Paris Descartes; Centre d'Infectiologie Necker Pasteur; IHU Imagine; Hôpital Necker Enfants Malades; Assistance Publique-Hôpitaux de Paris (APHP); Paris France
| | - B. Rammaert
- Université Paris Descartes; Centre d'Infectiologie Necker Pasteur; IHU Imagine; Hôpital Necker Enfants Malades; Assistance Publique-Hôpitaux de Paris (APHP); Paris France
| | - S. Laurent
- Service d'anatomopathologie; Hôpital Cochin; Université Paris Descartes; APHP; Paris France
| | - F. Lanternier
- Université Paris Descartes; Centre d'Infectiologie Necker Pasteur; IHU Imagine; Hôpital Necker Enfants Malades; Assistance Publique-Hôpitaux de Paris (APHP); Paris France
| | - S. Pol
- Service d'hépatologie; Hôpital Cochin; Université Paris Descartes; APHP; Paris France
| | - N. Franck
- Service de dermatologie; Hôpital Cochin; Pavillon Tarnier; Université Paris Descartes; APHP; Paris France
| | - M.F. Mamzer
- Service de transplantation rénale; Hôpital Necker Enfants Malades; Université Paris Descartes; APHP; Paris France
| | - N. Dupin
- Service de dermatologie; Hôpital Cochin; Pavillon Tarnier; Université Paris Descartes; APHP; Paris France
| | - O. Lortholary
- Université Paris Descartes; Centre d'Infectiologie Necker Pasteur; IHU Imagine; Hôpital Necker Enfants Malades; Assistance Publique-Hôpitaux de Paris (APHP); Paris France
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Gamaletsou MN, Rammaert B, Bueno MA, Sipsas NV, Moriyama B, Kontoyiannis DP, Roilides E, Zeller V, Taj-Aldeen SJ, Miller AO, Petraitiene R, Lortholary O, Walsh TJ. Candida Arthritis: Analysis of 112 Pediatric and Adult Cases. Open Forum Infect Dis 2015; 3:ofv207. [PMID: 26858961 PMCID: PMC4742637 DOI: 10.1093/ofid/ofv207] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/23/2015] [Indexed: 12/11/2022] Open
Abstract
Background. Candida arthritis is a debilitating form of deeply invasive candidiasis. However, its epidemiology, clinical manifestations, management, and outcome are not well understood. Methods. Cases of Candida arthritis were reviewed from 1967 through 2014. Variables included Candida spp in joint and/or adjacent bone, underlying conditions, clinical manifestations, inflammatory biomarkers, diagnostic imaging, management, and outcome. Results. Among 112 evaluable cases, 62% were males and 36% were pediatric. Median age was 40 years (range, <1–84 years). Most patients (65%) were not pharmacologically immunosuppressed. Polyarticular infection (≥3 joints) occurred in 31% of cases. Clinical manifestations included pain (82%), edema (71%), limited function (39%), and erythema (22%) with knees (75%) and hips (15%) most commonly infected. Median erythrocyte sedimentation rate was 62 mm/hr (10–141) and C reactive protein 26 mg/dL (0.5–95). Synovial fluid median white blood cell count was 27 500/µL (range, 100–220 000/µL) with 90% polymorphonuclear neutrophils (range, 24–98). Adjacent osteomyelitis was present in 30% of cases. Candida albicans constituted 63%, Candida tropicalis 14%, and Candida parapsilosis 11%. Most cases (66%) arose de novo, whereas 34% emerged during antifungal therapy. Osteolysis occurred in 42%, joint-effusion in 31%, and soft tissue extension in 21%. Amphotericin and fluconazole were the most commonly used agents. Surgical interventions included debridement in 25%, irrigation 10%, and drainage 12%. Complete or partial response was achieved in 96% and relapse in 16%. Conclusion. Candida arthritis mainly emerges as a de novo infection in usually non-immunosuppressed patients with hips and knees being most commonly infected. Localizing symptoms are frequent, and the most common etiologic agents are C albicans, C tropicalis, and C parapsilosis. Management of Candida arthritis remains challenging with a clear risk of relapse, despite antifungal therapy.
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Affiliation(s)
- Maria N Gamaletsou
- Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York; National and Kapodistrian and University of Athens, Greece; Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York
| | - Blandine Rammaert
- Université Paris-Descartes, Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France
| | - Marimelle A Bueno
- Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology , New York, New York
| | - Nikolaos V Sipsas
- National and Kapodistrian and University of Athens, Greece; Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York
| | - Brad Moriyama
- Department of Pharmacy , National Institutes of Health Clinical Center , Bethesda, Maryland
| | | | - Emmanuel Roilides
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York; 3rd Department of Pediatrics, Aristotle University School of Health Sciences and Hippokration General Hospital, Thessaloniki, Greece
| | - Valerie Zeller
- Osteoarticular Reference Center , Groupe Hospitalier Diaconesses-Croix Saint-Simon , Paris , France
| | | | - Andy O Miller
- Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York; Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York; Hospital for Special Surgery, New York, New York
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology , New York, New York
| | - Olivier Lortholary
- Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York; Université Paris-Descartes, Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine
| | - Thomas J Walsh
- Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York; Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York; Hospital for Special Surgery, New York, New York
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Taj-Aldeen SJ, Rammaert B, Gamaletsou M, Sipsas NV, Zeller V, Roilides E, Kontoyiannis DP, Miller AO, Petraitis V, Walsh TJ, Lortholary O. Osteoarticular Infections Caused by Non-Aspergillus Filamentous Fungi in Adult and Pediatric Patients: A Systematic Review. Medicine (Baltimore) 2015; 94:e2078. [PMID: 26683917 PMCID: PMC5058889 DOI: 10.1097/md.0000000000002078] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Osteoarticular mycoses due to non-Aspergillus moulds are uncommon and challenging infections. A systematic literature review of non-Aspergillus osteoarticular mycoses was performed using PUBMED and EMBASE databases from 1970 to 2013. Among 145 patients were 111 adults (median age 48.5 [16-92 y]) and 34 pediatric patients (median age 7.5 [3-15 y]); 114 (79.7%) were male and 88 (61.9%) were immunocompromised. Osteomyelitis was due to direct inoculation in 54.5%. Trauma and puncture wounds were more frequent in children (73.5% vs 43.5%; P = 0.001). Prior surgery was more frequent in adults (27.7% vs 5.9%; P = 0.025). Vertebral (23.2%) and craniofacial osteomyelitis (13.1%) with neurological deficits predominated in adults. Lower limb osteomyelitis (47.7%) and knee arthritis (67.8%) were predominantly seen in children. Hyalohyphomycosis represented 64.8% of documented infections with Scedosporium apiospermum (33.1%) and Lomentospora prolificans (15.8%) as the most common causes. Combined antifungal therapy and surgery was used in 69% of cases with overall response in 85.8%. Median duration of therapy was 115 days (range 5-730). When voriconazole was used as single agent for treatment of hyalohyphomycosis and phaeohyphomycosis, an overall response rate was achieved in 94.1% of cases. Non-Aspergillus osteoarticular mycoses occur most frequently in children after injury and in adults after surgery. Accurate early diagnosis and long-course therapy (median 6 mo) with a combined medical-surgical approach may result in favorable outcome.
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Affiliation(s)
- Saad J Taj-Aldeen
- From the Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar (SJT-A); Center for Osteoarticular Mycoses, Hospital for Special Surgery (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); International Osteoarticular Mycoses Study Consortium, NY (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); Weill Cornell Medical College, Doha, Qatar (SJT-A); Université Paris-Descartes, Sorbonne Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine (BR, OL); Institut Pasteur, Mycology Molecular Unit, Paris, France (BR, OL); Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University (MG, AOM, VP, TJW); Pediatrics, and Microbiology & Immunology, Weill Cornell Medical Center of Cornell University, New York, NY (MG, NVS, TJW); National and Kapodistrian University of Athens, Athens, Greece (MG, NVS); Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France (VZ); Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine, Aristotle University, School of Health Sciences, and Hippokration Hospital, Thessaloniki, Greece (ER); and MD Anderson Cancer Center, Houston, TX (DPK)
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Claessens YE, Debray MP, Tubach F, Brun AL, Rammaert B, Hausfater P, Naccache JM, Ray P, Choquet C, Carette MF, Mayaud C, Leport C, Duval X. Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia. Am J Respir Crit Care Med 2015; 192:974-82. [DOI: 10.1164/rccm.201501-0017oc] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Abstract
Nocardia are Gram-positive filamentous bacteria responsible for infections ranging from opportunistic life-threatening disseminated diseases to chronic skin and soft-tissue infections.Even if virtually all organs can be infected, articular involvement is rare. Therefore, we report 3 recent cases and performed a literature review of cases of Nocardia arthritis in order to describe clinical features, therapeutic challenges, and outcome of these patients.Among 34 patients (31 in the literature plus our 3 cases), 21 (62%) were due to hematogenous dissemination, 9 (26%) were due to direct bacterial inoculation through the skin, and in 4 cases, the mechanism of infection was unknown. Four out of these 34 cases occurred on prosthetic joints.Whereas hematogenous infections mostly occurred in immunocompromised hosts (17 of 21, 81%), direct inoculation was mostly seen in immunocompetent patients.Eighty-two percent of patients (28 out of 34) received trimethoprim-sulfamethoxazole-containing regimens and median antibiotic treatment duration was 24 weeks (range, 12-120) for hematogenous infections and 12 weeks (range, 6-24) for direct inoculations. Outcome was favorable in 27 cases despite unsystematic surgical management (17 cases) without sequelae in 70% of the cases.Nocardia arthritis is rare but its management is complex and should rely on a combined approach with rheumatologist, infectious diseases expert, and surgeon.
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Affiliation(s)
- Hélène Chaussade
- From the Université Paris Descartes, Centre d'Infectiologie Necker-Pasteur, Hôpital Necker Enfants malades, Institut Imagine, Paris, France (HC, DL, BR, OL); Service de médecine interne et maladies infectieuses, Hôpital Bretonneau, Tours, France (GG, LB); Service de Pneumologie, Hôpital Foch, Suresnes, France (EC); Service de radiologie, Hôpital Necker EM, Paris, France (SP); Service de bactériologie, Hôpital Necker EM, Paris, France (HL); and Service d'orthopédie, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France (VZ)
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