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Akroum S, Tubiana S, de Broucker T, Dournon N, Varon E, Ploy MC, Mourvillier B, Oziol E, Lacassin F, Laurichesse H, Hoen B, Duval X, Burdet C. Long-term neuro-functional disability in adult patients with community-acquired bacterial meningitis. Infection 2022; 50:1363-1372. [PMID: 35657529 DOI: 10.1007/s15010-022-01855-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence of neuro-functional disability and its determinants 12 months after community-acquired bacterial meningitis (CABM) in adult patients. METHODS In a prospective multicenter cohort study (COMBAT), all consecutive cases of CABM were enrolled and followed up for 12 months. Neuro-functional disability at 12 months was evaluated using a combination of the Glasgow Outcome Scale (functional disability), and the modified Rankin Disability Scale (physical disability). Factors associated with neuro-functional disability were identified by multivariate logistic regression. RESULTS Among 281 patients, 84 (29.9%) patients exhibited neuro-functional disability at 12 months: 79 (28.1%) with functional disability and 51 (18.1%) with physical disability. Overall, 6 patients (2.1%) died during the follow-up. The most common pathogen identified was Streptococcus pneumoniae (131/272, 48.2%); 77/268 patients (28.7%) had a physical disability at hospital discharge. Factors independently associated with 12-month neuro-functional disability were a pneumococcal meningitis (adjusted OR = 2.8; 95% confidence interval (CI) = [1.3; 6.7]), the presence of a physical disability at hospital discharge (aOR = 2.3; 95%CI = [1.2; 4.4]) and the presence of behavioral disorders at hospital-discharge (aOR = 5.9; 95%CI = [1.6; 28.4]). Dexamethasone use was not significantly associated with neuro-functional disability (OR = 0.2; 95%CI = [< 0.1;1.3]). CONCLUSION Neuro-functional disability is frequently reported 12 months after CABM. Detailed neurological examination at discharge is needed to improve the follow-up. TRIAL REGISTRATION NCT01730690.
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Affiliation(s)
- Souade Akroum
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France
| | - Sarah Tubiana
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Centre de Ressources Biologiques, AP-HP, Hôpital Bichat, 75018, Paris, France
| | | | - Nathalie Dournon
- Service de maladies infectieuses et tropicales, dermatologie, médecine interne, Centre Hospitalier Universitaire de Pointe-à-Pitre, 97159, Pointe-à-Pitre, France
| | - Emmanuelle Varon
- Centre Hospitalier Intercommunal de Créteil, Centre National de Référence des Pneumocoques, 94010, Créteil, France
| | - Marie Cécile Ploy
- Centre Hospitalier Universitaire de Limoges, Observatoire Régional des Pneumocoques, 87000, Limoges, France
| | - Bruno Mourvillier
- Service de Médecine Intensive et Réanimation Polyvalente, CHU Reims, 51100, Reims, France
| | - Eric Oziol
- Service de Médecine Interne, Centre Hospitalier de Béziers, 34500, Béziers, France
| | - Flore Lacassin
- Service de Médecine Interne, Centre Hospitalier Territorial de Nouméa, 98849, Nouméa, France
| | - Henri Laurichesse
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Bruno Hoen
- Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, 54511, Vandoeuvre-lès-Nancy, France
| | - Xavier Duval
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France. .,Université Paris Cité, IAME, INSERM, 75018, Paris, France.
| | - Charles Burdet
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Département d'Epidémiologie, Biostatistique et Recherche, AP-HP, Hôpital Bichat, 75018, Paris, France
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Bonnet B, Cosme J, Dupuis C, Coupez E, Adda M, Calvet L, Fabre L, Saint-Sardos P, Bereiziat M, Vidal M, Laurichesse H, Souweine B, Evrard B. Severe COVID-19 is characterized by the co-occurrence of moderate cytokine inflammation and severe monocyte dysregulation. EBioMedicine 2021; 73:103622. [PMID: 34678611 PMCID: PMC8526358 DOI: 10.1016/j.ebiom.2021.103622] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/10/2021] [Accepted: 09/28/2021] [Indexed: 02/07/2023] Open
Abstract
Background SARS-CoV-2 has been responsible for considerable mortality worldwide, owing in particular to pulmonary failures such as ARDS, but also to other visceral failures and secondary infections. Recent progress in the characterization of the immunological mechanisms that result in severe organ injury led to the emergence of two successive hypotheses simultaneously tested here: hyperinflammation with cytokine storm syndrome or dysregulation of protective immunity resulting in immunosuppression and unrestrained viral dissemination. Methods In a prospective observational monocentric study of 134 patients, we analysed a panel of plasma inflammatory and anti-inflammatory cytokines and measured monocyte dysregulation via their membrane expression of HLA-DR. We first compared the results of patients with moderate forms hospitalized in an infectious disease unit with those of patients with severe forms hospitalized in an intensive care unit. In the latter group of patients, we then analysed the differences between the surviving and non-surviving groups and between the groups with or without secondary infections. Findings Higher blood IL-6 levels, lower quantitative expression of HLA-DR on blood monocytes and higher IL-6/mHLA-DR ratios were statistically associated with the risk of severe forms of the disease and among the latter with death and the early onset of secondary infections. Interpretation The unique immunological profile in patients with severe COVID-19 corresponds to a moderate cytokine inflammation associated with severe monocyte dysregulation. Individuals with major CSS were rare in our cohort of hospitalized patients, especially since the use of corticosteroids, but formed a very severe subgroup of the disease. Funding None.
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Affiliation(s)
- Benjamin Bonnet
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France; Laboratoire d'Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Justine Cosme
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Claire Dupuis
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Elisabeth Coupez
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Mireille Adda
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Laure Calvet
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Laurie Fabre
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Pierre Saint-Sardos
- Laboratoire de Bactériologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Marine Bereiziat
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Magali Vidal
- Service de Maladies Infectieuses et Tropicales, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Henri Laurichesse
- Service de Maladies Infectieuses et Tropicales, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Bertrand Souweine
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Bertrand Evrard
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France; Laboratoire d'Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France.
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3
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Poncet-Megemont L, Paris P, Tronchere A, Salazard JP, Pereira B, Dallel R, Aumeran C, Beytout J, Jacomet C, Laurichesse H, Lesens O, Mrozek N, Vidal M, Moisset X. High Prevalence of Headaches During Covid-19 Infection: A Retrospective Cohort Study. Headache 2020; 60:2578-2582. [PMID: 32757419 PMCID: PMC7436456 DOI: 10.1111/head.13923] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [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: 06/04/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023]
Abstract
Objectives To document the prevalence of new headaches in patients with Covid‐19 infection and the potential association with other neuro‐sensorial symptoms (anosmia and ageusia). The persistence of these symptoms 1 month after recovery was also documented. Background Headaches are a very common symptom of viral infections. Surprisingly, early Chinese studies reported a relatively low prevalence (12‐15%) of headaches associated with Covid‐19. Methods All the patients with laboratory‐confirmed or chest‐CT‐confirmed Covid‐19 infection, diagnosed between February 27th and April 15th, 2020 in the dedicated laboratory of Clermont‐Ferrand University Hospital were followed for 1 month after recovery. Results A total of 139 consecutive patients (mean [SD] age, 48.5 [15.3] years; 87 women [62.6%]) were interviewed 1 month after disappearance of fever and dyspnea (semi‐structured phone interview). Overall, 59.0% (82/139) of people with Covid‐19 had mild disease, 36.7% (51/139) had severe disease, and 4.3% (6/139) had critical illness. Eighty‐two (59.0%; 95% CI: 50.3 to 67.3) reported new headaches during the acute phase and 3.6% (5/139) had persistent headaches 1 month after fever and dyspnea remission. Anosmia and ageusia were also very common, occurring in 60.4% (84/139) and 58.3% (81/139) of the patients, respectively. These 2 symptoms persisted in 14.4% (20/139) and 11.5% (16/139) of Covid‐19 patients 1 month after recovery. Headaches were neither clearly associated with anosmia, nor with ageusia, and were not associated with disease severity (ie, requiring hospitalization or intensive care unit). Conclusion This specific study highlights the high prevalence of new headaches during Covid‐19 infection in French patients. Further studies are needed to refine the characterization of patients with Covid‐19‐associated headaches.
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Affiliation(s)
- Louis Poncet-Megemont
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Pauline Paris
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Amélie Tronchere
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Pascal Salazard
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Radhouane Dallel
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Claire Aumeran
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean Beytout
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Christine Jacomet
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Henri Laurichesse
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Olivier Lesens
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Natacha Mrozek
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Magali Vidal
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Xavier Moisset
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Goncalves-Mendes N, Talvas J, Dualé C, Guttmann A, Corbin V, Marceau G, Sapin V, Brachet P, Evrard B, Laurichesse H, Vasson MP. Impact of Vitamin D Supplementation on Influenza Vaccine Response and Immune Functions in Deficient Elderly Persons: A Randomized Placebo-Controlled Trial. Front Immunol 2019; 10:65. [PMID: 30800121 PMCID: PMC6375825 DOI: 10.3389/fimmu.2019.00065] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [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: 09/07/2018] [Accepted: 01/11/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Immunosenescence contributes to reduced vaccine response in elderly persons, and is worsened by deficiencies in nutrients such as Vitamin (Vit-D). The immune system is a well-known target of Vit-D, which can both potentiate the innate immune response and inhibit the adaptive system, and so modulate vaccination response. Objective: This randomized placebo-controlled double-blind trial investigated whether Vit-D supplementation in deficient elderly persons could improve influenza seroprotection and immune response. Design: Deficient volunteers (Vit-D serum <30 ng/mL) were assigned (V1) to receive either 100,000 IU/15 days of cholecalciferol (D, n = 19), or a placebo (P, n = 19), over a 3 month period. Influenza vaccination was performed at the end of this period (V2), and the vaccine response was evaluated 28 days later (V3). At each visit, serum cathelicidin, immune response to vaccination, plasma cytokines, lymphocyte phenotyping, and phagocyte ROS production were assessed. Results: Levels of serum 25-(OH)D increased after supplementation (D group, V1 vs. V2: 20.7 ± 5.7 vs. 44.3 ± 8.6 ng/mL, p < 0.001). No difference was observed for serum cathelicidin levels, antibody titers, and ROS production in D vs. P groups at V3. Lower plasma levels of TNFα (p = 0.040) and IL-6 (p = 0.046), and higher ones for TFGβ (p = 0.0028) were observed at V3. The Th1/Th2 ratio was lower in the D group at V2 (D: 0.12 ± 0.05 vs. P: 0.18 ± 0.05, p = 0.039). Conclusions: Vit-D supplementation promotes a higher TGFβ plasma level in response to influenza vaccination without improving antibody production. This supplementation seems to direct the lymphocyte polarization toward a tolerogenic immune response. A deeper characterization of metabolic and molecular pathways of these observations will aid in the understanding of Vit-D's effects on cell-mediated immunity in aging. This clinical trial was registered at clinicaltrials.gov as NCT01893385.
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Affiliation(s)
| | - Jérémie Talvas
- University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, Clermont-Ferrand, France
| | - Christian Dualé
- CHU Clermont-Ferrand, INSERM CIC 1405, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Aline Guttmann
- CHU Clermont-Ferrand, Biostatistics Unit, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Violaine Corbin
- CHU Clermont-Ferrand, Infectious Diseases Department, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Geoffroy Marceau
- CHU Clermont-Ferrand, Biochemistry and Molecular Biology Department, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Vincent Sapin
- CHU Clermont-Ferrand, Biochemistry and Molecular Biology Department, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Patrick Brachet
- University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, Clermont-Ferrand, France
| | - Bertrand Evrard
- University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Immunology Department, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Henri Laurichesse
- University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Infectious Diseases Department, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Marie-Paule Vasson
- University of Clermont Auvergne, INRA, UMR 1019 Human Nutrition Unit, Clermont-Ferrand, France.,CHU Clermont-Ferrand, Nutrition Unit, University of Clermont Auvergne, Clermont-Ferrand, France.,Centre Jean Perrin, Nutrition Unit, Clermont-Ferrand, France
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Laurichesse H, Corbin V, Dubray C, Laurichesse G, Bonnet R, Taha M, Beytout J. Protection vaccinale et immunogénicité secondaire à une campagne vaccinale de masse, avec un vaccin monovalent conjugué C, justifiée par des cas groupés sévères d’infection invasive à méningocoques C : bilan épidémiologique et immunologique à distance, 2002–2016. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.072] [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: 11/26/2022]
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Laurichesse G, Casanova S, Corbin V, Laurichesse H, Henquell C, Jacomet C. Régression des marqueurs biologiques d’inflammation et de fibrose hépatique après réponse virologique prolongée secondaire à un traitement par antiviraux oraux d’action directe anti-VHC : bilan du suivi prolongé d’une cohorte de patients F3/F4 co-infectés VIH/VHC. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.208] [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: 11/30/2022]
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Sauvat L, Letertre-Gibert P, Lesens O, Vidal-Roux M, Laurichesse H. Exanthème maculopapuleux et méningocoque. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.071] [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: 11/24/2022]
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Laurichesse G, Casanova S, Mirand A, Corbin V, Letertre P, Mrozek N, Vidal M, Henquel C, Laurichesse H, Jacomet C. Biological hepatic markers of inflammation and fibrosis following durable sustained virological response to direct acting antiviral agents in HIV/HCV co-infected patients: preliminary results from the cohort driven by the CoReVIH at the University-Hospital of Clermont-Ferrand, France. J Virus Erad 2018. [DOI: 10.1016/s2055-6640(20)30393-9] [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] Open
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Saba G, Andrade LF, Gaillat J, Bonnin P, Chidiac C, Illes HG, Laurichesse H, Messika J, Ricard JD, Detournay B, Petitpretz P, de Pouvourville G. Costs associated with community acquired pneumonia in France. Eur J Health Econ 2018; 19:533-544. [PMID: 28547724 DOI: 10.1007/s10198-017-0900-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context. METHODS Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients. RESULTS Five hundred twenty-four patients were enrolled in 40 public centers from October 2011 to April 2014. Average age was 63 (SD 17); 55.0% of them were male. Average length of stay was 15 days (SD 23). Average cost of stay for the French Sickness Fund was €7293 (SD €7363). Average cost of follow-up was €1242 (SD €3000) and decreased steadily through time. When controlling for patient's socioeconomic characteristics, severity of disease and hospital stay, results showed a concave relationship between hospital costs and age. Obesity, the severity of the disease and comorbidities were associated with constantly increasing inpatient costs. Concerning follow-up costs, we found the same concave relationship with age, while gender, a history of pneumonia and severity of the disease were the most important predictors of high costs after discharge. CONCLUSION Pneumocost is the first French study providing a robust estimation of the cost of managing invasive pneumococcal pneumonia in the French context.
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Affiliation(s)
- Grèce Saba
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France
| | - Luiz Flavio Andrade
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
| | | | | | | | | | - Henri Laurichesse
- Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jonathan Messika
- AP-HP, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, 178 rue des Renouillers, 92700, Colombes, France
- INSERM, IAME, UMR 1137, 75018, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018, Paris, France
| | - Jean-Damien Ricard
- AP-HP, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, 178 rue des Renouillers, 92700, Colombes, France
- INSERM, IAME, UMR 1137, 75018, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018, Paris, France
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Andrade LF, Saba G, Ricard JD, Messika J, Gaillat J, Bonnin P, Chidiac C, Illes HG, Laurichesse H, Detournay B, Petitpretz P, de Pouvourville G. Health related quality of life in patients with community-acquired pneumococcal pneumonia in France. Health Qual Life Outcomes 2018; 16:28. [PMID: 29394941 PMCID: PMC5797362 DOI: 10.1186/s12955-018-0854-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 09/13/2017] [Accepted: 01/25/2018] [Indexed: 12/21/2022] Open
Abstract
Background Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. Methods A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. Results Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. “Usual activities” was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. Conclusion This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
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Affiliation(s)
- Luiz Flavio Andrade
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
| | - Grèce Saba
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France
| | - Jean-Damien Ricard
- Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM, IAME, UMR 1137, University of Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018, Paris, France
| | - Jonathan Messika
- Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM, IAME, UMR 1137, University of Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018, Paris, France
| | | | | | | | | | - Henri Laurichesse
- Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
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Pradat P, Pugliese P, Poizot-Martin I, Valantin MA, Cuzin L, Reynes J, Billaud E, Huleux T, Bani-Sadr F, Rey D, Frésard A, Jacomet C, Duvivier C, Cheret A, Hustache-Mathieu L, Hoen B, Cabié A, Cotte L, Chidiac C, Ferry T, Ader F, Biron F, Boibieux A, Miailhes P, Perpoint T, Schlienger I, Lippmann J, Braun E, Koffi J, Longuet C, Guéripel V, Augustin-Normand C, Brochier C, Degroodt S, Pugliese P, Ceppi C, Cua E, Cottalorda J, Courjon J, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Fuzibet J, Garraffo R, Joulie A, Risso K, Mondain V, Naqvi A, Oran N, Perbost I, Pillet S, Prouvost-Keller B, Wehrlen-Pugliese S, Rosenthal E, Sausse S, Rio V, Roger P, Brégigeon S, Faucher O, Obry-Roguet V, Orticoni M, Soavi M, Geneau de Lamarlière P, Laroche H, Ressiot E, Carta M, Ducassou M, Jacquet I, Gallie S, Galinier A, Ritleng A, Ivanova A, Blanco-Betancourt C, Lions C, Debreux C, Obry-Roguet V, Poizot-Martin I, Agher R, Katlama C, Valantin M, Duvivier C, Lortholary O, Lanternier F, Charlier C, Rouzaud C, Aguilar C, Henry B, Lebeaux D, Cessot G, Gergely A, Consigny P, Touam F, Louisin C, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte M, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, Atoui N, Casanova M, Faucherre V, Jacquet J, Le Moing V, Makinson A, Merle De Boever C, Montoya-Ferrer A, Psomas C, Reynes J, Raffi F, Allavena C, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet C, Jovelin T, Hall N, Bernaud C, Morineau P, Reliquet V, Aubry O, Point P, Besnier M, Larmet L, Hüe H, Pineau S, André-Garnier E, Rodallec A, Choisy P, Vandame S, Huleux T, Ajana F, Alcaraz I, Baclet V, Huleux T, Melliez H, Viget N, Valette M, Aissi E, Allienne C, Meybeck A, Riff B, Bani-Sadr F, Rouger C, Berger J, N'Guyen Y, Lambert D, Kmiec I, Hentzien M, Lebrun D, Migault C, Rey D, Batard M, Bernard-Henry C, Cheneau C, de Mautort E, Fischer P, Partisani M, Priester M, Lucht F, Frésard A, Botelho-Nevers E, Gagneux-Brunon A, Cazorla C, Guglielminotti C, Daoud F, Lutz M, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Corbin V, Aumeran C, Baud O, Casanova S, Coban D, Hustache-Mathieu L, Thiebaut-Drobacheff M, Foltzer A, Gendrin V, Bozon F, Chirouze C, Abel S, Cabié A, Césaire R, Santos GD, Fagour L, Najioullah F, Ouka M, Pierre-François S, Pircher M, Rozé B, Hoen B, Ouissa R, Lamaury I. Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"? J Infect 2017; 75:234-241. [PMID: 28579302 DOI: 10.1016/j.jinf.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/17/2017] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients. METHODS All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection. RESULTS Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR. CONCLUSIONS HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.
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Affiliation(s)
- Pierre Pradat
- Center for Clinical Research, Department of Hepatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet, Nice, France
| | - Isabelle Poizot-Martin
- Immuno-hematology Clinic, Assistance Publique - Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, France; Aix-Marseille University, Inserm U912 (SESSTIM), Marseille, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Lise Cuzin
- CHU Toulouse, COREVIH, Toulouse, France; Université de Toulouse III, Toulouse, France; INSERM, UMR, 1027, Toulouse, France
| | - Jacques Reynes
- Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier, Montpellier, France
| | - Eric Billaud
- Department of Infectious Diseases, Hotel Dieu Hospital, Nantes, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, CHU, Reims, France; Université de Reims Champagne-Ardenne, Faculté de médecine, EA-4684/SFR CAP-SANTE, Reims, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg, France
| | - Anne Frésard
- Department of Infectious Diseases, CHU, Saint-Etienne, France
| | - Christine Jacomet
- Department of Infectious Diseases, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Claudine Duvivier
- Department of Infectious Diseases, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | - Antoine Cheret
- Department of Internal Medicine, CHU, Bicètre, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | | | - Bruno Hoen
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, and Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, and Inserm CIC 1424, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France
| | - André Cabié
- Department of Infectious Diseases, CHU de Martinique, Fort-de-France, France; Université des Antilles EA4537 and INSERM CIC1424, Fort-de-France, France
| | - Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France.
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Letertre-Gibert P, Diallo I, Pereira B, Coban D, Heng A, Lesens O, Laurichesse H, Drabo Y, Jacomet C. Atteintes rénales chez les personnes vivant avec le VIH traitées en Afrique par une combinaison antirétrovirale comprenant du tenofovir disoproxil fumarate. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.331] [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: 11/28/2022]
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15
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Chidiac C, Bonnin P, Detournay B, Illes HG, Gaillat J, Laurichesse H, Messika J, Ricard JD, Saba G, Petitpretz P, Pouvourville GD. Streptococcus pneumoniae Community-Acquired Pneumonia (SP-CAP) in a French Cohort of Hospitalized Patients: Economic Burden and Impact on Quality of Life (QoL). Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Christian Chidiac
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | | | - Grèce Saba
- Chair of Health Systems, ESSEC Business School, Cergy-Pontoise, France
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16
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Chidiac C, Laurichesse H, Illes HG, Gaillat J, Bonnin P, Ricard JD, Messika J, Detournay B, Saba G, Petitpretz P, de Pouvourville G. Coût des pneumonies communautaires à pneumocoque hospitalisées en France. Résultats intermédiaires de l’étude prospective PNEUMOCOST. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.04.019] [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: 11/17/2022] Open
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17
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Jacomet C, Illes G, Kwiatkowski F, Vidal M, Mrozek N, Aumeran C, Corbin V, Lesens O, Laurichesse H, Bailly P. Prevalence of aortic valve dystrophy and insufficiency in a cohort of 255 HIV-positive patients followed-up in a cardiology department between 2012 and 2014. Int J Cardiol 2016; 220:82-6. [PMID: 27372049 DOI: 10.1016/j.ijcard.2016.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/26/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To study valve appearance and the presence of valve disease in a cohort of people living with HIV (PLHIV). DESIGN A prospective study of PLHIV examined at the cardiology department of the Clermont Ferrand university hospital group (CHU) between January 1, 2012, and December 31, 2014. Were excluded those with a history of infection associated with a possible endocarditis. METHODS Demographic, medical characteristics and cardiovascular disease risk factors at time of cardiovascular examination and Doppler-echocardiography were recorded and analyzed. RESULTS In total, 903 PLHIV were examined in the infectious diseases department, 255 of whom were included. These consisted of 67 women (26.3%) and 188 men, of a mean age of 51.2±9.7years, in whom coronary artery disease was diagnosed in 18 patients (7.0%), two women and 16 men, representing a prevalence of 3.0% in females and 8.5% in males. The appearance of the aortic cusps was considered dystrophic in 14.1% of cases (36/255), dysplastic in two cases (0.8%), exhibiting a bicuspid deformity in one case. The prevalence of aortic valve abnormality was therefore 6.0% in the women (4/67) and 17.0% in the men (32/188). On facing off this data with the Kora Monica study findings, an increase in prevalence appears only to truly manifest after 50years of age. We registered 35 aortic insufficiency cases (13.7%), representing a higher incidence than that of the Framingham cohort, with age and masculine gender being the determining factors. CONCLUSION Valve disease, along with coronary artery disease, should be closely monitored in PLHIV.
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Affiliation(s)
- C Jacomet
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - G Illes
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - F Kwiatkowski
- Clermont-Ferrand University Hospital, Statistics Department, F-63000 Clermont Ferrand, France.
| | - M Vidal
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - N Mrozek
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - C Aumeran
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - V Corbin
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - O Lesens
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - H Laurichesse
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - P Bailly
- Clermont-Ferrand University Hospital, Cardiology Department and Centre Jean Perrin, Surgical Thoracic Department, F-63000 Clermont Ferrand, France.
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18
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Lesens O, Mihaila L, Robin F, Baud O, Romaszko JP, Tourniac O, Constantin JM, Souweine B, Bonnet R, Bouvet A, Beytout J, Traore O, Laurichesse H. Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a French University Hospital. Infect Control Hosp Epidemiol 2016; 27:984-6. [PMID: 16941329 DOI: 10.1086/504932] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Accepted: 05/13/2005] [Indexed: 11/03/2022]
Abstract
An outbreak of infection with vancomycin-resistantEnterococcus faeciumoccurred at Hôtel-Dieu Hospital (Clermont-Ferrand, France). A case-control study was performed in the infectious diseases and hematology units of the hospital. Urinary catheter use (odds ratio [OR], 12 [95% confidence interval {CI}, 1.5-90];P<.02), prior exposure to a third-generation cephalosporin (OR, 22 [95% CI, 3-152];P= .002), and prior exposure to antianaerobials (OR, 11 [95% CI, 1.5-88];P<.02) were independently predictive of vancomycin-resistantEnterococcus faeciumcarriage.
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Affiliation(s)
- Olivier Lesens
- Service des Maladies Infectieuses et Tropicales, Clermont-Ferrand, France.
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Outh R, Vidal M, Albaret J, Mrozek N, Laurichesse H, Beytout J, Lesens O. ENDO-05 - Impact et pronostic de l’insuffisance rénale aiguë au cours de l’endocardite infectieuse. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30374-2] [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: 10/21/2022]
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20
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de Pouvourville G, Petitprez P, Saba G, Chidiac C, Gaillat J, Laurichesse H, Bonnin P, Ricard J, Messika J, Detournay B. SP-07 - Qualité de vie des patients hospitalisés après un épisode d’infection au pneumocoque. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30508-x] [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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21
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Laurichesse G, Casanova S, Corbin V, Mirand A, Henquell C, Lesens O, Jacomet C, Beytout J, Laurichesse H. HEP-06 - Nouveaux antiviraux oraux contre le virus de l’hépatite C chez des patients co-infectés VIH-VHC : remarquables résultats des combinaisons orales sans interféron, 2014-2015. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30383-3] [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: 10/21/2022]
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22
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Laurichesse G, Casanova S, Mirand A, Corbin V, Mrozek N, Vidal M, Henquell C, Beytout J, Jacomet C, Laurichesse H. Effectiveness of oral direct antiviral agents against chronic hepatitis C virus infection for HIV/HCV co-infected patients: a success story from a prospective cohort. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)31204-8] [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: 11/26/2022] Open
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23
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Jouannic JM, Favre R, Benachi A, Laurichesse H. Réponse à l’article : « L’interruption médicale de grossesse sans fœticide : enquête nationale » par Chappé et al. J Gynecol Obstet Biol Reprod 2015 Jul 20 [Epub ahead of print]. ACTA ACUST UNITED AC 2016; 45:97-8. [DOI: 10.1016/j.jgyn.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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24
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Lelong A, Laurichesse H, Perthus, Vendittelli F, Gerbaud L. Measuring the impact of social deprivation on pregnancy: results from the CAFE study. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.061] [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: 11/13/2022] Open
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25
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Outh R, Makarawiez C, Le Quang C, Laurichesse H, Vendittelli F, Le Guenno G, Rieu V, Ruivard M. Prophylaxie chez des femmes enceintes ayant des antécédents de maladie thromboembolique veineuse : analyse rétrospective monocentrique. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Lesens O, Desbiez F, Theïs C, Ferry T, Bensalem M, Laurichesse H, Tauveron I, Beytout J, Aragón Sánchez J. Staphylococcus aureus–Related Diabetic Osteomyelitis. INT J LOW EXTR WOUND 2014; 14:284-90. [DOI: 10.1177/1534734614559931] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and can be treated medically or by surgery. We investigated the outcome of consecutive patients with a diagnosis of S aureus DFO retrospectively in 4 hospitals according to the type of management, medical (including debridement at bedside) or surgical. The outcome was classified as either favorable or failure (relapse, impaired wound healing, or amputation). Seventy-four patients with S aureus DFO, including 26 with methicillin-resistant S aureus, were included with a mean duration of follow-up of 21 ± 1 months. As part of the initial treatment, 47% underwent bone surgery followed with a short course of antibiotic. Others were treated with antibiotic therapy alone with bedside debridement. The outcome was favorable for 84% of these patients, with similar rates in the surgical and medical groups (80% vs 87%, P > .05). Patients in the medical group were less frequently hospitalized (49% vs 94%, P < .001) and had a shorter length of hospital stay (17 ± 3 vs 50 ± 12 days, P = .004). Patients in the surgery group received a shorter course of antibiotic therapy (10 ± 2 vs 11 ± 1 weeks, P = .001) with fewer side effects (9% vs 33%, P = .01). The type of management was not associated with subsequent new episode of noncontiguous DFO, which developed in 32% of cases. In conclusion, except significant differences in duration of hospitalization and antibiotic therapy, medical and surgical management of S aureus DFO had similar outcomes with a cure rate >80%.
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Affiliation(s)
- Olivier Lesens
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Françoise Desbiez
- Service d’endocrinologie Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Clément Theïs
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Tristant Ferry
- University of Lyon Claude Bernard, Lyon, France
- Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Henri Laurichesse
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | | | - Jean Beytout
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
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27
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Sciauvaud J, Rigal E, Pascal J, Nourrisson C, Poirier P, Poirier V, Vidal M, Mrozek N, Laurichesse H, Beytout J, Labbe A, Lesens O. Transmission of infectious diseases from internationally adopted children to their adoptive families. Clin Microbiol Infect 2014; 20:746-51. [DOI: 10.1111/1469-0691.12454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 11/05/2013] [Accepted: 11/07/2013] [Indexed: 11/28/2022]
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28
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Bonnin N, Laurichesse H, Beytout J, Mrozek N, Lesens O, André M, Aumaître O, Bacin F, Romazko JP, Chiambaretta F. Ophthalmologists play a key role in the management of syphilis presenting with ocular involvement. Acta Ophthalmol 2014; 92:e328-9. [PMID: 24330492 DOI: 10.1111/aos.12315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nicolas Bonnin
- Ophthalmology department; RMND-M2O Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
- Biochemistry Laboratory; Medicine Faculty; EA 7281 R2D2; Auvergne University; Clermont-Ferrand France
| | - Henri Laurichesse
- Infectious Diseases department; RHEUNNIRS Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Jean Beytout
- Infectious Diseases department; RHEUNNIRS Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Natacha Mrozek
- Infectious Diseases department; RHEUNNIRS Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Olivier Lesens
- Infectious Diseases department; RHEUNNIRS Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Marc André
- Internal Medicine department; RMND-M2O Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Olivier Aumaître
- Internal Medicine department; RMND-M2O Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Franck Bacin
- Ophthalmology department; RMND-M2O Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Jean-Pierre Romazko
- Bacteriology laboratory; Biology Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
| | - Frédéric Chiambaretta
- Ophthalmology department; RMND-M2O Pole; Clermont-Ferrand University Hospital; Clermont-Ferrand France
- Biochemistry Laboratory; Medicine Faculty; EA 7281 R2D2; Auvergne University; Clermont-Ferrand France
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29
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Grobost V, Rigal E, Pavier Y, Vidal M, Mrozek N, Beytout J, Laurichesse H, Lesens O. Suppressive therapy using azithromycin in 2 rare cases of recurrent staphylococcal infections. Diagn Microbiol Infect Dis 2014; 79:90-2. [PMID: 24629578 DOI: 10.1016/j.diagmicrobio.2014.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/17/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
Recurrent staphylococcal skin and soft tissue infections may recur despite decontamination and multiple courses of antibiotic therapy and may dramatically impair the patient's quality of life. We report successful use of long-term azithromycin prophylaxis in a recurrent laryngitis and a scalp folliculitis due to methicillin-susceptible Staphylococcus aureus.
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Affiliation(s)
- Vincent Grobost
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France.
| | - Emilie Rigal
- Department of Dermatology, CHU Estaing, 1 Place Lucie et Raymond Aubrac 63100 Clermont-Ferrand, France
| | - Yoann Pavier
- Department of Otorhinolaryngology, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Magali Vidal
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Natacha Mrozek
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Jean Beytout
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Henri Laurichesse
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Olivier Lesens
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
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30
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Chidiac C, Laurichesse H, Illes G, Gaillat J, Bonnin P, Ricard JD, Messika J, Detournay B, Saba G, Petitpretz P, De Pouvourville G. 777Cost of Treating Patients with Pneumococcal Community-Acquired Pneumonia (CAP) in French Hospitals: Interim Results of the Prospective PNEUMOCOST Study. Open Forum Infect Dis 2014. [DOI: 10.1093/ofid/ofu052.485] [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: 11/13/2022] Open
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31
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Archimbaud C, Ouchchane L, Mirand A, Chambon M, Demeocq F, Labbé A, Laurichesse H, Schmidt J, Clavelou P, Aumaître O, Regagnon C, Bailly JL, Henquell C, Peigue-Lafeuille H. Improvement of the management of infants, children and adults with a molecular diagnosis of Enterovirus meningitis during two observational study periods. PLoS One 2013; 8:e68571. [PMID: 23874676 PMCID: PMC3708915 DOI: 10.1371/journal.pone.0068571] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 01/11/2013] [Accepted: 05/29/2013] [Indexed: 12/02/2022] Open
Abstract
Enteroviruses (EVs) are a major cause of aseptic meningitis, and RNA detection using molecular assay is the gold standard diagnostic test. The aim of this study was to assess the impact of an EV positive diagnosis on the clinical management of patients admitted for meningitis over the course of two observational study periods (2005 and 2008–09) in the same clinical departments. We further investigated in multivariate analysis various factors possibly associated with hospital length of stay (LOS) in all age groups (infants, children, and adults). The results showed an overall improvement in the management of patients (n = 142) between the study periods, resulting in a significantly shorter hospital LOS for adults and children, and a shorter duration of antibiotic use for adults and infants. In multivariate analysis, we observed that the time from molecular test results to discharge of patients and the median duration of antibiotic treatment were associated with an increase in LOS in all age groups. In addition, among adults, the turnaround time of the molecular assay was significantly correlated with LOS. The use of CT scan in children and hospital admission outside the peak of EV prevalence in infants tended to increase LOS. In conclusion, the shorter length of stay of patients with meningitis in this study was due to various factors including the rapidity of the EV molecular test (particularly in adults), greater physician responsiveness after a positive result (in adults and children), and greater experience on the part of physicians in handling EV meningitis, as evidenced by the shorter duration of antibiotic use in adults and infants.
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Affiliation(s)
- Christine Archimbaud
- Université d'Auvergne, Laboratoire de Virologie - EPIE EA4843, Clermont-Ferrand, France.
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32
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Mazeau P, Curinier S, Kandem-Simo A, Delabaere A, Laurichesse H, Lemery D, Gallot D. [Prenatal diagnosis and evolution of patent urachus]. ACTA ACUST UNITED AC 2013; 43:393-6. [PMID: 23523249 DOI: 10.1016/j.jgyn.2013.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 02/01/2013] [Accepted: 02/15/2013] [Indexed: 11/17/2022]
Abstract
Prenatal ultrasonographic features of patent urachus consist in anechoic proximal cord cyst communicating with the bladder associated with large umbilicus. Distinction should be made with omphalocele and bladder extrophy. Spontaneous evolution leads to rupture during mid-trimester and bladder protrusion. Karyotyping is not mandatory in isolated typical cases. Early postnatal surgery is usually required.
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Affiliation(s)
- P Mazeau
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - S Curinier
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - A Kandem-Simo
- Service de chirurgie pédiatrique, pôle de pédiatrie, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - A Delabaere
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France; R2D2-EA7281, faculté de médecine, université d'Auvergne, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - H Laurichesse
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - D Lemery
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France
| | - D Gallot
- Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France; R2D2-EA7281, faculté de médecine, université d'Auvergne, place Henri-Dunant, 63000 Clermont-Ferrand, France.
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Laurichesse H, Zimmermann U, Galtier F, Launay O, Duval X, Richard P, Sadorge C, Soubeyrand B. Immunogenicity and safety results from a randomized multicenter trial comparing a Tdap-IPV vaccine (REPEVAX®) and a tetanus monovalent vaccine in healthy adults: new considerations for the management of patients with tetanus-prone injuries. Hum Vaccin Immunother 2012; 8:1875-81. [PMID: 23032160 PMCID: PMC3656080 DOI: 10.4161/hv.22083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED In adults with a tetanus-prone injury, combined vaccines such as Tdap-IPV (REPEVAX®) can boost immunity against several diseases simultaneously. This Phase IIIb, parallel-group, open-label trial compared antibody responses to Tdap-IPV and tetanus monovalent vaccine (TMV; Vaccin Tétanique Pasteur® or Tetavax®) against tetanus toxoid 10 and 28 d post-vaccination. Between July and December 2009, four centers in France and five in Germany recruited healthy adults who had received a tetanus-containing vaccine 5-10 y previously. Participants were randomized 1:1 to receive at the first visit a single dose (0.5 mL) of Tdap-IPV or TMV, with follow-up visits at Day 10 and Day 28. OUTCOMES per protocol (PP) population immunogenicity at Day 10 (primary) and at Day 28 (secondary); safety throughout the study. Of 456 adults randomized, 223 received Tdap-IPV and 233 received TMV (PP population: 183 and 199 participants, respectively). All participants receiving Tdap-IPV and 99.0% receiving TMV had an anti-tetanus antibody concentration ≥ 0.1 IU/mL, confirming non-inferiority of Tdap-IPV to TMV (95% confidence interval of the difference: -1.2, 3.6). Number of adverse events reported was comparable in each group. Injection-site reactions were reported by 76.6% participants receiving Tdap-IPV and 74.6% receiving TMV. Systemic events (e.g., malaise, myalgia and headache) were reported in 47.7% and 39.7% of the Tdap-IPV and the TMV groups, respectively. Tdap-IPV is effective and well-tolerated for use in the management of tetanus-prone injuries in emergency settings in persons for whom a booster against diphtheria, pertussis and poliomyelitis is also needed.
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Affiliation(s)
- Henri Laurichesse
- CHU Clermont-Ferrand, INSERM/Centre d'Investigation Clinique (CIC) 501, UMR 1019 INRA-UdA, Univ-Clermont-1, Clermont-Ferrand, France
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Duval X, Caplanusi A, Laurichesse H, Deplanque D, Loulergue P, Vaman T, Launay O, Gillard P. Flexibility of interval between vaccinations with AS03A-adjuvanted influenza A (H1N1) 2009 vaccine in adults aged 18-60 and >60 years: a randomized trial. BMC Infect Dis 2012; 12:162. [PMID: 22824474 PMCID: PMC3522029 DOI: 10.1186/1471-2334-12-162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 07/14/2011] [Accepted: 06/29/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Flexibility of vaccination schedule and lower antigen content can facilitate pandemic vaccine coverage. We assessed the immune response and safety of AS03-adjuvanted A/California/7/2009 H1N1 pandemic vaccine containing half of the registered adult haemagglutinin (HA) antigen content, administered as a two-dose schedule at intervals of 21 days or 6 months in both young and elderly adults. METHODS In this open-label randomized trial, healthy adults aged 18-60 years (N = 163) and >60 years (N = 143) received AS03A-adjuvanted A/California/7/2009 H1N1 vaccine containing 1.9 μg HA on Day 0. A second dose was given on Day 21 (n = 177) or Day 182 (n = 106). Haemagglutination-inhibition (HI) antibody responses were analyzed on Days 0, 21, 42, 182, 364 and additionally on Day 203 for subjects vaccinated on Day 182. Solicited and unsolicited adverse events were recorded. RESULTS The HI antibody response in both age strata 21 days after the first dose met and exceeded all regulatory acceptance criteria although the results suggested a lower response in the older age stratum (geometric mean titres [GMTs] for HI antibodies of 420.5 for subjects aged 18-60 years and 174.4 for those >60 years). A second dose of AS03A adjuvanted A/H1N1/2009 vaccine induced a further increase in antibody titres and the response was similar whether the second dose was administered at 21 days (GMTs of 771.8 for 18-60 years and 400.9 for >60 years) or 6 months (GMTs of 708.3 for 18-60 years and 512.1 for >60 years) following the first dose. Seroprotection rates remained high at 6 months after one dose or two doses while at 12 months rates tended to be higher for the 6 month interval schedule (93.3% for 18-60 years and 80.4% for >60 years) than the 21 day schedule (82.3% for 18-60 years and 50.0% for >60 years). Reactogenicity/safety profiles were similar for both schedules, there was no evidence of an increase in reactogenicity following the second dose. CONCLUSIONS The results indicate that flexibility in the dosing interval for AS03A adjuvanted vaccine may be possible. Such flexibility could help to reduce the logistic stress on delivery of pandemic vaccination programmes. TRIAL REGISTRATION ClinicalTrials.gov, NCT00975884.
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Affiliation(s)
- Xavier Duval
- Université Paris Diderot, Sorbonne Paris Cité, Paris, UMR 738, France.
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Lesens O, Schmidt A, De Rancourt F, Poirier V, Labbe A, Laurichesse H, Marty L, Beytout J, Vorilhon P. Health care support issues for internationally adopted children: a qualitative approach to the needs and expectations of families. PLoS One 2012; 7:e31313. [PMID: 22363614 PMCID: PMC3282684 DOI: 10.1371/journal.pone.0031313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 04/24/2011] [Accepted: 01/05/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Families of internationally adopted children may face specific problems with which general practitioners (GPs) may not be familiar. The aim of the study was to explore problems faced by families before, during and after the arrival of their internationally adopted child and to assess the usefulness of a specific medical structure for internationally adopted children, which could be a resource for the GP. METHODOLOGY/PRINCIPAL FINDINGS We conducted a qualitative study using individual semistructured guided conversations and interviewed 21 families that had adopted a total of 26 children internationally in the Puy de Dome department, France, in 2003. Quantitative data were used to describe the pathologies diagnosed and the investigations performed.Our study showed that the history of these families, from the start of the adoption project to its achievement, is complex and warrants careful analysis. Health-care providers should not only consider the medical aspects of adoption, but should also be interested in the histories of these families, which may play a role in the forming of attachments between the adoptee and their adoptive parents and prevent further trouble during the development of the child. We also showed that adoptive parents have similar fears or transient difficulties that may be resolved quickly by listening and reassurance. Most such families would support the existence of a specific medical structure for internationally adopted children, which could be a resource for the general practitioner. However, the health-care providers interviewed were divided on the subject and expressed their fear that a special consultation could be stigmatizing to children and families. CONCLUSIONS/SIGNIFICANCE A specific consultation with well-trained and experienced practitioners acting in close collaboration with GPs and paediatricians may be of help in better understanding and supporting adopted children and their families.
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Affiliation(s)
- Olivier Lesens
- Clermont Université Laboratoire Microorganismes: Génome Environnement (LMGE), Université d'Auvergne, Clermont-Ferrand, France.
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Mrozek N, Pereira B, Soubrier M, Gourdon F, Laurichesse H. Screening of tuberculosis before biologics. Med Mal Infect 2012; 42:1-4. [DOI: 10.1016/j.medmal.2011.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 03/20/2011] [Accepted: 08/03/2011] [Indexed: 12/31/2022]
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Bommenel T, Launay O, Meynard JL, Gilquin J, Katlama C, Lascaux AS, Mahamat A, Martinez V, Pradier C, Rouveix E, Simon A, Costagliola D, Abgrall S, Abgrall S, Barin F, Bentata M, Billaud E, Boue F, Burty C, Cabie A, Costagliola D, Cotte L, de Truchis P, Duval X, Duvivier C, Enel P, Gasnault J, Gaud C, Gilquin J, Grabar S, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary-Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorge F, Poizot-Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot-Dupont H, Viard JP, Viget N, Brosseau M, Salomon V, Jacquemet N, Guiguet M, Lanoy E, Lievre L, Selinger-Leneman H, Lacombe JM, Potard V, Bricaire F, Herson S, Desplanque N, Girard PM, Meyohas MC, Picard O, Cadranel J, Mayaud C, Clauvel JP, Decazes JM, Gerard L, Molina JM, Diemer M, Sellier P, Honore P, Jeantils V, Tassi S, Mechali D, Taverne B, Bouvet E, Crickx B, Ecobichon JL, Picard-Dahan C, Yeni P, Berthe H, Dupont C, Chandemerle C, Mortier E, Tisne-Dessus D, Weiss L, Salmon D, Auperin I, Roudiere L, Fior R, Delfraissy JF, Goujard C, Jung C, Lesprit P, Vittecoq D, Fraisse P, Rey D, Beck-Wirth G, Stahl JP, Lecercq P, Gourdon F, Laurichesse H, Fresard A, Lucht F, Bazin C, Verdon R, Chavanet P, Arvieux C, Michelet C, Choutet P, Goudeau A, Maitre MF, Hoen B, Elinger P, Faller JP, Borsa-Lebas F, Caron F, Daures JP, May T, Rabaud C, Berger JL, Remy G, Arlet-Suau E, Cuzin L, Massip P, Thiercelin Legrand MF, Pontonnier G, Yasdanpanah Y, Dellamonica P, Pugliese P, Aleksandrowicz K, Quinsat D, Ravaux I, Delmont JP, Moreau J, Gastaut JA, Retornaz F, Soubeyrand J, Galinier A, Ruiz JM, Allegre T, Blanc PA, Bonnet-Montchardon D, Lepeu G, Granet-Brunello P, Esterni JP, Pelissier L, Cohen-Valensi R, Nezri M, Chapadaud S, Laffeuillade A, Raffi F, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Trepo C, Strobel M, Bissuel F, Pradinaud R, Sobesky M, Contant M. Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir. J Antimicrob Chemother 2011; 66:1869-77. [DOI: 10.1093/jac/dkr208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lesens O, Desbiez F, Vidal M, Robin F, Descamps S, Beytout J, Laurichesse H, Tauveron I. Culture of per-wound bone specimens: a simplified approach for the medical management of diabetic foot osteomyelitis. Clin Microbiol Infect 2011; 17:285-91. [DOI: 10.1111/j.1469-0691.2010.03194.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Caillaud D, Evrard B, Laurichesse H, Souweine B. Rôle des endotoxines de l’environnement intérieur dans les symptômes asthmatiques. ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2010.12.004] [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: 12/01/2022]
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Loulergue P, Duval X, Galtier F, Lenzi N, Laurichesse H, Launay O. Questions for Biotechs: REIVAC. Human Vaccines 2011; 7:142-3. [DOI: 10.4161/hv.7.2.15130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Aumeran C, Poincloux L, Souweine B, Robin F, Laurichesse H, Baud O, Bommelaer G, Traoré O. Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010; 42:895-9. [PMID: 20725887 DOI: 10.1055/s-0030-1255647] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Infection is a recognized complication of endoscopic retrograde cholangiopancreatography (ERCP). We describe the epidemiologic and molecular investigations of an outbreak of ERCP-related severe nosocomial infection due to KLEBSIELLA PNEUMONIAE producing extended-spectrum beta-lactamase (ESBL). PATIENTS AND METHODS We conducted epidemiologic and molecular investigations to identify the source of the outbreak in patients undergoing ERCP. We carried out reviews of the medical and endoscopic charts and microbiological data, practice audits, surveillance cultures of duodenoscopes and environmental sites, and molecular typing of clinical and environmental isolates. RESULTS Between December 2008 and August 2009, 16 patients were identified post-ERCP with KLEBSIELLA PNEUMONIAE that produced extended-spectrum beta-lactamase type CTX-M-15. There were 8 bloodstream infections, 4 biliary tract infections, and 4 cases of fecal carriage. The microorganism was isolated only from patients who had undergone ERCP. Environmental investigations found no contamination of the washer-disinfectors or the surfaces of the endoscopy rooms. Routine surveillance cultures of endoscopes were repeatedly negative during the outbreak but the epidemic strain was finally isolated from one duodenoscope by flushing and brushing the channels. Molecular typing confirmed the identity of the clinical and environmental strains. Practice audits showed that manual cleaning and drying before storage were insufficient. Strict adherence to reprocessing procedures ended the outbreak. CONCLUSIONS The endoscopes used for ERCP can act as a reservoir for the emerging ESBL-producing K. PNEUMONIAE. Regular audits to ensure rigorous application of cleaning, high-level disinfection, and drying steps are crucial to avoid contamination.
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Affiliation(s)
- C Aumeran
- Service d'Hygiène Hospitalière, CHU Clermont-Ferrand, France
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Abstract
INTRODUCTION Endotoxin is a collective term designating a characteristic group of chemical constituents of the outer membrane of Gram negative bacteria, the lipopolysaccharides (LPS). BACKGROUND LPS provocation tests in healthy subjects (50 microg) induce asthma-like airflow obstruction with a neutrophilic inflammatory influx, similar to reactions observed in non-atopic asthma. Asthmatic subjects show the same reaction with smaller doses of LPS (20 microg), revealing higher sensitivity to LPS than normal subjects. Low levels (2 microg) of LPS do not induce either airflow obstruction or bronchial hyperreactivity. Among exposed workers, particularly in agriculture, endotoxin is the most significant component of the bioaerosol that is associated with airway disease. In clinical studies, exposure to LPS is associated with severe asthma. Conversely, epidemiological studies, in both urban and rural areas, assessing the relationship between exposure to LPS and asthma and asthma- related symptoms are inconsistent. PERSPECTIVES Longitudinal epidemiological studies, especially in farm children, may confirm the putative protective effects of LPS with respect to atopic asthma. CONCLUSION Exposure to indoor LPS is frequently associated with asthma and asthma-like symptoms in current studies. Their definitive role needs to be confirmed by birth cohort studies currently under way that should define the controversial protective effect of LPS with respect to atopic asthma in farming populations.
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Affiliation(s)
- D Caillaud
- Service de Pneumologie, CHU de Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, France.
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Corbin V, Vidal M, Beytout J, Laurichesse H, D'Incan M, Souteyrand P, Lesens O. [Prognostic value of the LRINEC score (Laboratory Risk Indicator for Necrotizing Fasciitis) in soft tissue infections: a prospective study at Clermont-Ferrand University hospital]. Ann Dermatol Venereol 2009; 137:5-11. [PMID: 20110062 DOI: 10.1016/j.annder.2009.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The LRINEC score was developed in a retrospective study in order to distinguish necrotizing fasciitis from severe soft tissue infections using laboratory data. AIM To evaluate the prognostic value of the LRINEC score in infectious cellulitis. PATIENTS AND METHODS A prospective study was performed at the departments of infectious diseases and dermatology of the Clermont-Ferrand University Hospital. The three evaluation criteria were: time from initiation of antibiotics to regression of erythema, duration of fever and occurrence of complications (abscess, surgery, septic shock, necrotizing fasciitis, death, transfer to intensive care). Potential predictive variables were: LRINEC score>6 at admission, comorbidities, local appearance, clinical presentation and soft tissue ultrasound results. RESULTS Fifty patients were included. The rate of complications was higher for patients with a LRINEC score>6 (54%) than for patients with a score<6 (12%, P=0.008). However, a LRINEC score>6 on admission was not significantly associated with increased duration of erythema or of fever. Prior lymphoedema was associated with a better prognosis. DISCUSSION The LRINEC score may be a useful tool for the detection of complicated forms of soft tissue infections. Patients with a LRINEC score>6 on admission should be carefully evaluated (hospitalization, surgical assessment, close monitoring).
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Affiliation(s)
- V Corbin
- Service des maladies infectieuses et tropicales, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
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Vacher A, Chabrot P, Cassagnes L, Lesens O, Buc E, Pezet D, Laurichesse H, Boyer L. [Role of endovascular treatment of symptomatic splanchnic artery stenoses in HIV patients: report of three cases]. ACTA ACUST UNITED AC 2009; 90:221-4. [PMID: 19308007 DOI: 10.1016/s0221-0363(09)72473-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Patients with HIV or AIDS frequently present with GI symptoms, sometimes due to early and diffuse atherosclerosis. We report 3 cases of HIV patients with abdominal pain due to severe splanchnic arterial stenosis. Only one patient presented typical clinical findings of mesenteric ischemic. Endovascular treatment was performed in all three cases. Good clinical outcome was immediate in 2 cases. In the third case, subsequent bowel resection was required due to irreversible ischemic injury in spite of local thrombolysis and endovascular revascularization in a patient presenting with acute severe mesenteric ischemia. In all three cases, vascular patency was demonstrated at follow-up. Mesenteric ischemia is a severe complication requiring early diagnosis in HIV patients, especially those with vascular risk factors, especially since endovascular treatment is a valid therapeutic option.
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Affiliation(s)
- A Vacher
- Services de Radiologie B, Chirurgie Digestive, et Maladies infectieuses et Tropicales, CHU Clermont-Ferrand, 63003 Clermont-Ferrand
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Pialoux G, Salmi R, Laurichesse H, Mitanchez D, Foliguet B, Isnard Bagnis C. Souvenirs de la correction d’ECN 2008. Florilège à l’usage de ceux qui nous suivront à Rungis. Med Mal Infect 2009; 39:1-3. [DOI: 10.1016/j.medmal.2008.10.004] [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] [Received: 09/09/2008] [Revised: 10/08/2008] [Accepted: 10/13/2008] [Indexed: 11/26/2022]
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Mrozek N, Hamizi S, Gourdon F, Laurichesse H, Beytout J, Lesens O. [Potential nosocomial disseminated infection due to Nocardia asteroides after a prosthesis insertion in an immunocompetent patient]. Rev Med Interne 2008; 29:1034-7. [PMID: 18395304 DOI: 10.1016/j.revmed.2008.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Accepted: 02/21/2008] [Indexed: 10/22/2022]
Abstract
Nocardia infections are rare and usually occurred in immunocompromised patients with systemic dissemination from a lung infection. We report a case of an immunocompetent patient in whom Nocardia asteroides had cause psoas and cerebral abcess without pulmonary infection, a short period after a hip prosthesis insertion. The clinical history is highly suggestive of a hospital-acquired infection.
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Affiliation(s)
- N Mrozek
- Service des maladies infectieuses et tropicales, Hôtel-Dieu, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Dutheil F, Kelly C, Biat I, Provost D, Baud O, Laurichesse H, Chamoux A. [Relation between the level of knowledge and the rate of vaccination against the flu virus among the staff of the Clermont-Ferrand University hospital]. Med Mal Infect 2008; 38:586-94. [PMID: 18976872 DOI: 10.1016/j.medmal.2008.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2008] [Revised: 05/29/2008] [Accepted: 09/17/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The main aim of this study was to determine how much staff at the Clermont-Ferrand university hospital, France, knew about influenza and its relation with the vaccinal rate. The other aim was to develop better-targeted information campaigns and prevention policy in the work place. DESIGN A self-administered questionnaire was sent to the 7601 salaried staff of the hospital in May 2005. The staff was asked to give details on socioprofessional characteristics, vaccinal status, and knowledge about the influenza virus (mode of transmission, contagiousness, measures of prevention, populations affected, mortality, vaccination schedule, and vaccination target populations). Multiple-choice questions on knowledge of influenza were scored according to the answer given. RESULTS The response rate was 26.5%. The 2011 completed questionnaires were representative of the working staff. They showed a positive correlation between the rate of vaccination and knowledge of influenza, with a 0.98 coefficient. They also showed that the staff was very largely unaware of population groups most at risk for influenza (1% of correct answers). CONCLUSIONS Primary prevention campaigns will only be effective if the target population has a better awareness of the issues involved. This study highlights the areas in which knowledge was heterogeneous or inadequate, and the information that could be decisive in increasing vaccinal coverage among staff. This information should focus on modes of transmission, contagiousness, mortality, and above all on populations at risk.
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Affiliation(s)
- F Dutheil
- Service santé-travail-environnement, CHU de Clermont-Ferrand, 63001 Clermont-Ferrand, France
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Djeriri K, Laurichesse H, Merle JL, Charof R, Abouyoub A, Fontana L, Benchemsi N, Elharti E, El Aouad R, Chamoux A, Beytout J. Hepatitis B in Moroccan health care workers. Occup Med (Lond) 2008; 58:419-24. [PMID: 18562546 DOI: 10.1093/occmed/kqn071] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIM To evaluate knowledge and perception of hepatitis B, including prevention, among Moroccan health care workers (HCWs) and to estimate seroprevalence of hepatitis B and vaccine coverage (VC). METHODS Four hundred and twenty HCWs were randomly selected and stratified by site: 120 in Rabat, 140 in Taza and 160 in Témara-Skhirat. The study included an anonymous questionnaire about knowledge of hepatitis B and its prevention and a serological survey. Oral statements and vaccine registers were used to analyse the VC of the HCWs. Serological testing and VC were analysed according to the occupational exposure. RESULTS Participation rates in the questionnaire and serological tests were 68% (285/420) and 66% (276/420), respectively. Fifteen (5%) HCWs had a history of hepatitis B. All HCWs considered that hepatitis B virus (HBV) infection may be acquired through blood exposure. Vaccination was acknowledged as a necessary means against HBV transmission by 276 (98%) HCWs. Forty-two per cent HCWs had no HBV serological markers. The prevalence of hepatitis B surface antigen was 1%. The mean prevalence of hepatitis B core antibody (anti-HBc) was 28% and was significantly higher (P < 0.05) among nursing auxiliaries (57%), nurses (30%), medical physicians (31%) and midwives (25%) than among laboratory technicians (13%). According to the vaccination registers (available in two sites), VC (> or =3 doses) was 55%. VC was 75% among midwives, 61% among nurses, 53% among nursing auxiliaries and 38% among medical staff. Of the fully vaccinated HCWs without anti-HBc, 51% had serological evidence of protection. CONCLUSION HBV vaccines should be more readily available for Moroccan HCWs by reinforcing current vaccination programmes.
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Affiliation(s)
- K Djeriri
- Service Santé-Travail-Environnement, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
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Lyonne L, Magimel C, Cormerais L, Trouillier S, Bocquier B, Zenut M, Jacomet C, Laurichesse H, Beytout J, Lesens O. [Thromboembolic events at the time of highly active antiretroviral therapies against human immunodeficiency virus]. Rev Med Interne 2007; 29:100-4. [PMID: 18164785 DOI: 10.1016/j.revmed.2007.10.417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Revised: 10/15/2007] [Accepted: 10/22/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Vein thrombosis risk and pulmonary embolism seem to be more important among human immunodeficiency virus (HIV) infected patients. METHOD We performed a retrospective study including 780 HIV positive patients followed-up between January 2000 and June 2005 at the University Hospital of Clermont-Ferrand. RESULTS Among the 780 HIV-infected patients, six cases of thromboembolic events were identified including, four with pulmonary embolism. All the patients were receiving lopinavir/ritonavir combination. CONCLUSION Although uncommon, pulmonary embolism occurs more frequently among HIV positive patients than in general population. Clinicians must remain aware about the possibility of the occurrence of a thromboembolic event especially during the first few months after introduction of the antiretroviral therapy.
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Affiliation(s)
- L Lyonne
- Service maladies infectieuses et tropicales - Premier HO, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France
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Abergel A, Ughetto S, Dubost S, Bonny C, Aublet-Cuvelier B, Delarocque-Astagneau E, Bailly JL, Bommelaer G, Casanova S, Delteil J, Deny P, Laurichesse H, Odent-Malaure H, Roussel J, Peigue-Lafeuille H, Henquell C. The epidemiology and virology of hepatitis C virus genotype 5 in central France. Aliment Pharmacol Ther 2007; 26:1437-46. [PMID: 17900267 DOI: 10.1111/j.1365-2036.2007.03530.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND We previously reported high prevalence of hepatitis C virus genotype 5a (HCV 5) (14%) in Central France. AIM To identify the risk factors associated with HCV5 infection and to characterize local HCV5 lineages. METHOD A case-control study and phylogenetic analysis were conducted. RESULTS In all, 131 HCV5 and 343 HCV non 5 infected patients were enrolled. No HCV5 patient was born in sub-Saharan Africa and only two were injection drug user. HCV5 contamination was associated with living in a rural area called Vic le Comte (VLC) in non-transfused patients (OR = 17.7), with transfusion in patients living outside VLC (OR = 3.8) and with receiving injections in patients from VLC (OR = 3.1). More than 80% of the patients from outside VLC were contaminated by transfusion and those from VLC mainly by an iatrogenic factor - injections performed before 1972 by the local physician. Phylogenetic analysis of HCV5 isolates evidenced no distinct genetic cluster, but close relationships between the isolates of spouse pairs and between blood donors and recipients. CONCLUSIONS Our results suggest that HCV5 spread in our district by iatrogenic route before 1972 and then via transfusion to the whole district. Collaborative studies are underway to study viral sequences from different parts of Africa and Europe to estimate the origin of our HCV 5a strains.
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Affiliation(s)
- A Abergel
- CHU de Clermont-Ferrand, Service d'Hépato-Gastro-Entérologie, Hôtel-Dieu, Clermont-Ferrand, France.
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