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Lecomte R, Deschanvres C, Bourreau A, Ruffier d'Epenoux L, Le Turnier P, Gaborit B, Chauveau M, Michel M, Le Tourneau T, Bémer P, Corvec S, Boutoille D. Comparative effectiveness of empirical antibiotic treatments in methicillin-susceptible Staphylococcus aureus infective endocarditis: A post hoc analysis of a prospective French cohort study. Int J Infect Dis 2024; 142:106989. [PMID: 38428479 DOI: 10.1016/j.ijid.2024.106989] [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: 12/05/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES The empirical treatment of infective endocarditis is still debated. The aim of this study was to compare the impact of empirical treatment with antistaphylococcal penicillin (ASP) or cefazolin vs. other treatments in methicillin-susceptible Staphylococcus aureus (MSSA) endocarditis. METHODS A post hoc analysis of a prospective cohort study of patients hospitalized in a French reference centre with MSSA endocarditis was conducted between 2013 and 2022. The primary outcome was the duration of bacteraemia under treatment. RESULTS Of the 208 patients included, 101 patients (48.6%) were classified in the reference group (ASP or cefazolin) and 107 (52.4%) in the non-reference group. Empirical treatment with ASP/cefazolin was associated with a shorter duration of bacteraemia compared to other treatments (3.6 d vs. 4.6 d, P = 0.01). This difference was not corrected by the addition of an aminoglycoside (3.6 d vs. 4.7 d, P < 0.01). In multivariate analysis, empirical treatment with ASP/cefazolin was associated with a duration of bacteraemia ≤72 h (P = 0.02), whereas endocarditis on native valves (P = 0.01), and intracardiac abscess were associated with longer duration of bacteraemia (P = 0.01). CONCLUSIONS Empirical treatment of endocarditis with ASP or Cefazolin is more effective than other treatments in MSSA endocarditis, even when the other treatments are combined with aminoglycosides.
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Affiliation(s)
- Raphaël Lecomte
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France.
| | - Colin Deschanvres
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
| | - Alexis Bourreau
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
| | | | - Paul Le Turnier
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
| | - Benjamin Gaborit
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
| | - Marie Chauveau
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
| | - Magali Michel
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - Thierry Le Tourneau
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | | | - Stéphane Corvec
- Department of Bacteriology, Nantes, France; Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - David Boutoille
- Department of Infectious Diseases, CHU Hôtel-Dieu, Nantes, France; Centre d'Investigation Clinique, Unité d'Investigation Clinique, Nantes, France
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Kaasch AJ, López-Cortés LE, Rodríguez-Baño J, Cisneros JM, Dolores Navarro M, Fätkenheuer G, Jung N, Rieg S, Lepeule R, Coutte L, Bernard L, Lemaignen A, Kösters K, MacKenzie CR, Soriano A, Hagel S, Fantin B, Lafaurie M, Talarmin JP, Dinh A, Guimard T, Boutoille D, Welte T, Reuter S, Kluytmans J, Martin ML, Forestier E, Stocker H, Vitrat V, Tattevin P, Rommerskirchen A, Noret M, Adams A, Kern WV, Hellmich M, Seifert H. Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial. Lancet Infect Dis 2024; 24:523-534. [PMID: 38244557 DOI: 10.1016/s1473-3099(23)00756-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Staphylococcus aureus bloodstream infection is treated with at least 14 days of intravenous antimicrobials. We assessed the efficacy and safety of an early switch to oral therapy in patients at low risk for complications related to S aureus bloodstream infection. METHODS In this international, open-label, randomised, controlled, non-inferiority trial done in 31 tertiary care hospitals in Germany, France, the Netherlands, and Spain, adult patients with low-risk S aureus bloodstream infection were randomly assigned after 5-7 days of intravenous antimicrobial therapy to oral antimicrobial therapy or to continue intravenous standard therapy. Randomisation was done via a central web-based system, using permuted blocks of varying length, and stratified by study centre. The main exclusion criteria were signs and symptoms of complicated S aureus bloodstream infection, non-removable foreign devices, and severe comorbidity. The composite primary endpoint was the occurrence of any complication related to S aureus bloodstream infection (relapsing S aureus bloodstream infection, deep-seated infection, and mortality attributable to infection) within 90 days, assessed in the intention-to-treat population by clinical assessors who were masked to treatment assignment. Adverse events were assessed in all participants who received at least one dose of study medication (safety population). Due to slow recruitment, the scientific advisory committee decided on Jan 15, 2018, to stop the trial after 215 participants were randomly assigned (planned sample size was 430 participants) and to convert the planned interim analysis into the final analysis. The decision was taken without knowledge of outcome data, at a time when 126 participants were enrolled. The new sample size accommodated a non-inferiority margin of 10%; to claim non-inferiority, the upper bound of the 95% CI for the treatment difference (stratified by centre) had to be below 10 percentage points. The trial is closed to recruitment and is registered with ClinicalTrials.gov (NCT01792804), the German Clinical trials register (DRKS00004741), and EudraCT (2013-000577-77). FINDINGS Of 5063 patients with S aureus bloodstream infection assessed for eligibility, 213 were randomly assigned to switch to oral therapy (n=108) or to continue intravenous therapy (n=105). Mean age was 63·5 (SD 17·2) years and 148 (69%) participants were male and 65 (31%) were female. In the oral switch group, 14 (13%) participants met the primary endpoint versus 13 (12%) in the intravenous group, with a treatment difference of 0·7 percentage points (95% CI -7·8 to 9·1; p=0·013). In the oral switch group, 36 (34%) of 107 participants in the safety population had at least one serious adverse event compared with 27 (26%) of 103 participants in the intravenous group (p=0·29). INTERPRETATION Oral switch antimicrobial therapy was non-inferior to intravenous standard therapy in participants with low-risk S aureus bloodstream infection. However, it is necessary to carefully assess patients for signs and symptoms of complicated S aureus bloodstream infection at the time of presentation and thereafter before considering early oral switch therapy. FUNDING Deutsche Forschungsgemeinschaft. TRANSLATIONS For the German, Spanish, French and Dutch translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Achim J Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany.
| | - Luis Eduardo López-Cortés
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Department of Medicine, Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Department of Medicine, Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - José Miguel Cisneros
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Department of Medicine, Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - M Dolores Navarro
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Department of Medicine, Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, University Clinics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Norma Jung
- Department I of Internal Medicine, University Clinics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Faculty of Medicine, University Medical Centre Freiburg, Freiburg, Germany
| | - Raphaël Lepeule
- Antimicrobial Stewardship Team, Department of Prevention, Diagnosis, and Treatment of Infections, Henri-Mondor University Hospital, Creteil, France
| | - Laetitia Coutte
- Antimicrobial Stewardship Team, Department of Prevention, Diagnosis, and Treatment of Infections, Henri-Mondor University Hospital, Creteil, France
| | - Louis Bernard
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Adrien Lemaignen
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Katrin Kösters
- Medical Clinic II-Clinic for Gastroenterology, Hepatology, Neurogastroenterology, Infectious Diseases, Hematology, Oncology and Palliative Medicine, Helios Klinikum Krefeld, Krefeld, Germany
| | - Colin R MacKenzie
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Alex Soriano
- Department of Infectious Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), CIBERINFEC, Barcelona, Spain
| | - Stefan Hagel
- Institute for Infectious Diseases and Infection Control, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany
| | - Bruno Fantin
- Internal Medicine Department, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | | | | | - Aurélien Dinh
- Infectious Diseases Department, Raymond-Poincaré University Hospital, Garches, France
| | - Thomas Guimard
- Infectious Diseases Department, CHD Vendée, La Roche-sur-Yon, France
| | - David Boutoille
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Tobias Welte
- Clinic for Respiratory Medicine and Infectious Diseases, Member of the German Center of Lung Research, Medical School Hannover, Hannover, Germany
| | - Stefan Reuter
- Department of Infectious Diseases and General Internal Medicine, Department of Infection Control, Klinikum Leverkusen, Leverkusen, Germany
| | - Jan Kluytmans
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maria Luisa Martin
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Fundació Institut d'Investigació Sanitària Illes Balears, Palma de Mallorca, Spain
| | - Emmanuel Forestier
- Infectious Diseases Department, Centre Hospitalier Métropole Savoie, Chambéry, France
| | - Hartmut Stocker
- Klinik für Infektiologie, St Joseph Hospital Berlin Tempelhof, Berlin, Germany
| | - Virginie Vitrat
- Infectious Diseases Unit, Centre Hospitalier d'Annecy Genevois, Epagny Metz-Tessy, France
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Anna Rommerskirchen
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Marion Noret
- French National Network of Clinical Research in Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Winfried V Kern
- Division of Infectious Diseases, Department of Medicine II, Faculty of Medicine, University Medical Centre Freiburg, Freiburg, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Harald Seifert
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; Institute of Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany
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Meschiari M, Asquier-Khati A, Tiseo G, Luque-Paz D, Murri R, Boutoille D, Falcone M, Mussini C, Tattevin P. Treatment of infections caused by multidrug-resistant Gram-negative bacilli: a practical approach by the Italian (SIMIT) and French (SPILF) Societies of Infectious Diseases. Int J Antimicrob Agents 2024:107186. [PMID: 38688353 DOI: 10.1016/j.ijantimicag.2024.107186] [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: 01/03/2024] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION The emergence of multidrug-resistant Gram-negative bacilli, and the development of new antibiotics have complexified selection of optimal regimens. International guidelines are valuable tools, though limited by scarcity of high-quality randomized trials in many situations. METHODS A panel of experts from the French and Italian Societies of Infectious Diseases aimed to address unresolved issues in clinical practice based on their experience, updated literature review, and open discussions. RESULTS The panel reached a consensus for the following 'first-choices': i) cefepime for ventilator-acquired pneumonia due to AmpC β-lactamase-producing Enterobacterales; ii) The β-lactam/β-lactamase inhibitors combination most active in vitro, or cefiderocol combined with fosfomycin, and aerosolized colistin or aminoglycosides, for severe pneumonia due to Pseudomonas aeruginosa resistant to ceftolozane-tazobactam; iii) high-dose piperacillin-tazobactam (including loading dose and continuous infusion), for complicated urinary tract infections (cUTIs) caused by ESBL-producing Enterobacterales with piperacillin-tazobactam MIC ≤8 mg/L; iv) high-dose cefepime for cUTIs due to AmpC β-lactamase-producing Enterobacterales other than Enterobacter species if cefepime MIC ≤2 mg/L; v) ceftolozane-tazobactam or ceftazidime-avibactam plus metronidazole for intra-abdominal infections (IAIs) due to 3rd generation cephalosporin-resistant Enterobacterales; vi) ceftazidime-avibactam plus aztreonam plus metronidazole for IAIs due to metallo β-lactamase-producing Enterobacterales; vii) ampicillin-sulbactam plus colistin for bloodstream infections (BSIs) caused by carbapenem-resistant Acinetobacter baumannii (CRAB); viii) meropenem-vaborbactam for BSI caused by KPC-producing Enterobacterales; ix) ceftazidime-avibactam plus fosfomycin for neurological infections caused by carbapenem-resistant P. aeruginosa. CONCLUSIONS These expert choices were based on the necessary balance between antimicrobial stewardship principles, and the need to provide optimal treatment for individual patients in each situation.
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Affiliation(s)
- Marianna Meschiari
- Infectious Diseases Unit, Azienda Ospedaliera-Universitaria of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Antoine Asquier-Khati
- Infectious Diseases Department, Nantes University Hospital, INSERM CIC 1413, Nantes, France
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - David Luque-Paz
- Infectious Diseases and Intensive Care Units, Pontchaillou University Hospital, Rennes, France
| | - Rita Murri
- Infectious Diseases, Fondazione Policlinico Gemelli IRCCS Rome, Italy; Catholic
| | - David Boutoille
- Infectious Diseases Department, Nantes University Hospital, INSERM CIC 1413, Nantes, France
| | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Cristina Mussini
- Infectious Diseases Unit, Azienda Ospedaliera-Universitaria of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Units, Pontchaillou University Hospital, Rennes, France.
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Timsit JF, Mootien J, Akrich B, Bourge X, Brassac I, Castan B, Mackosso C, Tavares LM, Ruiz F, Boutoille D, Ruimy R. Ceftolozane/Tazobactam for the Treatment of Complicated Infections in Hospital Settings-A French Real-world Study. Open Forum Infect Dis 2024; 11:ofae037. [PMID: 38390458 PMCID: PMC10883286 DOI: 10.1093/ofid/ofae037] [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: 08/28/2023] [Indexed: 02/24/2024] Open
Abstract
Background This study describes the conditions of use of ceftolozane/tazobactam (C/T) and associated outcomes in French hospital settings. Methods This was a prospective, multicenter, French observational study. Patients who received at least 1 dose of C/T were included and followed up as per routine clinical practice, until stop of C/T. Results A total of 260 patients were enrolled between October 2018 and December 2019 in 30 centers across France. Of these, 177 (68.0%) received C/T as per indication of usage following the results of the antibiogram (documented cases). Among documented patients, the mean age was 61.8 years, 73.4% were males, and 93.8% presented with multidrug-resistant (MDR) bacteria at inclusion. C/T was most frequently prescribed for pneumonia (48.6%), bacteremia (14.7%), complicated intra-abdominal infections (13.0%), or complicated urinary tract infections (9.6%). Pseudomonas aeruginosa was the species most frequently isolated with 212 strains from 155 patients, and 96.2% of these strains were susceptible to C/T. The median duration of C/T treatment was 16.1 days (1-115, n = 176). Complete or partial cure was achieved in 71.7% of patients, C/T was discontinued upon adaptation to microbiology results in 11.3% of patients for the following reasons: treatment failure in 2.8%, death in 4.0%, adverse events in 1.7%, and other in 8.5%. Conclusions This is the first prospective observational study of C/T utilization in a health care setting enrolling many patients in France. C/T demonstrated a high rate of clinical effectiveness in MDR infections, confirming it as an effective treatment option for complicated infections in a high-risk population.
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Affiliation(s)
| | - Joy Mootien
- Unité Fonctionnelle de Conseil en Antibiothérapie, CHU Mulhouse, Mulhouse, France
| | | | | | | | - Bernard Castan
- Service de Médecine Interne et Maladies Infectieuses, CH Périgueux, Périgueux, France
| | | | | | | | - David Boutoille
- Service des Maladies Infectieuses, Nantes Université, CIC 1413, Inserm, Nantes, France
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Lécuyer R, Issa N, Camou F, Lavergne RA, Gabriel F, Morio F, Canet E, Raffi F, Boutoille D, Cady A, Gousseff M, Crabol Y, Néel A, Tessoulin B, Gaborit B. Characteristics and Prognosis Factors of Pneumocystis jirovecii Pneumonia According to Underlying Disease: A Retrospective Multicenter Study. Chest 2024:S0012-3692(24)00022-9. [PMID: 38215935 DOI: 10.1016/j.chest.2024.01.015] [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: 10/11/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Pneumocystis jirovecii pneumonia (PcP) remains associated with high rates of mortality, and the impact of immunocompromising underlying disease on the clinical presentation, severity, and mortality of PcP has not been adequately evaluated. RESEARCH QUESTION Does the underlying disease and immunosuppression causing PcP impact the outcome and clinical presentation of the disease? STUDY DESIGN AND METHODS In this multicenter retrospective observational study, conducted from January 2011 to December 2021, all consecutive patients admitted with a proven or probable diagnosis of PcP according to the European Organisation for Research and Treatment of Cancer consensus definitions were included to assess the epidemiology and impact of underlying immunosuppressive diseases on overall and 90-day mortality. RESULTS Overall, 481 patients were included in the study; 180 (37.4%) were defined as proven PcP and 301 (62.6%) were defined as probable PcP. Patients with immune-mediated inflammatory diseases (IMIDs) or solid tumors had a statistically poorer prognosis than other patients with PcP at day 90. In multivariate analysis, among the HIV-negative population, solid tumor underlying disease (OR, 5.47; 95% CI, 2.16-14.1; P < .001), IMIDs (OR, 2.19; 95% CI, 1.05-4.60; P = .037), long-term corticosteroid exposure (OR, 2.07; 95% CI, 1.03-4.31; P = .045), cysts in sputum/BAL smears (OR, 1.92; 95% CI, 1.02-3.62; P = .043), and SOFA score at admission (OR, 1.58; 95% CI, 1.39-1.82; P < .001) were independently associated with 90-day mortality. Prior corticotherapy was the only immunosuppressant associated with 90-day mortality (OR, 1.67; 95% CI, 1.03-2.71; P = .035), especially for a prednisone daily dose ≥ 10 mg (OR, 1.80; 95% CI, 1.14-2.85; P = .010). INTERPRETATION Among patients who were HIV-negative, long-term corticosteroid prior to PcP diagnosis was independently associated with increased 90-day mortality, specifically in patients with IMIDs. These results highlight both the needs for PcP prophylaxis in patients with IMIDs and to early consider PcP curative treatment in severe pneumonia among patients with IMIDs.
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Affiliation(s)
- Romain Lécuyer
- Internal Medicine and Infectious Diseases, Centre Hospitalier Bretagne-Atlantique, Vannes, France; Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR1155, Nantes, France
| | - Nahéma Issa
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Fabrice Camou
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Rose-Anne Lavergne
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR1155, Nantes, France
| | - Frederic Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, Bordeaux, France
| | - Florent Morio
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR1155, Nantes, France; Laboratoire de Parasitologie-Mycologie, Institut de Biologie, University Hospital, Nantes, France
| | - Emmanuel Canet
- Medical Intensive Care, University Hospital, Nantes, France
| | - François Raffi
- Department of Infectious Diseases, University Hospital of Nantes and Centre d'Investigation Clinique 1413, INSERM, Nantes, France
| | - David Boutoille
- Department of Infectious Diseases, University Hospital of Nantes and Centre d'Investigation Clinique 1413, INSERM, Nantes, France; Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France
| | - Anne Cady
- Department of Microbiology, Centre Hospitalier Bretagne-Atlantique, Vannes, France
| | - Marie Gousseff
- Internal Medicine and Infectious Diseases, Centre Hospitalier Bretagne-Atlantique, Vannes, France
| | - Yoann Crabol
- Internal Medicine and Infectious Diseases, Centre Hospitalier Bretagne-Atlantique, Vannes, France
| | - Antoine Néel
- CRTI UMR 1064, INSERM, Université de Nantes, Nantes, France; Department of Internal Medicine, University Hospital, Nantes, France
| | - Benoît Tessoulin
- INSERM, U1232, Hematology Department, Nantes University Hospital, CRCI(2)NA, Nantes University, Nantes, France
| | - Benjamin Gaborit
- Department of Infectious Diseases, University Hospital of Nantes and Centre d'Investigation Clinique 1413, INSERM, Nantes, France; Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France.
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Danneels P, Chabrun F, Picard L, Martinet P, Rezig S, Lorleac'h A, Buzelé R, Beaudron A, Kempf M, Le Moal G, Revest M, Boutoille D, Lemaignen A, Grandiere-Perez L, Nacher M, Dubée V. Enterococcus faecalis endocarditis risk assessment in patients with bacteremia: External validation of the DENOVA score. J Infect 2023; 87:571-573. [PMID: 37683897 DOI: 10.1016/j.jinf.2023.09.001] [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: 08/31/2023] [Accepted: 09/03/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Pierre Danneels
- Infectious Diseases and Tropical Medicine, University Hospital, Angers, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Floris Chabrun
- Biochemistry and Molecular Biology Laboratory, University Hospital, Angers, France
| | - Léa Picard
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Pauline Martinet
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Aurélien Lorleac'h
- Infectious Diseases and Tropical Medicine, Groupe Hospitalier Bretagne Sud, Lorient, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Rodolphe Buzelé
- Infectious Diseases and Tropical Medicine, General Hospital, St-Brieuc, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Aurélie Beaudron
- Department of Bacteriology, General Hospital, Le Mans, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Marie Kempf
- Department of Bacteriology, University Hospital, Angers, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Gwenaël Le Moal
- Infectious Diseases and Tropical Medicine, University Hospital, Poitiers, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - David Boutoille
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Adrien Lemaignen
- Infectious Diseases and Tropical Medicine, University Hospital, Tours, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Lucia Grandiere-Perez
- Infectious Diseases and Tropical Medicine, General Hospital, Le Mans, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France
| | - Mathieu Nacher
- Clinical Investigation Center, General Hospital, Cayenne, France
| | - Vincent Dubée
- Infectious Diseases and Tropical Medicine, University Hospital, Angers, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France; Univ Angers, Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, F-44000 Nantes, France.
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7
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Hervochon C, Hennart B, Leroy AG, Corvec S, Boutoille D, Senneville É, Sotto A, Illes G, Chavanet P, Dubée V, Bleibtreu A, De Carné MC, Talarmin JP, Revest M, Castan B, Bellouard R, Dailly É, Allorge D, Dinh A, Le Turnier P, Gregoire M. Dalbavancin plasma concentrations in 133 patients: a PK/PD observational study. J Antimicrob Chemother 2023; 78:2919-2925. [PMID: 37864551 DOI: 10.1093/jac/dkad331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023] Open
Abstract
OBJECTIVES Limited pharmacokinetics data support dalbavancin long-term use in off-label indications and the optimal dosing regimen is debated. We aimed to describe dalbavancin concentrations in an observational retrospective multicentre study. METHODS Patients from 13 French hospitals, treated with 1500 mg doses of dalbavancin and for whom therapeutic drug monitoring was performed from June 2018 to March 2021 were included. Dalbavancin plasma concentrations were described at peak and 1, 2, 3, 4, 6 and 8 weeks after the last 1500 mg dose. Concentrations in patients weighing more or less than 75 kg and with a GFR greater or less than 60 mL/min were compared. Microbiological data were collected and dalbavancin MIC was measured when possible. RESULTS One hundred and thirty-three patients were included (69% treated for bone and joint infections, 16% for endocarditis). Thirty-five patients received a single dose of dalbavancin and 98 received several administrations. Two, 3 and 4 weeks after the last dose, median plasma concentrations were respectively 25.00, 14.80 and 9.24 mg/L for the first doses and 34.55, 22.60 and 19.20 mg/L for the second or subsequent doses. Weight and renal function had an impact on pharmacokinetics. Infection was documented in 105 patients (Staphylococcus spp. in 68% of cases). Staphylococcus aureus was isolated in 32.5% of cases (median MIC: 0.047 mg/L) and Staphylococcus epidermidis in 27% of cases (median MIC of 0.047 mg/L). CONCLUSIONS Plasma concentrations of dalbavancin were consistent with those described in clinical trials and those sought during the industrial development of the molecule.
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Affiliation(s)
- Charles Hervochon
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, 9 quai Moncousu 44093, F-44000 Nantes, France
| | - Benjamin Hennart
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59037 Lille, France
| | - Anne-Gaëlle Leroy
- Nantes Université, CHU Nantes, INCIT 1302, Service de Bactériologie et Contrôles Microbiologiques, F-44000 Nantes, France
- Laboratoire de Microbiologie, CHU Sud Réunion, Saint-Pierre, La Réunion, France
| | - Stéphane Corvec
- Nantes Université, CHU Nantes, INCIT 1302, Service de Bactériologie et Contrôles Microbiologiques, F-44000 Nantes, France
| | - David Boutoille
- Nantes Université, CHU Nantes, INSERM, Service de Maladies Infectieuses et Tropicales, CIC 1413, F-44000 Nantes, France
| | - Éric Senneville
- Infectious Diseases Department, Gustave Dron Hospital, Tourcoing, France
| | - Albert Sotto
- Infectious Diseases Department, Nîmes University Hospital, Nîmes, France
| | - Gabriella Illes
- Infectious Disease Unit, Hospital of Mont-de-Marsan, Mont-de-Marsan, France
| | - Pascal Chavanet
- Infectious Diseases Department, Dijon University Hospital, Dijon, France
| | - Vincent Dubée
- Department of Infectious Diseases, University Hospital of Angers, Angers, France
| | - Alexandre Bleibtreu
- Department of Infectious and Tropical Diseases, Sorbonne Université, Pitié-Salpêtrière hospital, Assistance Publique-Hôpitaux de Paris, Emergence and diffusion of multiple resistance against antibiotics, CIMI, INSERM U1135, Paris, France
| | - Marie-Charlotte De Carné
- Service de Maladies Infectieuses et Tropicales - Médecine Interne, CH Versailles André Mignot, Le Chesnay, France
| | | | - Matthieu Revest
- Service des Maladies Infectieuses et Réanimation Médicale, CHU Rennes, Rennes, France
| | - Bernard Castan
- Département de Maladies infectieuses et Tropicales, CHG, 24000 Périgueux, France
| | - Ronan Bellouard
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, 9 quai Moncousu 44093, F-44000 Nantes, France
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, F-44000 Nantes, France
| | - Éric Dailly
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, 9 quai Moncousu 44093, F-44000 Nantes, France
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, F-44000 Nantes, France
| | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59037 Lille, France
| | - Aurélien Dinh
- Infectious Disease Department, Raymond-Poincaré University Hospital, Paris Saclay University, Assistance Publique-Hôpitaux de Paris, Garches, France
| | - Paul Le Turnier
- Nantes Université, CHU Nantes, INSERM, Service de Maladies Infectieuses et Tropicales, CIC 1413, F-44000 Nantes, France
- Infectious Diseases Department, Cayenne Hospital, Cayenne, French Guiana
| | - Matthieu Gregoire
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, 9 quai Moncousu 44093, F-44000 Nantes, France
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, F-44000 Nantes, France
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Coste A, Conrad A, Porcher R, Poirée S, Peterlin P, Defrance C, Letscher-Bru V, Morio F, Gastinne T, Bougnoux ME, Suarez F, Nevez G, Dupont D, Ader F, Halfon-Domenech C, Ducastelle-Leprêtre S, Botterel F, Millon L, Guillerm G, Ansart S, Boutoille D, Ledoux MP, Herbrecht JE, Robin C, Melica G, Danion F, Blanchard E, Paccoud O, Garcia-Hermoso D, Lortholary O, Herbrecht R, Lanternier F. Improving Diagnosis of Pulmonary Mucormycosis: Leads From a Contemporary National Study of 114 Cases. Chest 2023; 164:1097-1107. [PMID: 37419276 DOI: 10.1016/j.chest.2023.06.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/24/2023] [Revised: 06/04/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Pulmonary mucormycosis (PM) is a life-threatening invasive mold infection. Diagnosis of mucormycosis is challenging and often delayed, resulting in higher mortality. RESEARCH QUESTION Are the disease presentation of PM and contribution of diagnosis tools influenced by the patient's underlying condition? STUDY DESIGN AND METHODS All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed. Cases were defined according to updated European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria with the addition of diabetes and trauma as host factors and positive serum or tissue PCR as mycologic evidence. Thoracic CT scans were reviewed centrally. RESULTS A total of 114 cases of PM were recorded, including 40% with disseminated forms. Main underlying conditions were hematologic malignancy (49%), allogeneic hematopoietic stem cell transplantation (21%), and solid organ transplantation (17%). When disseminated, main dissemination sites were the liver (48%), spleen (48%), brain (44%), and kidneys (37%). Radiologic presentation included consolidation (58%), pleural effusion (52%), reversed halo sign (26%), halo sign (24%), vascular abnormalities (26%), and cavity (23%). Serum quantitative polymerase chain reaction (qPCR) was positive in 42 (79%) of 53 patients and BAL in 46 (50%) of 96 patients. Results of transthoracic lung biopsy were diagnostic in 8 (73%) of 11 patients with noncontributive BAL. Overall 90-day mortality was 59%. Patients with neutropenia more frequently displayed an angioinvasive presentation, including reversed halo sign and disseminated disease (P < .05). Serum qPCR was more contributive in patients with neutropenia (91% vs 62%; P = .02), and BAL was more contributive in patients without neutropenia (69% vs 41%; P = .02). Serum qPCR was more frequently positive in patients with a > 3 cm main lesion (91% vs 62%; P = .02). Overall, positive qPCR was associated with an early diagnosis (P = .03) and treatment onset (P = .01). INTERPRETATION Neutropenia and radiologic findings influence disease presentation and contribution of diagnostic tools during PM. Serum qPCR is more contributive in patients with neutropenia and BAL examination in patients without neutropenia. Results of lung biopsies are highly contributive in cases of noncontributive BAL.
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Affiliation(s)
- Anne Coste
- Infectious Diseases Department, La Cavale Blanche Hospital, Brest University Hospital, Brest, France; UMR 1101, Laboratoire de Traitement de l'Information Médicale, Université de Bretagne Occidentale, Brest, France
| | - Anne Conrad
- Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon 1, CNRS, UMR 5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Raphaël Porcher
- Centre d'Epidémiologie Clinique, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Sylvain Poirée
- Radiology Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Pierre Peterlin
- Clinical Hematology Department, Nantes University Hospital, Nantes, France
| | - Claire Defrance
- Radiology Department, Nantes University Hospital, Nantes, France
| | - Valérie Letscher-Bru
- Parasitology and Medical Mycology Laboratory, Strasbourg University Hospital, Strasbourg, France; Institut de Parasitologie et Pathologie Tropicale, UR 7292, Strasbourg University, Strasbourg, France
| | - Florent Morio
- Parasitology and Mycology Laboratory, Nantes University Hospital, Nantes, France; UR 1155 IICiMed, Nantes University, Nantes, France
| | - Thomas Gastinne
- Clinical Hematology Department, Nantes University Hospital, Nantes, France
| | - Marie-Elisabeth Bougnoux
- Mycology and Parasitology Laboratory, Necker-Enfants Malades Hospital, AP-HP, Paris, France; Unité Biologie et Pathogénicité Fongiques, Institut Pasteur, Paris, France
| | - Felipe Suarez
- Hematology Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Gilles Nevez
- Mycology and Parasitology Department, La Cavale Blanche University Hospital, Brest, France
| | - Damien Dupont
- Medical Mycology and Parasitology Department, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Florence Ader
- Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon 1, CNRS, UMR 5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | | | | | - Françoise Botterel
- Mycology and Parasitology Unit, Henri Mondor University Hospital, AP-HP, Créteil, France; EA DYNAMYC 1380, Université Paris-Est Créteil, Créteil, France
| | - Laurence Millon
- Mycology and Parasitology Laboratory, Besançon University Hospital, Besançon, France; UMR 6249, CNRS Chrono-Environnement, Université de Bourgonne Franche-Comté, Besançon, France
| | - Gaelle Guillerm
- Hematology Department, Morvan Hospital, Brest University Hospital, Brest, France
| | - Séverine Ansart
- Infectious Diseases Department, La Cavale Blanche Hospital, Brest University Hospital, Brest, France; UMR 1101, Laboratoire de Traitement de l'Information Médicale, Université de Bretagne Occidentale, Brest, France
| | - David Boutoille
- Infectious Diseases Department, Nantes University Hospital, Nantes, France; Centre d'Investigation Clinique, INSERM 1413, Nantes University Hospital, Nantes, France
| | - Marie-Pierre Ledoux
- Hematology Department, European Strasbourg Cancer Institute, Strasbourg, France
| | | | - Christine Robin
- Hematology Department, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Giovanna Melica
- Infectious Diseases Department, Henri Mondor Hospital, AP-HP, Créteil, France
| | - François Danion
- Infectious Diseases Department, Strasbourg University Hospital, Strasbourg, France; UMR_S 1109, INSERM, ImmunoRhumatologie Moléculaire, Strasbourg University, Strasbourg, France
| | - Elodie Blanchard
- Pneumology Department, Bordeaux University Hospital, Bordeaux, France
| | - Olivier Paccoud
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
| | - Olivier Lortholary
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
| | - Raoul Herbrecht
- Hematology Department, European Strasbourg Cancer Institute, Strasbourg, France
| | - Fanny Lanternier
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France.
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Courjon J, Senneville E, Illes HG, Pavese P, Boutoille D, Daoud FC, Dunkel N, Tattevin P. Effectiveness and safety of dalbavancin in France: a prospective, multicentre cohort study. Int J Antimicrob Agents 2023; 62:106945. [PMID: 37543122 DOI: 10.1016/j.ijantimicag.2023.106945] [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: 12/05/2022] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES Dalbavancin is a lipoglycopeptide antibiotic approved for the treatment of acute bacterial skin and skin structure infections. However, several studies have suggested that it is used mostly for off-label indications. We aimed to describe the use of dalbavancin in patients who received at least one dose of the antibiotic in France. METHODS Prospective, observational, multicentre study conducted in France from September 2018 to April 2020. The primary outcome was the clinical response at 30 days after the last dalbavancin dose. RESULTS A total of 151 patients in 16 centres were included in this study. The main infection sites were bone and joint infections (55.0%), multisite infections (15.9%), and vascular infections (14.6%), and the primary pathogens were coagulase-negative staphylococci (N = 82), Staphylococcus aureus (N = 51), and enterococci (N = 27). Most patients (71.5%) received three previous antibiotic treatments. The number of dalbavancin injections per patient was 1 in 26 patients (17.2%), 2 in 95 patients (62.9%), 3 in 17 patients (11.3%), and more than 3 in 13 patients (8.6%), with a mean cumulative dose of 3089 ± 1461 mg per patient. Among the 129 patients with a complete follow-up, clinical success was achieved in 119 patients (92.2%). At least 1 adverse event was reported in 67 patients (44.4%), including 12 (7.9%) patients with dalbavancin-related adverse events. CONCLUSIONS The results of the study showed that dalbavancin is used mostly for off-label indications and in heavily pretreated patients in France. The clinical response at 30 days after the last dose was favourable in most patients, with a good safety profile.
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Affiliation(s)
- Johan Courjon
- Université Côte d'Azur, CHU Nice, Nice, France, Infectious Disease Unit, Nice, France.
| | - Eric Senneville
- Infectious Diseases Department, Gustave Dron Hospital, Tourcoing, France
| | | | - Patricia Pavese
- Infectious Diseases Department, Grenoble Alpes University Hospital, La Tronche, France
| | - David Boutoille
- Department of Infectious Disease and CIC-UIC 1413 INSERM, Nantes University Hospital, Nantes, France
| | | | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
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10
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Sebillotte M, Boutoille D, Declerck C, Talarmin JP, Lemaignen A, Piau C, Revest M, Tattevin P, Gousseff M. Non-HACEK gram-negative bacilli endocarditis: a multicentre retrospective case-control study. Infect Dis (Lond) 2023; 55:599-606. [PMID: 37353977 DOI: 10.1080/23744235.2023.2226212] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) caused by non-HACEK gram-negative bacilli (GNB) is poorly characterised and may be emerging as a consequence of medical progress. METHODS We performed an observational retrospective case-control study. Cases were non-HACEK GNB IE, definite or possible (modified Duke criteria), diagnosed in adults between 2007 and 2020 in six French referral hospitals. Two controls were included for each case (IE due to other bacteria, matched by sites and diagnosis date). RESULTS Non-HACEK GNB were identified in 2.4% (77/3230) of all IE during the study period, with a mean age of 69.2 ± 14.6 years, and a large male predominance (53/77, 69%). Primary pathogens were Escherichia coli (n = 33), Klebsiella sp. (n = 12) and Serratia marcescens (n = 9), including eight (10%) multidrug-resistant GNB. Compared to controls (n = 154: 43% Streptococcus sp., 41% Staphylococcus sp. and 12% Enterococcus sp.), non-HACEK GNB IE were independently associated with intravenous drug use (IVDU, 8% vs. 2%, p = .003), active neoplasia (15% vs. 6%, p = .009), haemodialysis (9% vs. 3%, p = .007) and healthcare-associated IE (36% vs. 18%, p = .002). Urinary tract was the main source of infection (n = 25, 33%) and recent invasive procedures were reported in 29% of cases. Non-HACEK GNB IE were at lower risk of embolism (31% vs. 47%, p = .002). One-year mortality was high (n = 28, 36%). Comorbidities, particularly malignant hemopathy and cirrhosis, were associated with increased risk of death. CONCLUSIONS Non-HACEK GNB are rarely responsible for IE, mostly as healthcare-associated IE in patients with complex comorbidities (end-stage renal disease, neoplasia), or in IVDUs.
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Affiliation(s)
- Marine Sebillotte
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - David Boutoille
- Maladies Infectieuses, CIC 1413 INSERM, Hôtel Dieu, Centre Hospitalier Universitaire, Nantes, Nantes, France
| | - Charles Declerck
- Maladies Infectieuses, Hôpital Larrey, Centre Hospitalier Universitaire, Angers, Angers, France
| | | | - Adrien Lemaignen
- Maladies Infectieuses, EA 7505 Education-Ethics-Health, Hôpital Bretonneau, Centre Hospitalier Universitaire, Tours, Tours, France
| | - Caroline Piau
- Bactériologie, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Matthieu Revest
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Pierre Tattevin
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Marie Gousseff
- Maladies infectieuses, Centre Hospitalier Bretagne-Atlantique, Vannes, France
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11
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Conlin M, Leroy AG, Asquier-Khati A, Boutoille D, Birgand G. Qualitative assessment of the national initiative to implement antimicrobial stewardship centres in French administrative regions. Antimicrob Resist Infect Control 2023; 12:41. [PMID: 37098636 PMCID: PMC10127160 DOI: 10.1186/s13756-023-01245-9] [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: 12/22/2022] [Accepted: 04/17/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND In May 2020, the French Ministry of Health funded the creation of regional antimicrobial stewardship (AMS) coordination centres (CRAtb) in preparation for the new national framework for the prevention of antimicrobial resistance. This study aimed to assess through qualitative methods the implementation process, the activities carried out, and the interactions with other regional stakeholders of the newly created CRAtb. METHODS We conducted a mixed-method study based on a cross-sectional survey and semi-structured interviews by French regions among implemented CRAtb. Of the eight eligible French regions with an existing CRAtb, seven participated to the online survey. Regional partners involved in AMS from the eight regions were interviewed between September 2021 and April 2022. The survey questionnaire addressed, through closed questions, the organization of the CRAtb, articulation with other regional actors involved in AMS and infection prevention and control (IPC), and AMS activities. The semi-structured interviews approached the implementation and the role of CRAtb, and the collaboration of other AMS and IPC stakeholders. Interview transcripts were analysed using thematic content analysis methodology. RESULTS AMS activities carried out by CRAtb were mainly focusing on hospitals (n = 3), primary care (n = 2) and nursing homes (n = 1). Education mostly relied on training days and AMS help lines, communication on websites and newsletters. CRAtb members reported still being more engaged in providing advice to professionals for individual antibiotic treatments rather than collective-level AMS activities. Interactions were frequent between CRAtb, IPC regional centres and health authorities, but rarely involved other stakeholders. Interviews were performed with 28 professionals involved in AMS from eight regions. Pre-existing networks and working relationships in AMS and more broadly facilitated the implementation of CRAtb. Streamlining and decompartmentalizing IPC and AMS regional activities were considered a way to optimise the prevention of antimicrobial resistance across sectors. The engagement with liberal health professionals was identified as a significant obstacle for CRAtb. CONCLUSIONS Two years after the launch of a new national framework, the implementation of CRAtb appeared complex in most regions. An integrative model joining IPC and AMS efforts, relying on existing networks, with engagement from liberal health profession organisations may be the next pivotal step.
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Affiliation(s)
- Michèle Conlin
- National center for the surveillance and prevention of the antimicrobial resistance and healthcare associated infections in primary cares and nursing homes, PRIMO, France
| | - Anne-Gaëlle Leroy
- National center for the surveillance and prevention of the antimicrobial resistance and healthcare associated infections in primary cares and nursing homes, PRIMO, France
| | - Antoine Asquier-Khati
- Service des Maladies Infectieuses et Tropicales, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France
| | - David Boutoille
- Service des Maladies Infectieuses et Tropicales, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France
| | - Gabriel Birgand
- National center for the surveillance and prevention of the antimicrobial resistance and healthcare associated infections in primary cares and nursing homes, PRIMO, France.
- Centre d'appui à la prévention des infections associées aux soins des Pays de la Loire, 5 rue Pr Yves Boquien, Nantes, 44093, France.
- NIHR Health Protection Research Unit, Antimicrobial Resistance and Healthcare Associated Infection at Imperial College London, Hammersmith Campus, London, W12 0NN, UK.
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12
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Caruana E, Salomon J, Rodriguez L, Boutoille D. Descriptive management of suspected acute cystitis in adult patients by French general practitioners during remote consultation. Infect Dis Now 2023; 53:104707. [PMID: 37044246 DOI: 10.1016/j.idnow.2023.104707] [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: 11/09/2022] [Revised: 03/15/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The main objective of this study was to analyze French general practitioners' (GP) online prescriptions for suspected acute cystitis using a single nationwide teleconsultation platform. PATIENTS AND METHODS First, a descriptive study of management for suspected cystitis was conducted from the 1st of January to the 31st of December 2020. After which, following pedagogical intervention, a pre/post descriptive analysis of the antibiotics prescribed was carried out. RESULTS Some 496,041 teleconsultations (TCs) were carried out in 2020 on the Qare platform. Among them, 15089 TCs for cystitis with ICD-10 encoding (N30) were analyzed. Fosfomycin trometamol was the most prescribed antibiotic (n=10297, 69%), while fluoroquinolones (n=1568, 10.6%) were the second. Urine test strip was prescribed in 3157 (20%) and urine culture in 7033 (47%) of the TCs. July-August 2020 and July-August 2021 were compared and while a significant drop in fluoroquinolone prescriptions and a major increase in Fosfomycin trometamol were observed, there was no change in the prescriptions of urine culture. An average antibiotic conformity rate of 61.5% was observed before the intervention, and 68.8% afterwards. CONCLUSIONS Cystitis is a recurrent reason for remote consultation. The study demonstrated sizable over-prescription of urine culture, ultrasound, and fluoroquinolones. Intervention should be improved and strengthened to guarantee continuous training and awareness of GP's on appropriate cystitis prescriptions in telemedicine.
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Affiliation(s)
- E Caruana
- Cabinet de médecine générale, 56 Rue Charles Rivière, 44400 Rezé 75008 Paris
| | - J Salomon
- Pédiatre MD, PhD, Directrice Médicale Adjointe Qare, Référente Médicale Formation et Qualité, 36, avenue Pierre 1er de Serbie 75008 Paris
| | - L Rodriguez
- Infirmier Support et Formation Qare. 36 Avenue Pierre 1er de Serbie
| | - D Boutoille
- Infectiologue CHU de Nantes, CHU de Nantes, 1 place Alexis Ricordeau 44093, Nantes
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13
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Asquier-Khati A, Deschanvres C, Chaslerie A, Pereira O, Boutoille D, Birgand G. Expert consensus on monitoring antimicrobial stewardship in French nursing homes using assessed reimbursement database indicators. JAC Antimicrob Resist 2023; 5:dlad037. [PMID: 37008823 PMCID: PMC10064325 DOI: 10.1093/jacamr/dlad037] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/11/2023] [Indexed: 04/03/2023] Open
Abstract
Objectives Monitoring the appropriateness of antibiotic prescriptions with indicators based on reimbursement data is required to guide antibiotic stewardship (AMS) interventions in nursing homes (NHs). Quantity metrics (QMs) monitor the volume of prescriptions while proxy indicators (PIs) reflect the appropriateness of antibiotic use. Our objectives were: (i) to provide a relevant consensual set of indicators to be used in French NHs; and (ii) to assess the feasibility of their implementation at the national and local scale. Methods Nine French professional organizations implicated in AMS in NHs were asked to nominate at least one member to create a national expert panel of 20 physicians. Twenty-one recently published QMs and 11 PIs were assessed by the expert panel. Indicators were evaluated using a RAND-modified Delphi procedure comprising two online surveys and a videoconference meeting. Indicators were kept in the final list if >70% of stakeholders validated their relevance for estimating the volume (QMs) and appropriateness (PIs) of prescriptions. Results Of the 21 QM indicators submitted to the panel, 14 were selected, describing the consumption of antibiotics overall (n = 3), broad-spectrum (n = 6) and second-line antibiotics (n = 2). The three remaining QMs evaluated the route of administration (n = 1) and urine culture prescriptions (n = 2). Ten PIs (six modified, two rejected, one new) were selected to assess the appropriateness of prescriptions for urinary tract infections (n = 2), seasonal variations in prescriptions (n = 2), repeated prescriptions of fluoroquinolones (n = 1), cephalosporins’ route of administration (n = 1), duration of treatment (n = 1), rate of second-line antibiotics (n = 1), co-prescriptions with non-steroidal anti-inflammatory drugs (n = 1), and flu vaccine coverage (n = 1). The panel was in favour of using these indicators for regional and facility level AMS programmes (91%), feedback to NH prescribers (82%), benchmarking by health authorities (55%) and public reporting at the facility level (9%). Conclusions This consensual list of indicators, covering a wide range of frequent clinical situations, may be used as part of the French national AMS strategy for monitoring antibiotic prescriptions in NHs at the national and local levels. Regional AMS networks might manage this selected list to guide personalized action plans with concrete objectives of reducing the quantity and improving the quality of antibiotic prescriptions.
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Affiliation(s)
| | - Colin Deschanvres
- Infectious Disease Department, Hotel-Dieu University Hospital, 1 Pl. Alexis Ricordeau, 44093, Nantes, France
| | - Anicet Chaslerie
- Medical Department, Regional Health Insurance Grand Est, Strasbourg, France
| | - Ouarda Pereira
- Medical Department, Regional Health Insurance Pays de la Loire, Nantes, France
| | - David Boutoille
- Infectious Disease Department, Hotel-Dieu University Hospital, 1 Pl. Alexis Ricordeau, 44093, Nantes, France
| | - Gabriel Birgand
- Regional Center for Infection Prevention and Control Pays de la Loire, Hotel-Dieu University Hospital, Nantes, France
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College, Hammersmith Campus, London, UK
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14
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Godefroy T, Frécon G, Asquier-Khati A, Mateus D, Lecomte R, Rizkallah M, Piriou N, Jamet B, Le Tourneau T, Pallardy A, Boutoille D, Eugène T, Carlier T. 18F-FDG-Based Radiomics and Machine Learning: Useful Help for Aortic Prosthetic Valve Infective Endocarditis Diagnosis? JACC Cardiovasc Imaging 2023:S1936-878X(23)00093-1. [PMID: 37052569 DOI: 10.1016/j.jcmg.2023.01.020] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/25/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Fluorine-18 fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET)/computed tomography (CT) results in better sensitivity for prosthetic valve endocarditis (PVE) diagnosis, but visual image analysis results in relatively weak specificity and significant interobserver variability. OBJECTIVES The primary objective of this study was to evaluate the performance of a radiomics and machine learning-based analysis of 18F-FDG PET/CT (PET-ML) as a major criterion for the European Society of Cardiology score using machine learning as a major imaging criterion (ESC-ML) in PVE diagnosis. The secondary objective was to assess performance of PET-ML as a standalone examination. METHODS All 18F-FDG-PET/CT scans performed for suspected aortic PVE at a single center from 2015 to 2021 were retrospectively included. The gold standard was expert consensus after at least 3 months' follow-up. The machine learning (ML) method consisted of manually segmenting each prosthetic valve, extracting 31 radiomics features from the segmented region, and training a ridge logistic regressor to predict PVE. Training and hyperparameter tuning were done with a cross-validation approach, followed by an evaluation on an independent test database. RESULTS A total of 108 patients were included, regardless of myocardial uptake, and were divided into training (n = 68) and test (n = 40) cohorts. Considering the latter, PET-ML findings were positive for 13 of 22 definite PVE cases and 3 of 18 rejected PVE cases (59% sensitivity, 83% specificity), thus leading to an ESC-ML sensitivity of 72% and a specificity of 83%. CONCLUSIONS The use of ML for analyzing 18F-FDG-PET/CT images in PVE diagnosis was feasible and beneficial, particularly when ML was included in the ESC 2015 criteria. Despite some limitations and the need for future developments, this approach seems promising to optimize the role of 18F-FDG PET/CT in PVE diagnosis.
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Affiliation(s)
- Thomas Godefroy
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France
| | - Gauthier Frécon
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France; ECN, LS2N, Nantes, France
| | - Antoine Asquier-Khati
- Nantes Université, CHU Nantes, INSERM, Infectious Diseases Department, Nantes, France
| | | | - Raphaël Lecomte
- Nantes Université, CHU Nantes, INSERM, Infectious Diseases Department, Nantes, France
| | | | - Nicolas Piriou
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France; Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Bastien Jamet
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France
| | - Thierry Le Tourneau
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Amandine Pallardy
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France
| | - David Boutoille
- Nantes Université, CHU Nantes, INSERM, Infectious Diseases Department, Nantes, France
| | - Thomas Eugène
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France.
| | - Thomas Carlier
- Nantes Université, CHU Nantes, INSERM, Nuclear Médicine, Nantes, France
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15
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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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Bouchand C, Navas D, Corvec S, Pattier S, Roussel JC, Lepoivre T, Bonsergent M, Boutoille D, Bémer P, Lecomte R. Postoperative linezolid-resistant methicillin-resistant Staphylococcus epidermidis mediastinitis in a heart transplant patient: first case of therapeutic success with delafloxacin. J Glob Antimicrob Resist 2023; 32:72-73. [PMID: 36720384 DOI: 10.1016/j.jgar.2023.01.004] [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: 09/15/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/30/2023] Open
Affiliation(s)
- Camille Bouchand
- Nantes Université, Centre Hospitalier Universitaire (CHU) Nantes, Service d'Hygiène Hospitalière, France.
| | | | - Stéphane Corvec
- Nantes Université, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, France
| | - Sabine Pattier
- Nantes Université, CHU Nantes, Unité de Transplantation Thoracique, France
| | - Jean-Christian Roussel
- Nantes Université, CHU Nantes, Service de Chirurgie Thoracique et Cardiovasculaire, France
| | - Thierry Lepoivre
- Nantes Université, CHU Nantes, Service d'Anesthésie-Réanimation, France
| | | | - David Boutoille
- Nantes Université, CHU Nantes, Service des Maladies Infectieuses et Tropicales, France
| | - Pascale Bémer
- Nantes Université, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, France
| | - Raphaël Lecomte
- Nantes Université, CHU Nantes, Service des Maladies Infectieuses et Tropicales, France
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17
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Bellouard R, Rambaud A, Delaunay C, Dailly É, Lecomte R, Deschanvres C, Leroy AG, Boutoille D, Le Turnier P, Grégoire M. Development and validation of a dosing nomogram for continuous infusion cloxacillin in infective endocarditis. J Antimicrob Chemother 2023; 78:965-974. [PMID: 36760090 DOI: 10.1093/jac/dkad030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Cloxacillin is the first-line treatment for methicillin-susceptible staphylococcal infective endocarditis (IE). The recommended dose is 12 g per day regardless of the patient characteristics, despite the importance of renal function on its pharmacokinetics. OBJECTIVES We sought to build a population pharmacokinetics model of continuous infusion cloxacillin in IE patients to evaluate the influence of multiple covariates and then develop a nomogram based on significant covariates for individual adaptation. PATIENTS AND METHODS We included patients of a local IE cohort who were treated with cloxacillin administered by continuous infusion, excluding those who received intermittent or continuous dialysis, extracorporeal membrane oxygenation or extracorporeal circulation. The population pharmacokinetic analysis was performed using Pmetrics. The influence of weight, ideal weight, height, body mass index, body surface area, glomerular filtration rate (GFR) calculated with the Chronic Kidney Disease Epidemiology Collaboration formula (both expressed in mL/min/1.73 m² and in mL/min) and serum protein level on cloxacillin pharmacokinetics was assessed. Accounting for relevant covariates, a dosing nomogram was developed to determine the optimal daily dose required to achieve a steady-state plasma concentration range of 20-50 mg/L with a probability ≥0.9. RESULTS A total of 114 patients (331 plasma concentrations) were included. A one-compartment model including GFR expressed in mL/min as a covariate was chosen. Using the nomogram, achieving the cloxacillin concentration target requires a daily dose ranging from 3.5 to 13.1 g for a GFR ranging from 20 to 125 mL/min. CONCLUSIONS This work provided a practical tool for cloxacillin dose adjustment in IE according to renal function.
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Affiliation(s)
- Ronan Bellouard
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, Service de Pharmacologie Clinique, F-44000 Nantes, France
| | - Antoine Rambaud
- Nantes Université, CHU Nantes, Service de Pharmacologie Clinique, F-44000 Nantes, France
| | - Clarisse Delaunay
- Nantes Université, CHU Nantes, Service de Maladies Infectieuses et Tropicales, F-44000 Nantes, France
| | - Éric Dailly
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, Service de Pharmacologie Clinique, F-44000 Nantes, France
| | - Raphaël Lecomte
- Nantes Université, CHU Nantes, Service de Maladies Infectieuses et Tropicales, F-44000 Nantes, France
| | - Colin Deschanvres
- Nantes Université, CHU Nantes, Service de Maladies Infectieuses et Tropicales, F-44000 Nantes, France
| | - Anne-Gaëlle Leroy
- Nantes Université, CHU Nantes, Service de Bactériologie et Contrôles Microbiologiques des Produits de Santé, F-44000 Nantes, France
| | - David Boutoille
- Nantes Université, CHU Nantes, INSERM, Service de Maladies infectieuses et Tropicales, CIC 1413, F-44000 Nantes, France
| | - Paul Le Turnier
- Nantes Université, CHU Nantes, INSERM, Service de Maladies infectieuses et Tropicales, CIC 1413, F-44000 Nantes, France
| | - Matthieu Grégoire
- Nantes Université, CHU Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR 1155, Service de Pharmacologie Clinique, F-44000 Nantes, France
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18
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Leroy AG, Crenn V, Le Turnier P, Pineau S, Grossi O, Bémer P, d’Epenoux LR, Tessier E, Bourigault C, Boutoille D, Lecomte R, Deschanvres C, Chauveau M, Nich C, Touchais S, Bouchand C, Troussier B, Plantard B, Hay B, Texier A. Cefazolin resistance among gram-negative bacilli isolated from prosthetic joint infections: a French observational study. Clin Microbiol Infect 2023; 29:263-264. [PMID: 36332877 DOI: 10.1016/j.cmi.2022.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Anne-Gaëlle Leroy
- Service de Bactériologie et des Contrôles Microbiologiques, CHU de Nantes, Université de Nantes, Nantes, France; Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France
| | - Vincent Crenn
- Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France; Nantes Université, CHU Nantes, Clinique Chirurgicale Orthopédique et Traumatologique, Nantes, France; Centre de Recherche en Cancérologie et Immunologie Nantes-Angers, INSERM UMR 1307, CNRS UMR 6075-Team 9 CHILD (Chromatin and Transcriptional Deregulation in Pediatric Bone Sarcoma), Nantes Université, Nantes, France
| | - Paul Le Turnier
- Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France; Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France
| | - Samuel Pineau
- Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France; Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France; Service d'Infectiologie, Hôpital Privé Du Confluent, Nantes, France
| | - Olivier Grossi
- Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France; Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire, Nantes, France; Service d'Infectiologie, Hôpital Privé Du Confluent, Nantes, France
| | - Pascale Bémer
- Service de Bactériologie et des Contrôles Microbiologiques, CHU de Nantes, Université de Nantes, Nantes, France; Nantes Study Group Member of Centre de Référence des Infections Ostéo-articulaires Complexes du Grand Ouest, Nantes, France.
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Bornand E, Letourneux F, Deschanvres C, Boutoille D, Lucet JC, Lepelletier D, Leclere B, Mayol S, Peiffer-Smadja N, Birgand G. Social representations of mask wearing in the general population during the COVID-19 pandemic. Front Public Health 2023; 11:1136980. [PMID: 37168075 PMCID: PMC10165064 DOI: 10.3389/fpubh.2023.1136980] [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: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction Although one of the most prominent interventions against COVID-19, face masks seem poorly adopted by the general population. A growing body of literature has found that using face masks has social meaning. This qualitative study assessed the perceptions, representations and practices of mask wearing in the general population. Methods A qualitative survey by short semi-structured walking interviews was carried out from April to December 2021 in 11 cities in France's Pays de la Loire region. Study locations were selected for their varied geographical, social, and economic characteristics, with urbanized and rural areas. Four domains linked to perceptions of masks and wearing them were explored: (i) evolution in mask wearing, (ii) decision-making methods for wearing and not wearing; (iii) incorporating the mask into way of life; (iv) projecting into the future. Results A total of 116 people were interviewed. Masks marked a shift from the ordinary world to the pandemic. Overall, interviewees considered masks an obstacle to breathing, communication, and social interactions, leading to establishing strategies circumventing the mask mandate. Poor attention was paid to their medical usefulness as an obligatory clothing accessory. Mask-wearing decisions were driven by social relations, common sense, and vulnerability. The greater the feeling of security (i.e., being with close relatives), the less it was worn or worn properly, with decreased attention to others and their health. Most participants did not remember learning to wear a mask. Some were convinced that mask-wearing could not be learned (experiential knowledge). Institutions (school and work) played a central role by facilitating incorporation of masks into daily life. Conclusions This study emphasizes the need to reinforce the individual medical values of face masks to prevent COVID-19. Ambitious education and training programmes should be planned to learn how and when to wear masks. Institutions (work and school) may be critical for this purpose.
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Affiliation(s)
- Elvire Bornand
- Centre Nantais de Sociologie (CENS), Université de Nantes, Nantes, France
| | | | - Colin Deschanvres
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - David Boutoille
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Jean-Christophe Lucet
- Equipe de Prévention du Risque Infectieux, Claude Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Didier Lepelletier
- Unité de Gestion du Risque Infectieux, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Brice Leclere
- Department of Medical Evaluation and Epidemiology, CHU Nantes, Nantes, France
| | - Séverine Mayol
- Department of Medical Evaluation and Epidemiology, CHU Nantes, Nantes, France
| | - Nathan Peiffer-Smadja
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France
- Infectious and Tropical Diseases Department, Bichat—Claude Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, London, United Kingdom
| | - Gabriel Birgand
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, London, United Kingdom
- Center for the Prevention of Healthcare Associated Infections Pays de la Loire, Nantes, France
- *Correspondence: Gabriel Birgand
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Barré T, Carrat F, Ramier C, Fontaine H, Di Beo V, Bureau M, Dorival C, Larrey D, Delarocque-Astagneau E, Mathurin P, Marcellin F, Petrov-Sanchez V, Cagnot C, Carrieri P, Pol S, Protopopescu C, Alric L, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Ahmed SNS, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Faure M, Froissart B, Hilleret MN, Zarski JP, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Samuel D, Antonini T, Coilly A, Duclos-Vallée JC, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Sebal F, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Bourlière M, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Cagnot C. Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort. J Cannabis Res 2022; 4:31. [PMID: 35690798 PMCID: PMC9188079 DOI: 10.1186/s42238-022-00138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection. Methods Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models. Results Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37–0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19–0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38–0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI. Conclusions We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure. Trial registration ClinicalTrials.gov identifier: NCT01953458.
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Godefroy T, Frecon G, Asquier-Khati A, Mateus D, Lecomte R, Rizkallah M, Piriou N, Le Tourneau T, Boutoille D, Eugene T, Carlier T. 18F-FDG-based radiomics and machine learning: a useful help for aortic prosthetic valve infective endocarditis diagnosis? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.318] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
FDG PET/CT allows for a better sensitivity in the prosthetic valve endocartitis (PVE) diagnostic when integrated to ESC 2015 criteria, but visual image analysis results in a weaker specificity and is subject to an inter-observer variability. We therefore aimed to evaluate the interest of quantitative analysis using radiomics and machine learning of FDG PET/CT scans in the PVE diagnostic.
Material and methods
Between 2015 and 2021, patients referred for a FDG PET/CT in our nuclear medicine department with suspected PVE were retrospectively included. The initial development of the model was focused on aortic prosthetic valve (aPV). The aPV was segmented and 31 radiomics features were extracted using the IBSI compliant PyRadiomics framework. Radiomics features were first tested by shuffling 50 times the signal within the aortic segmentation and non-contributive (i.e. identical results within 2×1,96σ over 50 iterations) were excluded. Correlated features were further removed using the variable inflation factor blinded to outcome and remaining features were standardized. Four machine learning algorithms (Ridge and LASSO logistic regression, support vector classifier and random forest) were evaluated and tuned through the use of a training database of patients with aPV included from 2015 to 2019 (excluding positive patient with a mitral and aortic valve). The procedure was further tested through 100 loops on an additional cohort of patients with only aPV included after 2019. ROC curves were subsequently computed and sensitivity was derived based on a fixed specificity of 0.7. Gold standard consisted in an expert consensus from the Endocarditis team. Primary objective was to assess the diagnostic performances of our combined approach using radiomics features and clinical features related to the PET exam (i.e time between aPV implantation and FDG PET/CT, time between antibiotics initiation and FDG PET/CT, extracardiac positive foci, spleen uptake and bone marrow uptake greater than liver uptake).
Results
108 patients were included, for a total of 65 definite PVE and 43 rejected PVE according to the expert consensus. The four algorithms were trained on a total of 68 patients and further tested on a cohort of 40 patients. The performance metrics are reported in the table. Support vector classifier achieved the best scores with an AUC of 0.79±0.01 (sensitivity 0.74±0.03; specificity 0.7). When adding clinical features, AUC was 0.82±0.02 (sensitivity 0.78±0.02; specificity 0.7).
Conclusion
When analyzed with our machine learning-based algorithms, FDG PET/CT reached acceptable diagnostic performances in terms of sensitivity for a specificity corresponding to the results reported by the ENDOPET study (1). These preliminary results obtained on a small test dataset suggest that an artificial intelligence-based algorithm may then guide the final diagnosis especially in this area of subjective visual assessment of PVE.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Godefroy
- University Hospital of Nantes , Nantes , France
| | - G Frecon
- University Hospital of Nantes , Nantes , France
| | | | - D Mateus
- Numerical Science Laboratory of Nantes , Nantes , France
| | - R Lecomte
- University Hospital of Nantes , Nantes , France
| | - M Rizkallah
- Numerical Science Laboratory of Nantes , Nantes , France
| | - N Piriou
- University Hospital of Nantes , Nantes , France
| | | | - D Boutoille
- University Hospital of Nantes , Nantes , France
| | - T Eugene
- University Hospital of Nantes , Nantes , France
| | - T Carlier
- University Hospital of Nantes , Nantes , France
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22
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Coste A, Conrad A, Porcher R, Poirée S, Peterlin P, Defrance C, Letscher-Bru V, Morio F, Gastinne T, Bougnoux ME, Suarez F, Nevez G, Dupont D, Ader F, Halfon-Domenech C, Ducastelle-Duprêtre S, Botterel F, Millon L, Guillerm G, Ansart S, Boutoille D, Ledoux MP, Robin C, Herbrecht JE, Melica G, Danion F, Paccoud O, Lortholary O, Herbrecht R, Lanternier F. P397 Influence of underlying conditions on disease presentation and diagnostic strategy during pulmonary mucormycosis: Anational study of 114 cases. Med Mycol 2022. [PMCID: PMC9509859 DOI: 10.1093/mmy/myac072.p397] [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
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Pulmonary mucormycosis (PM) is a life-threatening invasive fungal infection mostly affecting immunocompromised patients. We aimed to study the influence of underlying conditions on disease presentation and diagnostic strategy during PM. Methods All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed. Cases were defined according to EORTC/MSG 2019 criteria with the addition of diabetes and traumatism as host factors and positive serum or tissue PCR as mycological evidence. Thoracic CT scans were reviewed centrally. Results Among 114 cases of PM, 52 (46%) were proven and 62 (54%) were probable, including 12 cases with a positive serum qPCR as the sole mycological criterion. Hematological malignancy was the most common risk factor (49%), followed by allogeneic hematopoietic stem-cell transplantation (21%), and solid organ transplantation (SOT, 17%). Fever was the first symptom for 66% patients and was more frequent in patients with neutropenia than in those without (97% vs 52%, P <.01). A total of 46 (40%) patients had a disseminated infection, which was more frequently reported in neutropenic patients (50% vs 25%, P <.01). Main dissemination sites were the liver (48%), spleen (48%), brain (44%), and kidneys (37%). Sinusitis was present in 13% of cases. Chest radiological presentation included consolidation (58%), pleural effusion (52%), reversed halo sign (26%), halo sign (24%), vascular abnormalities (26%), and excavation (23%). The excavation was more frequently reported in SOT patients (64%, P <.01) compared with other groups. Vascular involvement was associated with reversed halo sign and Rhizomucor infection. Neutropenic patients presented more frequently than non-neutropenic patients with ground-glass opacities (75 vs 49%, P = .01), halo sign (32% vs 10%, P = .02), and reversed halo sign (35 vs 10%, P <.01). A total of 83 (73%) patients had a positive fungal culture from any type of respiratory sample. Serum qPCR was positive for 42/53 patients (79%) and respiratory fluid qPCR for 16/21 (76%) patients. In neutropenic patients, BAL culture was less often positive (30% vs 66%, P <.01), and serum qPCR was more frequently positive (91% vs 62%, P = .02). A transthoracic lung biopsy was contributive in 8/11 (73%) patients with negative bronchoalveolar lavage (BAL). Serum qPCR was more frequently positive in patients with the main lesion of >3 cm in diameter (91% vs 62%, P = .02). Rhizomucor spp. Was identified in 31 patients (32%), Rhizopus spp. In 29 patients (30%), Lichtheimia spp. In 24 patients (25%), Mucor spp. In 10 patients (10%) and Cunninghamella spp. In 4 patients (4%). Neutropenic patients were more frequently infected with Rhizomucor (43% vs 13%, P <.01) and less frequently with Rhizopus (17% vs 50%, P <.01). Histopathological specimens were available for 48 patients (42%) and revealed Mucorales hyphae in 85% of cases. Patients with a disseminated infection and neutropenia presented more often with angioinvasion than patients with localized disease (50% vs 9%, P <.01 and 38% vs 13%, P = .10). Overall, 90-day mortality was 59%. Conclusion Underlying conditions significantly influenced clinical and radiological presentation and diagnostic tools’ contribution. Neutropenic patients present more frequently with dissemination, fever, reversed halo sign, pathological angioinvasion, the negativity of BAL culture, the positivity of serum qPCR, and Rhizomucor infection.
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Affiliation(s)
- Anne Coste
- Brest University Hospital , Brest , France
| | | | | | | | | | | | | | - Florent Morio
- Strasbourg University Hospital , Strasbourg , France
| | | | | | - Felipe Suarez
- Assistante Public - Hôpitaux de Paris , Paris , France
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24
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Danneels P, Hamel JF, Picard L, Rezig S, Martinet P, Lorleac’h A, Talarmin JP, Buzelé R, Guimard T, Le Moal G, Brochard-Libois J, Beaudron A, Letheulle J, Codde C, Chenouard R, Boutoille D, Lemaignen A, Bernard L, Cattoir V, Dubée V. Impact of Enterococcus faecalis Endocarditis Treatment on Risk of Relapse. Clin Infect Dis 2022; 76:281-290. [PMID: 36124844 PMCID: PMC9839190 DOI: 10.1093/cid/ciac777] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 05/31/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Enterococcus faecalis infective endocarditis (EFIE) is characterized by a higher frequency of relapses than other infective endocarditis. The role of the treatment on its occurrence remains poorly understood. The aim of this study was to investigate whether the antibiotic regimen could impact the risk of relapse in EFIE. MATERIALS This was a multicenter retrospective study of patients diagnosed with definite EFIE between 2015 and 2019 in 14 French hospitals. The primary endpoint was the occurrence of relapses within the year following endocarditis diagnosis. As death was a competing risk for relapse, Fine and Gray models were used for studying risk factors and impact of treatment. RESULTS Of the 279 patients included, 83 (29.7%) received the amoxicillin-gentamicin (A-G) combination, 114 (40.9%) amoxicillin-ceftriaxone (A-C), 63 (22.6%) A-G and A-C (A-G/A-C) sequentially, 9 (3.2%) amoxicillin (A), and 10 received other treatments. One-year-relapse rate was 9.3% (26 patients). Relapse occurred after a median delay of 107 days from EFIE diagnosis; 6 occurred after 6 months, and 6 were diagnosed by blood cultures in asymptomatic patients. In multivariate analysis, surgery during treatment was a protective factor against one-year relapse and death.The cumulative incidence of relapse 1 year after endocarditis was 46.2% for patients treated with amoxicillin, 13.4% with A-G, 14.7% with A-C, and 4.3% with A-G/A-C (P≥.05 in multivariate analysis). CONCLUSIONS Relapses after treatment of EFIE are frequent, frequently asymptomatic, and may occur more than 6 months after the initial episode.
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Affiliation(s)
- Pierre Danneels
- Infectious Diseases and Tropical Medicine, Angers University Hospital, Angers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | | | - Léa Picard
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Pauline Martinet
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Aurélien Lorleac’h
- Infectious Diseases and Tropical Medicine, Groupe Hospitalier Bretagne Sud, Lorient, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Jean-Philippe Talarmin
- Infectious Diseases and Tropical Medicine, Cornouaille Hospital, Quimper, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Rodolphe Buzelé
- Infectious Diseases and Tropical Medicine, Saint-Brieuc General Hospital, Saint-Brieuc, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Thomas Guimard
- Infectious Diseases and Tropical Medicine, Vendée Departmental Hospital, La Roche Sur Yon, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Gwenaël Le Moal
- Infectious Diseases and Tropical Medicine, Poitiers University Hospital, Poitiers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Julia Brochard-Libois
- Infectious Diseases and Tropical Medicine, Saint Nazaire General Hospital, St-Nazaire, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Aurélie Beaudron
- Department of Bacteriology, Le Mans General Hospital, Le Mans, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Julien Letheulle
- Service de médecine polyvalente, Centre Hospitalier de Laval, Laval, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Cyrielle Codde
- Infectious Diseases and Tropical Medicine, Limoges University Hospital, Limoges, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Rachel Chenouard
- Department of Bacteriology, Angers University Hospital, Angers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - David Boutoille
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire de Nantes, Nantes, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Adrien Lemaignen
- Infectious Diseases and Tropical Medicine, Tours University Hospital, Tours, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Louis Bernard
- Infectious Diseases and Tropical Medicine, Tours University Hospital, Tours, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Vincent Cattoir
- Department of Bacteriology, Pontchaillou University Hospital, Rennes, France,National Reference Center for Enterococci, Pontchaillou University Hospital, Rennes, France,INSERM unit U1230, University of Rennes 1, Rennes, France
| | - Vincent Dubée
- Correspondence: V. Dubée, Infectious Diseases and Tropical Medicine, University Hospital. 4, Rue Larrey, 49100 Angers, France ()
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Bémer P, Aubry A, Tessier E, Ruffier d'Epenoux L, Lakhal K, Lepoivre T, Boutoille D, Deschanvres C, Lecomte R, Navas D, Guillouzouic A, Corvec S. Emergence of methicillin-resistant Staphylococcus epidermidis resistant to linezolid: activity of ceftaroline versus ceftobiprole in a French University Hospital. Int J Antimicrob Agents 2022; 60:106613. [PMID: 35691604 DOI: 10.1016/j.ijantimicag.2022.106613] [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: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Pascale Bémer
- Service de Bactériologie et des Contrôles Microbiologiques, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France.
| | - Arthur Aubry
- Service de Bactériologie et des Contrôles Microbiologiques, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France
| | - Eve Tessier
- Service de Bactériologie et des Contrôles Microbiologiques, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France
| | - Louise Ruffier d'Epenoux
- Service de Bactériologie et des Contrôles Microbiologiques, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France
| | - Karim Lakhal
- Service d'Anesthésie-Réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire, Nantes, France
| | - Thierry Lepoivre
- Service d'Anesthésie-Réanimation, Hôpital Laënnec, Centre Hospitalier Universitaire, Nantes, France
| | - David Boutoille
- Service des Maladies Infectieuses, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France; Centre d'Investigation Clinique Unité d'Investigation Clinique, Centre Hospitalier Universitaire, Nantes, France
| | - Colin Deschanvres
- Service des Maladies Infectieuses, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France; Centre d'Investigation Clinique Unité d'Investigation Clinique, Centre Hospitalier Universitaire, Nantes, France
| | - Raphaël Lecomte
- Service des Maladies Infectieuses, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France; Centre d'Investigation Clinique Unité d'Investigation Clinique, Centre Hospitalier Universitaire, Nantes, France
| | - Dominique Navas
- Pharmacie, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France
| | - Aurélie Guillouzouic
- Service de Bactériologie et des Contrôles Microbiologiques, Hôtel-Dieu, Centre Hospitalier Universitaire, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie et des Contrôles Microbiologiques, Université de Nantes, CHU Nantes, Nantes, France
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Paumier A, Asquier-Khati A, Thibaut S, Coeffic T, Lemenand O, Larramendy S, Leclère B, Caillon J, Boutoille D, Birgand G. Assessment of Factors Associated With Community-Acquired Extended-Spectrum β-Lactamase-Producing Escherichia coli Urinary Tract Infections in France. JAMA Netw Open 2022; 5:e2232679. [PMID: 36129706 PMCID: PMC9494187 DOI: 10.1001/jamanetworkopen.2022.32679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is considered a leading pathogen contributing to the global burden of antimicrobial resistance. OBJECTIVE To better understand factors associated with the heterogeneity of community-acquired ESBL-producing E coli urinary tract infections (UTIs) in France. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study performed from January 1 to December 31, 2021, was based on data collected via PRIMO (Surveillance and Prevention of Antimicrobial Resistance in Primary Care and Nursing Homes), a nationwide clinical laboratory surveillance system in France. Strains of E coli isolated from community urine samples from January 1 to December 31, 2019, from 59 administrative departments of metropolitan France were included. MAIN OUTCOMES AND MEASURES Quasi-Poisson regression models were used to assess the associations between several ecological factors available on government and administration websites between 2010 and 2020 (demographic population structure, living conditions, baseline health care services, antibiotic consumptions, economic indicators, animal farming density, and environmental characteristics) and the number of ESBL-producing E coli strains isolated from urine samples of individuals with community-acquired UTI in 2019. RESULTS Among 444 281 E coli isolates from urine samples tested in 1013 laboratories, the mean prevalence of ESBL-producing E coli was 3.0% (range, 1.4%-8.8%). In an adjusted model, the number of community-acquired ESBL-producing E coli UTIs in each department was positively associated with the percentage of children younger than 5 years (adjusted β1 coefficient, 0.112 [95% CI, 0.040-0.185]; P = .004), overcrowded households (adjusted β1 coefficient, 0.049 [95% CI, 0.034 to 0.062]; P < .001), consumption of fluoroquinolones (adjusted β1 coefficient, 0.002 [95% CI, 0.001-0.002]; P < .001), and tetracyclines (adjusted β1 coefficient, 0.0002 [0.00004 to 0.00039]; P = .02), and poultry density (adjusted β1 coefficient, 0.0001 [95% CI, 0.0001-0.0002]; P < .001). The social deprivation index (adjusted β1 coefficient, -0.115 [95% CI, -0.165 to -0.064]; P < .001) and the proportion of water surface area (adjusted β1 coefficient, -0.052 [-0.081 to -0.024]; P = .001) were negatively associated with a higher number of community-acquired ESBL-producing E coli UTIs. CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that multiple human health, animal health, and environmental factors are associated with the occurence of community-acquired ESBL E coli UTI. Strategies to mitigate ESBL in the community should follow the One Health approach and address the role played by fluoroquinolones, tetracycline use, poultry density, overcrowded households, and preschool-aged children.
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Affiliation(s)
- Adeline Paumier
- Centre d’Appui à la Prévention des Infections Associées aux Soins des Pays de la Loire, Centre Hospitalier Universitaire (CHU)–Le Tourville, Nantes, France
| | - Antoine Asquier-Khati
- Centre d’Appui à la Prévention des Infections Associées aux Soins des Pays de la Loire, Centre Hospitalier Universitaire (CHU)–Le Tourville, Nantes, France
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Sonia Thibaut
- French National Surveillance System of Antimicrobial Resistance in Primary Care and Nursing Homes, PRIMO, CHU–Le Tourville, Nantes, France
| | - Thomas Coeffic
- French National Surveillance System of Antimicrobial Resistance in Primary Care and Nursing Homes, PRIMO, CHU–Le Tourville, Nantes, France
| | - Olivier Lemenand
- French National Surveillance System of Antimicrobial Resistance in Primary Care and Nursing Homes, PRIMO, CHU–Le Tourville, Nantes, France
| | - Stéphanie Larramendy
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Brice Leclère
- Department of Infectious Diseases, University Hospital of Nantes and Centre d’Investigation Clinique 1413, Institut National de la Santé et de la Recherche Médicale, Nantes, France
| | - Jocelyne Caillon
- French National Surveillance System of Antimicrobial Resistance in Primary Care and Nursing Homes, PRIMO, CHU–Le Tourville, Nantes, France
| | - David Boutoille
- Department of Medical Evaluation and Epidemiology, CHU Nantes, Pays de la Loire, Nantes, France
| | - Gabriel Birgand
- Centre d’Appui à la Prévention des Infections Associées aux Soins des Pays de la Loire, Centre Hospitalier Universitaire (CHU)–Le Tourville, Nantes, France
- French National Surveillance System of Antimicrobial Resistance in Primary Care and Nursing Homes, PRIMO, CHU–Le Tourville, Nantes, France
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, London, United Kingdom
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Kong WKF, Salsano A, Giacobbe DR, Popescu BA, Laroche C, Duval X, Schueler R, Moreo A, Colonna P, Piper C, Calvo-Iglesias F, Badano LP, Srdanovic I, Boutoille D, Huttin O, Stöhr E, Timóteo AT, Vaskelyte JJ, Sadeghpour A, Tornos P, Abid L, Poh KK, Habib G, Lancellotti P. Outcomes of culture-negative vs. culture-positive infective endocarditis: the ESC-EORP EURO-ENDO registry. Eur Heart J 2022; 43:2770-2780. [PMID: 35695691 PMCID: PMC9459867 DOI: 10.1093/eurheartj/ehac307] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/21/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
AIM Fatality of infective endocarditis (IE) is high worldwide, and its diagnosis remains a challenge. The objective of the present study was to compare the clinical characteristics and outcomes of patients with culture-positive (CPIE) vs. culture-negative IE (CNIE). METHODS AND RESULTS This was an ancillary analysis of the ESC-EORP EURO-ENDO registry. Overall, 3113 patients who were diagnosed with IE during the study period were included in the present study. Of these, 2590 (83.2%) had CPIE, whereas 523 (16.8%) had CNIE. As many as 1488 (48.1%) patients underwent cardiac surgery during the index hospitalization, 1259 (48.8%) with CPIE and 229 (44.5%) with CNIE. The CNIE was a predictor of 1-year mortality [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.04-1.56], whereas surgery was significantly associated with survival (HR 0.49, 95% CI 0.41-0.58). The 1-year mortality was significantly higher in CNIE than CPIE patients in the medical subgroup, but it was not significantly different in CNIE vs. CPIE patients who underwent surgery. CONCLUSION The present analysis of the EURO-ENDO registry confirms a higher long-term mortality in patients with CNIE compared with patients with CPIE. This difference was present in patients receiving medical therapy alone and not in those who underwent surgery, with surgery being associated with reduced mortality. Additional efforts are required both to improve the aetiological diagnosis of IE and identify CNIE cases early before progressive disease potentially contraindicates surgery.
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Affiliation(s)
- William K F Kong
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Antonio Salsano
- Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
- Division of Cardiac Surgery, Ospedale Policlinico San Martino—IRCCS, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Infectious Diseases Unit, Ospedale Policlinico San Martino—IRCCS, Genoa, Italy
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy ‘Carol Davila’ Euroecolab, Emergency Institute for Cardiovascular Diseases ‘Prof. Dr. C. C. Iliescu’, Bucharest, Romania
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | - Xavier Duval
- INSERM Clinical Investigation Center 1425, Université Paris Diderot, Sorbonne Paris-Cité, IAME 1138, Paris, France
- AEPEI Service de Maladies Infectieuses et Tropicales, APHP, Hôpital Bichat, Paris, France
| | | | - Antonella Moreo
- Dipartimento CardioToracoVascolare ‘De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico University Hospital of Bari, Bari, Italy
| | - Cornelia Piper
- Clinic for General and Interventional Cardiology/Angiology, Herz-und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | | | - Luigi P Badano
- University of Milano-Bicocca, Milano, Italy
- Department of Cardiovascular, Neural and Metabolic Sciences; Istituto Auxologico Italiano, IRCCS—San Luca Hospital, Milano, Italy
| | - Ilija Srdanovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia
| | - David Boutoille
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital, Nantes, France
| | - Olivier Huttin
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, Nancy, France
- CIC-Plurithématique 1433, Inserm U1116, CHRU Nancy, Université de Lorraine, CIC-IT, U1433, CHRU de Nancy, France
- INSERM U1254, IADI, Université de Lorraine, Nancy, France
| | | | - Ana Teresa Timóteo
- Secretária-Geral Sociedade Portuguesa Cardiologia, Lisbon, Portugal
- Assistente Hospitalar Graduada Cardiologia, Hospital Santa Marta, Centro Hospitalar Universitário Lisbon Central, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
| | | | - Anita Sadeghpour
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran
- Duke Cardiovascular MR Center, Durham, NC, USA
| | - Pilar Tornos
- Cardiology Service, Hospital Quiron, Barcelona, Spain
| | | | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
- University Hospital of Liege (CHU), Liege, Belgium
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De Castro N, Mechaï F, Bachelet D, Canestri A, Joly V, Vandenhende M, Boutoille D, Kerjouan M, Veziris N, Molina JM, Grall N, Tattevin P, Laouénan C, Yazdanpanah Y. Treatment with a three-drug regimen for pulmonary tuberculosis based on rapid molecular detection of isoniazid resistance: a non-inferiority randomized trial (FAST-TB). Open Forum Infect Dis 2022; 9:ofac353. [PMID: 35949399 PMCID: PMC9356674 DOI: 10.1093/ofid/ofac353] [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] [Received: 04/26/2022] [Accepted: 07/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background The rationale behind the use of ethambutol in the standard tuberculosis treatment is to prevent the emergence of resistance to rifampicin in case of primary resistance to isoniazid. We evaluated whether early detection of isoniazid resistance using molecular testing allows the use an ethambutol-free regimen. Methods FAST-TB, a phase 4, French, multicenter, open-label, non-inferiority trial, compared 2 strategies: (1) polymerase chain reaction (PCR)-based detection of isoniazid and rifampicin resistance at baseline using Genotype MTBDRplus version 2.0 followed by ethambutol discontinuation if no resistance was detected (PCR arm) and (2) a standard 4-drug combination, pending phenotypic drug-susceptibility results (C arm). Adult patients with smear-positive pulmonary tuberculosis were enrolled. The primary endpoint was the proportion of patients with treatment success defined as bacteriological or clinical cure at the end of treatment. A non-inferiority margin of 10% was used. Results Two hundred three patients were randomized, 104 in the PCR arm and 99 in the C arm: 26.6% were female, median age was 37 (interquartile range, 28–51) years, 72.4% were born in Africa, and 5.4% were infected with human immunodeficiency virus. Chest x-ray showed cavities in 64.5% of the cases. Overall, 169 patients met criteria of treatment success: 87 of 104 (83.7%) in the PCR arm and 82 of 99 (82.8%) in the C arm with a difference of +0.8% (90% confidence interval, −7.9 to 9.6), meeting the noninferiority criteria in the intention-to-treat population (P = .02). Conclusions In a setting with low prevalence of primary isoniazid resistance, a 3-drug combination with isoniazid, rifampicin, and pyrazinamide, based on rapid detection of isoniazid resistance using molecular testing, was noninferior to starting the recommended 4-drug regimen.
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Affiliation(s)
| | - F Mechaï
- AP-HP Hôpital Avicenne , Bobigny , France
| | - D Bachelet
- AP-HP Hôpital Bichat-Claude Bernard , Paris , France
| | | | - V Joly
- AP-HP Hôpital Bichat-Claude Bernard , Paris , France
| | - M Vandenhende
- Hôpital Saint-André - CHU de Bordeaux , France
- Université Bordeaux , Bordeaux , France
| | - D Boutoille
- CHU Nantes , Nantes , France
- Centre d'Investigation Clinique, Unité d'Investigation Clinique 1413 INSERM , Nantes , France
| | | | - N Veziris
- Sorbonne Université, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris) , UMR 1135 , France
- AP-HP Hôpital Saint-Antoine, Centre National de Référence des Mycobactéries , Paris , France
| | - JM Molina
- APHP Hôpital Saint-Louis , Paris , France
- Université de Paris , Paris , France
| | - N Grall
- AP-HP Hôpital Bichat-Claude Bernard , Paris , France
| | - P Tattevin
- CHU de Rennes , Rennes , France
- Université de Rennes , France
| | - C Laouénan
- AP-HP Hôpital Bichat-Claude Bernard , Paris , France
| | - Y Yazdanpanah
- AP-HP Hôpital Bichat-Claude Bernard , Paris , France
- Université de Paris , Paris , France
- Inserm , IAME UMR 1137 INSERM, Paris , France
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29
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Paret R, Le Bourgeois A, Guillerm G, Tessoulin B, Rezig S, Gastinne T, Couturier MA, Boutoille D, Lecomte R, Ader F, Le Gouill S, Ansart S, Talarmin JP, Gaborit B. Safety and risk of febrile recurrence after early antibiotic discontinuation in high-risk neutropenic patients with haematological malignancies: a multicentre observational study. J Antimicrob Chemother 2022; 77:2546-2556. [PMID: 35748614 DOI: 10.1093/jac/dkac190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/16/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Early antibiotic discontinuation according to the Fourth European Conference on Infections in Leukaemia (ECIL-4) recommendations is not systematically applied in high-risk neutropenic patients with haematological malignancies. METHODS A retrospective multicentre observational study was conducted over 2 years to evaluate the safety of early antibiotic discontinuation for fever of unknown origin (FUO) during neutropenia after induction chemotherapy or HSCT, in comparison with a historical cohort. We used Cox proportional hazards models, censored on neutropenia resolution, to analyse factors associated with febrile recurrence. RESULTS Among 147 included patients in the ECIL-4 cohort, mainly diagnosed with acute leukaemia (n = 104, 71%), antibiotics were discontinued during 170 post-chemotherapy neutropenic episodes. In comparison with the historical cohort of 178 episodes of neutropenia without antibiotic discontinuation, no significant differences were observed regarding febrile recurrences [71.2% (121/170) versus 71.3% (127/178), P = 0.97], admission in ICUs [6.5% (11/170) versus 11.2% (20/178), P = 0.17], septic shock [0.6% (1/170) versus 3.9% (7/178), P = 0.07] and 30 day mortality [1.4% (2/147) versus 2.7% (4/150), P = 0.084]. In the ECIL-4 cohort, the rate of bacteraemia in case of febrile recurrence was higher [27.1% (46/170) versus 11.8% (21/178), P < 0.01] and antibiotic consumption was significantly lower (15.5 versus 19.9 days, P < 0.001). After early antibiotic discontinuation according to ECIL-4 recommendations, enterocolitis was associated with febrile recurrence [HR = 2.31 (95% CI = 1.4-3.8), P < 0.001] and stage III-IV oral mucositis with bacteraemia [HR = 2.26 (95% CI = 1.22-4.2), P = 0.01]. CONCLUSIONS After an FUO episode in high-risk neutropenia, compliance with ECIL-4 recommendations for early antibiotic discontinuation appears to be safe and mucosal damage was associated with febrile recurrence and bacteraemia. Prospective interventional studies are warranted to assess this strategy in high-risk neutropenic patients.
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Affiliation(s)
- Raphael Paret
- Department of Infectious Diseases, University Hospital of Brest, Brest, France
| | - Amandine Le Bourgeois
- Department of Haematology, University Hospital of Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes, France
| | - Gaëlle Guillerm
- Department of Haematology, University Hospital of Brest, Brest, France
| | - Benoit Tessoulin
- Department of Haematology, University Hospital of Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes, France
| | - Schéhérazade Rezig
- Department of Infectious Diseases, University Hospital of Brest, Brest, France
| | - Thomas Gastinne
- Department of Haematology, University Hospital of Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes, France
| | | | - David Boutoille
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, Nantes, France.,Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, F-44000 Nantes, France
| | - Raphael Lecomte
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, Nantes, France
| | - Florence Ader
- Department of Infectious Diseases, University Hospital of Lyon, Lyon, France
| | - Steven Le Gouill
- Department of Haematology, University Hospital of Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes, France
| | - Séverine Ansart
- Department of Infectious Diseases, University Hospital of Brest, Brest, France
| | - Jean Philippe Talarmin
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital Quimper, Quimper, France
| | - Benjamin Gaborit
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, Nantes, France.,Nantes Université, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, F-44000 Nantes, France
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Vibert M, Guimard T, Brochard J, Takoudju EM, Larrose C, Boutoille D, Le Turnier P. Leptospirosis in retirees living in rural areas: a poorly recognized emerging problem in mainland France? Open Forum Infect Dis 2022; 9:ofac269. [PMID: 35854997 PMCID: PMC9290540 DOI: 10.1093/ofid/ofac269] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/27/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Among 40 patients diagnosed with leptospirosis in 3 hospitals of western mainland France between 2014 and 2018 half were at least 60 years old and retired. Their exposure factors were mainly rural residential environment with limited remarkable risk factors. Better awareness and information on leptospirosis appear necessary in this population.
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Affiliation(s)
| | - Thomas Guimard
- Post Emergency and Infectious Diseases department, La Roche sur Yon Hospital , La Roche sur Yon, France
| | - Julia Brochard
- Polyvalent Medicine department, Saint Nazaire Hospital , Saint Nazaire, France
| | - Eve-Marie Takoudju
- Microbiology department, La Roche sur Yon Hospital , La Roche sur Yon, France
| | - Catherine Larrose
- Medical biology department, Nantes University Hospital , Nantes, France
| | - David Boutoille
- Nantes University Hospital Infectious Diseases department, Nantes University Hospital, Nantes, France and INSERM CIC 1413, , Nantes, France
| | - Paul Le Turnier
- Nantes University Hospital Infectious Diseases department, Nantes University Hospital, Nantes, France and INSERM CIC 1413, , Nantes, France
- Infectious Diseases department, Cayenne Hospital , Cayenne, French Guiana
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque AM, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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Carrieri P, Carrat F, Di Beo V, Bourlière M, Barré T, De Ledinghen V, Pageaux GP, Bureau M, Cagnot C, Dorival C, Delarocque-Astagneau E, Marcellin F, Pol S, Fontaine H, Protopopescu C, Laurent Alric, Bonnet D, Payssan-Sicart V, Pomes C, Zoulim F, Maynard M, Bai R, Hucault L, Bailly F, Raffi F, Billaud E, Boutoille D, Lefebvre M, André-Garnier E, Cales P, Hubert I, Lannes A, Lunel F, Boursier J, Asselah T, Boyer N, Giuily N, Castelnau C, Scoazec G, Pol S, Fontaine H, Rousseaud E, Vallet-Pichard A, Sogni P, de Ledinghen V, Foucher J, Hiriart JB, M’Bouyou J, Irlès-Depé M, Bourlière M, Si Ahmed SN, Oules V, Tran A, Anty R, Gelsi E, Truchi R, Thabut D, Hammeche S, Moussali J, Causse X, De Dieuleveult B, Ouarani B, Labarrière D, Ganne N, Grando-Lemaire V, Nahon P, Brulé S, Ulker B, Guyader D, Jezequel C, Brener A, Laligant A, Rabot A, Renard I, Habersetzer F, Baumert TF, Doffoel M, Mutter C, Simo-Noumbissie P, Razi E, Bronowicki JP, Barraud H, Bensenane M, Nani A, Hassani-Nani S, Bernard MA, Pageaux GP, Larrey D, Meszaros M, Metivier S, Bureau C, Morales T, Peron JM, Robic MA, Decaens T, Froissart B, Hilleret MN, Costentin C, Gerster T, Riachi G, Goria O, Paris F, Montialoux H, Leroy V, Amaddeo G, Varaut A, Simoes M, Amzal R, Chazouillières O, Andreani T, Angoulevant B, Chevance A, Serfaty L, Duclos Vallée JC, Samuel D, Antonini T, Coilly A, Tateo M, Abergel A, Reymond M, Brigitte C, Benjamin B, Muti L, Geist C, Conroy G, Riffault R, Rosa I, Barrault C, Costes L, Hagège H, Loustaud-Ratti V, Carrier P, Debette-Gratien M, Mathurin P, Lassailly G, Lemaitre E, Canva V, Dharancy S, Louvet A, Minello A, Latournerie M, Bardou M, Mouillot T, D’Alteroche L, Barbereau D, Nicolas C, Elkrief L, Jaillais A, Gournay J, Chevalier C, Archambeaud I, Habes S, Portal I, Gelu-Simeon M, Saillard E, Lafrance MJ, Catherine L, Carrat F, Chau F, Dorival C, Goderel I, Lusivika-Nzinga C, Bellance MA, Bellet J, Monfalet P, Chane-Teng J, Bijaoui S, Pannetier G, Téoulé F, Nicol J, Bekhti R, Cagnot C, Boston A, Nailler L, Le Meut G, Diallo A, Petrov-Sanchez V, Marc Bourlière, Boursier J, Carrat F, Carrieri P, Delarocque-Astagneau E, De Ledinghen V, Dorival C, Fontaine H, Fourati S, Housset C, Larrey D, Nahon P, Pageaux GP, Petrov-Sanchez V, Pol S, Bruyand M, Wittkop L, Zoulim F, Zucman-Rossi J, L’hennaff M, Sizorn M, Boston A, Diallo A, Cagnot C, Bousselet A, Caralp M. Severe liver fibrosis in the HCV cure era: major effects of social vulnerability, diabetes, and unhealthy behaviors. JHEP Rep 2022; 4:100481. [PMID: 35514789 PMCID: PMC9065909 DOI: 10.1016/j.jhepr.2022.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022] Open
Abstract
Background & Aims After HCV cure, not all patients achieve significant liver fibrosis regression. We explored the effects of clinical and socio-behavioral factors on liver fibrosis, before and after HCV cure with direct-acting antivirals. Methods We analyzed data from the ongoing ANRS CO22 HEPATHER cohort, which prospectively collects clinical and socio-behavioral data on HCV-infected patients. Mixed-effects logistic regression models helped identify predictors of longitudinal measures of severe liver fibrosis, defined as a fibrosis-4 index >3.25. We also estimated the adjusted population attributable fractions (PAFs) for modifiable risk factors. Results Among the 9,692 study patients (accounting for 24,687 visits over 4 years of follow-up, 48.5% of which were post-HCV cure), 26% had severe fibrosis at enrolment. After multivariable adjustment, HCV-cured patients had an 87% lower risk of severe fibrosis. An inverse dose-response relationship was found for coffee consumption, with the risk of severe fibrosis diminishing by 58% per additional cup/day (adjusted odds ratio (aOR 0.42; 95% CI 0.38-0.46). Unemployment, low educational level, and diabetes were associated with a higher severe fibrosis risk (aOR 1.69; 95% CI 1.32-2.16, aOR 1.50; 95% CI 1.20-1.86, and aOR 4.27; 95% CI 3.15-5.77, respectively). Severe fibrosis risk was 3.6/4.6-fold higher in individuals with previous/current unhealthy alcohol use than in abstinent patients. All these associations remained valid after HCV cure. The risk factors accounting for the greatest severe fibrosis burden were unemployment, low education level, and diabetes (PAFs: 29%, 21%, and 17%, respectively). Conclusions Monitoring liver fibrosis after HCV cure is crucial for patients with low socioeconomic status, previous/current unhealthy alcohol use, and diabetes. Innovative HCV care models for the most socially vulnerable individuals and interventions for healthier lifestyles are needed to reinforce the positive effects of HCV cure on liver health. Lay summary After hepatitis C virus (HCV) cure, not all patients achieve significant liver fibrosis regression. Herein, we studied the effects of clinical and socio-behavioral factors on the risk of severe liver fibrosis. Coffee consumption was strongly inversely associated with severe fibrosis, while diabetes, previous and current unhealthy alcohol use were associated with a 4.3-, 3.6- and 4.6-fold higher risk of severe fibrosis, respectively. Unemployment and low educational level were also associated with a higher risk of severe fibrosis. All these associations remained valid after HCV cure. These results demonstrate the need to continue liver fibrosis monitoring in at-risk groups, and to facilitate healthier lifestyles after HCV cure as a clinical and public health priority. Liver fibrosis assessment is a key prognostic tool in the hepatitis C cure era. Significant liver fibrosis regression does not always occur after hepatitis C cure. Coffee intake displays protective effects on severe fibrosis even after HCV cure. Social vulnerability, diabetes, and unhealthy alcohol use predict severe fibrosis. Socio-behavioral factors are associated with severe fibrosis even after HCV cure.
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Millon L, Caillot D, Berceanu A, Bretagne S, Lanternier F, Morio F, Letscher-Bru V, Dalle F, Denis B, Alanio A, Boutoille D, Bougnoux ME, Botterel F, Chouaki T, Charbonnier A, Ader F, Dupont D, Bellanger AP, Rocchi S, Scherer E, Gbaguidi-Haore H, Herbrecht R. Evaluation of serum Mucorales PCR for the diagnosis of Mucormycoses: The MODIMUCOR prospective trial. Clin Infect Dis 2022; 75:777-785. [PMID: 34986227 DOI: 10.1093/cid/ciab1066] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [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: 08/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early diagnosis and prompt initiation of specific antifungal treatment is essential for improving the prognosis of mucormycosis. We aimed to assess the performance of serum Mucorales quantitative PCR (qPCR) for the early diagnosis and follow-up of mucormycosis. METHODS We prospectively enrolled 232 patients with suspicion of invasive mold disease, evaluated using standard imaging and mycological procedures. Thirteen additional patients with proven or probable mucormycosis were included to analyze DNA load kinetics. Serum samples were collected twice-a-week for Mucorales qPCR tests targeting the Mucorales species Lichtheimia, Rhizomucor and Mucor/Rhizopus. RESULTS The sensitivity was 85·2%, specificity 89·8%, and positive and negative likelihood ratios 8·3 and 0·17, respectively in this prospective study. The first Mucorales qPCR-positive serum was observed a median of four days (IQR, 0-9) before sampling of the first mycological or histological positive specimen and a median of one day (IQR, (-2)-6) before the first imaging was performed. Negativity of Mucorales qPCR within seven days after liposomal-amphotericin B initiation was associated with an 85% lower 30-day mortality rate (adjusted hazard Ratio = 0·15, 95%CI [0·03-0·73], p = 0·02). CONCLUSION Our study argues for the inclusion of qPCR for the detection of circulating Mucorales DNA for mucormycosis diagnosis and follow-up after treatment initiation. Positive results should be added to the criteria for the consensual definitions from the European Organization for the Research and Treatment of Cancer/ Mycoses Study Group Education and Research Consortium (EORTC/MSGERC), as already done for Aspergillus PCR.
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Affiliation(s)
- Laurence Millon
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Denis Caillot
- Department of Clinical Hematology, CHU Dijon, Dijon, France
| | - Ana Berceanu
- Service d'Hematologie, CHU Besançon, Besançon, France
| | - Stéphane Bretagne
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - Fanny Lanternier
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Université de Paris, Paris, France.,Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, IHU Imagine, Paris, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, CHU Nantes, Nantes, France.,Département de Parasitologie et Mycologie Médicale, EA1155 - IICiMed, Nantes Université, Nantes, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg Strasbourg, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon France.,UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - Blandine Denis
- Infectious Diseases Department, APHP, Saint-Louis Hospital, Paris, France
| | - Alexandre Alanio
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - David Boutoille
- Unité Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France
| | - Marie-Elisabeth Bougnoux
- Parasitology-Mycology Unit, Necker Enfants Malades Hospital, APHP, Paris, France.,Fungal Biology and Pathogenicity Unit - INRA USC 2019. Institut Pasteur, Paris, France
| | - Françoise Botterel
- EA Dynamyc 7380 UPEC, ENVA, Faculté de Médecine, Créteil, France.,Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, DHU VIC, CHU Henri Mondor, Créteil, France
| | - Taieb Chouaki
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens Picardie, Amiens, France.,Equipe AGIR : Agents Infectieux, Résistance et Chimiothérapie UR4294, Université de Picardie Jules Verne, Amiens, France
| | - Amandine Charbonnier
- Department of Clinical Hematology and Cellular Therapy, Amiens University Medical Center, Amiens, France
| | - Florence Ader
- Hospices Civils de Lyon, Département des Maladies Infectieuses et Tropicales, F-69004, Lyon, France
| | - Damien Dupont
- Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Steffi Rocchi
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Emeline Scherer
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Houssein Gbaguidi-Haore
- UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France.,Infection Control Department, CHU Besançon, Besançon, France
| | - Raoul Herbrecht
- Université de Strasbourg, INSERM, IRFAC UMR-S1113, Strasbourg, France.,Service d'Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
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Lécuyer R, Issa N, Tessoulin B, Lavergne RA, Morio F, Gabriel F, Canet E, Bressollette-Bodin C, Guillouzouic A, Boutoille D, Raffi F, Lecomte R, Le Turnier P, Deschanvres C, Camou F, Gaborit BJ. Epidemiology and clinical impact of respiratory co-infections at diagnosis of Pneumocystis jirovecii Pneumonia. J Infect Dis 2021; 225:868-880. [PMID: 34604908 DOI: 10.1093/infdis/jiab460] [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: 06/25/2021] [Accepted: 09/09/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To describe the epidemiology and clinical impact of respiratory co-infections at diagnosis of Pneumocystis jirovecii Pneumonia (PcP). METHODS A retrospective observational study was conducted between January 2011 and April 2019 to evaluate respiratory co-infections at diagnosis of PcP patients, in two tertiary care hospitals. Respiratory co-infection was defined by the identification of pathogens from P. jirovecii-positive samples. RESULTS Of the 7 882 respiratory samples tested for P. jirovecii during the 8-year study period, 328 patients with final diagnosis of PcP were included in this study. Mean age was 56.7 ± 14.9 years, 193 (58.8%) were male, 74 (22.6%) had a positive HIV serology, 125 (38.1%) had a viral co-infections, 76 (23.2%) a bacterial co-infections and 90-day mortality was 25.3%. In overall population, 90-Day mortality was independently associated with a solid tumor underlying disease (OR 11.8, 1.90-78, p=0.008), SOFA score at admission (OR 1.62, 1.34-2.05; p<0.001) and CMV respiratory co-infection (OR 3.44, 1.24-2.90; p=0.02). Among HIV-negative patients, respiratory CMV co-infection was associated with a worse prognosis, especially when treated with adjunctive corticosteroid therapy. CONCLUSIONS Respiratory CMV co-infection at diagnosis of PcP was independently associated with increased 90-day mortality, specifically in HIV-negative patients.
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Affiliation(s)
- Romain Lécuyer
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France.,EA 1155, Laboratory of targets and drugs for infections and cancer, IRS2-Nantes Biotech, Nantes, France
| | - Nahema Issa
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Benoit Tessoulin
- INSERM, U1232, Université de Nantes, Service d'Hématologie, University Hospital, Nantes, France
| | - Rose-Anne Lavergne
- EA 1155, Laboratory of targets and drugs for infections and cancer, IRS2-Nantes Biotech, Nantes, France.,Laboratoire de Parasitologie-Mycologie, Institut de Biologie, University Hospital, Nantes, France
| | - Florent Morio
- EA 1155, Laboratory of targets and drugs for infections and cancer, IRS2-Nantes Biotech, Nantes, France.,Laboratoire de Parasitologie-Mycologie, Institut de Biologie, University Hospital, Nantes, France
| | - Frederic Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, F-33000, Bordeaux, France
| | - Emmanuel Canet
- Medical Intensive Care, University Hospital, Nantes, France
| | | | | | - David Boutoille
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France.,EA 3826, Laboratory of clinical and experimental therapeutics of infections, IRS2-Nantes Biotech, Nantes, France
| | - François Raffi
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Raphael Lecomte
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Paul Le Turnier
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Colin Deschanvres
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Fabrice Camou
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Benjamin Jean Gaborit
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France.,EA 3826, Laboratory of clinical and experimental therapeutics of infections, IRS2-Nantes Biotech, Nantes, France
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Duval X, Le Moing V, Tubiana S, Esposito-Farèse M, Ilic-Habensus E, Leclercq F, Bourdon A, Goehringer F, Selton-Suty C, Chevalier E, Boutoille D, Piriou N, Le Tourneau T, Chirouze C, Seronde MF, Morel O, Piroth L, Eicher JC, Humbert O, Revest M, Thébault E, Devillers A, Delahaye F, Boibieux A, Grégoire B, Hoen B, Laouenan C, Iung B, Rouzet F. Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study. Clin Infect Dis 2021; 73:393-403. [PMID: 32488236 DOI: 10.1093/cid/ciaa666] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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: 12/27/2019] [Accepted: 05/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diagnostic and patients' management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients. METHODS In sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients' management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients' management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established. RESULTS Among the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P < .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients' managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32-48), which was most likely to occur in those with a noncontributing echocardiography (P < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV. CONCLUSIONS Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients. CLINICAL TRIALS REGISTRATION NCT02287792.
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Affiliation(s)
- Xavier Duval
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,INSERM UMR-1137 IAME, Paris, France.,University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France
| | - Vincent Le Moing
- Department of Infectious Diseases, University Hospital of Montpellier, Montpellier, France
| | - Sarah Tubiana
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,INSERM UMR-1137 IAME, Paris, France
| | - Marina Esposito-Farèse
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,Unité de Recherche Clinique, AP-HP, HUPNVS, Hôpital Universitaire Paris Nord-Val de Seine, Paris, France
| | - Emila Ilic-Habensus
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France
| | - Florence Leclercq
- Department of Cardiology, University Hospital of Montpellier, Montpellier, France
| | - Aurélie Bourdon
- Department of Nuclear Medicine, University Hospital of Montpellier, Montpellier, France
| | - François Goehringer
- Department of Infectious Diseases, University Hospital of Nancy, Nancy, France
| | | | - Elodie Chevalier
- Department of Nuclear Medicine, University Hospital of Nancy, Nancy, France
| | - David Boutoille
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital of Nantes, Nantes, France
| | - Nicolas Piriou
- Thorax Institute, INSERM, UMR 1087, University Hospital of Nantes, Nantes, France.,Department of Nuclear Medicine, Nantes University Hospital, G. et R. Laennec Hospital, Nantes, France
| | - Thierry Le Tourneau
- Thorax Institute, INSERM, UMR 1087, University Hospital of Nantes, Nantes, France
| | - Catherine Chirouze
- University Hospital of Besançon, France, UMR CNRS 6249 Chrono-Environnement, Bourgogne University, Franche-Comté, Dijon, France
| | | | - Olivier Morel
- Department of Nuclear Medicine, University Hospital of Besançon, Besançon, France
| | - Lionel Piroth
- Department of Infectious Diseases, University Hospital of Dijon, INSERM CIC 1432, CHU Dijon, France
| | | | - Olivier Humbert
- Department of Nuclear Medicine, University Hospital of Dijon, Dijon, France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, University Hospital of Rennes France, INSERM U1230 CHU Rennes, France.,INSERM CIC 1414, University Hospital of Rennes, France
| | | | - Anne Devillers
- Department of Nuclear Medicine, University Hospital of Rennes, France
| | | | - André Boibieux
- Department of Nuclear Medicine, University Hospital of Lyon, Lyon, France
| | - Bastien Grégoire
- Department of Infectious Diseases, University Hospital of Lyon, Lyon, France
| | - Bruno Hoen
- Department of Infectious Diseases, University Hospital of Nancy, Nancy, France
| | - Cédric Laouenan
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,INSERM UMR-1137 IAME, Paris, France.,University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France.,Unité de Recherche Clinique, AP-HP, HUPNVS, Hôpital Universitaire Paris Nord-Val de Seine, Paris, France
| | - Bernard Iung
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,INSERM UMR-1137 IAME, Paris, France.,University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France
| | - François Rouzet
- INSERM CIC 1425, Paris, France.,AP-HP, University Hospital of Bichat, Paris, France.,INSERM UMR-1137 IAME, Paris, France.,University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France.,Department of Nuclear Medicine, AP-HP, University Hospital of Bichat, Paris, France
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Lécuyer R, Issa N, Tessoulin B, Morio F, Gabriel F, Canet E, Boutoille D, Raffi F, Camou F, Gaborit B. Épidémiologie et impact pronostique des co-infections respiratoires associées au diagnostic de pneumocystose. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.023] [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: 11/15/2022]
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Sebillotte M, Boutoille D, Declerck C, Talarmin J, Lemaignen A, Piau C, Tattevin P, Gousseff M. Endocardites à bacilles Gram négatif non HACEK : étude rétrospective multicentrique cas-témoins. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.015] [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: 10/20/2022]
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Danneels P, Picard L, Rezig S, Martinet P, Talarmin JP, Buzele R, Cattoir V, Boutoille D, Bernard L. Évaluation de la prise en charge de l’endocardite à Enterococcus faecalis dans une inter-région. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.079] [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: 10/20/2022]
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Leroy A, Crenn V, Le Turnier P, Corvec S, Boutoille D, Nich C, Texier A, Pineau S, Bemer P, Grossi O. Facteurs de risque d’infection ostéoarticulaire sur prothèse (hanche ou de genou) à bacilles à Gram négatif : une double étude cas-témoins. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.028] [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: 11/15/2022]
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Boutfol W, Imboula E, Thibaut S, Cormier H, Abgueguen P, Boutoille D. Pathologies infectieuses en ville : comment se former à l’ère du COVID ? Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.105] [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: 10/20/2022]
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42
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Charret L, Bart G, Hoppe E, Dernis E, Cormier G, Boutoille D, Le Goff B, Darrieutort-Laffite C. Clinical characteristics and management of olecranon and prepatellar septic bursitis in a multicentre study. J Antimicrob Chemother 2021; 76:3029-3032. [PMID: 34293150 DOI: 10.1093/jac/dkab265] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/01/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND No current guidelines are available for managing septic bursitis (SB). OBJECTIVES To describe the clinical characteristics and management of olecranon and prepatellar SB in five French tertiary care centres. METHODS This is a retrospective observational multicentre study. SB was diagnosed on the basis of positive cultures of bursal aspirate. In the absence of positive bursal fluid, the diagnosis came from typical clinical presentation, exclusion of other causes of bursitis and favourable response to antibiotic therapy. RESULTS We included 272 patients (median age of 53 years, 85.3% male and 22.8% with at least one comorbidity). A microorganism was identified in 184 patients (67.6%), from bursal fluids in all but 4. We identified staphylococci in 135 samples (73.4%), streptococci in 35 (19%) and 10 (5.5%) were polymicrobial, while 43/223 bursal samples remained sterile (19.3%). Forty-nine patients (18%) were managed without bursal fluid analysis. Antibiotic treatment was initially administered IV in 41% and this route was preferred in case of fever (P = 0.003) or extensive cellulitis (P = 0.002). Seventy-one (26%) patients were treated surgically. A low failure rate was observed (n = 16/272, 5.9%) and failures were more frequent when the antibiotic therapy lasted <14 days (P = 0.02) in both surgically and medically treated patients. CONCLUSIONS Despite variable treatments, SB resolved in the majority of cases even when the treatment was exclusively medical. The success rate was equivalent in the non-surgical and the surgical management groups. However, a treatment duration of <14 days may require special attention in both groups.
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Affiliation(s)
- Laurie Charret
- Rheumatology Department, CHU Nantes, Nantes, France.,Rheumatology Department, CHD Vendée, La Roche-Sur-Yon, France
| | - Géraldine Bart
- Rheumatology Department, CHU Rennes, Rennes, France.,Centre de référence en infections ostéoarticulaires complexes du Grand Ouest (CRIOGO), CHU de Rennes, 35043, Rennes cedex, France
| | | | | | | | - David Boutoille
- Centre de référence en infections ostéoarticulaires complexes du Grand Ouest (CRIOGO), CHU de Rennes, 35043, Rennes cedex, France.,Department of Infectious Diseases, CHU Nantes, Nantes, France.,Centre d'Investigation Clinique, Unité d'Investigation Clinique 1413 INSERM, CHU Nantes, Nantes, France
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Rambaud A, Gaborit BJ, Deschanvres C, Le Turnier P, Lecomte R, Asseray-Madani N, Leroy AG, Deslandes G, Dailly É, Jolliet P, Boutoille D, Bellouard R, Gregoire M. Development and validation of a dosing nomogram for amoxicillin in infective endocarditis. J Antimicrob Chemother 2021; 75:2941-2950. [PMID: 32601687 DOI: 10.1093/jac/dkaa232] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Amoxicillin is the first-line treatment for streptococcal or enterococcal infective endocarditis (IE) with a dose regimen adapted to weight. OBJECTIVES Covariates influencing pharmacokinetics (PK) of amoxicillin were identified in order to develop a dosing nomogram based on identified covariates for individual adaptation. PATIENTS AND METHODS Patients treated with amoxicillin administered by continuous infusion for IE were included retrospectively. The population PK analysis was performed using the Pmetrics package for R (NPAG algorithm). Influence of weight, ideal weight, height, BMI, body surface area, glomerular filtration rate adapted to the body surface area and calculated by the CKD-EPI method (mL/min), additional ceftriaxone treatment and serum protein level on amoxicillin PK was tested. A nomogram was then developed to determine the daily dose needed to achieve a steady-state free plasma concentration above 4× MIC, 100% of the time, without exceeding a total plasma concentration of 80 mg/L. RESULTS A total of 160 patients were included. Population PK analysis was performed on 540 amoxicillin plasma concentrations. A two-compartment model best described amoxicillin PK and the glomerular filtration rate covariate significantly improved the model when included in the calculation of the elimination constant Ke. CONCLUSIONS This work allowed the development of a dosing nomogram that can help to increase achievement of the PK/pharmacodynamic targets in IE treated with amoxicillin.
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Affiliation(s)
- Antoine Rambaud
- Clinical Pharmacology Department, CHU Nantes, Nantes, France
| | - Benjamin Jean Gaborit
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France.,EA 3826, Laboratory of Clinical and Experimental Therapeutics of Infections, IRS2-Nantes Biotech, University of Nantes, France
| | - Colin Deschanvres
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France
| | - Paul Le Turnier
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France
| | - Raphaël Lecomte
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France
| | | | - Anne-Gaëlle Leroy
- EA 3826, Laboratory of Clinical and Experimental Therapeutics of Infections, IRS2-Nantes Biotech, University of Nantes, France.,Department of Bacteriology, CHU Nantes, Nantes, France
| | | | - Éric Dailly
- Clinical Pharmacology Department, CHU Nantes, Nantes, France.,EE 1701, MiHAR, University of Nantes, Nantes, France
| | - Pascale Jolliet
- Clinical Pharmacology Department, CHU Nantes, Nantes, France
| | - David Boutoille
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France.,EA 3826, Laboratory of Clinical and Experimental Therapeutics of Infections, IRS2-Nantes Biotech, University of Nantes, France
| | - Ronan Bellouard
- Clinical Pharmacology Department, CHU Nantes, Nantes, France.,EE 1701, MiHAR, University of Nantes, Nantes, France
| | - Matthieu Gregoire
- Clinical Pharmacology Department, CHU Nantes, Nantes, France.,UMR INSERM 1235, The Enteric Nervous System in Gut and Brain Disorders, University of Nantes, Nantes, France
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Varenne Y, Corvec S, Leroy AG, Boutoille D, Nguyễn MV, Touchais S, Bémer P, Hamel A, Waast D, Nich C, Gouin F, Crenn V. A Short-Course Antibiotic Prophylaxis Is Associated with Limited Antibiotic Resistance Emergence in Post-Operative Infection of Pelvic Primary Bone Tumor Resection. Antibiotics (Basel) 2021; 10:768. [PMID: 34202518 PMCID: PMC8300712 DOI: 10.3390/antibiotics10070768] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 11/17/2022] Open
Abstract
Resections of primary pelvic bone tumors are frequently complicated by surgical site infections (SSIs), thereby impairing the functional prognosis of patients, especially in case of implant removal. Although prophylactic antibiotics play an essential role in preventing SSIs, there are presently no recommendations that support their appropriate use. This study aimed to assess the impact of a 24 h prophylactic protocol on the bacterial ecology, the resistance pattern, and the SSI healing rate. We hypothesized that this protocol not only limits the emergence of resistance but also results in a good cure rate with implant retention in case of SSI. A retrospective study was performed that included all patients with an SSI following a pelvic bone tumoral resection between 2005 and 2017 who received a 24 h antibiotic prophylaxis protocol. Twenty-nine patients with an SSI were included. We observed a 75.9% rate of polymicrobial infection, with a high prevalence of digestive flora microorganisms and a majority of wild-type phenotypes. We confirmed that there was no significant emergence of resistant flora. After first-line debridement, antibiotics (DA) if any implant was used, or debridement, antibiotics, and implant retention (DAIR) whenever possible, we obtained a 79.3% cure rate, with implant removal in 20% of cases. The absence of an implant was significantly associated with SSI healing. Early infection management and low resistance profiles may also have a positive effect, but this needs to be confirmed in a larger cohort. In light of this, the use of a 24 h prophylactic protocol in primary pelvic bone tumor resections is associated with a favorable infection cure rate and implant retention in case of SSI, and minimal selection of resistant microorganisms.
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Affiliation(s)
- Yoann Varenne
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
| | - Stéphane Corvec
- Bacteriology Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (S.C.); (A.-G.L.); (P.B.)
- CRCINA, INSERM, University of Angers, University of Nantes, 44000 Nantes, France
| | - Anne-Gaëlle Leroy
- Bacteriology Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (S.C.); (A.-G.L.); (P.B.)
- Laboratoire EA 3826 “Thérapeutiques Cliniques et Expérimentales des Infections”, IRS2-Nantes Biotech, University of Nantes, 44000 Nantes, France
| | - David Boutoille
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital, 44000 Nantes, France;
| | - Mỹ-Vân Nguyễn
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
| | - Sophie Touchais
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
| | - Pascale Bémer
- Bacteriology Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (S.C.); (A.-G.L.); (P.B.)
| | - Antoine Hamel
- Pediatric Orthopedic Surgery Department, University Hospital, UHC of Nantes, 44903 Nantes, France;
- Anatomy Department, Medical Faculty, 44000 Nantes, France
| | - Denis Waast
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
| | - Christophe Nich
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
- PhyOs 1238, INSERM, University of Nantes, 44000 Nantes, France
| | - François Gouin
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
- Département de Chirurgie, Centre de Lutte Contre le Cancer Léon Bérard, 69008 Lyon, France
| | - Vincent Crenn
- Orthopedics and Trauma Department, University Hospital Hotel-Dieu, UHC of Nantes, 44000 Nantes, France; (Y.V.); (M.-V.N.); (S.T.); (D.W.); (C.N.); (F.G.)
- PhyOs 1238, INSERM, University of Nantes, 44000 Nantes, France
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Asquier-Khati A, Deschanvres C, Boutoille D, Lefebvre M, Le Turnier P, Gaborit B, Lakhal K, Buffenoir K, Khatchatourian L, Asseray N. Switch from parenteral to oral antibiotics for brain abscesses: a retrospective cohort study of 109 patients. J Antimicrob Chemother 2021; 75:3062-3066. [PMID: 32699907 DOI: 10.1093/jac/dkaa285] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/02/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Brain abscess is one of the most serious diseases of the CNS and is associated with high morbidity and mortality. With regard to the lack of data supporting an optimal therapeutic strategy, this study aimed to explore the prognostic factors of brain abscess, putting emphasis on the impact of therapeutic decisions. METHODS We retrospectively included patients hospitalized for brain abscess during a period of 13 years. Comorbidities (Charlson scale), clinical presentation, microbiology culture, radiological features and therapeutic management were collected. Glasgow Outcome Scale (GOS) at 3 months and length of hospital stay were, respectively, the main and the secondary outcomes. Logistic regression was used to determine factors associated with outcome independently. RESULTS Initial Glasgow Coma Scale (GCS) ≤14 and comorbidities (Charlson scale ≥2) were associated with poor neurological outcome while oral antibiotic switch was associated with better neurological outcome. Oral switch did not appear to be associated with an unfavourable evolution in the subset of patients without initial neurological severity (GCS >14) on admission. Duration of IV regimen and time to oral switch were associated with the length of inpatient stay. CONCLUSIONS This study confirms the role of GCS and comorbidities as prognostic factors and presents reassuring data regarding the safety of oral switch for the antibiotic treatment of brain abscesses. Oral switch could prevent catheter-induced iatrogenic complications and allow a higher quality of life for patients.
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Affiliation(s)
| | | | | | | | | | | | - Karim Lakhal
- Intensive Care Unit, CHU Laënnec, Nantes, France
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Bernard L, Arvieux C, Brunschweiler B, Touchais S, Ansart S, Bru JP, Oziol E, Boeri C, Gras G, Druon J, Rosset P, Senneville E, Bentayeb H, Bouhour D, Le Moal G, Michon J, Aumaître H, Forestier E, Laffosse JM, Begué T, Chirouze C, Dauchy FA, Devaud E, Martha B, Burgot D, Boutoille D, Stindel E, Dinh A, Bemer P, Giraudeau B, Issartel B, Caille A. Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection. N Engl J Med 2021; 384:1991-2001. [PMID: 34042388 DOI: 10.1056/nejmoa2020198] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The management of prosthetic joint infection usually consists of a combination of surgery and antimicrobial therapy. The appropriate duration of antimicrobial therapy for this indication remains unclear. METHODS We performed an open-label, randomized, controlled, noninferiority trial to compare 6 weeks with 12 weeks of antibiotic therapy in patients with microbiologically confirmed prosthetic joint infection that had been managed with an appropriate surgical procedure. The primary outcome was persistent infection (defined as the persistence or recurrence of infection with the initial causative bacteria, with an antibiotic susceptibility pattern that was phenotypically indistinguishable from that at enrollment) within 2 years after the completion of antibiotic therapy. Noninferiority of 6 weeks of therapy to 12 weeks of therapy would be shown if the upper boundary of the 95% confidence interval for the absolute between-group difference (the value in the 6-week group minus the value in the 12-week group) in the percentage of patients with persistent infection within 2 years was not greater than 10 percentage points. RESULTS A total of 410 patients from 28 French centers were randomly assigned to receive antibiotic therapy for 6 weeks (205 patients) or for 12 weeks (205 patients). Six patients who withdrew consent were not included in the analysis. In the main analysis, 20 patients who died during follow-up were excluded, and missing outcomes for 6 patients who were lost to follow-up were considered to be persistent infection. Persistent infection occurred in 35 of 193 patients (18.1%) in the 6-week group and in 18 of 191 patients (9.4%) in the 12-week group (risk difference, 8.7 percentage points; 95% confidence interval, 1.8 to 15.6); thus, noninferiority was not shown. Noninferiority was also not shown in the per-protocol and sensitivity analyses. We found no evidence of between-group differences in the percentage of patients with treatment failure due to a new infection, probable treatment failure, or serious adverse events. CONCLUSIONS Among patients with microbiologically confirmed prosthetic joint infections that were managed with standard surgical procedures, antibiotic therapy for 6 weeks was not shown to be noninferior to antibiotic therapy for 12 weeks and resulted in a higher percentage of patients with unfavorable outcomes. (Funded by Programme Hospitalier de Recherche Clinique, French Ministry of Health; DATIPO ClinicalTrials.gov number, NCT01816009.).
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Affiliation(s)
- Louis Bernard
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Cédric Arvieux
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Benoit Brunschweiler
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Sophie Touchais
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Séverine Ansart
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Jean-Pierre Bru
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Eric Oziol
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Cyril Boeri
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Guillaume Gras
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Jérôme Druon
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Philippe Rosset
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Eric Senneville
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Houcine Bentayeb
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Damien Bouhour
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Gwenaël Le Moal
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Jocelyn Michon
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Hugues Aumaître
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Emmanuel Forestier
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Jean-Michel Laffosse
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Thierry Begué
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Catherine Chirouze
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Fréderic-Antoine Dauchy
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Edouard Devaud
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Benoît Martha
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Denis Burgot
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - David Boutoille
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Eric Stindel
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Aurélien Dinh
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Pascale Bemer
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Bruno Giraudeau
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Bertrand Issartel
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
| | - Agnès Caille
- From the Division of Infectious Diseases (L.B., G.G.), Orthopedic Unit (J.D., P.R.), and INSERM Centre d'Investigation Clinique 1415 (B.G., A.C.), University Hospital, and University of Tours and University of Nantes, INSERM, SPHERE (Methods in Patient-Centered Outcomes and Health Research) Unité 1246 (B.G., A.C.), Tours, the Division of Infectious Diseases, University Hospital, Rennes (C.A.), the Orthopedic Unit, University Hospital, Amiens (B.B.), the Orthopedic Unit (S.T.), the Division of Infectious Diseases (D. Boutoille), and the Department of Bacteriology (P.B.), University Hospital, Nantes, the Division of Infectious Diseases (S.A.) and Orthopedic Unit (E. Stindel), University Hospital, Brest, the Division of Infectious Diseases, Regional Hospital, Annecy (J.-P.B.), the Division of Infectious Diseases, Regional Hospital, Beziers (E.O., H.A.), the Orthopedic Unit, University Hospital, Strasbourg (C.B.), the Division of Infectious Diseases, University Hospital, Tourcoing (E. Senneville), the Division of Infectious Diseases, Regional Hospital, Saint Quentin (H.B.), the Division of Infectious Diseases, General Hospital, Bourg en Bresse (D. Bouhour), the Division of Infectious Diseases, University Hospital, Poitiers (G.L.M.), the Division of Infectious Diseases, University Hospital, Caen (J.M.), the Division of Infectious Diseases, Regional Hospital, Chambery (E.F.), the Orthopedic Unit, University Hospital, Toulouse (J.M.L.), the Orthopedic Unit, University Hospital, Clamart (T.B.), the Division of Infectious Diseases, University Hospital, Besançon (C.C.), the Division of Infectious Diseases, University Hospital, Bordeaux (F.-A.D.), the Division of Internal Medicine, Pointoise Hospital, Pointoise (E.D.), the Division of Infectious Diseases, Regional Hospital, Chalon (B.M.), the Orthopedic Unit, Blois Polyclinic, La Chaussée-Saint-Victor (D. Burgot), the Mobile Unit of the Infectious Referents, University Hospital, Garches (A.D.), and the Mobile Unit of the Infectious Referents, Villeurbanne (B.I.) - all in France
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Gaborit BJ, Chaumette T, Chauveau M, Asquier-Khati A, Roquilly A, Boutoille D, Josien R, Salomon BL, Asehnoune K. Circulating Treg cells expressing TNF receptor type 2 contributes to sepsis-induced immunosuppression in patients during sepsis shock. J Infect Dis 2021; 224:2160-2169. [PMID: 34019653 DOI: 10.1093/infdis/jiab276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/07/2021] [Accepted: 05/17/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Septic shock remains a major cause of death that can be complicated by a long-term impairment in immune function defining immunosuppression induced by sepsis (IS). Among Treg cells, the tumor necrosis factor receptor 2 positive (TNFR2 pos) Treg cell subset endorses significant immunosuppressive functions in human tumors and in a sepsis mouse model but have not been investigated during septic shock in humans. METHODS We prospectively enrolled patients with septic shock hospitalized in Intensive Care Unit (ICU). We performed immunophenotyping and functional tests of CD4+T cells, Treg cells and TNFR2 posTregcells, on blood samples collected at 1, 4 and 7 days after admission in ICU. RESULTS We investigated 10 patients with septic shock and compared to 10 healthy controls. Although the proportions of circulating Tregcells and TNFR2 posTregcells subsets were not increased, their CTLA-4 expression and suppressive functions in vitro were increased at 4 days of septic shock. Also, PBMC from healthy donors cultured with serum from septic shock patients had increased CTLA4 expression in TNFR2 pos Treg cells compared to TNFR2 neg Treg cells. CONCLUSION In patients with septic shock, CTLA-4 expression and suppressive function were increased in circulating TNFR2 posTreg cells. We identify TNFR2 posTreg cells as a potential attractive target for therapeutic intervention.
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Affiliation(s)
- Benjamin Jean Gaborit
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Department of Infectious Diseases.,CHU Nantes, INSERM, CIC, Nantes, France
| | - Tanguy Chaumette
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France
| | - Marie Chauveau
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Department of Infectious Diseases.,CHU Nantes, INSERM, CIC, Nantes, France
| | - Antoine Asquier-Khati
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Department of Infectious Diseases.,CHU Nantes, INSERM, CIC, Nantes, France
| | - Antoine Roquilly
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Surgical Intensive Care Unit, Nantes, France
| | - David Boutoille
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Department of Infectious Diseases.,CHU Nantes, INSERM, CIC, Nantes, France
| | - Régis Josien
- Nantes Université, INSERM, Centre de Recherche en Transplantation et Immunologie UMR 1064, ITUN, Nantes, France.,CHU Nantes, Laboratoire d'Immunologie, CIMNA, Nantes, France
| | - Benoit L Salomon
- Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Karim Asehnoune
- Nantes Université, Thérapeutiques Anti-Infectieuses, Nantes, France.,CHU Nantes, Surgical Intensive Care Unit, Nantes, France
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48
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Le Bot A, Lecomte R, Gazeau P, Benezit F, Arvieux C, Ansart S, Boutoille D, Le Berre R, Chabanne C, Lesouhaitier M, Dejoies L, Flecher E, Chapplain JM, Tattevin P, Revest M. Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study. Clin Infect Dis 2021; 72:e249-e255. [PMID: 32706879 DOI: 10.1093/cid/ciaa1040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/20/2020] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND International guidelines recommend rifampin-based combinations for staphylococcal prosthetic valve endocarditis (PVE). However, no robust clinical data support this recommendation, and rifampin tolerability is an issue. We aimed to evaluate the impact of rifampin for the treatment of staphylococcal PVE. METHODS An observational retrospective cohort study of all adults with staphylococcal PVE (modified Duke criteria) was conducted in 3 referral centers for endocarditis, during years 2000-2018. Primary outcome measurement was 1-year mortality. RESULTS We enrolled 180 patients with PVE due to Staphylococcus aureus (n = 114, 63.3%), or coagulase-negative staphylococci (n = 66, 36.7%), on bioprosthesis (n = 111, 61.7%), mechanical valve (n = 67, 37.2%), or both (n = 2). There were 132 males (73.3%), and mean age was 70.4 ± 12.4 years. Valvular surgery was performed in 51/180 (28.3%) cases. Despite all isolates were susceptible to rifampin, only 101 (56.1%) were treated with rifampin, for a median duration of 33.0 days, whereas 79 (43.9%) received no rifampin. Baseline characteristics were similar in both groups. One-year mortality was, respectively, 37.6% (38/101), and 31.6% (25/79), in patients treated with, or without, rifampin (P = .62). Relapse rates were 5.9% (6/101), and 8.9% (7/79), P = .65. Patients treated with rifampin had longer hospital length-of-stay: 42.3 ± 18.6 vs 31.3 ± 14.0 days (P < .0001). On multivariate analysis, only cerebral emboli (odds ratio [OR] 2.95, 95% confidence interval [CI], 1.30-6.70, P = .009), definite endocarditis (OR 7.15, 95% CI, 1.47-34.77, P = .018), and methicillin-resistant S. aureus (OR 6.04, 95% CI, 1.34-27.26, P = .019), were associated with 1-year mortality. CONCLUSIONS A large proportion (43.9%) of staphylococcal PVE received no rifampin. One-year survival and relapse rates were similar in patients treated with or without rifampin.
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Affiliation(s)
- Audrey Le Bot
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Raphaël Lecomte
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital, Nantes, France
| | - Pierre Gazeau
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France
| | - François Benezit
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Cédric Arvieux
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Séverine Ansart
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France
| | - David Boutoille
- Department of Infectious Diseases, CIC UIC 1413 INSERM, University Hospital, Nantes, France
| | - Rozenn Le Berre
- Department of Internal Medecine and pneumology, La Cavale Blanche University Hospital, Brest, France
| | - Céline Chabanne
- Department of thoracic and cardiovascular surgery, Pontchaillou University Hospital, Rennes, France
| | - Matthieu Lesouhaitier
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Loren Dejoies
- Department of bacteriology, Pontchaillou University Hospital, Rennes, France.,University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR_1230, France
| | - Erwan Flecher
- Department of thoracic and cardiovascular surgery, Pontchaillou University Hospital, Rennes, France
| | - Jean-Marc Chapplain
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.,University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR_1230, France.,CIC-Inserm 1414, Pontchaillou University Hospital, Rennes, France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.,University of Rennes, Inserm, BRM (Bacterial Regulatory RNAs and Medicine), UMR_1230, France.,CIC-Inserm 1414, Pontchaillou University Hospital, Rennes, France
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49
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Lecomte R, Laine JB, Issa N, Revest M, Gaborit B, Le Turnier P, Deschanvres C, Benezit F, Asseray N, Le Tourneau T, Pattier S, Al Habash O, Raffi F, Boutoille D, Camou F. Long-term Outcome of Patients With Nonoperated Prosthetic Valve Infective Endocarditis: Is Relapse the Main Issue? Clin Infect Dis 2021; 71:1316-1319. [PMID: 31858123 DOI: 10.1093/cid/ciz1177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/22/2019] [Accepted: 12/07/2019] [Indexed: 12/19/2022] Open
Abstract
In nonoperated prosthetic valve endocarditis (PVE), long-term outcome is largely unknown. We report the follow-up of 129 nonoperated patients with PVE alive at discharge. At 1 year, the mortality rate was 24%; relapses and reinfection were rare (5% each). Enterococcal PVE was associated with a higher risk of relapse.
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Affiliation(s)
- Raphaël Lecomte
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Jean-Baptiste Laine
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Nahéma Issa
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, Rennes University Hospital, Rennes, France.,University of Rennes, Centre d'Investigation Clinique 1414, INSERM, Bacterial Regulatory RNAS and Medicine, Unité Mixte de Recherche 1230, Rennes, France
| | - Benjamin Gaborit
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Paul Le Turnier
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Colin Deschanvres
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - François Benezit
- Infectious Diseases and Intensive Care Unit, Rennes University Hospital, Rennes, France
| | - Nathalie Asseray
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Thierry Le Tourneau
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - Sabine Pattier
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - Ousama Al Habash
- Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, University Hospital, Nantes, France
| | - François Raffi
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - David Boutoille
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Fabrice Camou
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
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50
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Deschanvres C, Haudebourg T, Peiffer-Smadja N, Blanckaert K, Boutoille D, Lucet JC, Birgand G. How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study. Antimicrob Resist Infect Control 2021; 10:61. [PMID: 33781341 PMCID: PMC8006136 DOI: 10.1186/s13756-021-00927-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The appropriate use of facemasks, recommended or mandated by authorities, is critical to prevent the spread of COVID-19 in the community. We aim to evaluate frequency and quality of facemask use in general populations. METHODS A multi-site observational study was carried out from June to July 2020 in the west of France. An observer was positioned at a predetermined place, facing a landmark, and all individual passing between the observer and the landmark were included. The observer collected information on facemask use (type, quality of positioning), location and demographic characteristics. RESULTS A total of 3354 observations were recorded. A facemask was worn by 56.4% (n = 1892) of individuals, including surgical facemasks (56.8%, n = 1075) and cloth masks (43.2%, n = 817). The facemask was correctly positioned in 75.2% (n = 1422) of cases. The factors independently associated with wearing a facemask were being indoors (adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI] 2.28-3.19), being in a mandatory area (aOR, 6.92; 95% CI 5-9.7), female gender (aOR, 1.75; 95% CI 1.54-2.04), age 41-65 years (aOR, 1.7; 95% CI 1.43-2.02) and age > 65 years (aOR, 2.28; 95% CI 1.83-2.85). The factors independently associated with correct mask position were rural location (aOR, 1.38; 95% CI 1.07-1.79), being in an indoor area (aOR, 1.85; 95% CI 1.49-2.3), use of clothmask (aOR, 1.53; 95% CI 1.23-1.91), and age > 40 years (aOR, 1.75 95%CI 1.37-2.23). CONCLUSIONS During the initial phase of the COVID-19 pandemic, the frequency and quality of facemask wearing remained low in the community setting. Young people in general, and men in particular, represent the priority targets for information campaigns. Simplifying the rules to require universal mandatory facemasking seemed to be the best approach for health authorities.
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Affiliation(s)
- Colin Deschanvres
- Centre D'Appui À La Prévention Des Infections Associées Aux Soins (CPias) Des Pays de La Loire, Nantes University Hospital, 5 rue du Professeur Yves Boquien, 44000, Nantes, France. .,Infectious Disease Department, Nantes University Hospital, 44000, Nantes, France.
| | - Thomas Haudebourg
- Centre D'Appui À La Prévention Des Infections Associées Aux Soins (CPias) Des Pays de La Loire, Nantes University Hospital, 5 rue du Professeur Yves Boquien, 44000, Nantes, France
| | - Nathan Peiffer-Smadja
- INSERM, IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, 75018, Paris, France
| | - Karine Blanckaert
- Centre D'Appui À La Prévention Des Infections Associées Aux Soins (CPias) Des Pays de La Loire, Nantes University Hospital, 5 rue du Professeur Yves Boquien, 44000, Nantes, France
| | - David Boutoille
- Infectious Disease Department, Nantes University Hospital, 44000, Nantes, France
| | - Jean-Christophe Lucet
- INSERM, IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, 75018, Paris, France.,AP-HP, Hôpital Bichat - Claude Bernard, Infection Control Unit, 75018, Paris, France
| | - Gabriel Birgand
- Centre D'Appui À La Prévention Des Infections Associées Aux Soins (CPias) Des Pays de La Loire, Nantes University Hospital, 5 rue du Professeur Yves Boquien, 44000, Nantes, France.,NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance At Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
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