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Vassallo M, Denis E, Manni S, Lotte L, Fauque P, Sindt A. Treatment of long-term catheter-related bloodstream infections with short-course Daptomycin lock and systemic therapy associated with Taurolidine-lock: A multicenter experience. J Vasc Access 2023:11297298231152500. [PMID: 36726226 DOI: 10.1177/11297298231152500] [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] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Few studies describe the efficacy of antibiotic lock therapy (ALT) in long-term catheter-related bloodstream (CRBSI) infections. We applied local protocols combining Daptomycin (DPT) and Taurolidine ALT, associated with systemic antibiotic treatment (SAT), for conservative management of coagulase-negative Staphylococci (CoNS) CRBSI. METHODS Patients admitted for CoNS-associated CRBSI and treated with DPT and Taurolidine as ALT were retrospectively analyzed. Success was defined as catheter retention 30 days after ending treatment. Catheter removal within 30 days was considered as failure. RESULTS From April 2018 to September 2021, 22 subjects with CoNS-associated-CRBSI were included (95% with cancer, mean age 64 years, 59% male). Staphylococcus epidermidis was isolated in 82% of cases. Mean duration of DPT was 3.9 and 3 days as ALT and SAT, respectively. SAT also included Rifampin for 3 days. Taurolidine ALT was started on day 4 and was combined with oral SAT, that is, either Linezolid or Tedizolid. Mean duration of Taurolidine was 10.5 days, while total antibiotic treatment lasted 13.5 days. Clinical success and failure rates were 95% and 5%, respectively. DISCUSSION Short course DPT as ALT, combined with SAT and Taurolidine ALT, allowed high rates of conservative management of catheters in case of CoNS-associated-CRBSI.
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Affiliation(s)
- Matteo Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - Eric Denis
- Department of Internal Medicine, Antibes General Hospital, Antibes, France
| | - Sabrina Manni
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - Laurene Lotte
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | | | - Audrey Sindt
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
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Manni S, Ruetsch C, Fabre R, Ticchioni M, Graça D, Pradier C, Seitz-Polski B, Lotte L, Brglez V, Vassallo M. Immune response to BNT162b2 SARS-CoV-2 vaccine in patients living with HIV: The COVIH-DAPT study. Front Immunol 2023; 14:1136723. [PMID: 36949938 PMCID: PMC10025349 DOI: 10.3389/fimmu.2023.1136723] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Data on immune response to SARS-CoV-2 vaccine in patients living with HIV (PLWH) over a period longer than 3 months are currently limited. We measured the immune response after BNT162b2 vaccination against SARS-CoV-2 in this population. Methods We prospectively enrolled PLWH on successful antiretroviral therapy, initiating vaccination with two doses of the BNT162b2 SARS-CoV-2 vaccine administered at six-week interval. SARS-CoV-2 humoral and cellular responses and lymphocyte cell subsets were recorded at inclusion and 6 weeks (W6), 3 months (M3) and 6 months (M6) later. Humoral, humoral strong and cellular responders were defined by IgG titers >10, ≥264BAU/mL and IFN-γ T cell release, respectively. Results Nineteen subjects without SARS-CoV-2 infection were included (74% men, mean age 51 years, CD4 nadir 399/mm3). All subjects were humoral responders, their antibody titer peak reached at M3. Strong responders' rates were 63% and 21% at M3 and M6, respectively. CD19+CD10+ B cells had increased significantly at W6 then decreased at M3, while CD19+CD27+ B cells remained unchanged. Rates of patients with a cellular response increased from 39% at W6 to 69% at M6. Cellular responders had significantly higher CD3+, CD4+ and CD8+ Effector Memory cells at inclusion (p=0.048, p=0.024, p=0.012, respectively) and CD4+ Terminally Differentiated Effector Memory cells at M3 (p=0.044). Discussion PLWH have a robust immune response after SARS-CoV-2 vaccination, but a rapid decline in humoral response from 3 months onwards, due to a blunted memory B cell response. Analysis of lymphocyte subsets may help identify optimal times for vaccine boosters.
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Affiliation(s)
- Sabrina Manni
- Department of Infectious Diseases, Cannes General Hospital, Cannes, France
- *Correspondence: Sabrina Manni, ; Matteo Vassallo,
| | - Caroline Ruetsch
- Immunology Department, Nice University Hospital, Côte d’Azur University, Nice, France
- Mediterranean Centre for Molecular Medicine (C3M), Institut National de la Santé Et de la Recherche Médicale (INSERM) U1065, Côte d’Azur University, Nice, France
| | - Roxane Fabre
- Public Health Department, Nice University Hospital, Côte d'Azur Université, Nice, France
| | - Michel Ticchioni
- Immunology Department, Nice University Hospital, Côte d’Azur University, Nice, France
| | - Daisy Graça
- Immunology Department, Nice University Hospital, Côte d’Azur University, Nice, France
- Unité de Recherche Clinique Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Christian Pradier
- Public Health Department, Nice University Hospital, Côte d'Azur Université, Nice, France
| | - Barbara Seitz-Polski
- Immunology Department, Nice University Hospital, Côte d’Azur University, Nice, France
- Unité de Recherche Clinique Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Laurene Lotte
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Vesna Brglez
- Immunology Department, Nice University Hospital, Côte d’Azur University, Nice, France
- Unité de Recherche Clinique Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Matteo Vassallo
- Department of Infectious Diseases, Cannes General Hospital, Cannes, France
- Unité de Recherche Clinique Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
- *Correspondence: Sabrina Manni, ; Matteo Vassallo,
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Vassallo M, Clement N, Lotte L, Manni S, Sindt A, Bertrand PM, Durant J. Prevalence and Main Clinical Characteristics of Fully Vaccinated Patients Admitted to Hospital for Delta Variant COVID-19. Front Med (Lausanne) 2022; 9:809154. [PMID: 35308544 PMCID: PMC8924279 DOI: 10.3389/fmed.2022.809154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/07/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives The Delta variant of the novel beta coronavirus responsible for the current coronavirus pandemic (COVID-19) spread across Europe during the summer of 2021. Little is known of vaccine efficacy on this variant. Our aim was to study the prevalence and clinical characteristics of fully vaccinated subjects admitted to hospital for Delta variant COVID-19. Methods We identified patients admitted to Cannes hospital for Delta-variant-related Covid-19 infection from July to September 2021. Their main demographic parameters, inflammatory markers, and clinical characteristics were recorded. Differences between fully vaccinated subjects and unvaccinated or incompletely vaccinated individuals were analyzed. Results We included 126 patients (57% male, mean age 64 years, mean delay since symptoms onset 7.8 days). Among admitted patients, 94 (75%) were not vaccinated, 11 (8%) incompletely so and 21 (17%) were fully vaccinated. Fully vaccinated patients were older (77 vs. 61 vs. 62 years, p = 0.003), with fewer days since symptoms onset (5.9 vs. 8.0 vs. 9.3 days, p = 0.035) than unvaccinated or incompletely vaccinated patients, respectively. Severe pneumonia was less frequent among completely vaccinated subjects (67 vs. 84 vs. 100%, p = 0.038), while rates of transfer to the ICU, mechanical ventilation or death did not differ. Thirteen fully vaccinated patients underwent a thoracic CT scan, revealing involvement of lung parenchyma in four of them. Discussion Prevalence of hospitalization for Delta-variant COVID-19 in fully vaccinated subjects was low and, despite their age and comorbid conditions, these patients had a high rate of favorable outcome.
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Affiliation(s)
- Matteo Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - Nicolas Clement
- Intensive Care Unit, Cannes General Hospital, Cannes, France
| | - Laurene Lotte
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - Sabrina Manni
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - Audrey Sindt
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - Pierre M. Bertrand
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - Jacques Durant
- Department of Infectious Diseases, Nice University Hospital, Nice, France
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Vassallo M, Durant J, Fabre R, Ticchioni M, Lotte L, Sindt A, Puchois A, De Monte A, Cezar R, Corbeau P, Pradier C. Switching to a Dual-Drug Regimen in HIV-Infected Patients Could Be Associated With Macrophage Activation? Front Med (Lausanne) 2021; 8:712880. [PMID: 34458287 PMCID: PMC8387698 DOI: 10.3389/fmed.2021.712880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the effect on immune activation of switching from a triple-drug to a dual-drug regimen in HIV-1 infected patients on successful combination antiretroviral treatment (cART). Immunadapt is a prospective study evaluating the impact of cART simplification on immune activation. Methods: We prospectively collected blood samples in HIV-1 infected patients on stable and successful cART switching from triple to dual regimens as a simplifying strategy. We compared immune activation markers: high sensitivity CRP, IL-1, IL-6, IL-8, IP-10, MCP-1, TNF-alpha, soluble CD14 (sCD14), soluble CD163 (sCD163), lipopolysaccharide binding protein, and D-dimer before cART change and at least 6 months after the switch. Patients were stratified according to low or high risk factors of immune activation (low CD4 nadir, previous AIDS-defining condition or very-low-level viremia during follow-up). Results: From April 2019 to May 2020, 20 subjects were included (mean age 57 years, 25 years since HIV infection, CD4 666 cells/mm3, CD8 766 cells/mm3, CD4/CD8 0.94, CD4 nadir 326 cells/mm3, 15% with AIDS, 18 years on cART, 6 cART regimens received, current cART duration: 56 months). Fourteen patients were prescribed Dolutegravir + Rilpivirine and six received Dolutegravir + Lamivudine. After 6.9 months, a significant sCD163 increase (+ 25.5% vs. + 0.5%, p = 0.02) was observed in subjects with high risk factors, despite maintaining a viral load <50 cp/ml. Conclusion: cART simplification in favor of dual therapy is associated with macrophage activation in patients at risk of immune activation despite sustained virological control. Risk factors should thus be considered before generalizing such strategies.
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Affiliation(s)
- Matteo Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France.,Unité de Recherche Clinique Cote d'Azur (UR2CA), Centre Hospitalier Universitaire Pasteur 2, Nice, France
| | - Jacques Durant
- Infectious Diseases Department, Université Côte d'Azur, Nice, France
| | - Roxane Fabre
- Public Health Department, Nice University Hospital, Côte d'Azur University, Nice, France.,CoBTeK Lab, Nice University Hospital, Centre Memoire de Ressource et de Recherche, Côte d'Azur University, Nice, France
| | - Michel Ticchioni
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Laurene Lotte
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Audrey Sindt
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Annick Puchois
- Multipurpose Laboratory, Cannes General Hospital, Cannes, France
| | - Anne De Monte
- Laboratory of Virology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Renaud Cezar
- Laboratory of Immunology, Nimes University Hospital, Nimes, France
| | - Pierre Corbeau
- Laboratory of Immunology, Nimes University Hospital, Nimes, France
| | - Christian Pradier
- Public Health Department, Nice University Hospital, Côte d'Azur University, Nice, France
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Vassallo M, Manni S, Pini P, Blanchouin E, Ticchioni M, Seitz-Polski B, Puchois A, Sindt A, Lotte L, Fauque P, Durant J. Patients with Covid-19 exhibit different immunological profiles according to their clinical presentation. Int J Infect Dis 2020; 101:174-179. [PMID: 33002623 PMCID: PMC7521203 DOI: 10.1016/j.ijid.2020.09.1438] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES A novel beta coronavirus has been identified as responsible for the 2019 coronavirus infection (Covid-19). Clinical presentations range from asymptomatic cases to acute respiratory distress syndrome with fatal outcome. Such a broad spectrum of disease expression calls for an investigation of immune response characteristics. METHODS We identified subjects admitted for Covid-19 in whom a large panel of immunological markers were measured, including B- and T- and NK-lymphocyte phenotypes, T-lymphocyte subpopulation cells and plasma cytokines. Patients were divided according to symptom severity during hospitalisation, in those with uncomplicated and complicated infection. Differences between groups were analyzed. RESULTS Seventeen patients were included (mean age: 83 years; 9 women; mean delay of symptoms onset: 4 days). Six had uncomplicated infection, while 11 developed complicated forms during hospitalization. CD10 + B lymphocyte levels were inversely correlated with clinical severity (5.8% vs 2.0%, p = 0.04) and CD10+ levels above 3% were independently associated with uncomplicated forms [Odds Ratio 0.04 (CI 0.002-0.795, p = 0.034)]. TNF-alpha, IL-1, Il-6 and Il-8 measurements upon admission differed between patients who died and those who survived (p < 0.01 for all comparisons). CONCLUSIONS In a population of elderly patients recently infected with Covid-19, CD10 + B cell levels were inversely correlated with clinical severity. Cytokine values upon admission were highly predictive of fatal outcome during hospitalisation. These findings could explain differences in the clinical presentation and allow rapid identification of patients at risk for complications.
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Affiliation(s)
- M Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France.
| | - S Manni
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - P Pini
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - E Blanchouin
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - M Ticchioni
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - B Seitz-Polski
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - A Puchois
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - A Sindt
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - L Lotte
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - P Fauque
- Institut Polyclinique de Cannes (IPOCA), Cannes, France
| | - J Durant
- Infectious Diseases Department, Nive University Hospital, Université Côte d'Azur, Nice, France
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Gomes V, Lotte L, Feyeux H, Vassallo M, Boronad C. Impact médico-économique de la surveillance étroite et pluridisciplinaire des prescriptions de daptomycine. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.100] [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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Gomes V, Lotte L, Feyeux H, Vassallo M, Boronad C. Impact médico-économique de la surveillance étroite et pluridisciplinaire des prescriptions de daptomycine. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.104] [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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Lotte R, Lotte L, Ruimy R. Actinotignum schaalii (formerly Actinobaculum schaalii): a newly recognized pathogen-review of the literature. Clin Microbiol Infect 2015; 22:28-36. [PMID: 26577137 DOI: 10.1016/j.cmi.2015.10.038] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [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: 09/13/2015] [Revised: 10/14/2015] [Accepted: 10/29/2015] [Indexed: 11/19/2022]
Abstract
The genus Actinotignum contains three species, Actinotignum schaalii (formerly Actinobaculum schaalii), Actinotignum urinale and Actinotignum sanguinis. A. schaalii is the species most frequently involved in human infections, with 172 cases, mostly urinary tract infections (UTIs), reported so far. Invasive infections have also been described. This facultative anaerobic Gram-positive rod is part of the urinary microbiota of healthy patients. It is responsible for UTIs, particularly in elderly men and young children. A. schaalii is an underestimated cause of UTIs because of its fastidious growth on usual media and difficulties associated with its identification using phenotypic methods. Indeed, this slow-growth bacterium requires blood-enriched media and an incubation time of 48 hours under anaerobic or 5% CO2 atmosphere. Furthermore, only matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) or molecular-based methods allow the accurate identification of this bacteria. MALDI-TOF using Microflex LT with the Biotyper database (Bruker Daltonics, Bremen, Germany) is the most reliable technology for the routine identification of A. schaalii. The identification of this uropathogen is all the more important because it is resistant to trimethoprim/sulfamethoxazole and second-generation quinolones that are widely used in the treatment of UTIs. Antimicrobial therapy using β-lactams prolonged for up to 2 weeks is the most efficient treatment and should be recommended. Microbiologists should assess the presence of A. schaalii in urine using appropriate culture and identification methods in the case of a direct examination that is positive for small coccoid rods, a negative nitrite urinary stick associated with leukocyturia, treatment failure with trimethoprim/sulfamethoxazole or fluoroquinolones, or undocumented, repeated UTIs.
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Affiliation(s)
- R Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM U1065 (C3M), Bacterial Toxins in Host Pathogen Interactions, C3M, Bâtiment Universitaire Archimed, Nice, France.
| | - L Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France
| | - R Ruimy
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM U1065 (C3M), Bacterial Toxins in Host Pathogen Interactions, C3M, Bâtiment Universitaire Archimed, Nice, France
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Lotte L, Lotte R, Durand M, Degand N, Ambrosetti D, Michiels JF, Amiel J, Cattoir V, Ruimy R. Infections related to Actinotignum schaalii (formerly Actinobaculum schaalii): a 3-year prospective observational study on 50 cases. Clin Microbiol Infect 2015; 22:388-390. [PMID: 26551841 DOI: 10.1016/j.cmi.2015.10.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/29/2015] [Indexed: 11/17/2022]
Affiliation(s)
- L Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France
| | - R Lotte
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM 1065(C3M), Team6, Bâtiment universitaire Archimed, Nice, France.
| | - M Durand
- Nice Medical University, Nice-Sophia Antipolis University, Nice, France; Department of Urology at Nice Academic Hospital, Nice, France
| | - N Degand
- Department of Bacteriology at Nice Academic Hospital, Nice, France
| | - D Ambrosetti
- Nice Medical University, Nice-Sophia Antipolis University, Nice, France; Department of Pathology at Nice Academic Hospital, Nice, France
| | - J-F Michiels
- Nice Medical University, Nice-Sophia Antipolis University, Nice, France; Department of Pathology at Nice Academic Hospital, Nice, France
| | - J Amiel
- Nice Medical University, Nice-Sophia Antipolis University, Nice, France; Department of Urology at Nice Academic Hospital, Nice, France
| | - V Cattoir
- Department of Bacteriology at Caen Academic Hospital, Caen, France; National Reference Centre for Antimicrobial Resistance (lab 'Enterococci'), Caen, France; University of Caen Basse-Normandie, EA 4655 U2RM (team 'Antibioresistance'), Caen, France
| | - R Ruimy
- Department of Bacteriology at Nice Academic Hospital, Nice, France; Nice Medical University, Nice-Sophia Antipolis University, Nice, France; INSERM 1065(C3M), Team6, Bâtiment universitaire Archimed, Nice, France
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Tollkötter A, Lotte L, Kockmann N. Redispergierung von Gas/flüssig-Strömungen im modular aufgebauten mikrostrukturierten Reaktor. CHEM-ING-TECH 2013. [DOI: 10.1002/cite.201250702] [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: 11/09/2022]
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Affiliation(s)
- E Bindseil
- Institute of Veterinary Pathology, Royal Veterinary & Agricultural University, Copenhagen, Denmark
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