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Catho G, Rosa Mangeret F, Sauvan V, Chraïti MN, Pfister R, Baud O, Harbarth S, Buetti N. Risk of catheter-associated bloodstream infection by catheter type in a neonatal intensive care unit: a large cohort study of more than 1100 intravascular catheters. J Hosp Infect 2023; 139:6-10. [PMID: 37343772 DOI: 10.1016/j.jhin.2023.06.011] [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: 05/04/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the risk of catheter-associated bloodstream infection (CABSI) among different catheter types using a large prospective database in the neonatal intensive care unit (NICU) of a tertiary care centre in Switzerland. METHODS We included all neonates admitted to the NICU with at least one central intravascular catheter inserted between January 2017 and December 2020. We used marginal Cox model to determine the risk of CABSI among different catheter types. RESULTS A total of 574 neonates and 1103 intravascular catheters were included in the study: 581 venous umbilical catheters, 198 arterial umbilical catheters and 324 peripherally inserted central catheters (PICCs). We identified 17, four and four CABSIs in neonates with venous umbilical catheters, arterial umbilical catheters and PICCs, respectively. The risk of CABSI increased after two days of umbilical catheter maintenance. Using univariable Cox models, and adjusting for sex and gestational age, we observed a similar CABSI risk between venous and arterial umbilical catheters (HR 0.57; 95% CI 0.16e2.08). Birth weight was associated with CABSI, with higher weight being protective (HR 0.37, 95% CI 0.16e0.81). CONCLUSIONS Strategies aimed at reducing umbilical catheter dwell time, particularly in low and very low birth weight neonates, may be effective in decreasing the incidence of CABSI in this population.
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Affiliation(s)
- G Catho
- Infection Control Division, Geneva University Hospitals, Geneva, Switzerland; Division of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland.
| | - F Rosa Mangeret
- Neonatal Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - V Sauvan
- Infection Control Division, Geneva University Hospitals, Geneva, Switzerland
| | - M-N Chraïti
- Infection Control Division, Geneva University Hospitals, Geneva, Switzerland
| | - R Pfister
- Neonatal Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - O Baud
- Neonatal Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - S Harbarth
- Infection Control Division, Geneva University Hospitals, Geneva, Switzerland
| | - N Buetti
- Infection Control Division, Geneva University Hospitals, Geneva, Switzerland; IAME U 1137, INSERM, Université Paris-Cité, Paris, France
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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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Aupiais C, Ursino M, Thomas S, Baud O, Zohar S, Alberti C. Une approche bayésienne de non-infériorité, utilisant des marges élicitées chez des experts, comme aide à la décision lors du monitoring d’événements secondaires rares. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.035] [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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Abstract
Neonatal seizure related to stroke is a common diagnostic feature. Their treatment, although widely debated even today must be initiated in case of status epilepticus, clinical seizures of more than 5 minutes duration or short (> 30 secondes) and repeated clinical seizures (2 or more per hour). The treatment of neonatal seizures is a challenge that remains only partially solved. It should take into account the etiology of seizures, type of brain lesions and clinical/electrical response to treatment after the first line treatment. It is based on using a single anti-epileptic at its maximum dosage, and if needed, on the association with another anti-epileptic drug with a different mechanism of action. Phenobarbital remains the most commonly used drug for initial treatment of neonatal seizures and for which the most clinical experience has been accumulated. The lack of randomized controlled trials makes difficult recommendations about the optimal duration of treatment, but most experts agree that once arrested seizures, the duration of treatment should be as short as possible because of its potential risk on the developing brain. Novel neuroprotective strategies for reducing impact of neonatal stroke or promoting brain repair remain for the moment the concept stage, pre-clinical or parcel clinical data.
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Affiliation(s)
- O Baud
- AP-HP, néonatalogie, Hôpital universitaire Robert-Debré, 48, boulevard Sérurier, Paris, 7509 France.
| | - S Auvin
- AP-Hp neurologie et maladies métaboliques, Hôpital universitaire Robert-Debré, 48, boulevard Sérurier, Paris, 75019 France
| | - E Saliba
- Centre hospitalier régional universitaire, service de réanimation - néonatalogie, Hôpital d'enfants de Clocheville, 49, boulevard Béranger, Tours, 37044 France
| | - V Biran
- AP-HP, néonatalogie, Hôpital universitaire Robert-Debré, 48, boulevard Sérurier, Paris, 7509 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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Saliba E, Debillon T, Auvin S, Baud O, Biran V, Chabernaud JL, Chabrier S, Cneude F, Cordier AG, Darmency-Stamboul V, Diependaele JF, Debillon T, Dinomais M, Durand C, Ego A, Favrais G, Gruel Y, Hertz-Pannier L, Husson B, Marret S, N’Guyen The Tich S, Perez T, Saliba E, Valentin JB, Vuillerot C. Accidents vasculaires cérébraux ischémiques artériels néonatals : synthèse des recommandations. Arch Pediatr 2017; 24:180-188. [DOI: 10.1016/j.arcped.2016.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/25/2016] [Accepted: 11/22/2016] [Indexed: 12/01/2022]
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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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8
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Lhermet A, Lacombe Z, Baud O, Henquell C, Beytout J, Lesens O. INF-04 - Épidémie de varicelle chez des migrants Soudanais en provenance de Calais. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30590-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: 11/28/2022]
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9
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Mohamed D, Baud O, Maury L, Lebail F, Ramful D, El Moussawi F, Nicaise C, Zupan-Simunek V, Coursol A, Beuchée A, Bolot P, Andrini P, Alberti C. Test triangulaire tronqué dans un essai séquentiel pédiatrique : application à l’essai thérapeutique PREMILOC. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.03.094] [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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10
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Lesens O, Baud O, Henquell C, Lhermet Nurse A, Beytout J. Varicella outbreak in Sudanese refugees from Calais. J Travel Med 2016; 23:taw042. [PMID: 27378366 DOI: 10.1093/jtm/taw042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/17/2016] [Indexed: 11/14/2022]
Abstract
We describe an outbreak of varicella in 31 Sudanese refugees (all except one were male, mean age: 26 ± 1), from the Calais migrant camp and sheltered in a French transit area. The attack rate was 39%. Adults are scantly immunized against varicella zoster virus in East Africa and may be exposed to epidemics once in France.
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Affiliation(s)
- O Lesens
- Service Des Maladies Infectieuses Et Tropicales, CHU Gabriel Montpied, Clermont-Ferrand, France.,UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont University, Université D'Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - O Baud
- Service d'hygiène hospitalière, CHU Gabriel Montpied, Clermont-Ferrand, France.,Antenne Régionale Auvergne de lutte contre les infections nosocomiales, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - C Henquell
- Service de virologie, CHU Gabriel Montpied, Clermont-Ferrand, France.,EA-4843 EPIE, Université d'Auvergne
| | - A Lhermet Nurse
- Service Des Maladies Infectieuses Et Tropicales, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - J Beytout
- Service Des Maladies Infectieuses Et Tropicales, CHU Gabriel Montpied, Clermont-Ferrand, France
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11
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Moustafa F, Nguyen G, Mathevon T, Baud O, Saint-Denis J, Dublanchet N, Pereira B, Shinjo C, Romaszko JP, Dopeux L, Dutheil F, Schmidt J. Evaluation of the efficacy and tolerance of a short 7 day third-generation cephalosporin treatment in the management of acute pyelonephritis in young women in the emergency department. J Antimicrob Chemother 2016; 71:1660-4. [DOI: 10.1093/jac/dkw021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/18/2016] [Indexed: 11/12/2022] Open
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12
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Becquet O, El Khabbaz F, Alberti C, Mohamed D, Blachier A, Biran V, Sibony O, Baud O. [Insulin treatment of gestational diabetes and respiratory outcome in late-preterm and term babies]. Arch Pediatr 2016; 23:261-7. [PMID: 26879967 DOI: 10.1016/j.arcped.2015.12.008] [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: 05/11/2015] [Revised: 07/15/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
Abstract
While the incidence of diabetes mellitus (DM) during pregnancy has been steadily increasing in recent years, the link between gestational DM and respiratory outcome in neonates has not been firmly established. To address this gap in understanding, we asked whether DM status and its treatment during pregnancy influence risk of neonatal respiratory distress. We conducted retrospective analysis of a large cohort to determine the relationship between maternal DM status (non-DM, insulin-treated DM [DTI], and non-insulin-treated DM [DTR]) and respiratory distress in term and near-term singletons, born at Robert-Debré Hospital over a 7-year period. Of 18,095 singletons delivered at 34 weeks of gestation or later, 412 (2.3%) were admitted to the NICU for respiratory distress within the first hours of life. The incidence of NICU admissions due to respiratory distress was 2.2% in the non-DM group, 2.1% in the DTR group, and 5.7% in the DTI group. Insulin treatment of DM, together with several other perinatal factors, was associated with an increased risk for severe respiratory distress. In a multivariate model, we found that DTI, but not DTR, was a risk factor independent of gestational age and cesarean section, with an IRR of 1.44 (95% CI, 1.00-2.08). The data indicate that newborns of mothers with DM treated with diet are not at risk for severe respiratory distress. Conversely, newborns of mothers with DM treated with insulin are associated with elevated risk for severe respiratory disease and should therefore be closely monitored.
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Affiliation(s)
- O Becquet
- Université Paris Diderot, Sorbonne Paris Cité, 75019 Paris, France; Neonatal Intensive Care Unit, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - F El Khabbaz
- Neonatal Intensive Care Unit, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - C Alberti
- Université Paris Diderot, Sorbonne Paris Cité, 75019 Paris, France; Inserm U1123, CIC-EC 1426, Unit of Clinical Epidemiology, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - D Mohamed
- Inserm U1123, CIC-EC 1426, Unit of Clinical Epidemiology, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - A Blachier
- Département d'information médicale, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - V Biran
- Université Paris Diderot, Sorbonne Paris Cité, 75019 Paris, France; Neonatal Intensive Care Unit, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - O Sibony
- Université Paris Diderot, Sorbonne Paris Cité, 75019 Paris, France; Service de gynécologie-obstétrique, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - O Baud
- Université Paris Diderot, Sorbonne Paris Cité, 75019 Paris, France; Neonatal Intensive Care Unit, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 75019 Paris, France.
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Leger P, Bonnin P, Moretti R, Tanaka S, Duranteau J, Renolleau S, Baud O, Charriaut-Marlangue C. Early Recruitment of Cerebral Microcirculation by Neuronal Nitric Oxide Synthase Inhibition in a Juvenile Ischemic Rat Model. Cerebrovasc Dis 2015; 41:40-9. [DOI: 10.1159/000441663] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/13/2015] [Indexed: 11/19/2022] Open
Abstract
Background: The development of collateral circulation is proposed as an inherent compensatory mechanism to restore impaired blood perfusion after ischemia, at least in the penumbra. We have studied the dynamic macro- and microcirculation after ischemia-reperfusion in the juvenile rat brain and evaluated the impact of neuronal nitric oxide synthase (nNOS) inhibition on the collateral flow. Methods: Fourteen-day-old (P14) rats were subjected to ischemia-reperfusion and treated with either PBS or 7-nitroindazole (7-NI, an nNOS inhibitor, 25 mg/kg). Arterial blood flow (BF) was measured using 2D-color-coded pulsed ultrasound imaging. Laser speckle contrast (LSC) imaging and sidestream dark-field videomicroscopy were used to measure cortical and microvascular BF, respectively. Results: In basal conditions, 7-NI reduced BF in the internal carotids (by ∼25%) and cortical (by ∼30%) BF, as compared to PBS. During ischemia, the increased mean BF velocity in the basilar trunk after both PBS and 7-NI demonstrated the establishment of collateral support and patency. Upon re-flow, BF immediately recovered to basal values in the internal carotid arteries under both conditions. The 7-NI group showed increased collateral flow in the penumbral tissue during early re-flow compared to PBS, as shown with both LSC imaging and side-stream dark-field videomicroscopy. The proportion of perfused capillaries was significantly increased under 7-NI as compared to PBS when given before ischemia (67.0 ± 3.9 vs. 46.8 ± 8.8, p < 0.01). Perfused capillaries (63.1 ± 17.7 vs. 81.1 ± 20.7, p < 0.001) and the BF index (2.4 ± 0.6 vs. 1.3 ± 0.1, p < 0.001) significantly increased under 7-NI given at the re-flow onset. Conclusions: Collateral support in the penumbra is initiated during ischemia, and may be increased during early re-flow by neuronal NOS inhibition (given in pre- and post-treatment), which may preserve brain tissue in juvenile rats.
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14
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Lopez E, Beuchée A, Truffert P, Pouvreau N, Patkai J, Baud O, Boubred F, Flamant C, Jarreau PH. L’érythropoïétine humaine recombinante chez le nouveau-né : recommandations pour la pratique clinique de la Société française de néonatologie. Arch Pediatr 2015; 22:1092-7. [DOI: 10.1016/j.arcped.2015.07.001] [Citation(s) in RCA: 10] [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: 05/20/2015] [Accepted: 07/03/2015] [Indexed: 02/07/2023]
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15
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Bremond-Gignac D, Jacqz-Aigrain E, Abdoul H, Beresniak A, Baud O, Alberti C. Ophthalmic insert for pupillary mydriasis in neonates. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0505] [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: 11/29/2022]
Affiliation(s)
- D. Bremond-Gignac
- Pediatric Ophthalmology; APHP-Hôpital Universitaire Necker Enfants Malades; Paris France
- CNRS Unit FR3636; Binocular Vision; Paris V University; France
| | | | - H. Abdoul
- APHP-Hôpital Universitaire Robert Debre; 75019 Paris France
| | | | - O. Baud
- APHP-Hôpital Universitaire Robert Debre; 75019 Paris France
| | - C. Alberti
- APHP-Hôpital Universitaire Robert Debre; 75019 Paris France
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Bremond-Gignac D, Jacqz-Aigrain E, Abdoul H, Beresniak A, Baud O, Alberti C. Ophthalmic insert for pupillary mydriasis in neonates. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1505] [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: 11/30/2022]
Affiliation(s)
- D. Bremond-Gignac
- Pediatric Ophthalmology; APHP- Hôpital Universitaire Necker Enfants Malades; Paris France
- CNRS Unit FR3636; Binocular Vision; Paris V University; France
| | | | - H. Abdoul
- APHP- Hôpital Universitaire Robert Debre; 75019 Paris France
| | | | - O. Baud
- APHP- Hôpital Universitaire Robert Debre; 75019 Paris France
| | - C. Alberti
- APHP- Hôpital Universitaire Robert Debre; 75019 Paris France
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17
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Nazzi T, Nishibayashi LL, Berdasco-Muñoz E, Baud O, Biran V, Gonzalez-Gomez N. [Language acquisition in preterm infants during the first year of life]. Arch Pediatr 2015; 22:1072-7. [PMID: 26299908 DOI: 10.1016/j.arcped.2015.07.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/01/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
Abstract
Previous studies have shown that preterm children are at a higher risk for cognitive and language delays than full-term children. Most of these studies have concentrated on the effects of prematurity during the preschool or school years, while the effect of preterm birth on the early development of language, much of which occurs during the first year of life, remains very little explored. This article focuses on this crucial period and reviews the studies that have explored early phonological and lexical development in preterm infants. The results of these studies show uneven proficiency in different language subdomains in preterm infants. This raises the possibility that different constraints apply to the acquisition of different linguistic subcomponents in this population, in part as a result of a complex interaction between maturation, experience, and language subdomains.
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Affiliation(s)
- T Nazzi
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Laboratoire psychologie de la perception, CNRS, institut pluridisciplinaire des Saints-Pères, 45, rue des Saints-Pères, 75006 Paris, France.
| | - L L Nishibayashi
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - E Berdasco-Muñoz
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - O Baud
- Service de réanimation et de pédiatrie néonatales, hôpital Robert-Debré, 75019 Paris, France
| | - V Biran
- Service de réanimation et de pédiatrie néonatales, hôpital Robert-Debré, 75019 Paris, France
| | - N Gonzalez-Gomez
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Department of Psychology, Oxford Brookes University, Oxford, Royaume-Uni
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Pfalzgraf S, Guyot P, Laluque B, Jouannet-Romaszko M, Baud O, Romaszko J, Pelegrin S, Sautou V. CP-120 Comparison of antibiotic consumption and bacterial resistance in two teaching hospitals: impact of a multidisciplinary antibiotic management program. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.114] [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: 11/03/2022] Open
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Zana-Taieb E, Pham H, Franco-Montoya ML, Jacques S, Letourneur F, Baud O, Jarreau PH, Vaiman D. Impaired alveolarization and intra-uterine growth restriction in rats: a postnatal genome-wide analysis. J Pathol 2015; 235:420-30. [DOI: 10.1002/path.4470] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/17/2014] [Accepted: 10/13/2014] [Indexed: 02/06/2023]
Affiliation(s)
- E Zana-Taieb
- Université Paris Descartes; Paris France
- Fondation PremUp, 53 avenue de l'Observatoire, 75014 Paris; France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1141; Paris France
- Assistance Publique - Hôpitaux de Paris, Service de Médecine et Réanimation Néonatales de Port-Royal, Groupe Hospitalier Cochin, Broca, Hôtel-Dieu, 53 Avenue de l'Observatoire, 75014 Paris; France
| | - H Pham
- Fondation PremUp, 53 avenue de l'Observatoire, 75014 Paris; France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1141; Paris France
| | - ML Franco-Montoya
- Institut National de la Santé et de la Recherche Médicale (INSERM) U955 IMRB Equipe 04, Faculté de Médecine de Créteil, 94010 Créteil; France
| | - S Jacques
- Genom'ic, INSERM U1016, CNRS UMR8104, Paris; France
| | - F Letourneur
- Genom'ic, INSERM U1016, CNRS UMR8104, Paris; France
| | - O Baud
- Fondation PremUp, 53 avenue de l'Observatoire, 75014 Paris; France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1141; Paris France
- Assistance Publique - Hôpitaux de Paris, Service de Réanimation et Pédiatrie Néonatales, Hôpital Robert Debré, Paris; France
- Université Paris Diderot; Paris France
| | - PH Jarreau
- Université Paris Descartes; Paris France
- Fondation PremUp, 53 avenue de l'Observatoire, 75014 Paris; France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1141; Paris France
- Assistance Publique - Hôpitaux de Paris, Service de Médecine et Réanimation Néonatales de Port-Royal, Groupe Hospitalier Cochin, Broca, Hôtel-Dieu, 53 Avenue de l'Observatoire, 75014 Paris; France
| | - D Vaiman
- Institut Cochin, INSERM U1016-CNRS, UMRS 104; Paris France
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Soudée S, Schuffenecker I, Aberchih J, Josset L, Lina B, Baud O, Biran V. Infections néonatales à entérovirus en France en 2012. Arch Pediatr 2014; 21:984-9. [DOI: 10.1016/j.arcped.2014.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/12/2014] [Accepted: 06/24/2014] [Indexed: 11/26/2022]
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21
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Nguyen G, Moustafa F, Dublanchet N, Mathevon T, Baud O, Schmidt J. Étude pilote d’évaluation de l’efficacité et de la tolérance d’un traitement court par céphalosporine de 3e génération dans la prise en charge aux urgences des pyélonéphrites aiguës simples chez la femme. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.150] [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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Phan Duy A, El Khabbaz F, Renolleau C, Aberchich J, Heneau A, Pham H, Baud O. Retard de croissance intra-utérin et cerveau en développement. Arch Pediatr 2013; 20:1034-8. [DOI: 10.1016/j.arcped.2013.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
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Vincent A, Baud O, Armand N, Gavazzi G, Savey A, Fascia P. O074: EPIPA, a point prevalence survey of urinary, pulmonary and skin infections in 334 French nursing homes. Antimicrob Resist Infect Control 2013. [PMCID: PMC3687826 DOI: 10.1186/2047-2994-2-s1-o74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Biran V, Baud O, Gressens P. La neuroprotection pharmacologique : le modèle de la mélatonine. Arch Pediatr 2013. [DOI: 10.1016/s0929-693x(13)71384-8] [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: 11/25/2022]
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25
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Aumeran C, Baud O, Traoré O, Souweine B. [Investigation of hospital epidemics and guidelines for the management of suspected cases of measles and invasive meningococcal disease]. Reanimation 2011; 21:503-513. [PMID: 32288729 PMCID: PMC7117815 DOI: 10.1007/s13546-011-0345-9] [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: 10/14/2011] [Accepted: 11/03/2011] [Indexed: 11/27/2022]
Abstract
Outbreaks of infectious diseases within healthcare institutions must be detected early and controlled. Hospitals should develop a plan for coordinating all hospital components to respond to these critical situations. The knowledge of the different steps in an outbreak investigation can help identify the source of ongoing outbreaks and prevent additional cases. Outbreak investigation is based on a multidisciplinary approach and is an opportunity for research, training and program considerations.
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Affiliation(s)
- C. Aumeran
- Service d’hygiène hospitalière, pôle REUNNIRH, CHU de Clermont-Ferrand, hôpital Gabriel-Montpied, F-63003 Clermont-Ferrand, France
| | - O. Baud
- Service d’hygiène hospitalière, pôle REUNNIRH, CHU de Clermont-Ferrand, hôpital Gabriel-Montpied, F-63003 Clermont-Ferrand, France
| | - O. Traoré
- Service d’hygiène hospitalière, pôle REUNNIRH, CHU de Clermont-Ferrand, hôpital Gabriel-Montpied, F-63003 Clermont-Ferrand, France
- UFR médecine, Clermont Université, université d’Auvergne, BP 10448, F-63000 Clermont-Ferrand, France
- Équipe communauté microbienne environnement et santé, CNRS, UMR 6023, LMGE, F-63000 Clermont-Ferrand, France
| | - B. Souweine
- UFR médecine, Clermont Université, université d’Auvergne, BP 10448, F-63000 Clermont-Ferrand, France
- Équipe communauté microbienne environnement et santé, CNRS, UMR 6023, LMGE, F-63000 Clermont-Ferrand, France
- Service de réanimation médicale, pôle REUNNIRH, CHU de Clermont-Ferrand, hôpital Gabriel Montpied, F-63003 Clermont-Ferrand, France
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Biran V, Bodiou AM, Zana E, Gaudin A, Farnoux C, Hovhannisyan S, Alison M, Elmaleh M, Oury JF, Maury L, Baud O. [Cerebellar injury in premature infants less than 30 weeks of gestation]. Arch Pediatr 2011; 18:261-6. [PMID: 21292459 DOI: 10.1016/j.arcped.2010.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 05/05/2010] [Revised: 11/27/2010] [Accepted: 12/19/2010] [Indexed: 11/19/2022]
Abstract
UNLABELLED Traditionally, the cerebellum has been regarded as a central component of the motor system. Recent studies suggest an important role played by the cerebellum in the development of cognitive and social functions. The objective of this study was to evaluate the incidence of cerebellar injury and to define the obstetrical, neonatal, and radiologic characteristics, as well as the functional outcomes in a population of very preterm infants. METHODS This retrospective study included neonates born before 30 weeks of gestational age between March 2004 and July 2007. Infants underwent MRI studies at a term-adjusted age; for each preterm infant with cerebellar injury, we identified two infants for the control group with normal MRI, matched on the basis of gestational age. We collected pertinent demographic, prenatal, and acute postnatal data for all infants. Follow-up assessment was performed at 2 years, using the Brunet-Lezine scale. RESULTS A total of 148 ex-preterm infants were studied. Cerebellar injury was present in 14 (9 %) cases and associated with supratentorial parenchymal injury in 90 %. Duration of ventilation was longer in children with cerebellar injury, compared to controls (19.5 days vs 16.5 days; P=0.03). The other neonatal criteria analyzed were comparable between the two groups. Global developmental, functional, and social-behavioral deficits were more common and profound in preterm infants with cerebellar injury, with no significant difference. CONCLUSION This study confirms the high incidence of cerebellar injury in very preterm infants and the importance of a specific neurobehavioral follow-up.
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Affiliation(s)
- V Biran
- Service de réanimation et pédiatrie néonatales (Pr Y. Aujard), hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, université Paris 7 Denis-Diderot, 48, boulevard Sérurier, 75019 Paris, France.
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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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Baud O. Nutrition du prématuré et développement neurologique. Arch Pediatr 2010; 17:768-9. [DOI: 10.1016/s0929-693x(10)70101-9] [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: 11/29/2022]
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See H, Lachenaud J, Alberti C, Mariani-Kurkdjian P, Aujard Y, Baud O. Outcome of very preterm infants with Mycoplasma/Ureaplasma airway colonization treated with josamycine. Acta Paediatr 2010; 99:625-6. [PMID: 20055775 DOI: 10.1111/j.1651-2227.2009.01658.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H See
- NICU, INSERM, AP-HP, Hôpital Robert Debré and Université Paris 7, Paris, France
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Baud O, Olivier P, Vottier G, Pham H, Mercier JC, Loron G. Effet du NO inhalé sur le poumon et le cerveau en développement. Arch Pediatr 2009; 16 Suppl 1:S1-8. [DOI: 10.1016/s0929-693x(09)75295-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Autret-Leca E, Bauer S, Alberti C, Jonville-Béra AP, Aujard Y, Bensouda-Grimaldi L, Baud O. Corticothérapie postnatale chez le prématuré : étude des pratiques des centres français de néonatologie en 2006. Arch Pediatr 2009; 16:999-1004. [DOI: 10.1016/j.arcped.2009.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 09/22/2008] [Accepted: 03/25/2009] [Indexed: 11/28/2022]
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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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Page JP, Bonnin M, Bolandard F, Vernis L, Lavergne B, Baud O, Bazin JE, Vendittelli F. [Epidural analgesia in obstetrics: anaesthesiologists practice in Auvergne]. ACTA ACUST UNITED AC 2008; 27:685-93. [PMID: 18760564 DOI: 10.1016/j.annfar.2008.06.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 06/27/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the practice of labour epidural analgesia in Auvergne. STUDY DESIGN Cross-sectional study by a mail survey. METHODS An anonymous postal questionnaire was sent to all anaesthetists working in public or private hospital having a maternity unit. RESULTS The response rate was 82%. Eighty-eight percent of the respondents practise epidural analgesia in obstetrics (EAO) for labour pain relief, but 49% of them did so only on call. Fifty percent of the respondents ask for platelets and fibrinogen beforehand and 41% accept a one month validity for these tests. One third uses a full aseptic method (surgical hand washing, cap and face mask, sterile gloves and gown, double disinfection of patient's back). Nearly all respondents practice skin anaesthesia, 67% use saline solution for identification of the epidural space, 58% insert the catheter 4cm into the epidural space and 25% use a lidocaine-epinephrine epidural test dose. The analgesic solution is mostly based on ropivacaine (83%) associated with sufentanil (96%); patient controlled epidural analgesia rate is used by 58% of anaesthetists whereas 37% of them never use epidural clonidine and 52% never practice combined spinal epidural (CSE) analgesia during labour. CONCLUSION EAO is mainly practiced on call. There are too many laboratory tests ordered before EAO. Technique used to insert epidural catheter is partly uniform and ropivacaine with sufentanil is the analgesic solution most often used. CSE for labour analgesia is still not often used.
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Affiliation(s)
- J-P Page
- Pôle d'anesthésie-réanimation, polyclinique, CHU de Clermont-Ferrand, Hôtel-dieu, 63001 Clermont-Ferrand, France
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Autret-Leca E, Bauer S, Alberti C, Jonville-Béra AP, Aujard Y, Bensouda-Grimaldi L, Baud O. Postnatal glucocorticoids in preterm neonates: use in French neonatal centres in 2006. Arch Dis Child Fetal Neonatal Ed 2008; 93:F398. [PMID: 18723787 DOI: 10.1136/adc.2008.141085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fontaine RH, Cases O, Lelièvre V, Mesplès B, Renauld JC, Loron G, Degos V, Dournaud P, Baud O, Gressens P. IL-9/IL-9 receptor signaling selectively protects cortical neurons against developmental apoptosis. Cell Death Differ 2008; 15:1542-52. [PMID: 18551134 DOI: 10.1038/cdd.2008.79] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In mammals, programmed cell death (PCD) is a central event during brain development. Trophic factors have been shown to prevent PCD in postmitotic neurons. Similarly, cytokines have neurotrophic effects involving regulation of neuronal survival. Nevertheless, neuronal PCD is only partially understood and host determinants are incompletely defined. The present study provides evidence that the cytokine interleukin-9 (IL-9) and its receptor specifically control PCD of neurons in the murine newborn neocortex. IL-9 antiapoptotic action appeared to be time-restricted to early postnatal stages as both ligand and receptor transcripts were mostly expressed in neocortex between postnatal days 0 and 10. This period corresponds to the physiological peak of apoptosis for postmitotic neurons in mouse neocortex. In vivo studies showed that IL-9/IL-9 receptor pathway inhibits apoptosis in the newborn neocortex. Furthermore, in vitro studies demonstrated that IL-9 and its receptor are mainly expressed in neurons. IL-9 effects were mediated by the activation of the JAK/STAT (janus kinase/signal transducer and activator of transcription) pathway, whereas nuclear factor-kappaB (NF-kappaB) or Erk pathways were not involved in mediating IL-9-induced inhibition of cell death. Finally, IL-9 reduced the expression of the mitochondrial pro-apoptotic factor Bax whereas Bcl-2 level was not significantly affected. Together, these data suggest that IL-9/IL-9 receptor signaling pathway represents a novel endogenous antiapoptotic mechanism for cortical neurons by controlling JAK/STAT and Bax levels.
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Affiliation(s)
- O Baud
- Service de réanimation néonatale et de néonatologie, Inserm U 676 / Avenir, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.
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Baud O, Fontaine R, Olivier P, Maury L, El Moussawi F, Bauvin I, Arsac M, Hovhannisyan S, Farnoux C, Aujard Y. Rupture très prématurée des membranes: physiopathologie des conséquences neurologiques. Arch Pediatr 2007; 14 Suppl 1:S49-53. [DOI: 10.1016/s0929-693x(07)80011-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Aumeran C, Paillard C, Robin F, Kanold J, Baud O, Bonnet R, Souweine B, Traore O. Pseudomonas aeruginosa and Pseudomonas putida outbreak associated with contaminated water outlets in an oncohaematology paediatric unit. J Hosp Infect 2006; 65:47-53. [PMID: 17141370 DOI: 10.1016/j.jhin.2006.08.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [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: 03/30/2006] [Accepted: 08/30/2006] [Indexed: 10/23/2022]
Abstract
This paper describes an outbreak of Pseudomonas aeruginosa and Pseudomonas putida that occurred in an oncohaematology paediatric unit between January and April 2005. Eight children had nosocomial infections due to P. aeruginosa (N=5) or P. putida (N=3), which were recovered from central venous catheter blood cultures (N=4), the catheter exit site alone (N=2), or the catheter exit site and the catheter tip (N=2). Subsequent investigation showed that contaminated water outlets represented the possible source of spread. Studies of nursing and environmental cleaning practices revealed two modes of catheter contamination. A reduction in the size of the catheter dressing at the exit site gave less protective cover during showers, and a detergent-disinfectant diluted with tap water had contaminated perfusion bottles. Repetitive intergenic consensus polymerase chain reaction indicated two discrete patterns for P. aeruginosa and one for P. putida. The water network was chlorinated, and disposable seven-day filters were fitted on all taps and showers. Due to the deleterious effects of chlorination on the water network and the cost of the weekly filter change, a water loop producing microbiologically controlled water was installed. In addition, the concentration of the detergent-disinfectant was increased and refillable sprayers were replaced with ready-to-use detergent-disinfectant solution for high-risk areas. Following these measures, no Pseudomonas spp. have since been isolated in clinical or environmental samples from the ward.
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Affiliation(s)
- C Aumeran
- CHU Clermont-ferrand, Hôpital Gabriel Montpied, Service d'Hygiène Hospitalière, Clermont-Ferrand, France and Univ Clermont 1, UFR Médecine, EA 3843, Laboratoire de Virologie, Clermont-Ferrand, France.
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Tanase-Derkaoui D, le Huidoux P, Farnoux C, El-Moussawi F, Mariani-Kurkdjian P, Bingen E, Baud O, Aujard Y. [Two cases of Pseudomonas aeruginosa neonatal meningitis treated by ciprofloxacine]. Arch Pediatr 2006; 13 Suppl 1:S17-21. [PMID: 17370392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Two cases of Pseudomonas aeruginosa neonatal meningitis are reported. Case 1 occurred on day 6 of life, at home, in a full term newborn. Favourable outcome was obtained with a treatment associating ceftazidime, 21 days, gentamicin, 10 days and ciprofloxacin, 10 days. Case no 2 was a nosocomial meningitis in a 32 weeks and 4 days gestational age premature newborn. Despite in vitro effective antibiotherapy with ceftazidime, netilmicine and ciprofloxacine, six cerebral abscesses were observed during the second week of treatment. Ceftazidime was stopped after 6 weeks and ciprofloxacine prolonged until neuroradiological cure of cerebral lesions at one year of age. Normal outcome was observed at 3 and 4 and half year of age. Therapeutic indications and clinical tolerance of ciprofloxacine in neonatal meningitis are discussed.
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Affiliation(s)
- D Tanase-Derkaoui
- Service de néonatologie et de réanimation néonatale, hôpital Robert-Debré, 48, boulevard Serurier, 75010 Paris, France
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Chamoux A, Denis-Porret M, Rouffiac K, Baud O, Millot-Theis B, Souweine B. Étude d'impact d'une campagne active de vaccination antigrippale du personnel hospitalier du CHU de Clermont-Ferrand. Med Mal Infect 2006; 36:144-50. [PMID: 16581213 DOI: 10.1016/j.medmal.2006.01.004] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Accepted: 01/14/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Protecting health care units from influenza epidemics has a double purpose: to decrease the mortality rate of patients at risk and to reduce work-leave in medical staff. An annual vaccination appears to be the most effective prevention against influenza. In France however the vaccinal coverage of health workers does not exceed 15%. METHOD In the 2003-2004 winter, the department of occupational health and the nosocomial disease committee of the Clermont-Ferrand Teaching Hospital initiated an active vaccination campaign. Three joint actions were carried out: date and place of vaccination sessions were individually addressed to every healthcare worker, meetings on prevention of influenza were held, as well as vaccination sessions on the work place in exposed units. RESULTS Significant results were noted: vaccination rate increased 2.6 fold compared to the previous year (4.8 to 12.6%) and a vaccinal coverage rate of 29% in the exposed units. COMMENTS The results even if far from national objectives encourage the pursuit of the campaigns promoting information and vaccination on the work place. The high frequency of reported postinjection adverse effects (1 out of 3) should be taken into account in future information campaign.
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Affiliation(s)
- A Chamoux
- Service de santé-travail-environnement, CHU de Clermont-Ferrand, rue Montalembert, 63000 Clermont-Ferrand, France.
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Adle-Biassette H, Baud O, Verney C, Olivier P, Gressens P, Mikol J, Massias L, Evrard P, Hénin D. Lésions corticales induites par l’inhibition du transport de monocarboxylate durant le développement cérébral chez la souris. Rev Neurol (Paris) 2005. [DOI: 10.1016/s0035-3787(05)85202-6] [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: 10/28/2022]
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Abstract
Periventricular leukomalacia (PVL) is the major substrate of cerebral palsy in survivors of prematurity. Its pathogenesis is complex and likely involves ischemia/reperfusion in the critically ill premature infant, with impaired regulation of cerebral blood flow, as well as inflammatory mechanisms associated with maternal and/or fetal infection. During the peak period of vulnerability for PVL, developing oligodendrocytes (OLs) predominate in the white matter. We hypothesize that free radical injury to the developing OLs underlies, in part, the pathogenesis of PVL and the hypomyelination seen in long-term survivors. In human PVL, free radical injury is supported by evidence of oxidative and nitrative stress with markers to lipid peroxidation and nitrotyrosine, respectively. Evidence in normal human cerebral white matter suggests an underlying vulnerability of the premature infant to free radical injury resulting from a developmental mismatch of antioxidant enzymes (AOE) and subsequent imbalance in oxidant metabolism. In vitro studies using rodent OLs suggest that maturational susceptibility to reactive oxygen species is dependent, not only on levels of individual AOE, but also on specific interactions between these enzymes. Rodent in vitro data further suggest 2 mechanisms of nitric oxide damage: one involving the direct effect of nitric oxide on OL mitochondrial integrity and function, and the other involving an activation of microglia and subsequent release of reactive nitrogen species. The latter mechanism, while important in rodent studies, remains to be determined in the pathogenesis of human PVL. These observations together expand our knowledge of the role that free radical injury plays in the pathogenesis of PVL, and may contribute to the eventual development of therapeutic strategies to alleviate the burden of oxidative and nitrative injury in the premature infant at risk for PVL.
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Affiliation(s)
- R L Haynes
- Department of Pathology, Children's Hospital Boston, Boston, MA 02115, USA.
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Aujard Y, Maury L, Doit C, Mariani-Kurkdjian P, Baud O, Farnoux C, Bingen E. Ureaplasma urealyticum, Mycoplasma hominis et pathologiesnéonatales : Données personnelles et revue de la littérature. Arch Pediatr 2005; 12 Suppl 1:S12-8. [PMID: 15893230 DOI: 10.1016/s0929-693x(05)80004-1] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ureaplasma urealyticum and Mycoplasma hominis colonized 20-40% of newborns and are more frequent in premature. They are responsible for localized infections such as pleural effusion, pneumopathy, adenopathy, abscess or systemic sepsis. An important hyperleukocytosis is often associated with pulmonary infections. Their responsibility, as pathogen agents, is questionable in some non bacterial meningitis. There is large controversy for their role as cofactor, in chronic lung disease (bronchopulmonary dysplasia) and periventricular leukomalacia, because of a too low number of newborns in prospective trials. Genital mycoplamas are resistant to beta lactamines. Macrolides have a good sensitivity, particularly josamycine, but Mycoplasma hominis is resistant to erythromycin. For systemic sepsis, fluoroquinolones such as ciprofloxacine have less deleterious effects than IV erythromycin.
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Affiliation(s)
- Y Aujard
- Laboratoire de microbiologie, hôpital Robert-Debré, assistance publique-hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.
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Abstract
This review examines the risk/benefit ratio of postnatal steroid treatment in preterm infants and correlates epidemiological data with special emphasis on experimental evidence concening the impact of steroid on brain development. With all regimens, steroid treatment consistently reduced the need for assisted ventilation at 28 days of postnatal age or at term. However, neither oxygen at term nor neonatal mortality has been decreased by this treatment. Conversely, respiratory benefits should be weighed against several adverse effects: hyperglycemia, hypertension, gastrointestinal bleeding or perforation, increased risk of cerebral palsy. The impact of dexamethasone on brain development and risk factors of white matter damage could be involved in the association between postnatal steroid treatment and neurological impairment in treated infants. Injectable preparations of dexamethasone contain sulphiting preservatives which could account for the alterations in neuronal maturation observed in animal models. Early use of dexamethasone should especially be avoided for postnatal steroid treatment in premature infants. Other glucocorticoids as alternatives to dexamethasone need to be evaluated in appropriate and large controlled trials with long term follow up.
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Affiliation(s)
- O Baud
- Service de Néonatologie et INSERM E9935, Hôpital Robert Debré, 48, boulevard Sérurier, 75019 Paris.
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Foix-L'helias L, Baud O, Lenclen R, Kaminski M, Lacaze-Masmonteil T. Benefit of antenatal glucocorticoids according to the cause of very premature birth. Arch Dis Child Fetal Neonatal Ed 2005; 90:F46-8. [PMID: 15613573 PMCID: PMC1721804 DOI: 10.1136/adc.2003.042747] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 11/04/2022]
Abstract
In this observational study performed in a large cohort of very preterm singletons, respiratory outcome was found to be strongly dependent on the cause of premature delivery. Although less apparent in infants born to mothers with chorioamnionitis, exposure to antenatal glucocorticoids remained significantly associated with a decrease in the incidence of respiratory distress syndrome after adjustment for the main cause of premature birth.
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Affiliation(s)
- L Foix-L'helias
- Division of Neonatology, Antoine-Béclère University Hospital, Assistance Publique/Hôpitaux de Paris, Clamart, France
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Adle-Biassette H, Henin D, Verney C, Olivier P, Gressens P, Evrard P, Baud O. Lésions corticales induites par l’inhibition de transport de monocarboxylates durant le développement cérébral chez la souris. Ann Pathol 2004. [DOI: 10.1016/s0242-6498(04)94163-6] [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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Abstract
This review examines the risk/benefit ratio of postnatal steroid treatment in preterm infants and correlates epidemiological data with experimental evidence on the effect of glucocorticosteroids on brain development.
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Affiliation(s)
- O Baud
- Néonatologie et Labrotoire de Neurobiologie du Développement, INSERM E9935, Hôpital Robert Debré, Paris, Frnace.
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Abstract
Antenatal glucocorticoid therapy remains one the most striking successes in perinatal management of complicated pregnancies leading to premature birth. All women at risk of preterm delivery before 34 weeks gestation should be treated, given the anti-inflammatory and maturative properties of fluorocorticoids. Betamethasone is preferred to dexamethasone and no more than two courses, two weeks apart, should be given, until the evidence from further controlled trials on repeated doses becomes available.
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Affiliation(s)
- O Baud
- Service de Médecine Néonatale and Laboratoire de neurobiologie du développement, INSERM E9935, University Hospital Robert Debré, France.
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