1
|
Garofoli N, Joly V, Le Pluart D, Hobson CA, Beaumont AL, Lariven S, Grall N, Para M, Yazdanpanah Y, Lescure FX, Peiffer-Smadja N, Deconinck L, Thy M. Enterococcal endocarditis management and relapses. JAC Antimicrob Resist 2024; 6:dlae033. [PMID: 38449516 PMCID: PMC10915900 DOI: 10.1093/jacamr/dlae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Enterococcus faecalis is the third micro-organism causing endocarditis and is associated with a significant relapse rate. The objective of this study was to describe the management of patients with Enterococcus faecalis endocarditis (EE) and its implication for relapses. Methods We conducted a monocentric, retrospective analysis of all patients hospitalized for EE including endocarditis or infection of cardiac implantable electronic device defined by the modified ESC 2015 Duke criteria in a referral centre in Paris, France. Results Between October 2016, and September 2022, 54 patients with EE were included, mostly men (n = 40, 74%) with a median age of 75 [68-80] years. A high risk for infective endocarditis (IE) was found in 42 patients (78%), including 14 (26%) previous histories of IE, and 32 (59%) histories of valvular cardiac surgery. The aortic valve was the most frequently affected (n = 36, 67%). Combination therapy was mainly amoxicillin-ceftriaxone during all the curative antibiotic therapy duration (n = 31, 57%). Surgery was indicated for 40 patients (74%), but only 27 (50%) were operated on, mainly due to their frailty. Among the 17 deaths (32%), six (11%) happened during the first hospitalization for EE. A suppressive antibiotic treatment was initiated in 15 (29%) patients, mostly because of not performing surgery. During the 6-year study period an EE relapse occurred in three (6%) patients. Conclusions EE is a worrying disease associated with a high risk of relapse and significant mortality. Suppressive antibiotic therapy could be a key treatment to limit the occurrence of relapses.
Collapse
Affiliation(s)
| | - Véronique Joly
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Diane Le Pluart
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Claire Amaris Hobson
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Anne-Lise Beaumont
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Sylvie Lariven
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Nathalie Grall
- Bacteriology Laboratory, Hôpital Bichat—Claude-Bernard, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Marylou Para
- Cardiology Department, Hôpital Bichat—Claude-Bernard, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Yazdan Yazdanpanah
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - François-Xavier Lescure
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Nathan Peiffer-Smadja
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Laurène Deconinck
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Michael Thy
- Infectious and Tropical Diseases Department, Bichat—Claude-Bernard Hospital, Assistance Publique—Hôpitaux de Paris, Université Paris Cité, Paris, France
- EA7323, Pharmacology and Drug Evaluation in Children and Pregnant Women, Université Paris Cité, Paris, France
| |
Collapse
|
2
|
Rekik S, Pluart DL, Ferré V, Charpentier C, Laurain A, Ghosn J, Abramowitz L. Anogenital symptoms and lesions in a series of 20 patients infected with monkeypox virus. Colorectal Dis 2023; 25:1002-1005. [PMID: 36756717 DOI: 10.1111/codi.16513] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
AIM Monkeypox virus (MPXV) has been spreading in many European countries, the USA and Canada since May 2022. General symptoms, skin and anoperineal lesions have been reported. Anal pain is often reported, but anal canal lesions have yet to be described in these patients. The aim of this study was to describe anoperineal lesions in patients infected with MPXV undergoing systematic margin and anal canal examination at a tertiary care centre in France. METHOD In this prospective descriptive study, systematic anal examination was performed in 20 patients diagnosed with MPXV infection at Bichat Hospital, Paris, France between 6 and 11 July 2022. Anal swabs were also obtained from all these patients for polymerase chain reaction testing for MPXV. RESULTS All the patients were men that have sex with men (MSM). Sixteen patients had anal symptoms: 13 reported anal pain, and the other anal symptoms described were anal bleeding (n = 12), pruritus (n = 11), dyschezia (n = 10), tenesmus (n = 13), burning (n = 3), swelling (n = 9) and discharge of mucus (n = 9). Proctological examination detected: (i) anal margin lesions in 14 patients (vesicles, n = 8; pustules, n = 6; ulceration, n = 6); (ii) anal canal lesions in 16 patients (ulceration, n = 13; ulcers, n = 4; pustules, n = 1), seven of whom presented anal hypertonia; and (iii) rectal lesions in 12 patients (congested rectum, n = 6; erythema, n = 10; ulcers, n = 2; not seen in one case). the presence of mucus was noted in 10 patients and the presence of blood in six patients. CONCLUSION This is the first study to describe anal canal lesions in patients infected with MPXV. Most of the observed lesions were ulceration, accounting for the pain reported.
Collapse
Affiliation(s)
- Samia Rekik
- Service de Gastro-entérologie et Proctologie, AP-HP, Hôpital Bichat Claude-Bernard, Paris, France
| | - Diane Le Pluart
- Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Valentine Ferré
- Service de Virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Charlotte Charpentier
- Service de Virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Anne Laurain
- Service de Gastro-entérologie et Proctologie, AP-HP, Hôpital Bichat Claude-Bernard, Paris, France.,Clinique Blomet, Ramsay Générale de Santé, Paris, France
| | - Jade Ghosn
- Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Laurent Abramowitz
- Service de Gastro-entérologie et Proctologie, AP-HP, Hôpital Bichat Claude-Bernard, Paris, France.,Clinique Blomet, Ramsay Générale de Santé, Paris, France.,Hepato-gastro-enterology Department, Bichat Claude Bernard University Hospital, Paris, France
| |
Collapse
|
3
|
Mailhe M, Beaumont AL, Thy M, Le Pluart D, Perrineau S, Houhou-Fidouh N, Deconinck L, Bertin C, Ferré VM, Cortier M, De La Porte Des Vaux C, Phung BC, Mollo B, Cresta M, Bouscarat F, Choquet C, Descamps D, Ghosn J, Lescure FX, Yazdanpanah Y, Joly V, Peiffer-Smadja N. Clinical characteristics of ambulatory and hospitalized patients with monkeypox virus infection: an observational cohort study. Clin Microbiol Infect 2023; 29:233-239. [PMID: 36028090 PMCID: PMC9533921 DOI: 10.1016/j.cmi.2022.08.012] [Citation(s) in RCA: 92] [Impact Index Per Article: 92.0] [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: 07/27/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES A global outbreak of monkeypox virus infections in human beings has been described since April 2022. The objectives of this study were to describe the clinical characteristics and complications of patients with a monkeypox infection. METHODS All consecutive patients with a polymerase chain reaction (PCR)-confirmed monkeypox infection seen in a French referral centre were included. RESULTS Between 21 May and 5 July 2022, 264 patients had a PCR-confirmed monkeypox infection. Among them, 262 (262/264, 99%) were men, 245 (245/259, 95%) were men who have sex with men, and 90 (90/216, 42%) practiced chemsex in the last 3 months. Seventy-three (73/256, 29%) patients were living with human immunodeficiency virus infection, and 120 (120/169, 71%) patients were taking pre-exposure prophylaxis against human immunodeficiency virus infection. Overall, 112 (112/236, 47%) patients had contact with a confirmed monkeypox case; it was of sexual nature for 95% of the contacts (86/91). Monkeypox virus PCR was positive on the skin in 252 patients, on the oropharyngeal sample in 150 patients, and on blood in eight patients. The majority of patients presented with fever (171/253, 68%) and adenopathy (174/251, 69%). Skin lesions mostly affected the genital (135/252, 54%) and perianal (100/251, 40%) areas. Overall, 17 (17/264, 6%) patients were hospitalized; none of them were immunocompromised. Complications requiring hospitalization included cellulitis (n = 4), paronychia (n = 3), severe anal and digestive involvement (n = 4), non-cardia angina with dysphagia (n = 4), blepharitis (n = 1), and keratitis (n = 1). Surgical management was required in four patients. CONCLUSION The current outbreak of monkeypox infections has specific characteristics: it occurs in the men who have sex with men community; known contact is mostly sexual; perineal and anal areas are frequently affected; and severe complications include superinfected skin lesions, paronychia, cellulitis, anal and digestive involvement, angina with dysphagia, and ocular involvement.
Collapse
Affiliation(s)
- Morgane Mailhe
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Anne-Lise Beaumont
- Infectious and Tropical Diseases Department, Bichat - Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
| | - Michael Thy
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Diane Le Pluart
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Ségolène Perrineau
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Nadhira Houhou-Fidouh
- Virology Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Laurène Deconinck
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Chloé Bertin
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Valentine Marie Ferré
- Virology Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Marie Cortier
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Clémentine De La Porte Des Vaux
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Bao-Chau Phung
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Bastien Mollo
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Mélanie Cresta
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Fabrice Bouscarat
- Dermatology Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Christophe Choquet
- Emergency Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Diane Descamps
- Virology Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Jade Ghosn
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - François-Xavier Lescure
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Yazdan Yazdanpanah
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Véronique Joly
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Nathan Peiffer-Smadja
- Infectious and Tropical Diseases Department, Bichat – Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France,Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France
| |
Collapse
|
4
|
Bertin C, Beaumont AL, Merlant M, Mailhe M, Le Pluart D, Deconinck L, Thy M, Cortier M, Garé M, Dollat M, Rahi M, Joly V, Lariven S, Rioux C, Truong A, Deschamps L, Ferré VM, Charpentier C, Lescure FX, Bouscarat F, Descamps V, Yazdanpanah Y, Peiffer-Smadja N. Erythematous maculopapular rash in monkeypox virus infection: A retrospective case series of 30 patients. J Eur Acad Dermatol Venereol 2023; 37:e638-e641. [PMID: 36648134 DOI: 10.1111/jdv.18876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Affiliation(s)
- Chloé Bertin
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Anne-Lise Beaumont
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Marie Merlant
- Service de Dermatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Morgane Mailhe
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Diane Le Pluart
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Laurène Deconinck
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Michael Thy
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Marie Cortier
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Mathilde Garé
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Marion Dollat
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Mayda Rahi
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Véronique Joly
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Sylvie Lariven
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Christophe Rioux
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Audrey Truong
- Service d'anatomopathologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Lydia Deschamps
- Service d'anatomopathologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Valentine Marie Ferré
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat Claude Bernard, Université Paris Cité, Paris, France
| | - Charlotte Charpentier
- Service de Virologie, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat Claude Bernard, Université Paris Cité, Paris, France
| | - François-Xavier Lescure
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Fabrice Bouscarat
- Service de Dermatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Vincent Descamps
- Service de Dermatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Yazdan Yazdanpanah
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| | - Nathan Peiffer-Smadja
- Department of Infectious and Tropical Diseases, Bichat, Assistance Publique - Hôpitaux de Paris - Claude-Bernard University Hospital, Université Paris Cité, Paris, France
| |
Collapse
|
5
|
Thy M, Peiffer-Smadja N, Mailhe M, Kramer L, Ferré VM, Houhou N, Tarhini H, Bertin C, Beaumont AL, Garé M, Le Pluart D, Perrineau S, Rahi M, Deconinck L, Phung B, Mollo B, Cortier M, Cresta M, De La Porte Des Vaux C, Joly V, Lariven S, Rioux C, Somarriba C, Lescure FX, Charpentier C, Yazdanpanah Y, Ghosn J. Breakthrough Infections after Postexposure Vaccination against Mpox. N Engl J Med 2022; 387:2477-2479. [PMID: 36477495 DOI: 10.1056/nejmc2211944] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Mayda Rahi
- Bichat-Claude Bernard Hospital, Paris, France
| | | | - Bao Phung
- Bichat-Claude Bernard Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Khellaf L, Bouscarat F, Burrel S, Fidouh N, Hachon L, Bucau M, Lariven S, Boutolleau D, Joly V, Ghosn J, Le Pluart D, Thy M. Novel mutations in antiviral multiresistant HSV-2 genital lesion: A case report. J Med Virol 2022; 94:6122-6126. [PMID: 35973907 DOI: 10.1002/jmv.28070] [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: 04/28/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 01/07/2023]
Abstract
HSV-2 antiviral resistance mainly occurs in immunocompromised patients and especially in HIV-positive individuals receiving long-term antiviral treatment. Those situations can be challenging as few alternatives are available for HSV infection management. To describe clinical and virological significance of two novel potential HSV-2 resistance mutations after treating an obese patient with a pseudotumoral genital HSV-related lesion. Consecutive different antiviral treatments were used: valacyclovir (VACV) then foscarnet (FOS) then topical cidofovir (CDV) and finally imiquimod. Under VACV, genotypic resistance testing revealed a novel mutation within viral thymidine kinase (TK, gene UL23) not previously reported but probably accounting for antiviral resistance: W89G, similar to W88R mutation reported in HSV-1 TK, known to be associated with ACV resistance for HSV-1. Under FOS, while initial mutations were still present, a second genotypic resistance testing performed on persisting lesions showed a novel mutation within viral DNA polymerase (DNA pol, gene UL30): C625R. All three antivirals used in this case are small molecules and pharmacokinetics of VACV, FOS, and CDV have not been evaluated in animals and there are very few studies in human. As small molecules are poorly bound to proteins and distribution volume is increased in obese patients, there is risk of underdosage. This mechanism is suspected to be involved in emergence of resistance mutation and further data is needed to adapt, closely to patient profile, antiviral dosage. This report describes a chronic HSV-2 genital lesion, with resistance to current antivirals and novel mutations within viral TK and DNA pol which may confer antiviral resistance.
Collapse
Affiliation(s)
- Lucas Khellaf
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| | - Fabrice Bouscarat
- Department of Dermatology, Hôpital Bichat, Université de Paris, Paris, France
| | - Sonia Burrel
- Department of Virology, Centre National de Référence Herpès virus, Hôpital Pitié-Salpétrière, Sorbonne Université, INSERM U1136, Institut Pierre Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - Nadhira Fidouh
- Department of Virology, Hôpital Bichat, Université de Paris, Paris, France
| | - Lorry Hachon
- Department of Pharmacy, Hôpital Bichat, Université de Paris, Paris, France
| | - Margot Bucau
- Department of Pathology, Hôpital Bichat, Université de Paris, Paris, France
| | - Sylvie Lariven
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| | - David Boutolleau
- Department of Virology, Centre National de Référence Herpès virus, Hôpital Pitié-Salpétrière, Sorbonne Université, INSERM U1136, Institut Pierre Louis d'épidémiologie et de santé publique (IPLESP), Paris, France
| | - Véronique Joly
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| | - Jade Ghosn
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| | - Diane Le Pluart
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| | - Michaël Thy
- Department of Infectious Diseases, Hôpital Bichat, Université de Paris, Paris, France
| |
Collapse
|
7
|
Le Pluart D, Ruyer-Thompson M, Ferré VM, Mailhe M, Descamps D, Bouscarat F, Lescure FX, Lucet JC, Yazdanpanah Y, Ghosn J. A Healthcare-Associated Infection With Monkeypox Virus of a Healthcare Worker During the 2022 Outbreak. Open Forum Infect Dis 2022; 9:ofac520. [PMID: 36324328 PMCID: PMC9620545 DOI: 10.1093/ofid/ofac520] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 08/15/2022] [Accepted: 10/05/2022] [Indexed: 09/01/2023] Open
Abstract
This article describes a case of healthcare-associated monkeypox infection in France during the 2022 outbreak. A female medical resident accidently pricked herself with a soiled subcutaneous needle used to harvest a vesicle of a patient infected by monkeypox virus and developed 4 days later a unique skin lesion, positive for monkeypox virus.
Collapse
Affiliation(s)
- Diane Le Pluart
- Assistance Publique–Hôpitaux de Paris, Infectious and Tropical Diseases Department, Bichat–Claude Bernard Hospital, Paris, France
| | - Mirabelle Ruyer-Thompson
- Assistance Publique–Hôpitaux de Paris, Dermatology Department, Bichat–Claude Bernard Hospital, Paris, France
| | - Valentine Marie Ferré
- Assistance Publique–Hôpitaux de Paris, Department of Virology, Bichat–Claude Bernard Hospital, Paris, France
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| | - Morgane Mailhe
- Assistance Publique–Hôpitaux de Paris, Infectious and Tropical Diseases Department, Bichat–Claude Bernard Hospital, Paris, France
| | - Diane Descamps
- Assistance Publique–Hôpitaux de Paris, Department of Virology, Bichat–Claude Bernard Hospital, Paris, France
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| | - Fabrice Bouscarat
- Assistance Publique–Hôpitaux de Paris, Infection Control Unit, Bichat–Claude Bernard Hospital, Paris, France
| | - François-Xavier Lescure
- Assistance Publique–Hôpitaux de Paris, Infectious and Tropical Diseases Department, Bichat–Claude Bernard Hospital, Paris, France
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| | - Jean-Christophe Lucet
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
- Assistance Publique–Hôpitaux de Paris, Infection Control Unit, Bichat–Claude Bernard Hospital, Paris, France
| | - Yazdan Yazdanpanah
- Assistance Publique–Hôpitaux de Paris, Infectious and Tropical Diseases Department, Bichat–Claude Bernard Hospital, Paris, France
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| | - Jade Ghosn
- Assistance Publique–Hôpitaux de Paris, Infectious and Tropical Diseases Department, Bichat–Claude Bernard Hospital, Paris, France
- Université Paris Cité, Institut national de la santé et de la recherche médicale, Unité mixte de recherche 1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| |
Collapse
|
8
|
Seang S, Burrel S, Todesco E, Leducq V, Monsel G, Le Pluart D, Cordevant C, Pourcher V, Palich R. Evidence of human-to-dog transmission of monkeypox virus. Lancet 2022; 400:658-659. [PMID: 35963267 PMCID: PMC9536767 DOI: 10.1016/s0140-6736(22)01487-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Sophie Seang
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France.
| | - Sonia Burrel
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Eve Todesco
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Valentin Leducq
- Virology Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Gentiane Monsel
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Diane Le Pluart
- Infectious Diseases Department, Bichat-Claude Bernard University Hospital, AP-HP, Paris, France
| | - Christophe Cordevant
- Strategy and Programmes Department, Research and Reference Division, Anses, Maisons-Alfort, France
| | - Valérie Pourcher
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| | - Romain Palich
- Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health institute, INSERM 1136, Paris 75013, France
| |
Collapse
|
9
|
Gourjault C, Tarhini H, Rahi M, Thy M, Le Pluart D, Rioux C, Parisey M, Ismael S, Aidibi AAR, Paradis V, Ghosn J, Yazdanpanah Y, Lescure FX, Gervais A. Cholangitis in three critically ill patients after a severe CoVID-19 infection. IDCases 2021; 26:e01267. [PMID: 34485077 PMCID: PMC8406543 DOI: 10.1016/j.idcr.2021.e01267] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 12/11/2022] Open
Abstract
Coronavirus disease 2019 (CoVID-19) is a viral disease. Although the predominant presentation is respiratory disease, other manifestations such as gastrointestinal manifestations are commonly reported. Nevertheless, it has not been associated with chronic cholangitis or hepatic injury. In this study, we report three cases of severe CoVID-19 infection that required ICU admission, intubation, and sedation with ketamine. All three patients had abnormal liver function despite recovery and were diagnosed with cholangitis in the context of CoVID-19.
Collapse
Affiliation(s)
- Cyrille Gourjault
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Hassan Tarhini
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Mayda Rahi
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Michael Thy
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Diane Le Pluart
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Christophe Rioux
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | - Marion Parisey
- Service de maladies infectieuses et tropicale, Hôpital René Dubos, Pontoise, France
| | - Sophie Ismael
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| | | | - Valerie Paradis
- Centre National de la Recherche Scientifique, Formation de Recherche en Evolution, 2443 Paris, France.,Service d'Anatomie Pathologique, Hôpital Beaujon, Clichy, France
| | - Jade Ghosn
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France.,Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, 75006 Paris, France
| | - Yazdan Yazdanpanah
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France.,Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, 75006 Paris, France
| | - François-Xavier Lescure
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France.,Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, 75006 Paris, France
| | - Anne Gervais
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, 75018 Paris, France
| |
Collapse
|
10
|
Rahi M, Le Pluart D, Beaudet A, Ismaël S, Parisey M, Poey N, Tarhini H, Lescure FX, Yazdanpanah Y, Deconinck L. Sociodemographic characteristics and transmission risk factors in patients hospitalized for COVID-19 before and during the lockdown in France. BMC Infect Dis 2021; 21:812. [PMID: 34388990 PMCID: PMC8361240 DOI: 10.1186/s12879-021-06419-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/01/2020] [Accepted: 07/07/2021] [Indexed: 12/23/2022] Open
Abstract
Background The efficacy of lockdown in containing the COVID-19 pandemic has been reported in different studies. However, the impact on sociodemographic characteristics of individuals infected with SARS-CoV-2 has not been evaluated. The aim of this study was to describe the changes in sociodemographic characteristics of patients hospitalized for COVID-19 and to compare the transmission risk factors of COVID-19 before and during lockdown in France. Methods An observational retrospective study was conducted in a University Hospital in Paris, France. Data from patients hospitalized for COVID-19 in the Infectious Diseases Department between February 26 and May 11, 2020 were collected. The study population was divided into 2 groups: group A of patients infected before lockdown, and group B of patients infected during lockdown, considering a maximum incubation period of 14 days. Sociodemographic characteristics and transmission risk factors were compared between the 2 groups using Student’s t-test for continuous variables and Chi-2 test or Fisher exact test for categorical variables. Results Three hundred eighty-three patients were included in the study, 305 (79.6%) in group A and 78 (20.4%) in group B. Patients in group A were significantly younger (60.0 versus (vs) 66.5 years (p = 0.03)). The professionally active population was larger in group A (44.3% vs 24.4%). There were significantly more non-French-speaking people in group B (16.7% vs 6.6%, p < 0.01). Most patients from group A had individual accommodation (92.8% vs 74.4%, p < 0.01). Contact with a relative was the main transmission risk factor in both groups (24.6% vs 33.3%, p = 0.16). Recent travel and large gathering were found only in group A. The proportion of people living in disadvantaged conditions, such as homeless people or people living in social housing, was significantly higher in group B (11.5% vs 4.3%, p = 0.03) as was the proportion of institutionalized individuals (14.1% vs 3.0%, p < 0.01). Conclusions In this study conducted in patients hospitalized for COVID-19 in Paris, France, the likelihood of being infected despite the lockdown was higher for people who do not speak French, live in social housing, are homeless or institutionalized. Targeted measures have to be implemented to protect these populations.
Collapse
Affiliation(s)
- Mayda Rahi
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Diane Le Pluart
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Alexandra Beaudet
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Sophie Ismaël
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Marion Parisey
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Nora Poey
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Hassan Tarhini
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - François-Xavier Lescure
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| | - Yazdan Yazdanpanah
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France.
| | - Laurène Deconinck
- Infectious and Tropical Diseases Department
- , Bichat - Claude-Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France
| |
Collapse
|
11
|
Delory T, Gravier S, Le Pluart D, Gaube G, Simeon S, Davido B, Piet E, Lepeule R, Lesprit P, Lafaurie M. Temocillin versus carbapenems for urinary tract infection due to ESBL-producing Enterobacteriaceae: a multicenter matched case-control study. Int J Antimicrob Agents 2021; 58:106361. [PMID: 34000372 DOI: 10.1016/j.ijantimicag.2021.106361] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/20/2021] [Accepted: 05/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the efficacy of temocillin with carbapenems for extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae urinary tract infections (ESBL-E UTI). METHODS A multicenter retrospective case-control study of adults with ESBL-E UTI was conducted between January 2015 and October 2019. Cases received temocillin ≥ 50% of the effective antibiotic therapy duration and controls exclusively received carbapenem; they were statistically matched (1:1 ratio) on 6-month period, sex and age. The clinical cure at the end of antibiotic therapy was analysed using conditional logistic regression. RESULTS Seventy-two temocillin cases were matched to 72 carbapenem controls. Most (67%) were male, median age was 69.4 years, 81 (56%) were immunocompromised, including 44 (31%) solid organ transplant recipients. There was no difference between cases and controls for baseline characteristics and microorganisms involved: Klebsiella pneumoniae in 59 (41%), Escherichia coli in 57 (40%), and Enterobacter spp. in 24 (17%). The median time from admission to effective antibiotic therapy was 0 days [range, 0-2]. Among cases, first-line antibiotic therapy (≤ 72 hours) was temocillin in six (8%) and carbapenems in 39 (54%). Temocillin was given at the median daily dose of 4 g [range, 2-4] after 3 days [range, 2-5] of carbapenems. Patients received temocillin for 81% [range, 70-93] of the effective antibiotic course duration over 11 days [range, 8-14]. The effective antibiotic duration was similar in cases and controls (P = 0.067). Clinical cure at the end of antibiotic therapy was 94% (68/72) in cases vs. 99% (71/72) in controls (P = 0.206), with no difference among immunocompromised and solid organ transplant patients (P > 0.050). CONCLUSIONS Temocillin effectively relayed β-lactams, including carbapenems, to treat (complicated) ESBL-E UTI. Its efficacy was consistent among kidney transplant recipients.
Collapse
Affiliation(s)
- Tristan Delory
- APHP, Infectious Diseases and Tropical Medicine Department, Saint-Louis Hospital, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.
| | - Simon Gravier
- APHP, Infectious Diseases and Tropical Medicine Department, Saint-Louis Hospital, Paris, France; Infectious Diseases Department, Hôpitaux Civils de Colmar, Colmar, France
| | - Diane Le Pluart
- Unité Transversale d'hygiène et d'infectiologie, Service de Biologie Clinique, Hôpital Foch, Suresnes, France
| | - Géraldine Gaube
- APHP, Unité Transversale de Traitement des Infections, Département de Prevention Diagnostic et de Traitement des Infections, Hôpital Henri-Mondor, Créteil, France
| | - Soline Simeon
- APHP, Infectious Diseases and Tropical Medicine Department, Raymond-Poincaré, Hospital, Garches, France
| | - Benjamin Davido
- APHP, Infectious Diseases and Tropical Medicine Department, Raymond-Poincaré, Hospital, Garches, France
| | - Emilie Piet
- Infectious Diseases Department, Annecy-Genevois hospital, Epagny-Metz-Tessy, France
| | - Raphaël Lepeule
- APHP, Unité Transversale de Traitement des Infections, Département de Prevention Diagnostic et de Traitement des Infections, Hôpital Henri-Mondor, Créteil, France
| | - Philippe Lesprit
- Unité Transversale d'hygiène et d'infectiologie, Service de Biologie Clinique, Hôpital Foch, Suresnes, France
| | - Matthieu Lafaurie
- APHP, Infectious Diseases and Tropical Medicine Department, Saint-Louis Hospital, Paris, France.
| |
Collapse
|
12
|
Borie R, Savale L, Dossier A, Ghosn J, Taillé C, Visseaux B, Jebreen K, Diallo A, Tesmoingt C, Morer L, Goletto T, Faucher N, Hajouji L, Neukirch C, Phillips M, Stelianides S, Bouadma L, Brosseau S, Ottaviani S, Pluvy J, Le Pluart D, Debray MP, Raynaud-Simon A, Descamps D, Khalil A, Timsit JF, Lescure FX, Descamps V, Papo T, Humbert M, Crestani B, Dieude P, Vicaut E, Zalcman G. Glucocorticoids with low-dose anti-IL1 anakinra rescue in severe non-ICU COVID-19 infection: A cohort study. PLoS One 2020; 15:e0243961. [PMID: 33326457 PMCID: PMC7743937 DOI: 10.1371/journal.pone.0243961] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/02/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The optimal treatment for patients with severe coronavirus-19 disease (COVID-19) and hyper-inflammation remains debated. MATERIAL AND METHODS A cohort study was designed to evaluate whether a therapeutic algorithm using steroids with or without interleukin-1 antagonist (anakinra) could prevent death/invasive ventilation. Patients with a ≥5-day evolution since symptoms onset, with hyper-inflammation (CRP≥50mg/L), requiring 3-5 L/min oxygen, received methylprednisolone alone. Patients needing ≥6 L/min received methylprednisolone + subcutaneous anakinra daily either frontline or in case clinical deterioration upon corticosteroids alone. Death rate and death or intensive care unit (ICU) invasive ventilation rate at Day 15, with Odds Ratio (OR) and 95% CIs, were determined according to logistic regression and propensity scores. A Bayesian analysis estimated the treatment effects. RESULTS Of 108 consecutive patients, 70 patients received glucocorticoids alone. The control group comprised 63 patients receiving standard of care. In the corticosteroid±stanakinra group (n = 108), death rate was 20.4%, versus 30.2% in the controls, indicating a 30% relative decrease in death risk and a number of 10 patients to treat to avoid a death (p = 0.15). Using propensity scores a per-protocol analysis showed an OR for COVID-19-related death of 0.9 (95%CI [0.80-1.01], p = 0.067). On Bayesian analysis, the posterior probability of any mortality benefit with corticosteroids+/-anakinra was 87.5%, with a 7.8% probability of treatment-related harm. Pre-existing diabetes exacerbation occurred in 29 of 108 patients (26.9%). CONCLUSION In COVID-19 non-ICU inpatients at the cytokine release phase, corticosteroids with or without anakinra were associated with a 30% decrease of death risk on Day 15.
Collapse
Affiliation(s)
- Raphael Borie
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Laurent Savale
- Pulmonology Department, Kremlin-Bicêtre University Hospital, AP-HP, Paris-Saclay University, Kremlin-Bicêtre, France
| | - Antoine Dossier
- Internal Medicine Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Jade Ghosn
- Infectious Disease Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Camille Taillé
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Benoit Visseaux
- Virology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Kamel Jebreen
- Biostatistics and Clinical Research Department, University Hospital Lariboisière, AP-HP, Université de Paris, Paris, France
| | - Abourahmane Diallo
- Biostatistics and Clinical Research Department, University Hospital Lariboisière, AP-HP, Université de Paris, Paris, France
| | - Chloe Tesmoingt
- Pharmacy Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Lise Morer
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Tiphaine Goletto
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Nathalie Faucher
- Geriatrics Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Linda Hajouji
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Catherine Neukirch
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Mathilde Phillips
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Sandrine Stelianides
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Lila Bouadma
- Medical and infectious Diseases ICU, Intensive Care Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Solenn Brosseau
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Sébastien Ottaviani
- Rheumatology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Johan Pluvy
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Diane Le Pluart
- Infectious Disease Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Marie-Pierre Debray
- Radiology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Agathe Raynaud-Simon
- Pharmacy Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Diane Descamps
- Virology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Antoine Khalil
- Radiology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Jean Francois Timsit
- Medical and infectious Diseases ICU, Intensive Care Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Francois-Xavier Lescure
- Infectious Disease Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Vincent Descamps
- Dermatology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Thomas Papo
- Internal Medicine Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Marc Humbert
- Pulmonology Department, Kremlin-Bicêtre University Hospital, AP-HP, Paris-Saclay University, Kremlin-Bicêtre, France
| | - Bruno Crestani
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Philippe Dieude
- Rheumatology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | - Eric Vicaut
- Biostatistics and Clinical Research Department, University Hospital Lariboisière, AP-HP, Université de Paris, Paris, France
| | - Gérard Zalcman
- Pulmonology and Thoracic Oncology Department, University Hospital Bichat-Claude Bernard, AP-HP, Université de Paris, Paris, France
| | | |
Collapse
|
13
|
Dubert M, Visseaux B, Isernia V, Bouadma L, Deconinck L, Patrier J, Wicky PH, Le Pluart D, Kramer L, Rioux C, Le Hingrat Q, Houhou-Fidouh N, Yazdanpanah Y, Ghosn J, Lescure FX. Case report study of the first five COVID-19 patients treated with remdesivir in France. Int J Infect Dis 2020; 98:290-293. [PMID: 32619764 PMCID: PMC7326458 DOI: 10.1016/j.ijid.2020.06.093] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 05/12/2020] [Revised: 06/26/2020] [Accepted: 06/26/2020] [Indexed: 12/27/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the virus responsible for the coronavirus disease 2019 (COVID-19) outbreak worldwide. Data on treatment are scare and parallels have been made between SARS-CoV-2 and other coronaviruses. Remdesivir is a broad-spectrum antiviral with efficient in vitro activity against SARS-CoV-2. Evidence of clinical improvement in patients with severe COVID-19 treated with remdesivir is controversial. The aim of this study was to describe the clinical outcomes and virological monitoring of the first five COVID-19 patients admitted to the intensive care unit of Bichat-Claude Bernard University Hospital, Paris, France, for severe pneumonia related to SARS-CoV-2 and treated with remdesivir. Quantitative reverse transcription PCR was used to monitor SARS-CoV-2 in blood plasma and the lower and upper respiratory tract. Among the five patients treated, two needed mechanical ventilation and one needed high-flow cannula oxygen. A significant decrease in SARS-CoV-2 viral load in the upper respiratory tract was observed in most cases, but two patients died with active SARS-CoV-2 replication in the lower respiratory tract. Plasma samples were positive for SARS-CoV-2 in only one patient. Remdesivir was interrupted before the initialy planned duration in four patients, two because of alanine aminotransferase elevations (3 to 5 normal range) and two because of renal failure requiring renal replacement. This case series of five COVID-19 patients requiring intensive care unit treatment for respiratory distress and treated with remdesivir, highlights the complexity of remdesivir use in such critically ill patients.
Collapse
Affiliation(s)
- Marie Dubert
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France.
| | - Benoit Visseaux
- AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France
| | - Valentina Isernia
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Lila Bouadma
- University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Laurène Deconinck
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Juliette Patrier
- University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Paul-Henri Wicky
- University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Diane Le Pluart
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Laura Kramer
- AP-HP. Nord, Pharmacy Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Christophe Rioux
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Quentin Le Hingrat
- AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France
| | - Nadhira Houhou-Fidouh
- AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Yazdan Yazdanpanah
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France
| | - Jade Ghosn
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France
| | - Francois-Xavier Lescure
- AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France
| |
Collapse
|
14
|
Visseaux B, Le Hingrat Q, Collin G, Bouzid D, Lebourgeois S, Le Pluart D, Deconinck L, Lescure FX, Lucet JC, Bouadma L, Timsit JF, Descamps D, Yazdanpanah Y, Casalino E, Houhou-Fidouh N. Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection. J Clin Microbiol 2020; 58:e00630-20. [PMID: 32341142 PMCID: PMC7383528 DOI: 10.1128/jcm.00630-20] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [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: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023] Open
Abstract
In the race to contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), efficient detection and triage of infected patients must rely on rapid and reliable testing. In this work, we performed the first evaluation of the QIAstat-Dx respiratory SARS-CoV-2 panel (QIAstat-SARS) for SARS-CoV-2 detection. This assay is the first rapid multiplex PCR (mPCR) assay, including SARS-CoV-2 detection, and is fully compatible with a non-PCR-trained laboratory or point-of-care (PoC) testing. This evaluation was performed using 69 primary clinical samples (66 nasopharyngeal swabs [NPS], 1 bronchoalveolar lavage fluid sample [BAL], 1 tracheal aspirate sample, and 1 bronchial aspirate sample) comparing SARS-CoV-2 detection with the currently WHO-recommended reverse transcription-PCR (RT-PCR) (WHO-RT-PCR) workflow. Additionally, a comparative limit of detection (LoD) assessment was performed for QIAstat-SARS and WHO-RT-PCR using a quantified clinical sample. Compatibility of sample pretreatment for viral neutralization or viscous samples with the QIAstat-SARS system were also tested. The QIAstat-Dx respiratory SARS-CoV-2 panel demonstrated a sensitivity comparable to that of the WHO-recommended assay with a limit of detection at 1,000 copies/ml. The overall percent agreement between QIAstat-Dx SARS and WHO-RT-PCR on 69 clinical samples was 97% with a sensitivity of 100% (40/40) and specificity at 93% (27/29). No cross-reaction was encountered for any other respiratory viruses or bacteria included in the panel. The QIAstat-SARS rapid multiplex PCR panel provides a highly sensitive, robust, and accurate assay for rapid detection of SARS-CoV-2. This assay allows rapid decisions even in non-PCR-trained laboratory or point-of-care testing, allowing innovative organization.
Collapse
Affiliation(s)
- Benoit Visseaux
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Quentin Le Hingrat
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Gilles Collin
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Donia Bouzid
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service d'Accueil des Urgences, Hôpital Bichat, Paris, France
| | - Samuel Lebourgeois
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Diane Le Pluart
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Laurène Deconinck
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - François-Xavier Lescure
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Christophe Lucet
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Lila Bouadma
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-François Timsit
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Diane Descamps
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Yazdan Yazdanpanah
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Enrique Casalino
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service d'Accueil des Urgences, Hôpital Bichat, Paris, France
| | | |
Collapse
|