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Verot E, Chaux R, Gagnaire J, Bonjean P, Gagneux-Brunon A, Berthelot P, Pelissier C, Boulamail B, Chauvin F, Pozzetto B, Botelho-Nevers E. Evaluating the Knowledge of and Behavior Toward COVID-19 and the Possibility of Isolating at a City Level: Survey Study. JMIR Public Health Surveill 2024; 10:e47170. [PMID: 38602767 PMCID: PMC11013031 DOI: 10.2196/47170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/05/2023] [Accepted: 12/10/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Mass testing campaigns were proposed in France during the first wave of the COVID-19 pandemic to detect and isolate asymptomatic individuals infected by SARS-CoV-2. During mass testing in Saint-Étienne (February 2021), we performed a survey of the general population. OBJECTIVE We evaluated, on the scale of a city's population, the literacy level about SARS-CoV-2 transmission, barrier gesture respect, and isolation acceptability or possibility in case of SARS-CoV-2 infection. METHODS We used the validated CovQuest-CC questionnaire. Data were analyzed and correlated with volunteer characteristics and their SARS-CoV-2 screening results using multivariate analysis. RESULTS In total, 4707 participants completed the CovQuest-CC questionnaire. Multivariate analysis revealed that female sex was a determinant of a higher score of knowledge about SARS-CoV-2 transmission (adjusted β coefficient=0.14, 95% CI 0.04-0.23; corrected P=.02). Older ages of 50-59 years (adjusted β coefficient=0.25, 95% CI 0.19-0.31; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.15-0.34; corrected P<.001) were determinants of a higher score on barrier gesture respect compared to ages 20-49 years considered as reference. Female sex was also a determinant of a higher score on barrier gesture respect (adjusted β coefficient=0.10, 95% CI 0.02-4.63; corrected P<.001). The knowledge score was correlated with the score on barrier gesture respect measures (adjusted β coefficient=0.03, 95% CI 0.001-0.004; corrected P=.001). Older ages of 50-59 years (adjusted β coefficient=0.21, 95% CI 0.13-0.29; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.1-0.38; corrected P<.001) were determinants of a higher score on isolation acceptability or possibility compared to the age of 20-49 years considered as reference. Finally, the knowledge score regarding SARS-CoV-2 transmission was significantly associated with a lower risk of RT-PCR (reverse transcriptase-polymerase chain reaction) positivity (adjusted odds ratio 0.80, 95% CI 0.69-0.94; corrected P<.03), implying that a 1-point increase in the knowledge score lowers the risk of positivity by 20% on average. CONCLUSIONS This study identified factors associated with health literacy regarding SARS-CoV-2 infection in asymptomatic individuals in a large French city's population. We can confirm that in the context of the COVID-19 pandemic, the determinants of better health literacy are not the same as those in other contexts. It seems critical to obtain a more detailed understanding of the determinants of individual citizens' behavior, as part of a strategy to combat the large-scale spread of the virus. The harsh experience of this pandemic should teach us how to nurture research to structure customized interventions to encourage the adoption of ad hoc behaviors to engage citizens in adapting behaviors more favorable to their health.
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Affiliation(s)
- Elise Verot
- CIC EC 1408 INSERM Saint-Etienne, Saint-Etienne cedex 2, France
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Robin Chaux
- Unité de Recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Julie Gagnaire
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Paul Bonjean
- Unité de Recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Philippe Berthelot
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Laboratoire des Agents Infectieux et d'Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Carole Pelissier
- Occupational Health Service University Hospital Center of Saint-Etienne, Saint-Etienne, France
- UMRESTTE, Université Lyon 1, Université Gustave Eiffel-IFSTTAR, UMR t 9405, Lyon, France
| | - Billal Boulamail
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
| | - Franck Chauvin
- CIC EC 1408 INSERM Saint-Etienne, Saint-Etienne cedex 2, France
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Bruno Pozzetto
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Laboratoire des Agents Infectieux et d'Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
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Amandine GB, Gagnaire J, Pelissier C, Philippe B, Elisabeth BN. Vaccines for healthcare associated infections without vaccine prevention to date. Vaccine X 2022; 11:100168. [PMID: 35600984 PMCID: PMC9118472 DOI: 10.1016/j.jvacx.2022.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/28/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022] Open
Abstract
In spite of the widespread implementation of preventive strategies, the prevalence of healthcare-associated infections (HAIs) remains high. The prevalence of multidrug resistant organisms is high in HAIs. In 2019, the World Health Organization retained antimicrobial resistance as one of the ten issues for global health. The development of vaccines may contribute to the fight against antimicrobial resistance to reduce the burden of HAIs. Staphylococcus aureus, Gram negative bacteria and Clostridium difficile are the most frequent pathogens reported in HAIs. Consequently, the development of vaccines against these pathogens is crucial. At this stage, the goal of obtaining effective vaccines against S.aureus and Gram negative bacteria has not yet been achieved. However, we can expect in the near future availability of a vaccine against C. difficile. In addition, identifying populations who may benefit from these vaccines is complex, as at-risk patients are not great responders to vaccines, or as vaccination may occur too late, when they are already confronted to the risk. Vaccinating healthcare workers (HCWs) against these pathogens may have an impact only if HCWs play a role in the transmission and in the pathogens acquisition in patients, if the vaccine is effective to reduce pathogens carriage and if vaccine coverage is sufficient to protect patients. Acceptance of these potential vaccines should be evaluated and addressed in patients and in HCWs.
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Affiliation(s)
- Gagneux-Brunon Amandine
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F42023 Saint-Etienne, France.,Department of Infectious Diseases, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Julie Gagnaire
- Department of Infectious Diseases, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France.,Infection Control Unit, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Carole Pelissier
- Occupational Health Department, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Berthelot Philippe
- CIRI - Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F42023 Saint-Etienne, France.,Department of Infectious Diseases, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France.,Infection Control Unit, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Botelho-Nevers Elisabeth
- Inserm, CIC 1408, I-REIVAC, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F42023 Saint-Etienne, France.,Department of Infectious Diseases, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
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Verot E, Bonjean P, Chaux R, Gagnaire J, Gagneux-Brunon A, Pozzetto B, Berthelot P, Botelho-Nevers E, Chauvin F. Development and Validation of the COVID-19 Knowledges and Behavior Questionnaire in a French Population (CoVQuest-CC). Int J Environ Res Public Health 2022; 19:ijerph19052569. [PMID: 35270262 PMCID: PMC8909952 DOI: 10.3390/ijerph19052569] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
Background: The SARS-CoV-2 pandemic has led most countries to take restrictive measures affecting social activities and individual freedoms to limit viral transmission. It was shown that practical, motivational and social barriers impact on adherence to the isolation and social distancing measures advocated by the health authorities. The purpose of this study was to develop and validate a COVID-19 Knowledges and Behavior Questionnaire adapted to a teenager and adult French population. Methods: CoVQuest-CC was developed by a multidisciplinary team made of infectious diseases physicians, medical virologist, specialists of infectious control, experts of the questionnaires methodology, experts in public health and prevention, and statisticians. CoVQuest-CC was responded to by a big cohort from the general population during their participation in a massive SARS-CoV-2 screening campaign in 2021 in Saint-Etienne, France. Results: The confirmatory factorial analysis yielded good results (CFI = 0.94, TLI = 0.94, RMSEA = 0.04), and confirmed the five-dimensional structure of the questionnaire. Each dimension had a satisfying internal consistency, with Cronbach alphas of 0.83, 0.71, 0.65, 0.72 and 0.83 for transmission knowledge, barrier gesture respect, tests acceptability, home isolation possibility and test practicability, respectively. Conclusions: According to our knowledge, CoVQuest-CC is the first validated, consistent and reliable self-administrated French-specific questionnaire investigating the general population’s knowledge and attitudes towards COVID-19. It shows acceptable psychometric properties and can be use by Public Health teams or caregivers for public health and research purposes. Trial Registration: The study protocol was approved by the IRB ILE-DE-FRANCE 1 (No. IRB: I ORG0009918). All participants were given written and verbal information about the study and gave informed consent to participate. ClinicalTrials.gov identifier (NCT number): NCT04859023.
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Affiliation(s)
- Elise Verot
- Laboratoire Parcours Santé Systémique, Université Claude Bernard Lyon 1, Université de Lyon, P2S UR 4129, F-69008 Lyon, France;
- Equipe PREDUCAN, CIC Inserm 1408 Saint-Etienne, F-42055 Saint-Etienne, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, F-42023 Saint-Etienne, France
- Laboratoire Parcours Santé Systémique, Université Jean Monnet, Université de Lyon, P2S UR 4129, F-42270 Saint-Etienne, France
- Correspondence: (E.V.); (P.B.)
| | - Paul Bonjean
- Unité de Recherche Clinique, Innovation, Pharmacologie, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France;
- Correspondence: (E.V.); (P.B.)
| | - Robin Chaux
- Unité de Recherche Clinique, Innovation, Pharmacologie, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France;
| | - Julie Gagnaire
- Team GIMAP, CIRI—Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F-42023 Saint-Etienne, France; (J.G.); (A.G.-B.); (B.P.); (P.B.); (E.B.-N.)
- Service d’Infectiologie, CIC Inserm 1408, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Team GIMAP, CIRI—Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F-42023 Saint-Etienne, France; (J.G.); (A.G.-B.); (B.P.); (P.B.); (E.B.-N.)
- Service d’Infectiologie, CIC Inserm 1408, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, F-42023 Saint-Etienne, France
| | - Bruno Pozzetto
- Team GIMAP, CIRI—Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F-42023 Saint-Etienne, France; (J.G.); (A.G.-B.); (B.P.); (P.B.); (E.B.-N.)
- Laboratoire des Agents Infectieux, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
| | - Philippe Berthelot
- Team GIMAP, CIRI—Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F-42023 Saint-Etienne, France; (J.G.); (A.G.-B.); (B.P.); (P.B.); (E.B.-N.)
- Service d’Infectiologie, CIC Inserm 1408, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, F-42023 Saint-Etienne, France
- Laboratoire des Agents Infectieux, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Team GIMAP, CIRI—Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, F-42023 Saint-Etienne, France; (J.G.); (A.G.-B.); (B.P.); (P.B.); (E.B.-N.)
- Service d’Infectiologie, CIC Inserm 1408, Centre Hospitalier Universitaire de Saint-Étienne, F-42055 Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, F-42023 Saint-Etienne, France
| | - Franck Chauvin
- Laboratoire Parcours Santé Systémique, Université Claude Bernard Lyon 1, Université de Lyon, P2S UR 4129, F-69008 Lyon, France;
- Equipe PREDUCAN, CIC Inserm 1408 Saint-Etienne, F-42055 Saint-Etienne, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, F-42023 Saint-Etienne, France
- Laboratoire Parcours Santé Systémique, Université Jean Monnet, Université de Lyon, P2S UR 4129, F-42270 Saint-Etienne, France
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Labetoulle R, Detoc M, Gagnaire J, Berthelot P, Pelissier C, Fontana L, Botelho-Nevers E, Gagneux-Brunon A. COVID-19 in health-care workers: lessons from SARS and MERS epidemics and perspectives for chemoprophylaxis and vaccines. Expert Rev Vaccines 2020; 19:937-947. [PMID: 33107353 DOI: 10.1080/14760584.2020.1843432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: The world is now facing the COVID-19 pandemic. Experience with SARS-CoV and MERS-CoV, and early reports about SARS-CoV-2 infection suggest that health-care settings and health-care workers (HCWs) are vulnerable in the context of the emergence of a new coronavirus. Areas covered: To highlight the need for prophylactic strategies particularly for HCWs, we identified SARS-CoV, MERS-CoV, and SARS-CoV-2 outbreaks in health-care settings and the incidence of infections in HCWs by a search on MEDLINE and MEDxRIV (for SARS-Cov-2). To identify prophylactic strategies against, we conducted a search on MEDLINE and clinicaltrials.gov about studies involving SARS-CoV, MERS-CoV, and SARS-CoV-2. Expert opinion: HCWs account for a great part of SARS, MERS, and SARS-CoV-2 infections, they may also contribute to the spread of the disease, particularly in health-care settings, and contribute to nosocomial outbreaks. Some preventive strategies were evaluated in previous emerging coronavirus epidemics, particularly in MERS-CoV. For COVID-19 prevention, different chemoprophylaxis with drug repositioning and new agents are under evaluation, and different vaccine candidates entered clinical development, with clinical trials. HCWs are a crucial target population for pre-exposure and post-exposure prophylaxis.
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Affiliation(s)
- Rémi Labetoulle
- Department of Microbiology, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Maëlle Detoc
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Julie Gagnaire
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Philippe Berthelot
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Carole Pelissier
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Luc Fontana
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
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Gagneux-Brunon A, Pelissier C, Gagnaire J, Pillet S, Pozzetto B, Botelho-Nevers E, Berthelot P. SARS-CoV-2 infection: advocacy for training and social distancing in healthcare settings. J Hosp Infect 2020; 106:610-612. [PMID: 32781200 PMCID: PMC7414384 DOI: 10.1016/j.jhin.2020.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
This article reports the observed rate of infection with severe acute respiratory syndrome coronavirus-2 in healthcare workers (HCWs) who worked on wards dedicated to care of patients with coronavirus disease 2019 (COVID-19) compared with HCWs who worked on non-COVID-19 wards. The infection rate was significantly higher among HCWs who worked on non-COVID-19 wards (odds ratio 2.3, P=0.005), illustrating the need to strengthen social distancing measures and training.
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Affiliation(s)
- A Gagneux-Brunon
- Infection Control Unit, Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France; GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Université Jean Monnet, Saint-Etienne, France; Institut Presage Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - C Pelissier
- Occupational Health Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - J Gagnaire
- Infection Control Unit, Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - S Pillet
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Université Jean Monnet, Saint-Etienne, France; Service des Agents Infectieux et Hygiène, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - B Pozzetto
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Université Jean Monnet, Saint-Etienne, France; Service des Agents Infectieux et Hygiène, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - E Botelho-Nevers
- Infection Control Unit, Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France; GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Université Jean Monnet, Saint-Etienne, France; Institut Presage Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - P Berthelot
- Infection Control Unit, Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France; GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Université Jean Monnet, Saint-Etienne, France; Institut Presage Université de Lyon, Université Jean Monnet, Saint-Etienne, France; Service des Agents Infectieux et Hygiène, University Hospital of Saint-Etienne, Saint-Etienne, France.
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6
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Gagnaire J, Botelho-Nevers E, Martin-Simoes P, Morel J, Zéni F, Maillard N, Mariat C, Haddar CH, Carricajo A, Fonsale N, Grattard F, Pozzetto B, Laurent F, Berthelot P, Verhoeven PO. Interplay of nasal and rectal carriage of Staphylococcus aureus in intensive care unit patients. Eur J Clin Microbiol Infect Dis 2019; 38:1811-1819. [PMID: 31273646 DOI: 10.1007/s10096-019-03613-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/11/2019] [Indexed: 12/22/2022]
Abstract
The aim of this study was to investigate the relationship between nasal and rectal Staphylococcus aureus carriage in intensive care unit (ICU) patients and the occurrence of ICU-acquired infections related to S. aureus carriage. Three hundred and ninety-five patients admitted in ICU were screened for S. aureus nasal and rectal carriages and followed to record S. aureus infections during their stay. S. aureus strains were genotyped by arbitrarily primed PCR, spa-typing, microarray and whole genome sequencing. At ICU admission, 112 of 363 (30.9%) patients carried S. aureus including 61 (16.8%) exclusive nasal carriers, 40 (11.0%) combined nasal and rectal carriers and 11 (3.0%) exclusive rectal carriers. The 152 S. aureus isolates from nasal and rectal swabs belonged to 19 clonal complexes (CCs). Patients colonized in both nose and rectum harboured different strains in at least 40% of cases according to arbitrarily primed PCR data. Nasal carriers of CC5 S. aureus had an increased risk of rectal carriage (RR = 1.85, P < .05). S. aureus nasal and rectal carriage was a risk factor of S. aureus ICU-acquired infection (RR = 4.04; 95%CI [1.38-11.76]). Incidence rates of endogenous ICU-acquired infections in exclusive nasal carriers, exclusive rectal carriers and in both nasal and rectal carriers were 0.08 (5/61), 0.09 (1/11) and 0.03 (1/40), respectively (p = 0.47). Rectal swabbing increased the detection of S. aureus carriage and revealed an important diversity of S. aureus strains in ICU patients. Further studies are needed to understand how S. aureus rectal carriage increases the risk of endogenous ICU-acquired infections.
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Affiliation(s)
- Julie Gagnaire
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France
| | - Elisabeth Botelho-Nevers
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France
| | - Patricia Martin-Simoes
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Université de Lyon, Lyon, France.,Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Jérôme Morel
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of St-Etienne, St-Etienne, France
| | - Fabrice Zéni
- Medical Intensive Care Unit, University Hospital of St-Etienne, St-Etienne, France
| | - Nicolas Maillard
- Nephrology, Dialysis and Renal Transplantation Department, University Hospital of St-Etienne, St-Etienne, France
| | - Christophe Mariat
- Nephrology, Dialysis and Renal Transplantation Department, University Hospital of St-Etienne, St-Etienne, France
| | - Cyrille H Haddar
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Anne Carricajo
- Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Nathalie Fonsale
- Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Florence Grattard
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Bruno Pozzetto
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Frédéric Laurent
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Université de Lyon, Lyon, France.,Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Philippe Berthelot
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France.,Infectious Diseases Department, University Hospital of St-Etienne, St-Etienne, France.,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Paul O Verhoeven
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), Université Jean Monnet, Université de Lyon, St-Etienne, France. .,Laboratory of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France.
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7
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Gagnaire J, Verhoeven PO, Grattard F, Rigaill J, Lucht F, Pozzetto B, Berthelot P, Botelho-Nevers E. Epidemiology and clinical relevance of Staphylococcus aureus intestinal carriage: a systematic review and meta-analysis. Expert Rev Anti Infect Ther 2017; 15:767-785. [PMID: 28726558 DOI: 10.1080/14787210.2017.1358611] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Recent data highlight the importance of screening more than one site for improving the detection of S. aureus colonization. Intestinal carriage is frequently under-investigated and its clinical impact ought to be defined a better way. Areas covered: This review and meta-analysis provide an updated overview of prevalence, characteristics and clinical significance of S. aureus intestinal carriage in different populations, both for methicillin-susceptible and -resistant S. aureus strains. Expert commentary: Intestinal S. aureus carriage is documented with higher prevalence in children and in patients with S. aureus skin and soft tissue infections. This site of colonization was shown to be associated with a high risk of dissemination in the environment and with S. aureus infection. Intestinal carriage is frequently retrieved in nasal carriers, reflecting probably an association with a high bacterial load. Exclusive intestinal carriage present in one third of intestinal carriers can be associated with infection. Comparative genotyping analysis of different strains from nasal and extra-nasal sites of carriage, including the intestinal ones, in the same individuals, would allow a better comprehension of the pathophysiology of S. aureus endogenous infection. It could also permit to improve the prevention of these infections by decolonization of sites implicated in infection genesis.
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Affiliation(s)
- Julie Gagnaire
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Paul O Verhoeven
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Florence Grattard
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Josselin Rigaill
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Frédéric Lucht
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Bruno Pozzetto
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Philippe Berthelot
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France.,c Laboratory of Infectious Agents and Hygiene , University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- a GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) , University of Lyon , Saint-Etienne , France.,b Infectious Diseases Department , University Hospital of Saint-Etienne , Saint-Etienne , France
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8
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Gagnaire J, Gagneux-Brunon A, Pouvaret A, Grattard F, Carricajo A, Favier H, Mattei A, Pozzetto B, Nuti C, Lucht F, Berthelot P, Botelho-Nevers E. Carbapenemase-producing Acinetobacter baumannii: An outbreak report with special highlights on economic burden. Med Mal Infect 2017; 47:279-285. [PMID: 28343727 DOI: 10.1016/j.medmal.2017.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/31/2016] [Accepted: 02/20/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to describe the management of a carbapenemase-producing Acinetobacter baumannii (CP-AB) outbreak using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement. We also aimed to evaluate the cost of the outbreak and simulate costs if a dedicated unit to manage such outbreak had been set-up. METHODS We performed a prospective epidemiological study. Multiple interventions were implemented including cohorting measures and limitation of admissions. Cost estimation was performed using administrative local data. RESULTS Five patients were colonized with CP-AB and hospitalized in the neurosurgery ward. The index case was a patient who had been previously hospitalized in Portugal. Four secondary colonized patients were further observed within the unit. The strains of A. baumannii were shown to belong to the same clone and all of them produced an OXA-23 carbapenemase. The closure of the ward associated with the discharge of the five patients in a cohorting area of the Infectious Diseases Unit with dedicated staff put a stop to the outbreak. The estimated cost of this 17-week outbreak was $474,474. If patients had been managed in a dedicated unit - including specific area for cohorting of patients and dedicated staff - at the beginning of the outbreak, the estimated cost would have been $189,046. CONCLUSION Controlling hospital outbreaks involving multidrug-resistant bacteria requires a rapid cohorting of patients. Using simulation, we highlighted cost gain when using a dedicated cohorting unit strategy for such an outbreak.
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Affiliation(s)
- J Gagnaire
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - A Gagneux-Brunon
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - A Pouvaret
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - F Grattard
- Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - A Carricajo
- Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - H Favier
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - A Mattei
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - B Pozzetto
- Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - C Nuti
- Neurosurgery unit, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - F Lucht
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - P Berthelot
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
| | - E Botelho-Nevers
- Infection control unit, infectious diseases department, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France
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9
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Botelho-Nevers E, Gagnaire J, Verhoeven PO, Cazorla C, Grattard F, Pozzetto B, Berthelot P, Lucht F. Decolonization of Staphylococcus aureus carriage. Med Mal Infect 2016; 47:305-310. [PMID: 27856080 DOI: 10.1016/j.medmal.2016.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 04/25/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
Staphylococcus aureus nasal colonization is a well-known independent risk factor for infection caused by this bacterium. Screening and decolonization of carriers have been proven effective in reducing S. aureus infections in some populations. However, a gap remains between what has been proven effective and what is currently done. We aimed to summarize recommendations and current knowledge of S. aureus decolonization to answer the following questions: Why? For whom? How? When? And what are the perspectives?
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Affiliation(s)
- E Botelho-Nevers
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France.
| | - J Gagnaire
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - P O Verhoeven
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - C Cazorla
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France
| | - F Grattard
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - B Pozzetto
- Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - P Berthelot
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France; Laboratory of infectious agents and hygiene, university hospital of Saint-Étienne, 42055 Saint-Étienne cedex 02, France
| | - F Lucht
- Infectious diseases department, university hospital of Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne cedex 02, France; Groupe immunité des muqueuses et agents pathogènes (GIMAP EA 3064), university of Lyon, 42023 Saint-Étienne, France
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10
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Verhoeven PO, Gagnaire J, Haddar CH, Grattard F, Thibaudin D, Afiani A, Cazorla C, Carricajo A, Mariat C, Alamartine E, Lucht F, Garraud O, Pozzetto B, Botelho-Nevers E, Berthelot P. Identifying Hemodialysis Patients With the Highest Risk of Staphylococcus aureus Endogenous Infection Through a Simple Nasal Sampling Algorithm. Medicine (Baltimore) 2016; 95:e3231. [PMID: 27057858 PMCID: PMC4998774 DOI: 10.1097/md.0000000000003231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In contrast to Staphylococcus aureus intermittent nasal carriers, persistent ones have the highest risk of infection. This study reports the usefulness of a simple nasal sampling algorithm to identify the S. aureus nasal carriage state of hemodialysis patients (HPs) and their subsequent risk of infection.From a cohort of 85 HPs, 76 were screened for S. aureus nasal carriage once a week during a 10-week period. The S. aureus nasal load was quantified by using either culture on chromogenic medium or fully automated real-time polymerase chain reaction assay. Molecular typing was used to compare strains from carriage and infection.The algorithm based on quantitative cultures was able to determine the status of S. aureus nasal carriage with a sensitivity of 95.8%, a specificity of 94.2%, a positive predictive value of 88.5%, and a negative predictive value of 98.0%. Of note, the determination of the S. aureus carriage state was obtained on the first nasal sample for all the 76 HPs, but 1 (98.7%). The algorithm based on quantitative polymerase chain reaction assay directly from the specimen yielded similar performances. During the 1-year follow-up after the last sampling episode, HPs classified as persistent nasal carriers with the algorithm were found to have a higher risk of S. aureus infection than those classified as nonpersistent carriers (P < 0.05), especially for infections of endogenous origin (P < 0.001).This simple algorithm is reliable for determining the S. aureus nasal carriage status in clinical practice and could contribute to characterize at an early stage of take-up patients with the highest risk of S. aureus infection.
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Affiliation(s)
- Paul O Verhoeven
- From the GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes) (POV, JG, CHH, FG, AC, CM, EA, FL, OG, BP, EB-N, PB), University of Lyon, 42023 Saint-Etienne; Laboratory of Infectious Agents and Hygiene (POV, CHH, FG, AC, BP, PB); Infectious Diseases Department (JG, CC, FL, EB-N, PB); Nephrology-Dialysis-Transplantation Department (DT, CM, EA), University Hospital of Saint-Etienne, 42055 Saint-Etienne Cedex 02; and ARTIC42 Center (AA), 42270, Saint-Priest en Jarez, France
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11
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Moriceau G, Gagneux-Brunon A, Gagnaire J, Mariat C, Lucht F, Berthelot P, Botelho-Nevers E. Preventing healthcare-associated infections: Residents and attending physicians need better training in advanced isolation precautions. Med Mal Infect 2016; 46:14-9. [DOI: 10.1016/j.medmal.2015.11.001] [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] [Received: 03/23/2015] [Revised: 08/20/2015] [Accepted: 11/02/2015] [Indexed: 12/09/2022]
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12
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Verhoeven PO, Gautret P, Haddar CH, Benkouiten S, Gagnaire J, Belhouchat K, Grattard F, Charrel R, Pozzetto B, Drali T, Lucht F, Brouqui P, Memish ZA, Berthelot P, Botelho-Nevers E. Molecular dynamics of Staphylococcus aureus nasal carriage in Hajj pilgrims. Clin Microbiol Infect 2015; 21:650.e5-8. [PMID: 25882367 DOI: 10.1016/j.cmi.2015.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/22/2015] [Accepted: 03/26/2015] [Indexed: 12/21/2022]
Abstract
During the 2012 Hajj season, the risk of acquisition of Staphylococcus aureus nasal carriage in a cohort of French pilgrims was 22.8%, and was statistically associated with the acquisition of viral respiratory pathogens (p 0.03). The carriage of S. aureus belonging to the emerging clonal complex 398 significantly increased following the pilgrimage (p < 0.05).
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Affiliation(s)
- P O Verhoeven
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - P Gautret
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - C H Haddar
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - S Benkouiten
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - J Gagnaire
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France
| | - K Belhouchat
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - F Grattard
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - R Charrel
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - B Pozzetto
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - T Drali
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - F Lucht
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - P Brouqui
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095 and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Z A Memish
- Public Health Directorate, Saudi Ministry of Health, World Health Organization Collaborating Centre for Mass Gathering Medicine and College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - P Berthelot
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France; Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - E Botelho-Nevers
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, Saint-Etienne, France; Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France.
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13
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Valour F, Rasigade JP, Trouillet-Assant S, Gagnaire J, Bouaziz A, Karsenty J, Lacour C, Bes M, Lustig S, Bénet T, Chidiac C, Etienne J, Vandenesch F, Ferry T, Laurent F. Delta-toxin production deficiency in Staphylococcus aureus: a diagnostic marker of bone and joint infection chronicity linked with osteoblast invasion and biofilm formation. Clin Microbiol Infect 2015; 21:568.e1-11. [PMID: 25677632 DOI: 10.1016/j.cmi.2015.01.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 01/21/2015] [Accepted: 01/24/2015] [Indexed: 11/29/2022]
Abstract
Biofilm formation, intra-osteoblastic persistence, small-colony variants (SCVs) and the dysregulation of agr, the major virulence regulon, are possibly involved in staphylococcal bone and joint infection (BJI) pathogenesis. We aimed to investigate the contributions of these mechanisms among a collection of 95 Staphylococcus aureus clinical isolates from 64 acute (67.4%) and 31 chronic (32.6%) first episodes of BJI. The included isolates were compared for internalization rate, cell damage and SCV intracellular emergence using an ex vivo model of human osteoblast infection. Biofilm formation was assessed in a microbead immobilization assay (BioFilm Ring test). Virulence gene profiles were assessed by DNA microarray. Seventeen different clonal complexes were identified among the screened collection. The staphylococcal internalization rate in osteoblasts was significantly higher for chronic than acute BJI isolates, regardless of the genetic background. Conversely, no differences regarding cytotoxicity, SCV emergence, biofilm formation and virulence gene distribution were observed. Additionally, agr dysfunction, detected by the lack of delta-toxin production using whole-cell matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) analysis (n = 15; 15.8%), was significantly associated with BJI chronicity, osteoblast invasion and biofilm formation. These findings provide new insights into MSSA BJI pathogenesis, suggesting the correlation between chronicity and staphylococcal osteoblast invasion. This adaptive mechanism, along with biofilm formation, is associated with agr dysfunction, which can be routinely assessed by delta-toxin detection using MALDI-TOF spectrum analysis, possibly providing clinicians with a diagnostic marker of BJI chronicity at the time of diagnosis.
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Affiliation(s)
- F Valour
- Department of Infectious Diseases, Hospices Civils de Lyon, France; Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France.
| | - J-P Rasigade
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | | | - J Gagnaire
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France
| | - A Bouaziz
- Department of Infectious Diseases, Hospices Civils de Lyon, France
| | - J Karsenty
- Department of Infectious Diseases, Hospices Civils de Lyon, France
| | - C Lacour
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France
| | - M Bes
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France
| | - S Lustig
- INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France; Orthopaedic Surgery department, Hospices Civils de Lyon, France
| | - T Bénet
- Department of Infection Control and Epidemiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
| | - C Chidiac
- Department of Infectious Diseases, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - J Etienne
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - F Vandenesch
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - T Ferry
- Department of Infectious Diseases, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - F Laurent
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
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14
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Verhoeven PO, Gagnaire J, Botelho-Nevers E, Grattard F, Carricajo A, Lucht F, Pozzetto B, Berthelot P. Detection and clinical relevance of Staphylococcus aureus nasal carriage: an update. Expert Rev Anti Infect Ther 2013; 12:75-89. [PMID: 24308709 DOI: 10.1586/14787210.2014.859985] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Staphylococcus aureus nasal carriage is a well-defined risk factor of infection with this bacterium. The increased risk of S. aureus infection in nasal carriers is supported by the fact that the strains isolated from both colonization and infection sites are indistinguishable in most of the cases. Persistent nasal carriage seems to be associated with an increased risk of infection and this status could be defined now in clinical routine by using one or two quantitative nasal samples. There is evidence for supporting the detection of nasal carriage of S. aureus in patients undergoing cardiac surgery and in those undergoing hemodialysis in order to implement decolonization measures. More studies are needed to determine which carriers have the highest risk of infection and why decolonization strategies failed to reduce S. aureus infection in some other groups of patients.
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Affiliation(s)
- Paul O Verhoeven
- GIMAP EA 3064 (Groupe Immunité des Muqueuses et Agents Pathogènes), University of Lyon, 42023 Saint-Etienne, France
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15
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Gagnaire J, Dauwalder O, Boisset S, Khau D, Freydière AM, Ader F, Bes M, Lina G, Tristan A, Reverdy ME, Marchand A, Geissmann T, Benito Y, Durand G, Charrier JP, Etienne J, Welker M, Van Belkum A, Vandenesch F. Detection of Staphylococcus aureus delta-toxin production by whole-cell MALDI-TOF mass spectrometry. PLoS One 2012; 7:e40660. [PMID: 22792394 PMCID: PMC3391297 DOI: 10.1371/journal.pone.0040660] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [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: 01/13/2012] [Accepted: 06/11/2012] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to detect the Staphylococcus aureus delta-toxin using Whole-Cell (WC) Matrix Assisted Laser Desorption Ionization-Time-of-Flight (MALDI-TOF) mass spectrometry (MS), correlate delta-toxin expression with accessory gene regulator (agr) status, and assess the prevalence of agr deficiency in clinical isolates with and without resistance to methicillin and glycopeptides. The position of the delta-toxin peak in the mass spectrum was identified using purified delta-toxin and isogenic wild type and mutant strains for agr-rnaIII, which encodes delta-toxin. Correlation between delta-toxin production and agr RNAIII expression was assessed by northern blotting. A series of 168 consecutive clinical isolates and 23 unrelated glycopeptide-intermediate S. aureus strains (GISA/heterogeneous GISA) were then tested by WC-MALDI-TOF MS. The delta-toxin peak was detected at 3005±5 Thomson, as expected for the naturally formylated delta toxin, or at 3035±5 Thomson for its G10S variant. Multivariate analysis showed that chronicity of S. aureus infection and glycopeptide resistance were significantly associated with delta-toxin deficiency (p = 0.048; CI 95%: 1.01-10.24; p = 0.023; CI 95%: 1.20-12.76, respectively). In conclusion, the S. aureus delta-toxin was identified in the WC-MALDI-TOF MS spectrum generated during routine identification procedures. Consequently, agr status can potentially predict infectious complications and rationalise application of novel virulence factor-based therapies.
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Affiliation(s)
- Julie Gagnaire
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
| | - Olivier Dauwalder
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Sandrine Boisset
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - David Khau
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
| | - Anne-Marie Freydière
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
| | - Florence Ader
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
- Hospices Civils de Lyon, Service de Maladies Infectieuses, Lyon, France
| | - Michèle Bes
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Gerard Lina
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Anne Tristan
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Marie-Elisabeth Reverdy
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
| | - Adrienne Marchand
- Laboratoire de Chimie et Microbiologie de l’Eau - UMR 6008 CNRS, IBMIG - UFR Sciences Fondamentales et Appliquées, Université de Poitiers, Poitiers, France
| | - Thomas Geissmann
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Yvonne Benito
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Géraldine Durand
- bioMérieux S.A, Microbiology Research & Development unit, La Balme Les Grottes, France
| | - Jean-Philippe Charrier
- bioMérieux S.A, Technology Research Department, Technology platform, Marcy L’Etoile France
| | - Jerome Etienne
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
| | - Martin Welker
- bioMérieux S.A, Microbiology Research & Development unit, La Balme Les Grottes, France
| | - Alex Van Belkum
- bioMérieux S.A, Microbiology Research & Development unit, La Balme Les Grottes, France
| | - François Vandenesch
- Hospices Civils de Lyon, Centre National de Référence des Staphylocoques, Centre de Biologie et de Pathologie Est, Bron, France
- Université de Lyon, Domaine de la Buire, Lyon, France
- INSERM U851, Bacterial Pathogenesis and Innate Immunity laboratory, Lyon, France
- * E-mail:
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Abstract
This study is a first kinetic approach about the compost liquor treatment by activated sludge. This industrial wastewater is highly loaded in organic and nitrogen compounds (COD≈12,000 mg L(-1) and NH(4)(+)-N≈4,000 mg L(-1)). The possibility of its treatment in an urban WWTP is studied measuring ammonia oxidation rate with non-acclimated sludge to the industrial effluent. Compost liquor appears as an inhibitor substrate. The ammonia oxidation rate can be modelled by the Haldane model: U(MAX)=0.180 d(-1), K(S)=12.0 mgN.L(-1) and K(I)=26.0 mgN.L(-1). The ammonia oxidation rate also follows for a synthetic substrate which has the same pollutant load as the real substrate. In this case, the ammonia oxidation rate can be modelled by the Monod model: U(MAX)=0.073 d(-1) and K(S)=4.3 mgN.L(-1). This result confirms that the ammonia oxidising bacteria are inhibited by the real wastewater. The following-up of nitrate production shows also the inhibition of nitrite oxidising bacteria. The compost liquor treatment seems not possible in an urban WWTP (<50,000 p.e.). That's why a specific WWTP is recommended and an acclimation step of activated sludge is essential.
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Affiliation(s)
- J Gagnaire
- Université Paul Cézanne Aix Marseille III, Laboratoire de Mécanique, Modélisation et Procédés Propres, M2P2 UMR-CNRS 6181, Europôle de l'Arbois, BP 80, Bâtiment Laennec, Hall C, 13545 Aix-en-Provence Cedex 4, France
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17
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Ducret F, Pointet P, Lauvergeon B, Jacoulet C, Gagnaire J. [Pregnancy under converting enzyme inhibitor]. Presse Med 1985; 14:897. [PMID: 2987897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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18
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Dugois P, Amblard P, Gagnaire J, Imbert R. [Layered abscess of the leg after phlebosclerosis: complication of septicemia of dental origin]. Lyon Med 1968; 219:1849-51. [PMID: 5728681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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