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Morquin D, Lejeune J, Agostini C, Godreuil S, Reynes J, Le Moing V, Lamy B. Time is of the Essence: Achieving Prompt and Effective Antimicrobial therapy of Bloodstream infection With Advanced Hospital Information Systems. Clin Infect Dis 2023:ciad744. [PMID: 38059510 DOI: 10.1093/cid/ciad744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023] Open
Abstract
The early administration of appropriate antibiotic therapy is crucial for the survival of patients with bacteremia. Current research focuses on improving analytical times through technology while there have been very few efforts to improve post-analytical times even though they represent 40% of the time between blood taking and appropriate treatment administration. One of the clues is the efficiency and appropriateness of the result communication system. Here, we review all delays in the whole process with the aim of improving time to appropriate treatment administration. We discuss causes for long times to adjust treatment once microbiological results are released. We argue that that the pervasive health information system in this organization serves as both a bottleneck and a rigid framework to focus on. Finally, we explore how should be conceived the next generation hospital information systems to effectively assist the doctors in treating patients with bacteremia.
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Affiliation(s)
- D Morquin
- CHU Montpellier, Département des Maladies Infectieuses et Tropicales - Montpellier, France
- Espace de Recherche et d'Intégration des Outils numériques en Santé (ERIOS)- CHU Montpellier, France
| | - J Lejeune
- CHU Montpellier, Département des Maladies Infectieuses et Tropicales - Montpellier, France
| | - C Agostini
- CHU Montpellier, Département des Maladies Infectieuses et Tropicales - Montpellier, France
| | - S Godreuil
- Université Montpellier, CHU Montpellier, Laboratoire de bactériologie, CHU - Montpellier, France
| | - J Reynes
- Université Montpellier, CHU Montpellier, Département des Maladies Infectieuses et Tropicales CHU - Montpellier, France
| | - V Le Moing
- Université Montpellier, CHU Montpellier, Département des Maladies Infectieuses et Tropicales CHU - Montpellier, France
| | - B Lamy
- Université Côte d'Azur, CHU, INSERM, C3M, France; Université Sorbonne Paris Nord, APHP, Hôpitaux universitaires Paris Seine saint-Denis, France
- Université Sorbonne Paris Nord (Paris 13), APHP, Hôpitaux universitaires Paris Seine saint-Denis, Bobigny, France
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Morquin D, Ologeanu‐Taddei R, Paré G, Wagner G. A method for resolving organisation‐enterprise system misfits: An action research study in a pluralistic organisation. Information Systems Journal 2023. [DOI: 10.1111/isj.12433] [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] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
| | | | - Guy Paré
- HEC Montréal Montreal Quebec Canada
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Mondesert E, Reynes J, Makinson A, Bargnoux AS, Plawecki M, Morquin D, Cristol JP, Badiou S. Cystatin C in addition to creatinine for better assessment of glomerular renal function decline in people with HIV receiving antiretroviral therapy. AIDS 2023; 37:447-454. [PMID: 36695357 DOI: 10.1097/qad.0000000000003434] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To compare the estimated glomerular filtration rate (eGFR) using the creatinine equation (eGFRcreat) or the cystatin C equation (eGFRcys) in people with HIV (PWH) under antiretroviral drugs. We specifically included patients with an eGFRcreat around 60 ml/min per 1.73 m2 to evaluate agreement on stage 2 and 3 chronic kidney disease (CKD) classification. DESIGN eGFRcreat, eGFRcys and resulting CKD staging were determined in 262 consecutive patients with HIV-1 (PWH) with a suppressed viral load (<200 copies/ml) under antiretroviral drugs and having impaired renal function (eGFRcreat between 45 and 80 ml/min per 1.73 m2). Antiretroviral drugs regimens were classified into eight groups: cobicistat (COBI)+elvitegravir (EVG), ritonavir (RTV)+protease inhibitor, dolutegravir (DTG), DTG+rilpivirine (RPV), RPV, raltegravir (RAL), bictegravir (BIC), and other antiretroviral drugs. RESULTS Mean eGFRcys was higher than mean eGFRcreat (77.7 ± 0.5 vs. 67.9 ± 7.9 ml/min per 1.73 m2, P < 0.0001). The differences were significant in five treatment groups with COBI/EVG; DTG; DTG+RPV; RPV; RAL. CKD classification was modified for 51% of patients when using eGFRcys instead of eGFRcreat, with reclassification to less severe stages in 37% and worse stages in 14%. CONCLUSION This study highlighted significant differences in eGFR depending on the renal marker used in PWH, having a significant impact on CKD classification. eGFRcys should be an additive tool for patients having eGFRcreat around 60 ml/min per 1.73 m2 for better identification of renal impairment.
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Affiliation(s)
| | - Jacques Reynes
- Department of Infectious Diseases, University Hospital of Montpellier, Institut National de la Santé et de Recherche Médicale U1175 and University of Montpellier
| | - Alain Makinson
- Department of Infectious Diseases, University Hospital of Montpellier, Institut National de la Santé et de Recherche Médicale U1175 and University of Montpellier
| | - Anne-Sophie Bargnoux
- Department of Biochemistry, University Hospital of Montpellier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Maëlle Plawecki
- Department of Biochemistry, University Hospital of Montpellier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, University Hospital of Montpellier, Institut National de la Santé et de Recherche Médicale U1175 and University of Montpellier
| | - Jean-Paul Cristol
- Department of Biochemistry, University Hospital of Montpellier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Stéphanie Badiou
- Department of Biochemistry, University Hospital of Montpellier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
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Berger M, Daubin D, Charriot J, Klouche K, Le Moing V, Morquin D, Halimi L, Jaussent A, Taourel P, Hayot M, Cristol JP, Nagot N, Fesler P, Roubille C. Mid-Term Sequelae of Surviving Patients Hospitalized in Intensive Care Unit for COVID-19 Infection: The REHCOVER Study. J Clin Med 2023; 12:jcm12031000. [PMID: 36769648 PMCID: PMC9917891 DOI: 10.3390/jcm12031000] [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: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES The objective of this prospective, single-center study was to explore the mid-term outcomes 6 to 9 months after hospitalization in an Intensive Care Unit (ICU) for severe COVID-19 infection. METHODS Patients systematically underwent biological tests, pulmonary function tests, chest computed tomography (CT) scan, and psychological tests. RESULTS Among 86 patients, including 71 (82.6%) men, median age of 65.8 years (56.7; 72.4), 57 (71.3%) patients presented post-COVID-19 asthenia, 39 (48.1%) muscle weakness, and 30 (36.6%) arthralgia. Fifty-two (64.2%) patients had a decreased diffusion capacity for carbon monoxide (DLCO) <80% and 16 (19.8%) had DLCO <60%. Chest CT-scans showed ground glass opacities in 35 (40.7%) patients, and reticular changes in 28 patients (33.7%), including fibrosis-like changes in 18 (21.7%) patients. Reticular changes and DLCO <60% were associated with length of stay in ICU, and reticular changes with higher maximal CRP level. The psychological questionnaires found 37.7% suffered from depression, 23.5% from anxiety, 42.4% from insomnia, and 9.4% from post-traumatic stress. Being female was associated with a higher frequency of depression and anxiety, with depression scores being associated with obesity. CONCLUSIONS Many patients hospitalized in ICU for severe COVID-19 infection have mid-term sequelae. Additional studies on the prognostic factors seem necessary.
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Affiliation(s)
- Marie Berger
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
| | - Delphine Daubin
- Critical Care Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Jeremy Charriot
- Department of Respiratory Diseases, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
| | - Kada Klouche
- Critical Care Unit, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
| | - Vincent Le Moing
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Infectious Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - Laurence Halimi
- Department of Respiratory Diseases, Montpellier University Hospital, 34090 Montpellier, France
| | - Audrey Jaussent
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Patrice Taourel
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Medical Imaging, Montpellier University Hospital, 34090 Montpellier, France
| | - Maurice Hayot
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Clinical Physiology, University Hospital of Montpellier, 34090 Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Department of Biochemistry and Hormonology, University Hospital of Montpellier, 34090 Montpellier, France
| | - Nicolas Nagot
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, 34090 Montpellier, France
| | - Pierre Fesler
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, Montpellier University Hospital, 34090 Montpellier, France
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, 34295 Montpellier, France
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France
- Correspondence: ; Tel.: +33(0)-4-6733-8443; Fax: +33(0)-4-6733-8453
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Goulabchand R, Makinson A, Morel J, Witkowski-Durand-Viel P, Nagot N, Loubet P, Roubille C, Noel D, Morquin D, Henry K, Mura T, Guilpain P. Hospitalizations for infections in primary Sjögren's syndrome patients: a nationwide incidence study. Ann Med 2022; 54:2672-2680. [PMID: 36173925 PMCID: PMC9542339 DOI: 10.1080/07853890.2022.2126517] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Primary Sjögren's syndrome (pSS) is an autoimmune disease with increased risk of infections. Here, we assessed whether pSS patients were at higher risk of hospitalization for community and opportunistic infections. METHODS We selected newly hospitalized pSS patients between 2011 and 2018, through a nationwide population-based retrospective study using the French Health insurance database. We compared the incidence of hospitalization for several types of infections (according to International Classification for Disease codes, ICD-10) between pSS patients and an age- and sex-matched (1:10) hospitalized control group. We calculated adjusted Hazard Ratios (aHR, 95% CI) adjusted on socio-economic status, past cardiovascular or lung diseases and blood malignancies factors. RESULTS We compared 25 661 pSS patients with 252 543 matched patients. The incidence of hospitalizations for a first community infection was increased in pSS patients [aHR of 1.29 (1.22-1.31), p < .001]. The incidence of hospitalization for bronchopulmonary infections was increased in pSS patients [aHR of 1.50 (1.34-1.69), p < .001, for pneumonia]. Hospitalizations for pyelonephritis and intestinal infections were increased [aHR of 1.55 (1.29-1.87), p < .001 and 1.18 (1.08-1.29), p < .001, respectively]. Among opportunistic infections, only zoster, and mycobacteria infections (tuberculosis and non-tuberculous) were at increased risk of hospitalization [aHR of 3.32 (1.78-6.18), p < .001; 4.35 (1.41-13.5), p = .011 and 2.54 (1.27-5.06), p = .008, respectively]. CONCLUSIONS pSS patients are at higher risk of hospitalization for infections. The increased risk of hospitalization for mycobacterial infections illustrates the potential bilateral relationship between the two conditions. Vaccination against respiratory pathogens and herpes zoster virus may help prevent some hospitalizations in pSS patients.KEY MESSAGESPrimary Sjögren's syndrome (pSS) increases hospitalization risk for community infections: bronchopulmonary, skin, dental, ear-nose-throat, intestinal infections and pyelonephritis.Hospitalizations for zoster and mycobacterial infections are also increased in this population.Dedicated preventive measures and vaccination campaigns could decrease the burden of infections in pSS patients.
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Affiliation(s)
- Radjiv Goulabchand
- Internal Medicine Department, CHU Nîmes, University Montpellier, Nîmes, France.,University of Montpellier, Montpellier, France.,IRMB, University of Montpellier, INSERM, Montpellier, France
| | - Alain Makinson
- University of Montpellier, Montpellier, France.,Department of Infectiology, INSERM U1175, Saint Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - Jacques Morel
- University of Montpellier, Montpellier, France.,Department of Rheumatology, Montpellier University Hospital, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Philine Witkowski-Durand-Viel
- University of Montpellier, Montpellier, France.,Department of Internal Medicine and Multi-organic Diseases, St Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Nicolas Nagot
- University of Montpellier, Montpellier, France.,Department of Medical Information, Montpellier University Hospital, Montpellier, France
| | - Paul Loubet
- University of Montpellier, Montpellier, France.,Department of infectious and Tropical Diseases, CHU Nîmes, University Montpellier, Nîmes, France
| | - Camille Roubille
- University of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France.,Department of Internal medicine, Lapeyronie Hospital, Montpellier University Hospital, Montpellier, France
| | - Danièle Noel
- IRMB, University of Montpellier, INSERM, Montpellier, France
| | - David Morquin
- University of Montpellier, Montpellier, France.,Department of Infectiology, INSERM U1175, Saint Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - Kim Henry
- Department of Internal Medicine and Multi-organic Diseases, St Eloi Hospital, Montpellier University Hospital, Montpellier, France
| | - Thibault Mura
- University of Montpellier, Montpellier, France.,Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, University Montpellier, Nîmes, France
| | - Philippe Guilpain
- University of Montpellier, Montpellier, France.,IRMB, University of Montpellier, INSERM, Montpellier, France.,Department of Internal Medicine and Multi-organic Diseases, St Eloi Hospital, Montpellier University Hospital, Montpellier, France
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Sofonea MT, Roquebert B, Foulongne V, Morquin D, Verdurme L, Trombert-Paolantoni S, Roussel M, Bonetti JC, Zerah J, Haim-Boukobza S, Alizon S. Analyzing and Modeling the Spread of SARS-CoV-2 Omicron Lineages BA.1 and BA.2, France, September 2021-February 2022. Emerg Infect Dis 2022; 28:1355-1365. [PMID: 35642476 PMCID: PMC9239895 DOI: 10.3201/eid2807.220033] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We analyzed 324,734 SARS-CoV-2 variant screening tests from France enriched with 16,973 whole-genome sequences sampled during September 1, 2021–February 28, 2022. Results showed the estimated growth advantage of the Omicron variant over the Delta variant to be 105% (95% CI 96%–114%) and that of the BA.2 lineage over the BA.1 lineage to be 49% (95% CI 44%–52%). Quantitative PCR cycle threshold values were consistent with an increased ability of Omicron to generate breakthrough infections. Epidemiologic modeling shows that, in spite of its decreased virulence, the Omicron variant can generate important critical COVID-19 activity in hospitals in France. The magnitude of the BA.2 wave in hospitals depends on the level of relaxing of control measures but remains lower than that of BA.1 in median scenarios.
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Berger M, Daubin D, Charriot J, Klouche K, Le Moing V, Arnaud B, Morquin D, Jaussent A, Taourel P, Hayot M, Nagot N, Fesler P, Roubille C. Devenir des patients hospitalisés en soins critiques pour infection à SARS-COV2 : évaluation standardisée des séquelles à 6–9 mois. Rev Med Interne 2022. [PMCID: PMC9212689 DOI: 10.1016/j.revmed.2022.03.307] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Identifié en Chine en décembre 2019, le Severe Acute Respiratory SyndromeCoronavirus 2 (SARS-COV2) s’est rapidement propagé au niveau mondial. Si les études se sont initialement concentrées sur la prise en charge de la phase aiguë de la COrona VIrus Disease (COVID), l’objectif de ce travail est de s’intéresser aux conséquences à distance d’une hospitalisation pour COVID sévère. Patients et méthodes Nous avons réalisé une étude prospective, monocentrique, incluant des patients 6 à 9 mois après leur hospitalisation en soins critiques (soins intensifs ou réanimation) pour une infection confirmée à SARS-COV2. Les patients étaient évalués au cours d’une hospitalisation de jour en médecine interne. L’entretien débutait par un recueil des antécédents du patient, des évènements et des symptômes post-COVID. L’examinateur procédait ensuite à un examen clinique détaillé et un test de marche des 6 minutes (TM6). Les patients réalisaient de manière systématique des explorations fonctionnelles respiratoires (EFR), une tomodensitométrie (TDM) thoracique non injectée, une échographie cardiaque trans-thoracique (ETT), et un bilan biologique complet. Une batterie de tests était réalisée, explorant la qualité de vie et les séquelles psychologiques. Résultats Quatre-vingt-six patients, dont 71 (82,6 %) hommes, d’âge médian 65,8 ans (56,7;72,4), ont été évalués dans un délai moyen de 7 mois (min 3,4; max 14,9). L’hypertension artérielle (46,5 %), le diabète (34,9 %) et la dyslipidémie (39,5 %) étaient les antécédents médicaux les plus représentés. Douze (14,0 %) patients avaient une pathologie pulmonaire sous-jacente, principalement une broncho-pneumopathie chronique obstructive (BPCO). L’indice de comorbidités de Charlson médian était de 1 (0,0; 2,0). La durée médiane du séjour en soins critiques était de 10,0 (6,0;17,0) jours. Cinquante-quatre (62,8 %) patients ont eu une ventilation invasive et 67 (77,9 %) patients ont reçu un traitement par corticothérapie. Cinquante-sept (71,3 %) patients ont présenté une asthénie post-COVID, 39 (48,1 %) une faiblesse musculaire, 30 (36,6 %) des arthralgies. Quinze patients ont développé un déséquilibre du diabète et 9 un déséquilibre de la pression artérielle. Dix-sept (21,3 %) patients avaient une distance au TM6 < 80 % de la théorique. Quarante-six patients53,5 %) avaient un score de dyspnée Medical Reaserch Council (MRC) de 0 et 24 (27,9 %) avaient un score MRC de 1. Treize (15,5 %) patients avaient une auscultation anormale à type de crépitants secs des bases. Cinquante-deux (64,2 %) patients ont présenté un déficit de la diffusion du CO défini par une DLCO < 80 % et 16 (19,8 %) avaient une DLCO < 60 %. Le scanner thoracique montrait chez 35 (40,7 %) patients des lésions de verre dépoli et 18 (21,7 %) de la fibrose. Trente-deux patients (37,6 %) avaient un score PHQ-9 significatif pour une dépression, 20 (23,5 %) un score GAD-7 significatif pour un trouble anxieux et 8 (9,4 %) patients avaient un score PCL5 supérieur au seuil évoquant un état de stress post-traumatique. Le niveau de qualité de vie à distance de l’épisode aigu était satisfaisant avec une médiane de l’EQ-5D-3L à 0,89 (0,64;1,00). En analyse univariée, la fibrose sur le scanner de réévaluation et une DLCO < 60 % étaient associées à la durée du séjour en soins critiques et au niveau maximal de CRP pendant l’épisode aigu. En analyse multivariée, la fibrose et la DLCO étaient associées à la durée de séjour. En analyse uni et multivariée, le PHQ-9 et le GAD-7 étaient associés au sexe féminin. Discussion À ce jour, rares sont les études qui ont étudié de manière systématisée les séquelles somatiques et psychologiques à long terme de la COVID chez les patients qui ont été pris en charge en soins critiques. Conformément à la littérature, la diminution de la DLCO est l’anomalie la plus fréquemment retrouvée aux EFR, les plages de verre dépoli persistent sur le scanner et des lésions fibrotiques sont retrouvées chez plus d’un patient sur 5 [1], [2]. Ces anomalies contrastent avec une plainte respiratoire modérée et un examen clinique rassurant. Les symptômes généraux (asthénie, faiblesse musculaire et arthralgies) sont au cœur de la plainte fonctionnelle. Les déséquilibres de la tension artérielle et du diabète observés justifient un suivi accru des pathologies chroniques au décours de l’épisode aigu. Enfin, nous avons noté une prévalence plus importante des troubles psychologiques que celles relevées rétrospectivement (dossier informatisé) dans une autre étude [3], renforçant, selon nous, la nécessité d’un dépistage systématique des troubles psychiatriques. Conclusion De nombreux patients présentent des séquelles à distance d’une COVID sévère nous incitant à un dépistage systématique afin de proposer une prise en charge adaptée.
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Schneider FS, Molina L, Picot MC, L'Helgoualch N, Espeut J, Champigneux P, Alali M, Baptiste J, Cardeur L, Carniel C, Davy M, Dedisse D, Dubuc B, Fenech H, Foulongne V, Gaillard CF, Galtier F, Makinson A, Marin G, Santos RM, Morquin D, Ouedraogo A, Lejeune AP, Quenot M, Keiflin P, Robles FC, Rego CR, Salvetat N, Trento C, Vetter D, Molina F, Reynes J. Performances of rapid and connected salivary RT-LAMP diagnostic test for SARS-CoV-2 infection in ambulatory screening. Sci Rep 2022; 12:2843. [PMID: 35181680 PMCID: PMC8857239 DOI: 10.1038/s41598-022-04826-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/22/2021] [Indexed: 12/27/2022] Open
Abstract
In the context of social events reopening and economic relaunch, sanitary surveillance of SARS-CoV-2 infection is still required. Here, we evaluated the diagnostic performances of a rapid, extraction-free and connected reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assay on saliva. Nasopharyngeal (NP) swabs and saliva from 443 outpatients were collected simultaneously and tested by reverse-transcription quantitative PCR (RT-qPCR) as reference standard test. Seventy-one individuals (16.0%) were positive by NP and/or salivary RT-qPCR. Sensitivity and specificity of salivary RT-LAMP were 85.9% (95%CI 77.8–94.0%) and 99.5% (98.7–100%), respectively. Performances were similar for symptomatic and asymptomatic participants. Moreover, SARS-CoV-2 genetic variants were analyzed and no dominant mutation in RT-LAMP primer region was observed during the period of the study. We demonstrated that this RT-LAMP test on self-collected saliva is reliable for SARS-CoV-2 detection. This simple connected test with optional automatic results transfer to health authorities is unique and opens the way to secure professional and social events in actual context of economics restart.
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Affiliation(s)
- Francisco Santos Schneider
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,SkillCell, Montpellier, France
| | - Laurence Molina
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Marie-Christine Picot
- Clinical Research and Epidemiology Unit, Department of Medical Information, Montpellier University Hospital, University of Montpellier, Montpellier, France.,INSERM Centre Investigation Clinique 1411, University Hospital, Montpellier, France
| | - Nicolas L'Helgoualch
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Julien Espeut
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,SkillCell, Montpellier, France
| | - Pierre Champigneux
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Mellis Alali
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Julie Baptiste
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,SkillCell, Montpellier, France
| | - Lise Cardeur
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | | | - Martin Davy
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,SkillCell, Montpellier, France
| | | | - Benjamin Dubuc
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Hugo Fenech
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Vincent Foulongne
- PCCEI, Univ Montpellier, INSERM, EFS, Univ Antilles, Montpellier, France
| | - Carole Fruchart Gaillard
- CEA, INRAE, Department of Medicines and Healthcare Technologies (DMTS), University of Paris-Saclay, SIMoS, Gif-sur-Yvette, France
| | - Florence Galtier
- INSERM Centre Investigation Clinique 1411, University Hospital, Montpellier, France
| | - Alain Makinson
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France.,TransVIHMI, IRD, INSERM, University of Montpellier, Montpellier, France
| | - Grégory Marin
- Clinical Research and Epidemiology Unit, Department of Medical Information, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Raissa Medina Santos
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - David Morquin
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France.,TransVIHMI, IRD, INSERM, University of Montpellier, Montpellier, France
| | - Alimata Ouedraogo
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Alexandra Prieux Lejeune
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,SkillCell, Montpellier, France
| | - Marine Quenot
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | | | - Francisco Checa Robles
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Carolina Rodrigues Rego
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.,Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Nicolas Salvetat
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Charline Trento
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Diana Vetter
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France
| | - Franck Molina
- Sys2Diag UMR9005 CNRS ALCEN, Cap Gamma, Parc Euromédecine, 1682 rue de la Valsière, CS 40182, 34184, Montpellier, CEDEX 4, France.
| | - Jacques Reynes
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France.,TransVIHMI, IRD, INSERM, University of Montpellier, Montpellier, France
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9
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Bedin AS, Makinson A, Picot MC, Mennechet F, Malergue F, Pisoni A, Nyiramigisha E, Montagnier L, Bollore K, Debiesse S, Morquin D, Bourgoin P, Veyrenche N, Renault C, Foulongne V, Bret C, Bourdin A, Le Moing V, Van de Perre P, Tuaillon E. Erratum to: Monocyte CD169 Expression as a Biomarker in the Early Diagnosis of Coronavirus Disease 2019. J Infect Dis 2022; 225:744. [PMID: 35031805 PMCID: PMC8935078 DOI: 10.1093/infdis/jiab599] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Anne-Sophie Bedin
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Alain Makinson
- INSERM U1175/IRD UMI 233, IRD, Montpellier University, Montpellier, France.,Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - Marie-Christine Picot
- INSERM, Centre d'Investigation Clinique 1411, Montpellier University, Montpellier, France.,Montpellier University Hospital, Montpellier, France
| | - Frank Mennechet
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Fabrice Malergue
- Department of Research and Development, Immunotech-Beckman Coulter, Marseille, France
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | | | - Lise Montagnier
- Laboratory of Virology, Montpellier University Hospital, France
| | - Karine Bollore
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Ségolène Debiesse
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - Pénélope Bourgoin
- Department of Research and Development, Immunotech-Beckman Coulter, Marseille, France
| | | | - Constance Renault
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Vincent Foulongne
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | - Caroline Bret
- Laboratory of Hematology, Montpellier University Hospital, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.,PhyMedExp, Montpellier University, CNRS, INSERM, Montpellier, France
| | - Vincent Le Moing
- INSERM U1175/IRD UMI 233, IRD, Montpellier University, Montpellier, France.,Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
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10
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Villerabel C, Makinson A, Jaussent A, Picot MC, Nègre-Pagès L, Rouvière JA, Favier V, Crampette L, Morquin D, Reynes J, Le Moing V, Tuaillon E, Venail F. Diagnostic Value of Patient-Reported and Clinically Tested Olfactory Dysfunction in a Population Screened for COVID-19. JAMA Otolaryngol Head Neck Surg 2021; 147:271-279. [PMID: 33410887 DOI: 10.1001/jamaoto.2020.5074] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance Recent studies have suggested that olfactory dysfunction and gustatory dysfunction are associated with coronavirus disease 2019 (COVID-19). However, olfaction has been evaluated solely on reported symptoms, after COVID-19 diagnosis, and in both mild and severe COVID-19 cases, but rarely has it been assessed in prospectively unselected populations. Objective To evaluate the diagnostic value of a semiobjective olfactory test developed to assess patient-reported chemosensory dysfunction prior to testing for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients attending a COVID-19 screening facility. Design, Setting, and Participants This prospective diagnostic study with participants and observers blinded to COVID-19 status was conducted in a COVID-19 screening center of a tertiary university hospital in France from March 23 to April 22, 2020. Participants were 854 consecutively included health care workers or outpatients with symptoms or with close contact with an index case. Exclusion criteria were prior chemosensory dysfunction, testing inability, or contraindications (n = 45). Main Outcomes and Measures Participants were interviewed to ascertain their symptoms and then underwent Clinical Olfactory Dysfunction Assessment (CODA), an ad hoc test developed for a simple and fast evaluation of olfactory function. This assessment followed a standardized procedure in which participants identified and rated the intensity of 3 scents (lavender, lemongrass, and mint) to achieve a summed score ranging from 0 to 6. The COVID-19 status was assessed using reverse transcriptase-polymerase chain reaction to detect the presence of SARS-CoV-2 in samples collected via nasopharyngeal swab (reference standard) to calculate the diagnostic values of patient-reported chemosensory dysfunction and CODA. Results Of 809 participants, the female to male sex ratio was 2.8, and the mean (SD) age was 41.8 (13.0) years (range, 18-94 years). All participants, if symptomatic, had mild disease at the time of testing, and 58 (7.2%) tested positive for SARS-CoV-2. Chemosensory dysfunction was reported by 20 of 58 participants (34.5%) with confirmed COVID-19 vs 29 of 751 participants (3.9%) who tested negative for COVID-19 (absolute difference, 30.6% [95% CI, 18.3%-42.9%]). Olfactory dysfunction, either self-reported or clinically ascertained (CODA score ≤3), yielded similar sensitivity (0.31 [95% CI, 0.20-0.45] vs 0.34 [95% CI, 0.22-0.48]) and specificity (0.97 [95% CI, 0.96-0.98) vs 0.98 [95% CI, 0.96-0.99]) for COVID-19 diagnosis. Concordance was high between reported and clinically tested olfactory dysfunction, with a Gwet AC1 of 0.95 (95% CI, 0.93-0.97). Of 19 participants, 15 (78.9%) with both reported olfactory dysfunction and a CODA score of 3 or lower were confirmed to have COVID-19. The CODA score also revealed 5 of 19 participants (26.3%) with confirmed COVID-19 who had previously unperceived olfactory dysfunction. Conclusions and Relevance In this prospective diagnostic study of outpatients with asymptomatic or mild to moderate COVID-19, systematically assessed anamnesis and clinical testing with the newly developed CODA were complementary and specific for chemosensory dysfunction. Olfactory dysfunction was suggestive of COVID-19, particularly when clinical testing confirmed anamnesis. However, normal olfaction was most common among patients with COVID-19.
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Affiliation(s)
- Charles Villerabel
- Department of Otorhinolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Hospital and University of Montpellier, Montpellier, France
| | - Alain Makinson
- Department of Infectious Diseases, Hospital and University of Montpellier, Montpellier, France.,INSERM U1175, Montpellier, France
| | - Audrey Jaussent
- Clinical Research and Epidemiology Unit, Department of Medical Information, Hospital and University of Montpellier, Montpellier, France
| | - Marie-Christine Picot
- Clinical Research and Epidemiology Unit, Department of Medical Information, Hospital and University of Montpellier, Montpellier, France.,INSERM CIC 1411, Montpellier, France
| | - Laurence Nègre-Pagès
- Clinical Research and Epidemiology Unit, Department of Medical Information, Hospital and University of Montpellier, Montpellier, France
| | | | - Valentin Favier
- Department of Otorhinolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Hospital and University of Montpellier, Montpellier, France
| | - Louis Crampette
- Department of Otorhinolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Hospital and University of Montpellier, Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, Hospital and University of Montpellier, Montpellier, France.,INSERM U1175, Montpellier, France
| | - Jacques Reynes
- Department of Infectious Diseases, Hospital and University of Montpellier, Montpellier, France.,INSERM U1175, Montpellier, France
| | - Vincent Le Moing
- Department of Infectious Diseases, Hospital and University of Montpellier, Montpellier, France.,INSERM U1175, Montpellier, France
| | - Edouard Tuaillon
- INSERM U1058-Pathogenesis and Control of Chronic Infections, Hospital and University of Montpellier, Montpellier, France
| | - Frédéric Venail
- Department of Otorhinolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Hospital and University of Montpellier, Montpellier, France.,INSERM U1051-Institute for Neurosciences of Montpellier, Montpellier, France
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11
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Bedin AS, Makinson A, Picot MC, Mennechet F, Malergue F, Pisoni A, Nyiramigisha E, Montagnier L, Bollore K, Debiesse S, Morquin D, Veyrenche N, Renault C, Foulongne V, Bret C, Bourdin A, Le Moing V, Van de Perre P, Tuaillon E. Monocyte CD169 Expression as a Biomarker in the Early Diagnosis of Coronavirus Disease 2019. J Infect Dis 2021; 223:562-567. [PMID: 33206973 PMCID: PMC7717347 DOI: 10.1093/infdis/jiaa724] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/17/2020] [Indexed: 11/14/2022] Open
Abstract
We assessed the expression of CD169, a type I interferon-inducible receptor, on monocytes (mCD169) in 53 adult patients admitted to the hospital during the COVID-19 outbreak for a suspicion of SARS-CoV-2 infection. mCD169 was strongly overexpressed in 30 out of 32 (93.7%) confirmed COVID-19 cases, compared to three out of 21 (14.3%) patients in whom the diagnosis of COVID-19 was finally ruled out. mCD169 was associated with the plasma interferon alpha level and thrombocytopenia. mCD169 testing may be helpful for the rapid triage of suspected COVID-19 patients during an outbreak.
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Affiliation(s)
- Anne-Sophie Bedin
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Alain Makinson
- INSERM U1175/IRD UMI 233, IRD, Montpellier University, Montpellier, France.,Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - Marie-Christine Picot
- INSERM, Centre d'Investigation Clinique 1411, Montpellier University, Montpellier, France.,Montpellier University Hospital, Montpellier, France
| | - Frank Mennechet
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Fabrice Malergue
- Department of Research and Development, Immunotech-Beckman Coulter, Marseille, France
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | | | - Lise Montagnier
- Laboratory of Virology, Montpellier University Hospital, France
| | - Karine Bollore
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Ségolène Debiesse
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - David Morquin
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | | | - Constance Renault
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France
| | - Vincent Foulongne
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | - Caroline Bret
- Laboratory of Hematology, Montpellier University Hospital, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.,PhyMedExp, Montpellier University, CNRS, INSERM, Montpellier, France
| | - Vincent Le Moing
- INSERM U1175/IRD UMI 233, IRD, Montpellier University, Montpellier, France.,Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM, EFS, Montpellier, France.,Laboratory of Virology, Montpellier University Hospital, France
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12
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Veyrenche N, Bolloré K, Pisoni A, Bedin AS, Mondain AM, Ducos J, Segondy M, Montes B, Pastor P, Morquin D, Makinson A, Le Moing V, Van de Perre P, Foulongne V, Tuaillon E. Diagnosis value of SARS-CoV-2 antigen/antibody combined testing using rapid diagnostic tests at hospital admission. J Med Virol 2021; 93:3069-3076. [PMID: 33554363 PMCID: PMC8013599 DOI: 10.1002/jmv.26855] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 12/20/2020] [Revised: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Abstract
The implementation of rapid diagnostic tests (RDTs) may enhance the efficiency of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) testing, as RDTs are widely accessible and easy to use. The aim of this study was to evaluate the performance of a diagnosis strategy based on a combination of antigen and immunoglobulin M (IgM) or immunoglobulin G (IgG) serological RDTs. Plasma and nasopharyngeal samples were collected between 14 March and 11 April 2020 at hospital admission from 45 patients with reverse transcription polymerase chain reaction (RT‐PCR) confirmed COVID‐19 and 20 negative controls. SARS‐CoV‐2 antigen (Ag) was assessed in nasopharyngeal swabs using the Coris Respi‐Strip. For IgM/IgG detection, SureScreen Diagnostics and Szybio Biotech RDTs were used in addition to laboratory assays (Abbott Alinity i SARS‐CoV‐2 IgG and Theradiag COVID‐19 IgM enzyme‐linked immunosorbent assay). Using the Ag RDT, 13 out of 45 (29.0%) specimens tested positive, the sensitivity was 87.0% for cycle threshold (Ct) values ≤25% and 0% for Ct values greater than 25. IgG detection was associated with high Ct values and the amount of time after the onset of symptoms. The profile of isolated IgM on RDTs was more frequently observed during the first and second week after the onset of symptoms. The combination of Ag and IgM/IgG RDTs enabled the detection of up to 84.0% of COVID‐19 confirmed cases at hospital admission. Antigen and antibody‐based RDTs showed suboptimal performances when used alone. However when used in combination, they are able to identify most COVID‐19 patients admitted in an emergency department. Antigen and antibody‐based RDTs showed suboptimal performances when used alone. The Ag RDT showed good sensitivity on samples with CT values below 25. IgM/IgG RDTs showed good sensitivity as of the second week after onset of symptoms. The combination of Ag and IgM/IgG RDTs identified most patients with COVID‐19. RDTs may have a significant place in the global response to the COVID‐19 pandemic.
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Affiliation(s)
- Nicolas Veyrenche
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | - Karine Bolloré
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | - Anne-Sophie Bedin
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | | | | | - Michel Segondy
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | | | | | - David Morquin
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, Montpellier, France.,Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Alain Makinson
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, Montpellier, France.,Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Vincent Le Moing
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, Montpellier, France.,Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | - Vincent Foulongne
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, INSERM, Etablissement Français du Sang, CHU Montpellier, Université de Montpellier, Montpellier, France
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13
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Bouchet F, Le Moing V, Dirand D, Cros F, Lienard A, Reynes J, Giraudon L, Morquin D. Effectiveness and Acceptance of Multimodal Antibiotic Stewardship Program: Considering Progressive Implementation and Complementary Strategies. Antibiotics (Basel) 2020; 9:antibiotics9120848. [PMID: 33260815 PMCID: PMC7760905 DOI: 10.3390/antibiotics9120848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/19/2020] [Accepted: 11/25/2020] [Indexed: 12/19/2022] Open
Abstract
Multiple modes of interventions are available when implementing an antibiotic stewardship program (ASP), however, their complementarity has not yet been assessed. In a 938-bed hospital, we sequentially implemented four combined modes of interventions over one year, centralized by one infectious diseases specialist (IDS): (1) on-request infectious diseases specialist consulting service (IDSCS), (2) participation in intensive care unit meetings, (3) IDS intervention triggered by microbiological laboratory meetings, and (4) IDS intervention triggered by pharmacist alert. We assessed the complementarity of the different cumulative actions through quantitative and qualitative analysis of all interventions traced in the electronic medical record. We observed a quantitative and qualitative complementarity between interventions directly correlating to a decrease in antibiotic use. Quantitatively, the number of interventions has doubled after implementation of IDS intervention triggered by pharmacist alert. Qualitatively, these kinds of interventions led mainly to de-escalation or stopping of antibiotic therapy (63%) as opposed to on-request IDSCS (32%). An overall decrease of 14.6% in antibiotic use was observed (p = 0.03). Progressive implementation of the different interventions showed a concrete complementarity of these actions. Combined actions in ASPs could lead to a significant decrease in antibiotic use, especially regarding critical antibiotic prescriptions, while being well accepted by prescribers.
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Affiliation(s)
- Flavien Bouchet
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, France; (V.L.M.); (J.R.); (D.M.)
- Pôle Appui aux Fonctions Cliniques, Département de la Pharmacie, Hôpitaux du Bassin de Thau, 34200 Sète, France; (D.D.); (L.G.)
- Correspondence:
| | - Vincent Le Moing
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, France; (V.L.M.); (J.R.); (D.M.)
| | - Delphine Dirand
- Pôle Appui aux Fonctions Cliniques, Département de la Pharmacie, Hôpitaux du Bassin de Thau, 34200 Sète, France; (D.D.); (L.G.)
| | - François Cros
- Département Informatique, Hôpitaux du Bassin de Thau, 34200 Sète, France;
| | - Alexi Lienard
- Département de Biologie Médicale, Hôpitaux du Bassin de Thau, 34200 Sète, France;
| | - Jacques Reynes
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, France; (V.L.M.); (J.R.); (D.M.)
| | - Laurent Giraudon
- Pôle Appui aux Fonctions Cliniques, Département de la Pharmacie, Hôpitaux du Bassin de Thau, 34200 Sète, France; (D.D.); (L.G.)
| | - David Morquin
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34000 Montpellier, France; (V.L.M.); (J.R.); (D.M.)
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14
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Viala B, Villiet M, Redor A, Didelot MN, Makinson A, Reynes J, Le Moing V, Morquin D. Using the clinical information system and self-supervision to rationalize the need for antibiotic stewardship: An interventional study in a 2000-bed university hospital. Int J Antimicrob Agents 2020; 57:106233. [PMID: 33232732 DOI: 10.1016/j.ijantimicag.2020.106233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/24/2020] [Accepted: 11/14/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To describe the usefulness of electronic medical records (EMRs) and a computerized physician order entry (CPOE) system to support and assess an antimicrobial stewardship programme (ASP). METHODS At the study hospital, infectious diseases specialists supervise antimicrobial prescription when solicited by physicians in charge of patients. From January to October 2015, treatment days of antibiotic prescription, supervised or unsupervised by infectious disease specialists (SAP or UAP, respectively) in all wards, except intensive care units emergency department, bone marrow transplantation units, and paediatric units, were calculated. Embedding recommendations on carbapenem indications as a checklist into the CPOE system, a self-administered ASP was implemented in 2017. EMRs were reviewed to determine global compliance with carbapenem prescription guidelines (combining introduction of therapy and 72-h assessment) before and after implementation of a self-administered ASP in departments with a low SAP rate for these antibiotics. RESULTS Among 16 090 prescriptions extracted, 19.9% were SAPs. Three patterns of prescription were identified. The first pattern (amoxicillin-clavulanate, ceftriaxone) was characterized by a high UAP rate in every department, the second pattern (cloxacillin, rifampin) was characterized by a high SAP rate in every department, and the third pattern (broad-spectrum beta-lactams) was characterized by heterogeneous distribution of SAP/UAP among departments. Carbapenem prescription was reviewed in five departments with a low SAP rate for carbapenems over 6 months: 94 before and 107 after implementation of the self-administered ASP. Global compliance with guidelines increased significantly from 22% to 37% (risk difference 15%, 95% confidence interval 2.3-28.5%; P=0.02). CONCLUSION A clinical information system may help to rationalize antibiotic stewardship in a context of scarce medical resources. Mapping of antibiotic prescriptions and self-supervision are efficient, complementary and easy-to-implement tools.
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Affiliation(s)
- Benjamin Viala
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France.
| | - Maxime Villiet
- Clinical Pharmacy Department, CHU Montpellier, Montpellier, France
| | - Alexis Redor
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
| | | | - Alain Makinson
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
| | - Jacques Reynes
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
| | - Vincent Le Moing
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
| | - David Morquin
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
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Bistoquet M, Galtier F, Marin G, Villard O, Ferreira R, Hermabessiere S, Montoya A, Jumas-Bilak E, Pageaux GP, Dereure O, Chanques G, Klouche K, Morquin D, Reynes J, Le Moing V, Picot MC, Tuaillon E, Makinson A. Increased risks of SARS-CoV-2 nosocomial acquisition in high-risk COVID-19 units justify personal protective equipment: a cross-sectional study. J Hosp Infect 2020; 107:108-110. [PMID: 33137443 PMCID: PMC7604137 DOI: 10.1016/j.jhin.2020.10.022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Affiliation(s)
- M Bistoquet
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France
| | - F Galtier
- Clinical Investigation Centre (CIC), Inserm 1411, University Hospital of Montpellier, Montpellier, France
| | - G Marin
- Department of Epidemiology, Medical Statistics and Public Health, University Hospital of Montpellier, Montpellier, France
| | - O Villard
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - R Ferreira
- Clinical Department for Osteoarticular Diseases and Biotherapy, University Hospital Montpellier, Montpellier, France
| | - S Hermabessiere
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France
| | - A Montoya
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France
| | - E Jumas-Bilak
- Hygiene Department, University Hospital Montpellier, Montpellier, France
| | - G-P Pageaux
- Department of Hepatology and Liver Transplantation,University Hospital Montpellier, Montpellier, France
| | - O Dereure
- Department of Dermatology, University Hospital of Montpellier, Montpellier, France
| | - G Chanques
- Department of Anaesthesia & Critical Care Medicine, Montpellier University Hospital, Montpellier, France; PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - K Klouche
- Intensive Care Unit, Univesity Hospital Montpellier, Montpellier, France
| | - D Morquin
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France
| | - J Reynes
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France; INSERM U1175/Institut de Recherche et de Developement, Unité Mixte International, Montpellier, France
| | - V Le Moing
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France; INSERM U1175/Institut de Recherche et de Developement, Unité Mixte International, Montpellier, France
| | - M-C Picot
- Department of Epidemiology, Medical Statistics and Public Health, University Hospital of Montpellier, Montpellier, France
| | - E Tuaillon
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, Etablissement Français du Sang, Montpellier, France
| | - A Makinson
- Infectious Diseases Departement, University Hospital Montpellier, Montpellier, France; INSERM U1175/Institut de Recherche et de Developement, Unité Mixte International, Montpellier, France.
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16
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Villerabel C, Makinson A, Jaussent A, Picot M, Nègre-Pagès L, Morquin D, Reynes J, Le Moing V, Tuaillon E, Venail F. Dépistage de la COVID-19 : valeurs diagnostiques d’une anosmie rapportée ou objectivée par un test clinique. Med Mal Infect 2020. [PMCID: PMC7442001 DOI: 10.1016/j.medmal.2020.06.154] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction Des études européennes suggèrent que l’anosmie est fortement associée à l’infection par SARS-CoV-2 (COVID-19). Cependant, dans ces études, les patients étaient sélectionnés et évalués après diagnostic, sans groupe contrôle, et les troubles olfactifs étaient rapportés sans évaluation clinique. Dans cette étude nous avons évalué la valeur diagnostique de l’anosmie rapportée et de l’anosmie objectivée par un test olfactif standardisé avant prélèvement dans un centre de dépistage du SARS-CoV-2. Matériels et méthodes Étude diagnostique proposée de façon consécutive à tout adulte se présentant pour un prélèvement diagnostique par RT-PCR nasopharyngé au centre de dépistage ambulatoire du SARS-CoV-2 du CHU entre le 23 mars et le 22 avril 2020. Les critères de non-inclusion étaient un antécédent de troubles olfactifs, une indication d’hospitalisation, une barrière de la langue, des troubles cognitifs, et une grossesse ou un allaitement en cours. Les personnes répondaient à un questionnaire syndromique, puis réalisaient un examen olfactif standardisé à l’aide de trois bandelettes imprégnées de 5 microlitres d’huiles essentielles (lavande, citronnelle et menthe poivrée). Un score basé sur la reconnaissance et l’intensité des odeurs variait de 0 (anosmie totale) à 6 (normosmie). Les personnes avec un score olfactif < 4 étaient considérées anosmiques. Le prélèvement nasopharyngé était ensuite réalisé. Les valeurs de sensibilité et de spécificité de l’anosmie rapportée ou objectivée étaient calculées par rapport au diagnostic de COVID-19 confirmé par RT-PCR. Résultats L’étude a été proposée à 854 personnes ; 809 personnes ont été incluses, dont 754 soignants. L’âge moyen était de 42 ans (±13vans), et 596 (74 %) des personnes étaient des femmes. Cinquante-huit (7,2 %) personnes ont été testées positives pour le SARS-CoV-2. Trente-huit personnes rapportaient une anosmie (4,7 % ; 38/809), 38 personnes un score d’anosmie clinique < 4, et 19 personnes les deux à la fois. La prévalence de l’anosmie rapportée ou objectivée par l’examen clinique était de 39,7 % (n = 23/58) chez les cas de COVID-19 confirmées. Les valeurs de sensibilité de l’anosmie rapportée et clinique étaient de 0,31 [IC95 % : 0,20–0,45] et 0,34 [0,22–0,48], et de spécificité 0,97 [0,96–0,98] et 0,98 [0,96–0,99] respectivement. Les valeurs prédictives positives de l’anosmie rapportée et clinique étaient de 0,47 [0,31–0,64] et 0,53 [0,36–0,69] respectivement, et les valeurs prédictives négatives identiques de 0,95 [0,93–0,96]. Sur les 19 personnes ayant à la fois une anosmie rapportée et clinique, 18 avaient la COVID-19. Conclusion Dans cette population de patients dépistés en ambulatoire pour une COVID-19 asymptomatique ou modérée et chez qui l’anosmie a été recherchée avant tout test virologique de SARS-CoV-2, les prévalences de l’anosmie rapportée ou clinique étaient faibles avec des discordances fréquentes. L’anosmie est un signe peu sensible mais cependant très spécifique de la maladie. La présence d’anosmie selon les deux méthodes était associée à une forte probabilité de maladie COVID-19.
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Meszaros M, Meunier L, Morquin D, Klouche K, Fesler P, Malezieux E, Makinson A, Le Moing V, Reynes J, Pageaux G. Abnormal liver tests in patients hospitalized with Coronavirus disease 2019: Should we worry? Liver Int 2020; 40:1860-1864. [PMID: 32495496 PMCID: PMC7300742 DOI: 10.1111/liv.14557] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 05/06/2020] [Revised: 05/23/2020] [Accepted: 05/30/2020] [Indexed: 01/08/2023]
Abstract
While several studies from China have reported COVID-19-related liver injury, there are currently no data on liver dysfunction in hospitalized COVID-19 patients in Europe. The aim of this study was to describe the prevalence and predictive value of abnormal liver function in patients hospitalized with COVID-19. This was a retrospective cohort study of confirmed COVID-19 patients hospitalized in two referral hospitals in France. Clinical, biological and radiological data were collected and analysed. In all, 234 patients confirmed to have COVID-19 by RT-PCR were included. Liver function was abnormal in 66.6% of patients on admission. In multivariate logistic regression, abnormal liver test on admission were associated with in-hospital aggravation (OR = 4.1, 95% CI 1.5-10.8; P = .004) and mortality (OR 3.3; 95% CI = 1.04-10.5; P = .04). This study of liver tests in a European COVID-19 population confirms a high prevalence of abnormal liver tests on admission that are predictive of severe disease course and higher in-hospital mortality.
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Affiliation(s)
- Magdalena Meszaros
- Department of Hepatology, Gastroenterology and Liver TransplantationMontpellier University HospitalUniversity of MontpellierMontpellierFrance
- Department of Gastroenterology and HepatologyNarbonne HospitalNarbonneFrance
| | - Lucy Meunier
- Department of Hepatology, Gastroenterology and Liver TransplantationMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - David Morquin
- Department of Infectious DiseasesMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Kada Klouche
- Department of Intensive Care LapeyronieMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Pierre Fesler
- Department of Internal Medicine LapeyronieMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Emilie Malezieux
- Department of Hepatology, Gastroenterology and Liver TransplantationMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Alain Makinson
- Department of Infectious DiseasesMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Vincent Le Moing
- Department of Infectious DiseasesMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Jacques Reynes
- Department of Infectious DiseasesMontpellier University HospitalUniversity of MontpellierMontpellierFrance
| | - Georges‐Philippe Pageaux
- Department of Hepatology, Gastroenterology and Liver TransplantationMontpellier University HospitalUniversity of MontpellierMontpellierFrance
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18
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Ayouba A, Thaurignac G, Morquin D, Tuaillon E, Raulino R, Nkuba A, Lacroix A, Vidal N, Foulongne V, Le Moing V, Reynes J, Delaporte E, Peeters M. Multiplex detection and dynamics of IgG antibodies to SARS-CoV2 and the highly pathogenic human coronaviruses SARS-CoV and MERS-CoV. J Clin Virol 2020; 129:104521. [PMID: 32623350 PMCID: PMC7308014 DOI: 10.1016/j.jcv.2020.104521] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Knowledge of the COVID-19 epidemic extent and the level of herd immunity is urgently needed to help manage this pandemic. METHODS We used a panel of 167 samples (77 pre-epidemic and 90 COVID-19 seroconverters) and SARS-CoV1, SARS-CoV2 and MERS-CoV Spike and/or Nucleopcapsid (NC) proteins to develop a high throughput multiplex screening assay to detect IgG antibodies in human plasma. Assay performances were determined by ROC curves analysis. A subset of the COVID-19+ samples (n = 36) were also tested by a commercial NC-based ELISA test and the results compared with those of the novel assay. RESULTS On samples collected ≥14 days after symptoms onset, the accuracy of the assay is 100 % (95 % CI: 100-100) for the Spike antigen and 99.9 % (95 % CI:99.7-100) for NC. By logistic regression, we estimated that 50 % of the patients have seroconverted at 5.7 ± 1.6; 5.7 ± 1.8 and 7.9 ± 1.0 days after symptoms onset against Spike, NC or both antigens, respectively and all have seroconverted two weeks after symptoms onset. IgG titration in a subset of samples showed that early phase samples present lower IgG titers than those from later phase. IgG to SARS-CoV2 NC cross-reacted at 100 % with SARS-CoV1 NC. Twenty-nine of the 36 (80.5 %) samples tested were positive by the commercial ELISA while 31/36 (86.1 %) were positive by the novel assay. CONCLUSIONS Our assay is highly sensitive and specific for the detection of IgG antibodies to SARS-CoV2 proteins, suitable for high throughput epidemiological surveys. The novel assay is more sensitive than a commercial ELISA.
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Affiliation(s)
- Ahidjo Ayouba
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France.
| | - Guillaume Thaurignac
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - David Morquin
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France; Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Raisa Raulino
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Antoine Nkuba
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Audrey Lacroix
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Nicole Vidal
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
| | - Vincent Foulongne
- Département de bacteriologie-virologie, CHU de Montpellier, 34295 Montpellier, France
| | - Vincent Le Moing
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France; Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Jacques Reynes
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France; Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Eric Delaporte
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France; Département de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Martine Peeters
- Recherches Translationnelles sur le VIH et Maladies Infectieuses/INSERM U1175, Institut de Recherche pour le Développement et Université de Montpellier, France
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19
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Chiriac AM, Al Ali O, Landry Q, Morquin D, Ferrando L, Molinari N, Demoly P. Designing a combined intervention for urgent betalactam administration in patients with a suspicion of penicillin allergy. World Allergy Organ J 2020. [DOI: 10.1016/j.waojou.2020.100392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Villard O, Morquin D, Molinari N, Raingeard I, Nagot N, Cristol JP, Jung B, Roubille C, Foulongne V, Fesler P, Lamure S, Taourel P, Konate A, Maria ATJ, Makinson A, Bertchansky I, Larcher R, Klouche K, Le Moing V, Renard E, Guilpain P. The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study. J Clin Med 2020; 9:jcm9072315. [PMID: 32708205 PMCID: PMC7408691 DOI: 10.3390/jcm9072315] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 06/29/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 01/08/2023] Open
Abstract
Background. The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic. Methods. Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients’ clinical courses. Results. Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L. Conclusions. Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.
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Affiliation(s)
- Orianne Villard
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Endocrinology, Diabetes, Nutrition, and INSERM 1411 Clinical Investigation Centre, Montpellier University Hospital, INSERM, 34000 Montpellier, France;
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34000 Montpellier, France
| | - David Morquin
- Department of Infectious and Tropical Diseases, Montpellier University Hospital, 34000 Montpellier, France;
| | - Nicolas Molinari
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- IMAG, CNRS, University of Montpellier, Montpellier University Hospital, 34000 Montpellier, France
| | - Isabelle Raingeard
- Department of Endocrinology, Diabetes, Nutrition, and INSERM 1411 Clinical Investigation Centre, Montpellier University Hospital, INSERM, 34000 Montpellier, France;
| | - Nicolas Nagot
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- IMAG, CNRS, University of Montpellier, Montpellier University Hospital, 34000 Montpellier, France
| | - Jean-Paul Cristol
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Laboratory of Biochemistry, Montpellier University Hospital, 34000 Montpellier, France
| | - Boris Jung
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Intensive Care Medicine, Montpellier University Hospital, 34000 Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 34000 Montpellier, France
| | - Camille Roubille
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 34000 Montpellier, France
| | - Vincent Foulongne
- Laboratory of Virology, Montpellier University Hospital, 34000 Montpellier, France;
| | - Pierre Fesler
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 34000 Montpellier, France
| | - Sylvain Lamure
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Infectious and Tropical Diseases, Montpellier University Hospital, 34000 Montpellier, France;
| | - Patrice Taourel
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Radiology, Montpellier University Hospital, 34000 Montpellier, France
| | - Amadou Konate
- Department of Internal Medicine—Multi-Organ Diseases, Local Referral Center for Auto-Immune Diseases, Montpellier University Hospital, 34000 Montpellier, France; (A.K.); (I.B.)
- Department of Internal Medicine—‘DIAGORA Unit’, Montpellier University Hospital, 34000 Montpellier, France
| | - Alexandre Thibault Jacques Maria
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Internal Medicine—Multi-Organ Diseases, Local Referral Center for Auto-Immune Diseases, Montpellier University Hospital, 34000 Montpellier, France; (A.K.); (I.B.)
- IRMB, INSERM U1183, Montpellier University Hospital, 34000 Montpellier, France
| | - Alain Makinson
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Infectious and Tropical Diseases, Montpellier University Hospital, 34000 Montpellier, France;
| | - Ivan Bertchansky
- Department of Internal Medicine—Multi-Organ Diseases, Local Referral Center for Auto-Immune Diseases, Montpellier University Hospital, 34000 Montpellier, France; (A.K.); (I.B.)
- Department of Internal Medicine—‘DIAGORA Unit’, Montpellier University Hospital, 34000 Montpellier, France
| | - Romaric Larcher
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Intensive Care Medicine, Montpellier University Hospital, 34000 Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 34000 Montpellier, France
| | - Kada Klouche
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Intensive Care Medicine, Montpellier University Hospital, 34000 Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 34000 Montpellier, France
| | - Vincent Le Moing
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Infectious and Tropical Diseases, Montpellier University Hospital, 34000 Montpellier, France;
| | - Eric Renard
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Endocrinology, Diabetes, Nutrition, and INSERM 1411 Clinical Investigation Centre, Montpellier University Hospital, INSERM, 34000 Montpellier, France;
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, 34000 Montpellier, France
| | - Philippe Guilpain
- Montpellier School of Medicine, University of Montpellier, 34000 Montpellier, France; (O.V.); (N.M.); (N.N.); (J.-P.C.); (B.J.); (C.R.); (P.F.); (S.L.); (P.T.); (A.T.J.M.); (A.M.); (R.L.); (K.K.); (V.L.M.); (E.R.)
- Department of Internal Medicine—Multi-Organ Diseases, Local Referral Center for Auto-Immune Diseases, Montpellier University Hospital, 34000 Montpellier, France; (A.K.); (I.B.)
- IRMB, INSERM U1183, Montpellier University Hospital, 34000 Montpellier, France
- Correspondence: ; Tel.: +33-4-67-33-73-32; Fax: +33-4-67-33-72-91
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Clark E, Guilpain P, Filip IL, Pansu N, Le Bihan C, Cartron G, Tchernonog E, Roubille C, Morquin D, Makinson A, Tuaillon E, Le Moing V. Convalescent plasma for persisting COVID-19 following therapeutic lymphocyte depletion: a report of rapid recovery. Br J Haematol 2020; 190:e154-e156. [PMID: 32593180 PMCID: PMC7361823 DOI: 10.1111/bjh.16981] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Evangéline Clark
- CHU Montpellier, University of Montpellier I, Montpellier, France
| | - Philippe Guilpain
- Internal Medicine: Multi-Organic Diseases, Local Referral Center for Systemic Autoimmune Diseases, Montpellier University Hospital, Montpellier University, Medical School, Montpellier, France.,IRMB, Universite Montpellier, INSERM, Montpellier, France
| | | | - Nathalie Pansu
- Tropical and Infectious Diseases, University Hospital, Montpellier, France
| | - Clément Le Bihan
- Tropical and Infectious Diseases, University Hospital, Montpellier, France
| | - Guillaume Cartron
- Department of Clinical Hematology, Montpellier University Hospital, Montpellier, France.,Institut de Génétique Moléculaire de Montpellier, CNRS 5535, Montpellier, France
| | - Emmanuelle Tchernonog
- Department of Clinical Hematology, Montpellier University Hospital, Montpellier, France
| | - Camille Roubille
- Internal medecine: CHU de Montpellier, hôpital Lapeyronie, Montpellier, France
| | - David Morquin
- Tropical and Infectious Diseases, University Hospital, Montpellier, France
| | - Alain Makinson
- Tropical and Infectious Diseases, University Hospital, Montpellier, France.,INSERM U1175/IRD UMI 233, IRD, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - Vincent Le Moing
- Tropical and Infectious Diseases, University Hospital, Montpellier, France
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Tuaillon E, Bolloré K, Pisoni A, Debiesse S, Renault C, Marie S, Groc S, Niels C, Pansu N, Dupuy AM, Morquin D, Foulongne V, Bourdin A, Le Moing V, Van de Perre P. Detection of SARS-CoV-2 antibodies using commercial assays and seroconversion patterns in hospitalized patients. J Infect 2020; 81:e39-e45. [PMID: 32504735 PMCID: PMC7834649 DOI: 10.1016/j.jinf.2020.05.077] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022]
Abstract
Objectives SARS-CoV-2 antibody assays are needed for serological surveys and as a complement to molecular tests to confirm COVID-19. However, the kinetics of the humoral response against SARS-CoV-2 remains poorly described and relies on the performance of the different serological tests. Methods In this study, we evaluated the performance of six CE-marked point-of-care tests (POC) and three ELISA assays for the diagnosis of COVID-19 by exploring seroconversions in hospitalized patients who tested positive for SARS-CoV-2 RNA. Results Both the ELISA and POC tests were able to detect SARS-CoV-2 antibodies in at least half of the samples collected seven days or more after the onset of symptoms. After 15 days, the rate of detection rose to over 80% but without reaching 100%, irrespective of the test used. More than 90% of the samples collected after 15 days tested positive using the iSIA and Accu-Tell® POC tests and the ID.Vet IgG ELISA assay. Seroconversion was observed 5 to 12 days after the onset of symptoms. Three assays suffer from a specificity below 90% (EUROIMMUN IgG and IgA, UNscience, Zhuhai Livzon). Conclusions The second week of COVID-19 seems to be the best period for assessing the sensitivity of commercial serological assays. To achieve an early diagnosis of COVID-19 based on antibody detection, a dual challenge must be met: the immunodiagnostic window period must be shortened and an optimal specificity must be conserved.
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Affiliation(s)
- E Tuaillon
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France.
| | - K Bolloré
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - A Pisoni
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - S Debiesse
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - C Renault
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - S Marie
- Montpellier University Hospital, Montpellier, France
| | - S Groc
- Montpellier University Hospital, Montpellier, France
| | - C Niels
- Montpellier University Hospital, Montpellier, France
| | - N Pansu
- Montpellier University Hospital, Montpellier, France
| | - A M Dupuy
- Montpellier University Hospital, Montpellier, France
| | - D Morquin
- Montpellier University Hospital, Montpellier, France
| | - V Foulongne
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - A Bourdin
- Montpellier University Hospital, Montpellier, France
| | - V Le Moing
- Montpellier University Hospital, Montpellier, France
| | - P Van de Perre
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
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Barraud O, Robert A, Laval L, Ruimy R, Morquin D, Boyer L, Lamy B. It takes two to tango: two Aeromonas isolates combine virulence and multidrug resistance in flap infection following leech therapy. Clin Microbiol Infect 2020; 26:793-794. [DOI: 10.1016/j.cmi.2019.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/04/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022]
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24
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Morquin D. [Legitimate resistance without technophobia: Analysis of electronic medical records impacts on the medical profession]. Rev Med Interne 2020; 41:617-621. [PMID: 32467002 DOI: 10.1016/j.revmed.2020.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/09/2019] [Revised: 02/09/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
The objective of this short narrative literature review is to highlight the different difficulties encountered by medical doctor in the daily use of EMR. We show that these are not simple transitional phenomena related to a "resistance to change", but rather the fact of a deeper and unfinished transformation. Beyond the "perception of misfit with work processes" or the threat of a loss of autonomy, we propose to analyze this so-called "resistance" in relation to the formalization of medical work induced by EMR. Our question concerns the compatibility of the multiple objectives of EMR, the potential influence of computerization on the steps of entering and consulting medical information, the impact on the clinical reasoning, the reality of assistance to medical "performance". The question is not so much what EMRs do less well than the paper record, but to provide insights into how tomorrow's EMRs will do better than today's.
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Affiliation(s)
- D Morquin
- Département des Maladies Infectieuses et Tropicales - CHU de Montpellier, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier, France; Délégation à l'Usage clinique du Numérique, CHU de Montpellier - Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier, France.
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25
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Makinson A, Tron L, Grabar S, Milleron B, Reynes J, Le Moing V, Morquin D, Lert F, Costagliola D, Guiguet M. Potential lung cancer screening outcomes using different age and smoking thresholds in the ANRS-CO4 French Hospital Database on HIV cohort. HIV Med 2019; 21:180-188. [PMID: 31730270 DOI: 10.1111/hiv.12811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES In most lung screening programmes, only subjects ≥ 55 years old and smoking ≥ 30 pack-years are eligible to undergo chest low-dose computed tomography. Whether the same criteria should apply to people living with HIV (PLHIV) is uncertain, given the increased lung cancer risks associated with immunodeficiency and high rates of smoking. We assessed different outcomes obtained from simulating one round of lung cancer screening in PLHIV using different age and smoking thresholds for eligibility. METHODS Data from the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS)-CO4 French Hospital Database on HIV (FHDH) cohort of PLHIV and a national representative survey of PLHIV in care in 2011 (the ANRS-VESPA2 [enquête sur les personnes atteintes] study) were used to estimate the maximum proportion of incident lung cancers occurring between 2012 and 2016 that would have potentially been detected by screening in 2011. Secondary outcomes were numbers of eligible subjects in the cohort and numbers of subjects needed to screen (NNS) to detect one lung cancer. RESULTS Among 77819 PLHIV in 2011 (median age 46 years; 66% men), 285 subjects subsequently developed lung cancer. Adoption of the US Preventive Services Task Force (USPSTF) recommendations (55-80 years; ≥ 30 pack-years) would have detected 31% of lung cancers at most. Lowering the minimum age to 50 and 45 years would have detected 49% and 60% of cancers, respectively, but would have greatly increased the number of eligible subjects and the NNS to detect one case of lung cancer. CONCLUSIONS Use of the USPSTF criteria would have detected only a minority of lung cancers in a large French cohort of PLHIV in 2011. Screening PLHIV at younger ages (45 or 50 years) and/or the use of lower smoking thresholds (20 pack-years) may be beneficial, despite the consequently higher numbers of eligible subjects and NNS to detect one case of lung cancer, and should be evaluated in future studies.
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Affiliation(s)
- A Makinson
- Infectious and Tropical Diseases Department, UMI 233/INSERM U1175, Montpellier University Hospital, Montpellier, France
| | - L Tron
- University Hospital of Caen, Caen, France.,ANTICIPE' U1086 INSERM-UCN, François Baclesse Center, Caen, France
| | - S Grabar
- INSERM, Institute of Epidemiology and Public Health Pierre Louis (IPLESP), Sorbonne Université, Paris, France.,Biostatistic and Epidemiology Unit, Cochin Hospital, Paris, France.,Paris-Descartes University, Paris, France
| | - B Milleron
- French Cooperative Thoracic Intergroup (IFCT), Paris, France.,Public Hospitals of Paris (APHP), University Hospitals of Bichat and Tenon, Paris, France
| | - J Reynes
- Infectious and Tropical Diseases Department, UMI 233/INSERM U1175, Montpellier University Hospital, Montpellier, France
| | - V Le Moing
- Infectious and Tropical Diseases Department, UMI 233/INSERM U1175, Montpellier University Hospital, Montpellier, France
| | - D Morquin
- Infectious and Tropical Diseases Department, UMI 233/INSERM U1175, Montpellier University Hospital, Montpellier, France
| | - F Lert
- Department of Epidemiology of Occupational and Social Determinants of Health, Center for Research in Epidemiology and Population Health, INSERM, Villejuif, France
| | - D Costagliola
- INSERM, Institute of Epidemiology and Public Health Pierre Louis (IPLESP), Sorbonne Université, Paris, France
| | - M Guiguet
- INSERM, Institute of Epidemiology and Public Health Pierre Louis (IPLESP), Sorbonne Université, Paris, France
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Gaudard P, Saour M, Morquin D, David H, Eliet J, Villiet M, Daures JP, Colson P. Acute kidney injury during daptomycin versus vancomycin treatment in cardiovascular critically ill patients: a propensity score matched analysis. BMC Infect Dis 2019; 19:438. [PMID: 31109283 PMCID: PMC6528203 DOI: 10.1186/s12879-019-4077-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/09/2019] [Indexed: 12/29/2022] Open
Abstract
Background Gram-positive organisms are a leading cause of infection in cardiovascular surgery. Furthermore, these patients have a high risk of developing postoperative renal failure in intensive care unit (ICU). Some antibiotic drugs are known to impair renal function. The aim of the study was to evaluate whether patients treated for Gram-positive cardiovascular infection with daptomycin (DAP) experienced a lower incidence of acute kidney injury (AKI) when compared to patients treated with vancomycin (VAN), with comparable efficacy. Methods ICU patients who received either DAP or VAN, prior to or after cardiovascular surgery or mechanical circulatory support, from January 2010 to December 2012, were included in this observational retrospective cohort study. We excluded patients with end stage renal disease and antibiotic prophylaxis. The primary endpoint was the incidence of AKI within the first week of treatment. Secondary endpoints were the incidence of AKI within the first 14 days of treatment, the severity of AKI including renal replacement therapy (RRT), the rates of clinical failure (unsuccessful infection treatment) and of premature discontinuation and mortality. To minimize selection bias, we used a propensity score to compare the 2 groups. Univariate and multivariate analysis were performed to determine factors associated with AKI. Results Seventy two patients, treated for infective endocarditis, cardiovascular foreign body infection, or surgical site infection were included (DAP, n = 28 and VAN, n = 44). AKI at day 7 was observed in 28 (64%) versus 6 (21%) of the VAN and DAP patients, respectively (p = 0.001). In the multivariate analysis adjusted to the propensity score, vancomycin treatment was the only factor associated with AKI (Odds Ratio 4.42; 95% CI: 1.39–15.34; p = 0.014). RRT was required for 2 (7%) DAP patients and 13 (30%) VAN patients, p = 0.035. Premature discontinuation and clinical failure occurred more frequently in VAN group than in DAP group (25% versus 4%, p = 0.022 and 42% versus 12%, respectively, p = 0.027). Conclusions Daptomycin appears to be safer than vancomycin in terms of AKI risk in ICU patients treated for cardiovascular procedure-related infection. Daptomycin could be considered as a first line treatment to prevent AKI in high-risk patients.
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Affiliation(s)
- Philippe Gaudard
- PhyMedExp, University of Montpellier, CNRS, INSERM, Department of cardiothoracic Anaesthesiology and Critical Care Medicine, CHU Montpellier, Montpellier, France.
| | - Marine Saour
- Department of cardiothoracic Anaesthesiology and Critical Care Medicine, CHU Montpellier, Montpellier, France
| | - David Morquin
- Infectious and Tropical Diseases Department, CHU Montpellier, Montpellier, France
| | - Hélène David
- PhyMedExp, University of Montpellier, CNRS, INSERM, Department of cardiothoracic Anaesthesiology and Critical Care Medicine, CHU Montpellier, Montpellier, France
| | - Jacob Eliet
- Department of cardiothoracic Anaesthesiology and Critical Care Medicine, CHU Montpellier, Montpellier, France
| | - Maxime Villiet
- Clinical Pharmacy Department, CHU Montpellier, Montpellier, France
| | - Jean-Pierre Daures
- Laboratory of Biostatistics and Epidemiology EA2415, University Institute for Clinical Research, Montpellier, France
| | - Pascal Colson
- Department of cardiothoracic Anaesthesiology and Critical Care Medicine, CHU Montpellier, Montpellier, France
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Rzepecki V, Reynes J, Le Moing V, Braquet P, Faucherre V, Lohan L, Morquin D, Makinson A. Severe HIV-associated aphthous stomatitis treated with etanercept. Med Mal Infect 2018; 49:219-220. [PMID: 30528070 DOI: 10.1016/j.medmal.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Affiliation(s)
- V Rzepecki
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - J Reynes
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - V Le Moing
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - P Braquet
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - V Faucherre
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - L Lohan
- Pharmacie, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - D Morquin
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - A Makinson
- Inserm U1175, maladies infectieuses, CHU de Montpellier, 34295 Montpellier cedex 5, France.
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Tudesq J, Cartron G, Rivière S, Morquin D, Iordache L, Mahr A, Pourcher V, Klouche K, Cerutti D, Faillie J, Le Quellec A, Guilpain P. Histoire naturelle des infections après traitement par rituximab : étude monocentrique rétrospective. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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29
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Chatre C, Dumont Y, Morquin D, Boever CMD, Gandet T, Albat B, Reynes J, Le Moing V. Les récidives d’endocardite infectieuse à entérocoque : fréquence et facteurs favorisants. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Fournier G, Morquin D, Goulabchand R, Tingaud C, de Boutray M. [Autochthonous dirofilariasis in the temporal muscle]. Med Mal Infect 2018; 48:424-426. [PMID: 29731192 DOI: 10.1016/j.medmal.2018.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/12/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Affiliation(s)
- G Fournier
- Département d'ORL et chirurgie maxillo-faciale, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Faculté de médecine, université de Montpellier, 641, avenue du Doyen-Gaston-Giraud, 34093 Montpellier, France.
| | - D Morquin
- Faculté de médecine, université de Montpellier, 641, avenue du Doyen-Gaston-Giraud, 34093 Montpellier, France; Département de maladie infectieuses et tropicales, hôpital Saint-Eloi, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - R Goulabchand
- Faculté de médecine, université de Montpellier, 641, avenue du Doyen-Gaston-Giraud, 34093 Montpellier, France; Département de médecine interne, maladie multi-organiques de l'adulte, hôpital Saint-Eloi, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - C Tingaud
- Service d'anatomopathologie, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - M de Boutray
- Département d'ORL et chirurgie maxillo-faciale, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Faculté de médecine, université de Montpellier, 641, avenue du Doyen-Gaston-Giraud, 34093 Montpellier, France
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31
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Bertrand K, Lamy B, De Boutray M, Yachouh J, Galmiche S, Leprêtre P, de Champfleur NM, Reynes J, Le Moing V, Morquin D. Osteomyelitis of the jaw: time to rethink the bone sampling strategy? Eur J Clin Microbiol Infect Dis 2018. [PMID: 29516234 DOI: 10.1007/s10096-018-3219-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This work aims at describing the diversity of osteomyelitis of the jaw (OJ) and at assessing the relevance of a new method designed to avoid salivary contamination during bone sampling in order to improve microbiological analysis and clinical decision-making. We reviewed medical and microbiological data of patients with a suspected OJ based on clinical and/or CT-scan signs and at least one bone sample made for microbiological analysis. During the study period, a new procedure for intraoral bone sampling was elaborated by surgeons and infectious diseases specialists authoring this article (based on stratified samples, cleaning of the surgical site and change of instruments between each sample). A comparison of the microbiological analyses between the two procedures was performed. From 2012 to 2017, 56 patients were included. Median age was 58 years (11-90), sex ratio: 1.24. Main risk factors were having a dental disease (n = 24) or cancer (n = 21). Nineteen patients with the new sample procedure were compared to 37 patients with standard procedure, especially non-cancer patients (n = 16 and 19, respectively). With the new procedure, a median of 3 (1-7) microorganisms per sample was recovered, vs. 7 (1-14) with the former (p < 0.001), a significant decrease of the microbial density was observed for all types of microbes, especially in deeper samples and cultures were more frequently sterile. The way sampling is managed deeply influences microbiological analysis. This strategy facilitates the distinction between pathogens and contaminants and should constitute the first step toward an evidence-based antimicrobial strategy for OJ.
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Affiliation(s)
- Kevin Bertrand
- Infectious Diseases Department, Perpignan Hospital, Perpignan, France.
| | - Brigitte Lamy
- Bacteriology Department, Nice Teaching Hospital, Nice, France
| | - Marie De Boutray
- Maxillofacial Department, Montpellier Teaching Hospital, Montpellier, France
| | - Jacques Yachouh
- Maxillofacial Department, Saint-Roch Clinic, Montpellier, France
| | - Sophie Galmiche
- Maxillofacial Department, Montpellier Teaching Hospital, Montpellier, France
| | - Pierre Leprêtre
- Medical Imaging Department, Montpellier Teaching Hospital, Montpellier, France
| | | | - Jacques Reynes
- Infectious Diseases Department, Montpellier Teaching Hospital, Montpellier, France.,UMI 233 TransVIHMI, University of Montpellier, Montpellier, France
| | - Vincent Le Moing
- Infectious Diseases Department, Montpellier Teaching Hospital, Montpellier, France.,UMI 233 TransVIHMI, University of Montpellier, Montpellier, France
| | - David Morquin
- Infectious Diseases Department, Montpellier Teaching Hospital, Montpellier, France.,UMI 233 TransVIHMI, University of Montpellier, Montpellier, France
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Tudesq JJ, Cartron G, Rivière S, Morquin D, Iordache L, Mahr A, Pourcher V, Klouche K, Cerutti D, Le Quellec A, Guilpain P. Clinical and microbiological characteristics of the infections in patients treated with rituximab for autoimmune and/or malignant hematological disorders. Autoimmun Rev 2017; 17:115-124. [PMID: 29180125 DOI: 10.1016/j.autrev.2017.11.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Rituximab is commonly used for the treatment of hematological malignancies and autoimmune diseases. Despite a reputation for good tolerance, case-series and registries reported rituximab-related infections of variable severity including opportunistic infections. We aimed at describing the natural history of infectious events (IE) after treatment by rituximab providing clinical and microbiological features and outcome. PATIENTS AND METHODS We retrospectively analyzed the medical records of patients treated with rituximab in an internal medicine department of a tertiary hospital between 2007 and 2015, and identified all IE after this therapy. Events' severity was assessed using the Common Terminological Criteria of Adverse Events (version 4.3) definitions. RESULTS Among 101 patients treated with rituximab, we identified 228 IE in 74 (73.3%) of these patients (median follow-up 30.4months). Indication for rituximab was either autoimmune disease (AID) (52.5% of patients), or monoclonal hematological disease (MHD) (47.5%). Patients received an overall median number of 5 rituximab infusions [interquartile range: 4-8], representing a cumulative dose of 4340mg [2620-6160]. After last rituximab infusion, IE occurred after 3.1months [0.7-9.4]. Respectively, IE were severe in 28.1% of cases in patients treated for AID vs 58.0% in patients treated for MHD (p<0.001), due to opportunistic pathogens in 7.8% vs 11.0% (p=0.49) and fatal in 4.7% vs 13.0% (p=0.044). Factor associated with mortality were polymicrobial infection (p<0.001), monoclonal hematological disease (p=0.035), use of steroids over 10mg/d within the last two weeks (p=0.003), and rituximab cumulative dose (p<0.001). We identified a group of 10 patients (9.9%) showing life-threatening, polymicrobial, and opportunistic infections constituting a 'catastrophic infectious syndrome', which was lethal in 7 cases. CONCLUSION IE after treatment by rituximab can be extremely severe, especially in patients immunocompromised by several other drugs. Further studies should focus on the group with life-threatening polymicrobial infections.
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Affiliation(s)
- Jean-Jacques Tudesq
- Internal Medicine and Multi-organic Diseases Department, Local Referral Center for Rare Autoimmune Diseases, Montpellier University Hospital, Montpellier F-34000, France; Medical Intensive Care Unit, Montpellier University Hospital, Montpellier F-34000, France
| | - Guillaume Cartron
- Clinical Hematology Department, Montpellier University Hospital, Montpellier, F-34000, France; Centre National de Recherche Scientifique (CNRS), UMR 5235, Montpellier University, Montpellier F-34000, France
| | - Sophie Rivière
- Internal Medicine and Multi-organic Diseases Department, Local Referral Center for Rare Autoimmune Diseases, Montpellier University Hospital, Montpellier F-34000, France
| | - David Morquin
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, F-34000, France
| | - Laura Iordache
- Internal Medicine Department, Saint-Louis University Hospital, AP-HP, Paris F-75010, France
| | - Alfred Mahr
- Internal Medicine Department, Saint-Louis University Hospital, AP-HP, Paris F-75010, France
| | - Valérie Pourcher
- Infectious Diseases Department, Pitié-Salpêtrière University Hospital, AP-HP, Paris F-75005, France
| | - Kada Klouche
- Medical Intensive Care Unit, Montpellier University Hospital, Montpellier F-34000, France
| | - Diane Cerutti
- Internal Medicine and Multi-organic Diseases Department, Local Referral Center for Rare Autoimmune Diseases, Montpellier University Hospital, Montpellier F-34000, France
| | - Alain Le Quellec
- Internal Medicine and Multi-organic Diseases Department, Local Referral Center for Rare Autoimmune Diseases, Montpellier University Hospital, Montpellier F-34000, France
| | - Philippe Guilpain
- Internal Medicine and Multi-organic Diseases Department, Local Referral Center for Rare Autoimmune Diseases, Montpellier University Hospital, Montpellier F-34000, France; Institut National de la Santé Et de la Rercherche Médicale (INSERM) U1183, Institute for Regenerative Medicine and Biotherapies (IRMB), Montpellier F-34000, France.
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Appelgren A, Morquin D, Dufour S, Le Moing V, Reynes J, Lotthé A, Parer S, Corbeau C, Aubry A, Sougakoff W, Solassol J, Bonzon L, Dumont Y, Godreuil S. Investigation of pre-XDR Beijing Mycobacterium tuberculosis transmission to a healthcare worker in France, 2016. J Hosp Infect 2017; 97:414-417. [PMID: 28669673 DOI: 10.1016/j.jhin.2017.06.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 06/27/2017] [Indexed: 11/26/2022]
Abstract
A case of occupational contamination of a healthcare worker by a pre-extensively drug-resistant (pre-XDR) Beijing strain of Mycobacterium tuberculosis at the University Hospital of Montpellier, France is reported. The index case was identified using genetic fingerprinting of isolates. This report underscores the risk of healthcare-associated contamination by pre-XDR tuberculosis (TB) in low-incidence countries and the importance of molecular tools for TB care. It also calls for increased vigilance in the management of multi-drug-resistant/XDR TB patients.
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Affiliation(s)
- A Appelgren
- Centre Hospitalier Universitaire de Montpellier, Laboratoire de Bactériologie, Montpellier, France; MIVEGEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France.
| | - D Morquin
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, Montpellier, France
| | - S Dufour
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, Montpellier, France
| | - V Le Moing
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, Montpellier, France; Université de Montpellier-IRD UMI233-INSERM U1175, Montpellier, France
| | - J Reynes
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, Montpellier, France; Université de Montpellier-IRD UMI233-INSERM U1175, Montpellier, France
| | - A Lotthé
- Centre Hospitalier Universitaire de Montpellier, Département d'Hygiène Hospitalière, Montpellier, France
| | - S Parer
- Centre Hospitalier Universitaire de Montpellier, Département d'Hygiène Hospitalière, Montpellier, France
| | - C Corbeau
- Centre Hospitalier Universitaire de Montpellier, Centre de Lutte Antituberculeuse, Montpellier, France
| | - A Aubry
- AP-HP, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Bactériologie-Hygiène, Paris, France; Sorbonne Universités, UPMC Université Paris 06, CR7, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bacteriology), Paris, France
| | - W Sougakoff
- AP-HP, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Bactériologie-Hygiène, Paris, France; Sorbonne Universités, UPMC Université Paris 06, CR7, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bacteriology), Paris, France
| | - J Solassol
- Centre Hospitalier Universitaire de Montpellier, Département Biopathologie cellulaire et tissulaire des tumeurs, Montpellier, France
| | - L Bonzon
- Centre Hospitalier Universitaire de Montpellier, Laboratoire de Bactériologie, Montpellier, France; MIVEGEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France
| | - Y Dumont
- Centre Hospitalier Universitaire de Montpellier, Laboratoire de Bactériologie, Montpellier, France; MIVEGEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France
| | - S Godreuil
- Centre Hospitalier Universitaire de Montpellier, Laboratoire de Bactériologie, Montpellier, France; MIVEGEC, UMR IRD 224-CNRS 5290-Université de Montpellier, Montpellier, France
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Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JLE, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing. J Frailty Aging 2017; 5:233-241. [PMID: 27883170 DOI: 10.14283/jfa.2016.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Pansu N, Hamoui M, Manna F, Morquin D, Reynes J, Le Moing V. Infections hématogènes de prothèses de hanche et de genou : description et analyse des facteurs associés à l’échec de la prise en charge. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dufour S, Braquet P, Makinson A, Morquin D, Canovas F, Marchandin H, Reynes J, Le Moing V. Infections hématogènes de prothèse articulaire après une bactériémie à Staphylococcus aureus : incidence et facteurs de risque, à propos d’une cohorte de 32 patients. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.219] [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: 11/29/2022]
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Morquin D, Ologeanu-Taddei R, Watbled L. Using Healthcare Work Process Modelling in Hospitals to Increase the Fit Between the Healthcare Workflow and the Electronic Medical Record. Stud Health Technol Inform 2017; 235:393-397. [PMID: 28423821] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
As with other organizations, hospitals tend to promote unrealistic expectations related to software implementaton. Quite often the real issue is a misfit between the software and organizational factors. Our paper shows how work process modelling within the hospital can reduce this misfit according to the vision developped by the ergonomics and the management of information systems. This idea is supported by two cases in two different University Hospitals in France, in which using work process modelling lead to identification of problems and their causes, and solutions. Modelling requires time, which may be considered costly by senior hospital managers, but also should be considered as an investment in order to achieve expected goals.
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Affiliation(s)
- David Morquin
- Montpellier Research in Management, University of Montpellier, France
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Morquin D, Tuaillon E, Makinson A, Bendriss S, Le Moing V, Reynes J. Impact of T cell activation, HIV replication and hepatitis C virus infection on neutrophil CD64 expression. Cytometry B Clin Cytom 2016; 92:492-497. [PMID: 27221825 DOI: 10.1002/cyto.b.21385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/29/2016] [Accepted: 05/23/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Overexpression of the Fc receptor CD64 on neutrophils is associated with innate immune response and bacterial infections. During HIV infection a large set of immune disorders including T-lymphocyte over-activation, microbial translocation, impairment of neutrophil functions, and immunodeficiency may interplay with neutrophil CD64 expression. METHODS Associations of neutrophil CD64 expression with CD8+ T cell activation, CD4+ T cells number, HIV, and HCV replications were investigated in HIV infected patients using a standardized method. RESULTS Higher neutrophil CD64 expression was observed in HIV infected subjects compared to healthy controls (0.91 vs. 0.75, P < 0.001). Among 115 HIV infected patients, nine (8.8%) had a CD64 expression over the clinical threshold as calculated against bead standard (i.e., 1.5). HIV viremic patients were more likely to have an index above 1.5 (OR: 6.68, P values: 0.01). A trend for correlation between CD64 expression and CD8 T cell activation was observed (P values: 0.08). Blood CD4+ T lymphocyte depletion and HCV replication did not affect neutrophil CD64 expression. CONCLUSIONS HIV infection and HIV replication are associated with up-regulation of neutrophil CD64. CD64 overexpression above the clinical threshold was observed in a minor proportion of HIV infected individuals treated by antiretroviral therapy and may be a marker of neutrophil activation related to non-AIDS-linked comorbidities. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- D Morquin
- Infectious and Tropical Diseases Department, UMI 233, Gui De Chauliac, University Hospital of Montpellier, Montpellier, France
| | - E Tuaillon
- Infectious and Tropical Diseases Department, UMI 233, Gui De Chauliac, University Hospital of Montpellier, Montpellier, France.,Department of Microbiology, Université Montpellier 1/Inserm UMR 1058, Lapeyronie, University Hospital of Montpellier, Montpellier, France
| | - A Makinson
- Infectious and Tropical Diseases Department, UMI 233, Gui De Chauliac, University Hospital of Montpellier, Montpellier, France
| | - S Bendriss
- Department of Microbiology, Université Montpellier 1/Inserm UMR 1058, Lapeyronie, University Hospital of Montpellier, Montpellier, France
| | - V Le Moing
- Infectious and Tropical Diseases Department, UMI 233, Gui De Chauliac, University Hospital of Montpellier, Montpellier, France
| | - J Reynes
- Infectious and Tropical Diseases Department, UMI 233, Gui De Chauliac, University Hospital of Montpellier, Montpellier, France
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Faucher JF, Morquin D, Reynes J, Chirouze C, Hoen B, Le Moing V. Serial use of pentamidine and miltefosine for treating Leishmania infantum-HIV coinfection. Parasitol Int 2016; 65:444-6. [PMID: 27353022 DOI: 10.1016/j.parint.2016.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/18/2015] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 11/17/2022]
Abstract
Liposomal amphotericin B (LAmb) may fail to heal Leishmania infantum visceral leishmaniasis (VL) in the immunodeficient host. There are currently no guidelines on how to treat such patients and efficacy of miltefosine monotherapy seems limited in this indication. We present 2 cases of patients with VL and AIDS for which LAmb had to be interrupted (one because of toxicity, one because of treatment failure) and who were treated effectively with pentamidine followed by miltefosine.
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Affiliation(s)
- Jean-François Faucher
- Service des maladies infectieuses et Tropicales, CHRU de Besançon, 25030 Besançon cedex, France.
| | - David Morquin
- Service des maladies infectieuses et Tropicales, CHU de Montpellier, 34295 Montpellier cedex 5, France.
| | - Jacques Reynes
- Service des maladies infectieuses et Tropicales, CHU de Montpellier, 34295 Montpellier cedex 5, France.
| | - Catherine Chirouze
- Service des maladies infectieuses et Tropicales, CHRU de Besançon, 25030 Besançon cedex, France.
| | - Bruno Hoen
- Service des maladies infectieuses et Tropicales, CHRU de Besançon, 25030 Besançon cedex, France.
| | - Vincent Le Moing
- Service des maladies infectieuses et Tropicales, CHU de Montpellier, 34295 Montpellier cedex 5, France.
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Dupont C, Terru D, Aguilhon S, Frapier JM, Paquis MP, Morquin D, Lamy B, Godreuil S, Parer S, Lotthé A, Jumas-Bilak E, Romano-Bertrand S. Source-case investigation of Mycobacterium wolinskyi cardiac surgical site infection. J Hosp Infect 2016; 93:235-9. [PMID: 27210271 DOI: 10.1016/j.jhin.2016.03.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 03/11/2016] [Accepted: 03/30/2016] [Indexed: 12/17/2022]
Abstract
The non-tuberculous mycobacteria (NTM) Mycobacterium wolinskyi caused bacteraemia and massive colonization of an aortic prosthesis in a patient 16 days after cardiac surgery, necessitating repeat surgery and targeted antimicrobial chemotherapy. The infection control team investigated the source and conditions of infection. Peri-operative management of the patient complied with recommendations. The environmental investigation showed that although M. wolinskyi was not recovered, diverse NTM species were present in water from point-of-use taps and heater-cooler units for extracorporeal circulation. This case and increasing evidence of emerging NTM infections in cardiac surgery led to the implementation of infection control procedures in cardiac surgery wards.
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Affiliation(s)
- C Dupont
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France.
| | - D Terru
- Laboratory of Bacteriology, University Hospital of Montpellier, Montpellier, France
| | - S Aguilhon
- Department of Cardiothoracic Surgery, University Hospital of Montpellier, Montpellier, France
| | - J-M Frapier
- Department of Cardiothoracic Surgery, University Hospital of Montpellier, Montpellier, France
| | - M-P Paquis
- Hospital Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, France
| | - D Morquin
- Infectious and Tropical Diseases Department, University Hospital of Montpellier, Montpellier, France
| | - B Lamy
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France; Laboratory of Bacteriology, University Hospital of Montpellier, Montpellier, France
| | - S Godreuil
- Laboratory of Bacteriology, University Hospital of Montpellier, Montpellier, France
| | - S Parer
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France; Hospital Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, France
| | - A Lotthé
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France; Hospital Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, France
| | - E Jumas-Bilak
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France; Hospital Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, France
| | - S Romano-Bertrand
- PHySE, Pathogènes Hydriques, Santé, Environnements, University Hospital of Montpellier, Montpellier, France; Hospital Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, France
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Ologeanu-taddei R, Morquin D, Vitari C. Perceptions of an Electronic Medical Record (EMR): Lessons from a French Longitudinal Survey. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.procs.2016.09.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ologeanu-Taddei R, Vitari C, Morquin D. What Could We Learn from the Influence of Age on Perceptions of a CIS by the Clinical Staff of a French Hospital? Stud Health Technol Inform 2016; 228:9-13. [PMID: 27577331] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Previous research highlighted generation and age effects on the perceptions and uses of technology. The goal of this study was to examine the relationship between age and perceptions of a Clinical Information System (CIS) for the clinical staff (especially physicians, nurses, medical secretaries). A survey was conducted in September 2015 in a French Teaching Hospital, based on a questionnaire consisting of items on the Likert scale. As results, the impact of age has a strong impact on Perceived Ease of Use, anxiety and Self-Efficacy. The result related to Perceived Ease of Use is unexpected. Younger staff reported to be less comfortable with technology than older staff. This result is not consistent with literature. We propose an explanation consisting in the importance of clinical process and organization knowledge and skills while general technology skills of young generations may be less significant.
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Affiliation(s)
| | - Claudio Vitari
- Montpellier Research in Management, University of Montpellier, France
| | - David Morquin
- Montpellier Research in Management, University of Montpellier, France
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Ologeanu-Taddei R, Morquin D, Domingo H, Bourret R. Understanding the acceptance factors of an Hospital Information System: evidence from a French University Hospital. AMIA Annu Symp Proc 2015; 2015:1001-1007. [PMID: 26958237 PMCID: PMC4765578] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this study was to examine the perceived usefulness, the perceived ease of use and the perceived behavioral control of a Hospital Information System (HIS) for the care staff. We administrated a questionnaire composed of open-end and closed questions, based on the main concepts of Technology Acceptance Model. As results, the perceived usefulness, ease of use and behavioral control (self-efficacy and organizational support) are correlated with medical occupations. As an example, we found that a half of the medical secretaries consider the HIS is ease of use, at the opposite to the anesthesiologists, surgeons and physicians. Medical secretaries reported also the highest rate of PBC and a high rate of PU. Pharmacists reported the highest rate of PU but a low rate of PBC, which is similar to the rate of the surgeons and physicians. Content analysis of open questions highlights factors influencing these constructs: ergonomics, errors in the documenting process, insufficient compatibility with the medical department or the occupational group. Consequently, we suggest that the gap between the perceptions of the different occupational groups may be explained by the use of different modules and by interdependency of the care stare staff.
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Affiliation(s)
- R Ologeanu-Taddei
- Montpellier Research Management (MRM), Montpellier University, France
| | - D Morquin
- Montpellier Research Management (MRM), Montpellier University, France; Montpellier University Hospital, Montpellier, France
| | - H Domingo
- Montpellier Research Management (MRM), Montpellier University, France; Montpellier University Hospital, Montpellier, France
| | - R Bourret
- Montpellier University Hospital, Montpellier, France
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Bousquet J, Bourret R, Camuzat T, Augé P, Domy P, Bringer J, Best N, Jonquet O, de la Coussaye JE, Noguès M, Robine JM, Avignon A, Blain H, Combe B, Dray G, Dufour V, Fouletier M, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laune D, Laurent C, Mares P, Marion C, Pastor E, Pélissier JY, Radier-Pontal F, Reynes J, Royère E, Ychou M, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet PA, Alomène B, Amouyal M, Arnavielhe S, Asteriou T, Attalin V, Aubas P, Azevedo C, Badin M, Bakhti, Baptista G, Bardy B, Battesti MP, Bénézet O, Bernard PL, Berr C, Berthe J, Bobia X, Bockaert J, Boegner C, Boichot S, Bonnin HY, Boulet P, Bouly S, Boubakri C, Bourdin A, Bourrain JL, Bourrel G, Bouix V, Breuker C, Bruguière V, Burille J, Cade S, Caimmi D, Calmels MV, Camu W, Canovas G, Carre V, Cavalli G, Cayla G, Chiron R, Claret PG, Coignard P, Coroian F, Costa DJ, Costa P, Cottalorda, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cristol JP, Cros V, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dhivert-Donnadieu H, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fesler P, Fraisse P, Froger J, Gabrion P, Galano E, Gellerat-Rogier M, Gellis A, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hantkié H, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Kouyoudjian P, Labauge P, Landreau L, Lapierre M, Leblond C, Léglise MS, Lemaitre JM, Le Moing V, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert JM, Makinson A, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Morquin D, Mottet D, Nérin P, Nicolas P, Ninot G, Nouvel F, Ortiz JP, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Picot MC, Pin JP, Pinto N, Porte E, Portejoie F, Pujol JL, Quantin X, Quéré I, Raffort N, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Rolland C, Roubille F, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Soua B, Stephan Y, Strubel D, Sultan A, Taddei-Ologeanu, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Touchon J, Tribout V, Uziel A, Van de Perre P, Vasquez X, Verdier JM, Vergne-Richard C, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Villiet M, Viollet E, Wojtusciszyn A, Aoustin M, Bourquin C, Mercier J. Introduction. Presse Med 2015; 44 Suppl 1:S1-5. [DOI: 10.1016/j.lpm.2015.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Brunel AS, Bañuls AL, Marchandin H, Bouzinbi N, Morquin D, Jumas-Bilak E, Corne P. Methicillin-sensitive Staphylococcus aureus CC398 in intensive care unit, France. Emerg Infect Dis 2015; 20:1511-5. [PMID: 25148514 PMCID: PMC4178408 DOI: 10.3201/eid2009.130225] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
During testing for Staphylococcus aureus in an intensive care unit in France in 2011, we found that methicillin-sensitive S. aureus clonal complex 398 was the most frequent clone (29/125, 23.2%). It was isolated from patients (5/89, 5.6%), health care workers (2/63, 3.2%), and environmental sites (15/864,1.7%). Results indicate emergence of this clone in a hospital setting.
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Morquin D, Ologeanu-Taddei R, Koumar Y, Bourret R, Reynes J. Implementing a tele-expertise system to optimise the antibiotic use and stewardship: The case of the Montpellier University Hospital (France). Stud Health Technol Inform 2015; 210:296-300. [PMID: 25991153] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper has two aims: 1) to describe the tele-expertise system implemented in the Montpellier University Hospital (France) in order to optimize antimicrobial use 2) to analyze the prescribers' adherence to this system. For the second purpose, an observational prospective study was conducted for 12 months. Data were collected from counselling advices, which were notified in the electronic medical records. 1386 tele-expertise actions were performed. Among them, 87% were made without clinical evaluation at the bedside. The prescribers' adherence rate to a diagnosis was 79%. For the therapeutic requests, 87% of answers were fully followed. The results outline how the tele-expertise system enables both infectious disease specialists and prescribers to make better decisions in particular cases.
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Affiliation(s)
- D Morquin
- Montpellier Management Research Center, University of Montpellier, France
| | - R Ologeanu-Taddei
- Montpellier Management Research Center, University of Montpellier, France
| | - Y Koumar
- Infectious and Tropical Diseases Department, Gui de Chauliac, Montpellier University Hospital, France
| | - R Bourret
- Research Division, Montpellier University Hospital, France
| | - J Reynes
- Infectious and Tropical Diseases Department, Gui de Chauliac, Montpellier University Hospital, France
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Ologeanu-Taddei R, Morquin D, Bourret R. Understanding the Perceived Usefulness and the Ease of Use of a Hospital Information System: the case of a French University Hospital. Stud Health Technol Inform 2015; 210:531-535. [PMID: 25991204] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The goal of this study was to examine the perceived usefulness and the perceived ease of use of a Hospital Information System (HIS) for the care staff. We administrated a questionnaire composed of open-end and closed questions. As results, the perceived usefulness and ease of use are correlated with medical occupations. Content analysis of open questions highlights three factors influencing these constructs: ergonomics, errors in the documenting process and insufficient compatibility with the medical department or the occupation. While the results are consistent with literature, they show medical occupations do not report the same low rate of perceived usefulness and of ease of use. The main explanation consists in the medical risk in the prescription process for anesthesiologists, surgeons and physicians.
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Affiliation(s)
- R Ologeanu-Taddei
- Montpellier Research in Management, University of Montpellier, France
| | - D Morquin
- Montpellier Research in Management, University of Montpellier, France
| | - R Bourret
- Innovation and Research Division, University Hospital of Montpellier, France
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Bousquet J, Bourquin C, Augé P, Domy P, Bringer J, Aoustin M, Camuzat T, Bourret R, Best N, Jonquet O, de la Coussaye J, Robine J, Avignon A, Blain H, Giraudeau N, Hève D, Jeandel C, Laffont I, Larrey D, Laurent C, Noguès M, Pélissier J, Radier-Pontal F, Royère E, Bedbrook A, Granier S, Abecassis F, Albert S, Adnet P, Alomène B, Amouyal M, Arnavieilhe S, Attalin V, Aubas P, Badin M, Baptista G, Bardy B, Battesti M, Bénézet O, Bernard P, Berr C, Berthe J, Bockaert J, Boubakri C, Bourdin A, Bourrain J, Bourrel G, Bouix V, Burille J, Cade S, Caimmi D, Calmels M, Camu W, Cavalli G, Cayla G, Chiron R, Combe B, Costa D, Costa P, Courrouy-Michel M, Courtet P, Cristol J, Cuisinier F, Daien C, Danko M, Dauenhauer P, Dauzat M, David M, Davy J, Delignières D, Demoly P, Dhivert-Donnadieu H, Dray G, Dujols P, Dupeyron A, Dupeyron G, Engberink O, Fesler P, Gellerat-Rogier M, Gouzi F, Gressard F, Hoa D, Jacquemin S, Gris J, Guillot B, Handweiler V, Hayot M, Jaber S, Jakovenko D, Jorgensen C, Journot L, Kaczorek M, Lapierre M, Laune D, Léglise M, Le Quellec A, Leclerc F, Lehmann S, Lognos B, Lussert J, Mandrick K, Marmelat V, Martin-Gousset P, Matheron A, Mathieu G, Mercier G, Messner P, Meunier C, Mondain M, Morel J, Morquin D, Nérin P, Ninot G, Nouvel F, Ortiz J, Pandraud G, Pasdelou M, Pasquié J, Pastor E, Perrey S, Pers Y, Picot M, Pin J, Pinto N, Portejoie F, Pujol J, Quantin X, Quéré I, Raffort N, Ramdani S, Reynes J, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Rolland C, Roubille F, Roux E, Salvat A, Savy J, Stephan Y, Strubel D, Sultan A, Tallon G, Tassery H, Torre K, Uziel A, Van de Perre P, Vasquez X, Verdier J, Vergotte G, Vian L, Viarouge-Reunier C, Vialla F, Viart F, Villain M, Viollet E, Ankri J, Berrut G, Crooks G, Joël M, Michel J, Samolinski B, Strandberg T, Vellas B, Mercier J. MACVIA-LR, Reference site of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) in Languedoc Roussillon. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.07.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mezidi M, Belafia F, Nougaret S, Pageaux GP, Conseil M, Panaro F, Boniface G, Morquin D, Jaber S, Jung B. Interferon gamma in association with immunosuppressive drugs withdrawal and antifungal combination as a rescue therapy for cerebral invasive Aspergillosis in a liver transplant recipient. Minerva Anestesiol 2014; 80:1359-1360. [PMID: 25057936] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- M Mezidi
- Department of Critical Care Medicine and Anesthesiology, Saint Eloi Teaching Hospital, Montpellier, France -
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Morquin D, Koumar Y, Ologeanu-Taddei R, Bousquet J, Bourret R, Reynes J. Integrating electronic medical records to improve antimicrobial stewardship at the Montpellier Hospital in France. World Hosp Health Serv 2014; 50:35-39. [PMID: 26502489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Improvements in the optimal use of antibiotics is the cornerstone of the French national point-of-care alert for antibiotics (2011-2016). Integrated electronic medical records for antibiotic prescriptions have been deployed in the Montpellier University Hospital (2,800 beds) since 2012. The present paper proposes an overview of integrated electronic medical records for antibiotic prescriptions and how telecounselling at the Montpellier Hospital fits with the global anti-infection ICT strategy. This management change is fully traceable. A review of the results of the project has lead to an improvement in patient care via a collaboration between IDS and other hospital members. This project is part of the Region Reference site of the European Innovation Partnership on Active and Healthy Ageing (MACVIA-LR).
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