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Hamadou L, Buteau F, Petrosyan E, Martineau D, Sauvat L, Audibert M, Lesens O. Costs associated with informal health care pathway for patients with suspected Lyme borreliosis. Infect Dis Now 2024; 54:104841. [PMID: 38012989 DOI: 10.1016/j.idnow.2023.104841] [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: 07/05/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES To compare the direct and indirect medical costs for patients with suspected Lyme borreliosis according to whether or not they had used an informal care pathway. PATIENTS AND METHODS We retraced the care pathways of participating patients by a prospective questionnaire survey and a retrospective analysis of care records. Direct and indirect costs were estimated using a micro-costing method from different perspectives. We compared the costs of patients who had consulted a "Lyme Doctor" (informal care pathway) with those who had only used the formal care pathway. Non-parametric tests were appraised the significance of the differences between the two groups of patients. RESULTS Out of 103 eligible patients, 49 (including 12 having used an informal health care pathway) agreed to be investigated. Five expenditure items entirely borne by patients were significantly higher for patients following an informal care pathway: productivity loss (3041 ± 6580 vs 194 ± 1177 euros, p = 0.01), alternative therapies (3484 ± 7308 vs 369 ± 956 euros), biological tests sent abroad (571 ± 1415 vs 17 ± 92 euros, p < 0.01), self-medication (918 ± 1998 vs 133 ± 689, p = 0.02) and transport (3 094 ± 3456 vs 1 123 ± 1903p = 0.01). CONCLUSIONS From the patient's standpoint, the informal care pathway involving consultation with a Lyme Doctor is far more expensive than the formal care pathway. More specifically, the patient has to bear the costs of alternative treatments and repeated, non-recommended examinations.
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Affiliation(s)
- Lamriss Hamadou
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Fantine Buteau
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Evelina Petrosyan
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Delphine Martineau
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Léo Sauvat
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Martine Audibert
- Centre d'Etudes et de Recherche sur le Développement International (CERDI), Foundation for studies and Research on International Development (FERDI), Université Clermont Auvergne, CNRS, IRD, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environmental Microorganism Laboratory, Clermont Auvergne University, Clermont-Ferrand, France; Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana.
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Lesens O, Forestier E, Botelho-Nevers E, Pavese P, David G, Nougarede B, Corbin V, Pereira B, Aumeran C, Sauvat L. Comparing ethanol lock therapy versus vancomycin lock in a salvation strategy for totally implantable vascular access device infections due to coagulase-negative staphylococci (the ETHALOCK study): a prospective double-blind randomized clinical trial. Eur J Clin Microbiol Infect Dis 2024; 43:223-232. [PMID: 37993679 DOI: 10.1007/s10096-023-04702-w] [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: 04/20/2023] [Accepted: 11/06/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Little is known about efficacy and safety of ethanol lock therapy (ELT) to treat totally implantable venous access device (TIVAD) infections. The objective of this trial was to evaluate the effectiveness and safety profile of a local treatment with ELT without removal for TIVAD infection due to coagulase-negative staphylococci. METHODS We performed a prospective, multicenter, double-blind, randomized clinical trial comparing the efficacy of 40% ELT versus vancomycin lock therapy (VLT) in TIVAD infections due to coagulase-negative staphylococci, complicated or not by bloodstream infection. RESULTS Thirty-one patients were assigned to the ELT group and 30 to the VLT arm. Concomitant bacteremia was present in 41 patients (67.2%). Treatment success was 58.1 % (18 of 31) for the ELT arm and 46.7% (14 of 30) for the VLT arm (p = 0.37). The overall treatment success was 52.5% (32). The risk of treatment failure due to uncontrolled infections, superinfections, and mechanical complications did not differ significantly between participants receiving ELT (13 out of 31 [42%]) and those receiving VLT (16 out of 30 [53%]) with a hazard ratio of 0.70 (p = 0.343; 95% CI [0.34-1.46], Cox model). Catheter malfunctions were significantly more frequent in the ELT arm (11 patients versus 2 in the VLT group, p = 0.01). CONCLUSIONS We found an overall high rate of treatment failure that did not differ between the ELT arm and the VLT arm. TIVAD removal must be prioritized to prevent complications (uncontrolled infections, superinfections, and catheter malfunctions) except in exceptional situations.
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Affiliation(s)
- Olivier Lesens
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana.
- Centre d'Investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana.
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France.
| | - Emmanuel Forestier
- Infectious Disease Department, Metropole Savoie Hospital Center, Chambery, France
| | | | - Patricia Pavese
- Infectious Disease Department, Grenoble University Hospital Center, Grenoble, France
| | - Gary David
- Infectious Disease Department, Villefranche sur Saône Hospital Center, Villefranche sur Saône, France
| | | | - Violaine Corbin
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Bruno Pereira
- Clinical Research Direction, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France
| | - Claire Aumeran
- Infection Control Department, 3IHP, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Léo Sauvat
- Infection Control Department, 3IHP, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
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Calmels A, Heng AE, Corbin V, Garrouste C, Greze C, Pereira B, Lesens O. Vaccination coverage reinforced by an infectious disease consultation during pretransplant check-up in patients awaiting kidney transplantation: A randomized study. Infect Dis Now 2023; 53:104718. [PMID: 37178869 DOI: 10.1016/j.idnow.2023.104718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/06/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Vaccine coverage (VC) in patients awaiting kidney transplantation is insufficient. METHODS We performed a prospective, single-center, interventional, randomized, open-label study comparing a reinforced group (infectious disease consultation proposed) and a standard group (letter stating vaccine recommendations sent to the nephrologist) of patients in our institution awaiting renal transplantation. FINDINGS Out of the 58 eligible patients, 19 declined to participate. Twenty patients were randomized to the standard group and 19 to the reinforced group. Essential VC increased from. 10% to 20% in the standard group and from 15.8% to 52.6% in the reinforced group (p < 0.034). The main obstacles identified were lack of vaccination traceability, refusal of an additional consultation and the journey time between home and hospital. CONCLUSION While introduction of an infectious disease consultation during the pre-transplant check-up significantly improved VC in patients, it is time-consuming and failed to achieve a satisfactory rate of VC.
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Affiliation(s)
- A Calmels
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - A-E Heng
- Department of Nephrology, University Hospital, Clermont-Ferrand, France
| | - V Corbin
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - C Garrouste
- Department of Nephrology, University Hospital, Clermont-Ferrand, France
| | - C Greze
- Department of Nephrology, University Hospital, Clermont-Ferrand, France
| | - B Pereira
- Clinical Research and Innovation Department, University Hospital, Clermont-Ferrand, France
| | - O Lesens
- Infectious and Tropical Disease Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France.
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Vourc'h G, Un K, Berthet E, Frey-Klett P, Le Masson P, Weil B, Lesens O. Design theory to better target public health priorities: An application to Lyme disease in France. Front Public Health 2022; 10:980086. [PMID: 36419992 PMCID: PMC9676681 DOI: 10.3389/fpubh.2022.980086] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
In the context of complex public health challenges led by interdependent changes such as climate change, biodiversity loss, and resistance to treatment, it is important to mobilize methods that guide us to generate innovative interventions in a context of uncertainty and unknown. Here, we mobilized the concept-knowledge (CK) design theory to identify innovative, cross-sectoral, and cross-disciplinary research and design programs that address the challenges posed by tick-borne Lyme disease in France, which is of growing importance in the French public health and healthcare systems. Within the CK methodological framework, we developed an iterative approach based on literature analysis, expert interviews, analysis of active French research projects, and work with CK experts to contribute to design "an action plan against Lyme disease." We produced a CK diagram that highlights innovative concepts that could be addressed in research projects. The outcome is discussed within four areas: (i) effectiveness; (ii) environmental sustainability in prevention actions; (iii) the promotion of constructive involvement of citizens in Lyme challenges; and (iv) the development of care protocols for chronic conditions with an unknown diagnosis. Altogether, our analysis questioned the health targets ranging from population to ecosystem, the citizen involvement, and the patient consideration. This means integrating social and ecological science, as well as the multidisciplinary medical patient journey, from the start. CK theory is a promising framework to assist public health professionals in designing programs for complex yet urgent contexts, where research and data collection are still not sufficient to provide clear guidance.
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Affiliation(s)
- Gwenaël Vourc'h
- INRAE, VetAgro Sup, UMR EPIA, Université Clermont Auvergne, Saint Genès Champanelle, France,INRAE, VetAgro Sup, UMR EPIA, Université de Lyon, Marcy l'Etoile, France
| | - Katherine Un
- INRAE, VetAgro Sup, UMR EPIA, Université Clermont Auvergne, Saint Genès Champanelle, France,INRAE, VetAgro Sup, UMR EPIA, Université de Lyon, Marcy l'Etoile, France,Centre de Gestion Scientifique, i3 UMR CNRS 9217, MINES ParisTech, PSL Research University, Paris, France
| | - Elsa Berthet
- INRAE, AgroParisTech, UMR SADAPT, Université Paris-Saclay, Paris, France,USC 1339, Centre d'Etudes Biologiques de Chizé, INRAE, Villiers-en-Bois, France,UMR 7372 Centre d'Études Biologiques de Chizé, CNRS, Univ. La Rochelle, Beauvoir-sur-Niort, France
| | | | - Pascal Le Masson
- Centre de Gestion Scientifique, i3 UMR CNRS 9217, MINES ParisTech, PSL Research University, Paris, France
| | - Benoit Weil
- Centre de Gestion Scientifique, i3 UMR CNRS 9217, MINES ParisTech, PSL Research University, Paris, France
| | - Olivier Lesens
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France,Service des maladies infectieuses et tropicales, Centre de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOA), Centre de Référence pour les Maladies Vectorielles liées aux Tiques (CRMVT), 3IHP, CHU, Clermont-Ferrand, France,*Correspondence: Olivier Lesens
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Corbeau M, Mulliez A, Chenaf C, Eschalier B, Lesens O, Vorilhon P. Trends of influenza vaccination coverage in pregnant women: a ten-year analysis from a French healthcare database. Sci Rep 2022; 12:7153. [PMID: 35505069 PMCID: PMC9062868 DOI: 10.1038/s41598-022-11308-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
Pregnant women have a high risk of severe influenza, associated with obstetrical complications. The World Health Organization (WHO) has recommended influenza vaccination for all pregnant women since 2012. The vaccination coverage remains low worldwide, and in Europe, due to a lack of proposition from the health care providers, and a high refusal rate from the women. The primary aim of this study was to estimate the influenza vaccination coverage (IVC) in a population of pregnant women in France, and to analyse its evolution from 2009 to 2018. The secondary objective was to describe the vaccinated population and to find determinants associated with the vaccination. This retrospective cohort study is based on the EGB French health care database, a representative sample of the French population containing data from the health insurance system. All pregnant women who delivered medically or spontaneously over the 2009–2018 period were included. In the 2009–2018 period, only 1.2% pregnant women were vaccinated against influenza (n = 875/72,207; 95% CI 1.14–1.30). The IVC slightly increased after the 2012 WHO recommendation, from 0.33 to 1.79% (p < 0.001) but remained extremely low (4.1% in 2018). Women younger than 25 years old had a low coverage (0.6%) whereas women over 35 years old were more likely to get the influenza vaccine (1.7%; OR: 2.82, 95% CI 2.14–3.71). The vaccination behavior was not influenced by multifetal pregnancy or parity, but socio-economically deprived women were less likely to be vaccinated (OR: 0.81, 95% CI: 0.67–0.98). Women with pre-existing medical conditions had an overall higher vaccination rate (2.5%; OR: 2.32, 95% CI: 1.94–2.77). The vaccine was mainly prescribed by family physicians (58%). Influenza vaccination in pregnant women in France remains very low, particularly in younger, healthy women, and measures such as information campaigns towards pregnant women and studies of the knowledge, attitudes, and practices of the health care professionals need to be undertaken to improve the coverage.
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Affiliation(s)
- Mélodie Corbeau
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Aurélien Mulliez
- Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | - Chouki Chenaf
- Service de Pharmacologie Médicale, Centres Addictovigilance et Pharmacovigilance, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, INSERM, U1107 "Neuro-Dol", Clermont-Ferrand, France
| | - Bénédicte Eschalier
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France. .,Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France. .,Université Clermont Auvergne, ACCePPT, Clermont-Ferrand, France.
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Bord S, Dernat S, Ouillon L, René-Martellet M, Vourc'h G, Lesens O, Forestier C, Lebert I. Tick ecology and Lyme borreliosis prevention: A regional survey of pharmacists’ knowledge in Auvergne-Rhône-Alpes, France. Ticks Tick Borne Dis 2022; 13:101932. [DOI: 10.1016/j.ttbdis.2022.101932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/14/2022]
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Hossain SI, de Goër de Herve J, Hassan MS, Martineau D, Petrosyan E, Corbin V, Beytout J, Lebert I, Durand J, Carravieri I, Brun-Jacob A, Frey-Klett P, Baux E, Cazorla C, Eldin C, Hansmann Y, Patrat-Delon S, Prazuck T, Raffetin A, Tattevin P, Vourc'h G, Lesens O, Nguifo EM. Exploring convolutional neural networks with transfer learning for diagnosing Lyme disease from skin lesion images. Comput Methods Programs Biomed 2022; 215:106624. [PMID: 35051835 DOI: 10.1016/j.cmpb.2022.106624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Lyme disease which is one of the most common infectious vector-borne diseases manifests itself in most cases with erythema migrans (EM) skin lesions. Recent studies show that convolutional neural networks (CNNs) perform well to identify skin lesions from images. Lightweight CNN based pre-scanner applications for resource-constrained mobile devices can help users with early diagnosis of Lyme disease and prevent the transition to a severe late form thanks to appropriate antibiotic therapy. Also, resource-intensive CNN based robust computer applications can assist non-expert practitioners with an accurate diagnosis. The main objective of this study is to extensively analyze the effectiveness of CNNs for diagnosing Lyme disease from images and to find out the best CNN architectures considering resource constraints. METHODS First, we created an EM dataset with the help of expert dermatologists from Clermont-Ferrand University Hospital Center of France. Second, we benchmarked this dataset for twenty-three CNN architectures customized from VGG, ResNet, DenseNet, MobileNet, Xception, NASNet, and EfficientNet architectures in terms of predictive performance, computational complexity, and statistical significance. Third, to improve the performance of the CNNs, we used custom transfer learning from ImageNet pre-trained models as well as pre-trained the CNNs with the skin lesion dataset HAM10000. Fourth, for model explainability, we utilized Gradient-weighted Class Activation Mapping to visualize the regions of input that are significant to the CNNs for making predictions. Fifth, we provided guidelines for model selection based on predictive performance and computational complexity. RESULTS Customized ResNet50 architecture gave the best classification accuracy of 84.42% ±1.36, AUC of 0.9189±0.0115, precision of 83.1%±2.49, sensitivity of 87.93%±1.47, and specificity of 80.65%±3.59. A lightweight model customized from EfficientNetB0 also performed well with an accuracy of 83.13%±1.2, AUC of 0.9094±0.0129, precision of 82.83%±1.75, sensitivity of 85.21% ±3.91, and specificity of 80.89%±2.95. All the trained models are publicly available at https://dappem.limos.fr/download.html, which can be used by others for transfer learning and building pre-scanners for Lyme disease. CONCLUSION Our study confirmed the effectiveness of even some lightweight CNNs for building Lyme disease pre-scanner mobile applications to assist people with an initial self-assessment and referring them to expert dermatologist for further diagnosis.
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Affiliation(s)
- Sk Imran Hossain
- Université Clermont Auvergne, CNRS, ENSMSE, LIMOS, F-63000 Clermont-Ferrand, France
| | - Jocelyn de Goër de Herve
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Md Shahriar Hassan
- Université Clermont Auvergne, CNRS, ENSMSE, LIMOS, F-63000 Clermont-Ferrand, France
| | - Delphine Martineau
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Evelina Petrosyan
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Violaine Corbin
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean Beytout
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Isabelle Lebert
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Jonas Durand
- Tous Chercheurs Laboratory, UMR 1136 'Interactions Arbres Micro-Organismes', INRAE, Centre INRAE Grand Est-Nancy, F-54280 Champenoux, France
| | | | - Annick Brun-Jacob
- Tous Chercheurs Laboratory, UMR 1136 'Interactions Arbres Micro-Organismes', INRAE, Centre INRAE Grand Est-Nancy, F-54280 Champenoux, France
| | - Pascale Frey-Klett
- INRAE, US 1371 Laboratory of Excellence ARBRE, Centre INRAE Grand Est-Nancy, Champenoux F-54280, France
| | - Elisabeth Baux
- Infectious Diseases Department, University Hospital of Nancy, Nancy, France
| | - Céline Cazorla
- Infectious Disease Department, University Hospital of Saint Etienne, Saint-Etienne, France
| | - Carole Eldin
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Yves Hansmann
- Service des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires, 67000 Strasbourg, France
| | - Solene Patrat-Delon
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Thierry Prazuck
- Department of Infectious and Tropical Diseases, CHR Orléans, Orléans, France
| | - Alice Raffetin
- Tick-Borne Diseases Reference Center, North region, Department of Infectious Diseases, Hospital of Villeneuve-Saint-Georges, 40 allée de la Source, 94190 Villeneuve-Saint-Georges; ESGBOR, European Study Group for Lyme Borreliosis
| | - Pierre Tattevin
- Department of Infectious Diseases and Intensive Care Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Gwenaël Vourc'h
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CRIOA, CHU Clermont-Ferrand, Clermont-Ferrand, France; UMR CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
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Chabaud A, Tetard M, Descamps S, Nguyen C, Rannou F, Tournadre A, Lesens O, Coudeyre E. Early rehabilitation management strategy for septic arthritis of the knee. Infect Dis Now 2022; 52:170-174. [DOI: 10.1016/j.idnow.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/18/2022] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
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Abbas A, Abdukahil SA, Abdulkadir NN, Abe R, Abel L, Absil L, Acharya S, Acker A, Adachi S, Adam E, Adrião D, Ageel SA, Ahmed S, Ain Q, Ainscough K, Aisa T, Ait Hssain A, Ait Tamlihat Y, Akimoto T, Akmal E, Al Qasim E, Alalqam R, Alam T, Al-dabbous T, Alegesan S, Alegre C, Alessi M, Alex B, Alexandre K, Al-Fares A, Alfoudri H, Ali I, Ali Shah N, Alidjnou KE, Aliudin J, Alkhafajee Q, Allavena C, Allou N, Altaf A, Alves J, Alves JM, Alves R, Amaral M, Amira N, Ammerlaan H, Ampaw P, Andini R, Andrejak C, Angheben A, Angoulvant F, Ansart S, Anthonidass S, Antonelli M, Antunes de Brito CA, Anwar KR, Apriyana A, Arabi Y, Aragao I, Arali R, Arancibia F, Araujo C, Arcadipane A, Archambault P, Arenz L, Arlet JB, Arnold-Day C, Aroca A, Arora L, Arora R, Artaud-Macari E, Aryal D, Asaki M, Asensio A, Ashley E, Ashraf M, Ashraf S, Asim M, Assie JB, Asyraf A, Atique A, Attanyake AMUL, Auchabie J, Aumaitre H, Auvet A, Azemar L, Azoulay C, Bach B, Bachelet D, Badr C, Baig N, Baillie JK, Baird JK, Bak 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D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
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Gaudin M, Tanguy G, Plagne M, Saussac A, Hansmann Y, Jaulhac B, Kelly M, Ouchchane L, Lesens O. E-learning versus face-to-face training: Comparison of two learning methods for Lyme borreliosis. Infect Dis Now 2021; 52:18-22. [PMID: 34768016 DOI: 10.1016/j.idnow.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/21/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare two learning methods for Lyme disease (e-learning versus face-to-face training) to assess knowledge and know-how. METHODS The study population was volunteer general medicine residents and family physicians (FP). Face-to-face training on Lyme disease was offered to each group. E-learning training was then offered to those who had not attended the face-to-face training. Theoretical knowledge was assessed by an identical pre- and post-test questionnaire and know-how by a script concordance test. RESULTS Seventy learners (47 FPs and 23 general medicine residents) were included in the face-to-face training group and 61 (33 FPs and 28 general medicine residents) in the e-learning group. The pre- and post-test scores were significantly improved in the FP group (difference of 29.3±1.9 [P<0.0001] out of 100) as well as in the general medicine resident group (difference of 38.2±2.7 [P<0.0001] out of 100). E-learning was more effective than face-to-face training, particularly among general medicine residents (progression of mean difference of 44.3±3.4/100 vs. 30.9±4.0/100; P=0.0138) and to a lesser extent among FPs (progression of 25.3±2.3/100 vs. 31.9±2.7/100; P=0.0757). Forty-six script concordance tests were completed by FPs and 20 by general medicine residents. Script concordance test results did not seem significant between the subgroups. CONCLUSIONS E-learning seems to be a good alternative to face-to-face training for Lyme disease. It seems to be more effective than face-to-face training for the acquisition of theoretical knowledge. The script concordance test evaluation of know-how did not show any difference between the two learning methods.
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Affiliation(s)
- M Gaudin
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - G Tanguy
- Research Unit ACCePPT self-medication, multi-professional support for patients, Clermont Auvergne University, Clermont-Ferrand, France
| | - M Plagne
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - A Saussac
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France
| | - Y Hansmann
- Service des Maladies Infectieuses, Hôpitaux Universitaires de Strasbourg, Unistra, Strasbourg, France
| | - B Jaulhac
- Service des Maladies Infectieuses, Hôpitaux Universitaires de Strasbourg, Unistra, Strasbourg, France
| | - M Kelly
- Medical Microbiologist and Infectious Diseases Specialist, Centre Universitaire de Santé de l'Estrie, Hôpital de Granby, Québec, Canada
| | - L Ouchchane
- Biostatistics Unit, Department of Public Health, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - O Lesens
- Infectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France.
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Duval M, Mirand A, Lesens O, Bay JO, Caillaud D, Gallot D, Lautrette A, Montcouquiol S, Schmidt J, Egron C, Jugie G, Bisseux M, Archimbaud C, Lambert C, Henquell C, Bailly JL. Retrospective Study of the Upsurge of Enterovirus D68 Clade D1 among Adults (2014-2018). Viruses 2021; 13:1607. [PMID: 34452471 PMCID: PMC8402803 DOI: 10.3390/v13081607] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 08/08/2021] [Indexed: 11/17/2022] Open
Abstract
Enterovirus D68 (EV-D68) has emerged as an agent of epidemic respiratory illness and acute flaccid myelitis in the paediatric population but data are lacking in adult patients. We performed a 4.5-year single-centre retrospective study of all patients who tested positive for EV-D68 and analysed full-length EV-D68 genomes of the predominant clades B3 and D1. Between 1 June 2014, and 31 December 2018, 73 of the 11,365 patients investigated for respiratory pathogens tested positive for EV-D68, of whom 20 (27%) were adults (median age 53.7 years [IQR 34.0-65.7]) and 53 (73%) were children (median age 1.9 years [IQR 0.2-4.0]). The proportion of adults increased from 12% in 2014 to 48% in 2018 (p = 0.01). All adults had an underlying comorbidity factor, including chronic lung disease in 12 (60%), diabetes mellitus in six (30%), and chronic heart disease in five (25%). Clade D1 infected a higher proportion of adults than clades B3 and B2 (p = 0.001). Clade D1 was more divergent than clade B3: 5 of 19 amino acid changes in the capsid proteins were located in putative antigenic sites. Adult patients with underlying conditions are more likely to present with severe complications associated with EV-D68, notably the emergent clade D1.
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Affiliation(s)
- Maxime Duval
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
| | - Audrey Mirand
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
- CHU Clermont-Ferrand, Centre National de Référence Des Entérovirus et Parechovirus, Laboratoire de Virologie, 63003 Clermont-Ferrand, France
| | - Olivier Lesens
- CHU Clermont-Ferrand, Service Des Maladies Infectieuses et Tropicales, 63003 Clermont-Ferrand, France;
| | - Jacques-Olivier Bay
- CHU Clermont-Ferrand, Service de Thérapie Cellulaire et Hématologie Clinique, 63003 Clermont-Ferrand, France;
| | - Denis Caillaud
- CHU Clermont-Ferrand, Service de Pneumologie, 63003 Clermont-Ferrand, France;
| | - Denis Gallot
- CHU Clermont-Ferrand, Service de Gynécologie-Obstétrique, 63003 Clermont-Ferrand, France;
| | | | - Sylvie Montcouquiol
- CHU Clermont-Ferrand, Centre de Référence et de Compétence Mucoviscidose, 63003 Clermont-Ferrand, France;
| | - Jeannot Schmidt
- CHU Clermont-Ferrand, Service Des Urgences, 63003 Clermont-Ferrand, France;
| | - Carole Egron
- CHU Clermont-Ferrand, Service de Pédiatrie Générale, 63003 Clermont-Ferrand, France;
| | - Gwendoline Jugie
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
| | - Maxime Bisseux
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
- CHU Clermont-Ferrand, Centre National de Référence Des Entérovirus et Parechovirus, Laboratoire de Virologie, 63003 Clermont-Ferrand, France
| | - Christine Archimbaud
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
- CHU Clermont-Ferrand, Centre National de Référence Des Entérovirus et Parechovirus, Laboratoire de Virologie, 63003 Clermont-Ferrand, France
| | - Céline Lambert
- CHU Clermont-Ferrand, Service Biométrie et Médico-Economie—Direction de la Recherche Clinique et Innovation, 63003 Clermont-Ferrand, France;
| | - Cécile Henquell
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
- CHU Clermont-Ferrand, Centre National de Référence Des Entérovirus et Parechovirus, Laboratoire de Virologie, 63003 Clermont-Ferrand, France
| | - Jean-Luc Bailly
- Université Clermont Auvergne, LMGE CNRS 6023, UFR de Médecine et des Professions Paramédicales, 63001 Clermont-Ferrand, France; (M.D.); (A.M.); (G.J.); (M.B.); (C.A.); (C.H.)
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Cornille C, Buron F, Lesens O. Épidémiologie des infections urinaires récidivantes : une enquête transversale départementale auprès des patients sujets aux infections urinaires. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.215] [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: 10/20/2022]
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Pascal C, Arquembourg J, Vorilhon P, Lesens O. Emergence of Lyme disease as a social problem: analysis of discourse using the media content. Eur J Public Health 2021; 30:504-510. [PMID: 31688903 DOI: 10.1093/eurpub/ckz198] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chronic Lyme disease (LD) is a matter of debate worldwide and has emerged as a social problem. We aim to analyze the media content and describe the transformation process of a collective pain into a social problem in France. METHODS Using social science methodology, a corpus of articles from 20 newspapers and videos from seven major TV stations from 1987 to 2017 were analyzed for discourse content. The speaking times and the frequency of interventions between doctors supporting the official guidelines and those against them were compared using the Mann-Whitney test and the Chi-square test, respectively. RESULTS In France, the media discourse is carried through testimonials from patient organizations and a professor of infectiology who acted as a whistleblower (WB). We showed that the emergence of the LD alert in the media corresponds to the process described by social sciences as 'naming, blaming, claiming'. Since his first article in 2014, the WB has featured in 24% (22/89) of newspaper articles compared with 20% (18/89) for doctors defending the official guidelines (P = 0.52). Since his first appearance on a TV newscast in 2014, the WB has appeared in 45% (22/49) of news reports on LD with 24% of the speaking time compared with 22% (11/49) for doctors defending the official guidelines (P = 0.018). CONCLUSIONS Media coverage of LD has been unbalanced since 2014 and promotes associations as well as the WB, who seems to be better identified than any of the different doctors defending the official guidelines.
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Affiliation(s)
- Clélia Pascal
- Infectious and Tropical Diseases Department, CRIOA, CHU Clermont-Ferrand, Clermont-Ferrand, France.,UMR CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jocelyne Arquembourg
- Sciences de l'Information et de la Communication, Université Sorbonne Nouvelle - Paris3, Paris, France
| | - Philippe Vorilhon
- Department of General Practice, Institut Pascal, CNRS, SIGMA Clermont, Clermont Auvergne University, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CRIOA, CHU Clermont-Ferrand, Clermont-Ferrand, France.,UMR CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
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Moisset X, Gautier N, Godet T, Parabère S, Pereira B, Meunier E, Gerbaud L, Lesens O, Henquell C, Beytout J, Clavelou P. Nasopharyngeal swab‐induced pain for SARS‐CoV‐2 screening: A randomised controlled trial of conventional and self‐swabbing. Eur J Pain 2021; 25:924-929. [DOI: 10.1002/ejp.1722] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Xavier Moisset
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Nicolas Gautier
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Thomas Godet
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Solène Parabère
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Bruno Pereira
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Estelle Meunier
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Laurent Gerbaud
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Olivier Lesens
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Cécile Henquell
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Jean Beytout
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand France
| | - Pierre Clavelou
- Université Clermont AuvergneCHU de Clermont‐FerrandInserm Clermont‐Ferrand 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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Sauvat L, Abdul Hamid AI, Blavignac C, Josse J, Lesens O, Gueirard P. Biofilm-coated microbeads and the mouse ear skin: An innovative model for analysing anti-biofilm immune response in vivo. PLoS One 2020; 15:e0243500. [PMID: 33275636 PMCID: PMC7717515 DOI: 10.1371/journal.pone.0243500] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022] Open
Abstract
Owing to its ability to form biofilms, Staphylococcus aureus is responsible for an increasing number of infections on implantable medical devices. The aim of this study was to develop a mouse model using microbeads coated with S. aureus biofilm to simulate such infections and to analyse the dynamics of anti-biofilm inflammatory responses by intravital imaging. Scanning electron microscopy and flow cytometry were used in vitro to study the ability of an mCherry fluorescent strain of S. aureus to coat silica microbeads. Biofilm-coated microbeads were then inoculated intradermally into the ear tissue of LysM-EGFP transgenic mice (EGFP fluorescent immune cells). General and specific real-time inflammatory responses were studied in ear tissue by confocal microscopy at early (4-6h) and late time points (after 24h) after injection. The displacement properties of immune cells were analysed. The responses were compared with those obtained in control mice injected with only microbeads. In vitro, our protocol was capable of generating reproducible inocula of biofilm-coated microbeads verified by labelling matrix components, observing biofilm ultrastructure and confirmed in vivo and in situ with a matrix specific fluorescent probe. In vivo, a major inflammatory response was observed in the mouse ear pinna at both time points. Real-time observations of cell recruitment at injection sites showed that immune cells had difficulty in accessing biofilm bacteria and highlighted areas of direct interaction. The average speed of cells was lower in infected mice compared to control mice and in tissue areas where direct contact between immune cells and bacteria was observed, the average cell velocity and linearity were decreased in comparison to cells in areas where no bacteria were visible. This model provides an innovative way to analyse specific immune responses against biofilm infections on medical devices. It paves the way for live evaluation of the effectiveness of immunomodulatory therapies combined with antibiotics.
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Affiliation(s)
- Léo Sauvat
- Laboratoire Microorganismes: Génome et Environnement, Université Clermont Auvergne, UMR CNRS 6023, Clermont-Ferrand, France.,Infectious and Tropical Diseases Department, CRIOA, CRMVT, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Aizat Iman Abdul Hamid
- Laboratoire Microorganismes: Génome et Environnement, Université Clermont Auvergne, UMR CNRS 6023, Clermont-Ferrand, France
| | - Christelle Blavignac
- Centre Imagerie Cellulaire Santé, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jérôme Josse
- CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, CNRS, UMR5308, École Normale Supérieure de Lyon, Université Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Olivier Lesens
- Laboratoire Microorganismes: Génome et Environnement, Université Clermont Auvergne, UMR CNRS 6023, Clermont-Ferrand, France.,Infectious and Tropical Diseases Department, CRIOA, CRMVT, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascale Gueirard
- Laboratoire Microorganismes: Génome et Environnement, Université Clermont Auvergne, UMR CNRS 6023, Clermont-Ferrand, France
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Aumeran C, Henquell C, Brebion A, Noureddine J, Traore O, Lesens O. Isolation gown contamination during healthcare of confirmed SARS-CoV-2-infected patients. J Hosp Infect 2020; 107:111-113. [PMID: 33188869 PMCID: PMC7657029 DOI: 10.1016/j.jhin.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/31/2022]
Affiliation(s)
- C Aumeran
- Infection Control Department, 3IHP, CHU, Clermont-Ferrand, France; Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France.
| | - C Henquell
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Virology Department, 3IHP, CHU, Clermont-Ferrand, France
| | - A Brebion
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Virology Department, 3IHP, CHU, Clermont-Ferrand, France
| | - J Noureddine
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Infectious and Tropical Diseases Department, CRIOA, 3IHP, CHU, Clermont-Ferrand, France
| | - O Traore
- Infection Control Department, 3IHP, CHU, Clermont-Ferrand, France; Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - O Lesens
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Infectious and Tropical Diseases Department, CRIOA, 3IHP, CHU, Clermont-Ferrand, France
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18
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Castagné B, Soubrier M, Prouteau J, Mrozek N, Lesens O, Tournadre A, Gadea E, Vidal M. A six-week antibiotic treatment of endocarditis with spondylodiscitis is not associated with increased risk of relapse: A retrospective cohort study. Infect Dis Now 2020; 51:253-259. [PMID: 33166612 DOI: 10.1016/j.medmal.2020.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/18/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND We compared the relapse rate at 1 year in patients with vertebral osteomyelitis with or without associated endocarditis. PATIENTS AND METHODS We conducted a retrospective cohort study. Inclusion criteria were patients hospitalized in the infectious disease, rheumatology, cardiology, cardiovascular surgery and two internal medicine units for vertebral osteomyelitis (blood culture and/or disco-vertebral biopsy) and compatible imaging, between 2014 and 2017. We compared patients with associated endocarditis (VO-EI group) and without endocarditis (VO group) using logistic regression to determine the factors associated with relapse and EI. The main outcome was the relapse rate at 1 year. RESULTS Out of the 207 eligible patients, 62 were included (35 in the VO group and 27 in the VO-EI group). Four patients presented with a new VO during follow-up, one (2.86%) patient in VO group and three (11.11%) in VO-EI group (P=0.68). There were more men in the VO-EI group than in the VO group (74.07% vs. 48.57%, P=0.04), valvulopathies (13/27 vs. 8/35, P=0.06), vertebral localization (1.22±0.50 vs. 1.03±0.17, P=0.04) and septic kidney embolism (5/27 vs. 0/35, P=0.01). Control blood cultures were more often positive in the VO-EI group (12/27 vs. 8/35, P=0.04). In 45% of patients, the germ was a staphylococcus, 29% streptococci, 10% enterococci, 10% gram-negative bacillus (GNB). There were more streptococci and enterococci in the VO-EI group than in the VO group (44.44% vs. 17.14% and 18.52% vs. 8.57%, respectively). Antibiotic safety was good and comparable between groups. CONCLUSION In a relatively small population, we did not find significantly more relapse in the endocarditis group.
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Affiliation(s)
- B Castagné
- Service de médecine interne, centre hospitalier Émile-Roux, 12, boulevard Dr André-Chantemesse, 43000 Le Puy-en-Velay, France.
| | - M Soubrier
- Service de rhumatologie, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - J Prouteau
- Service de maladies infectieuses, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - N Mrozek
- Service de maladies infectieuses, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - O Lesens
- Service de maladies infectieuses, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - A Tournadre
- Service de rhumatologie, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - E Gadea
- Service de médecine interne, centre hospitalier Émile-Roux, 12, boulevard Dr André-Chantemesse, 43000 Le Puy-en-Velay, France
| | - M Vidal
- Service de maladies infectieuses, CHU de Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
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Pascal C, Lesens O. The vaccination coverage in dispensaries on Mayotte Island is lacking for natives and migrants alike. Infect Dis Now 2020; 51:290-292. [PMID: 33069840 DOI: 10.1016/j.medmal.2020.10.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/18/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Assessing the vaccination coverage rate in Mayotte dispensaries. PATIENTS AND METHODS Prospective study in three dispensaries from June to July 2019. RESULTS Of the 162 patients included, 78% (126/162) were natives of the island and 19% (30/162) were from the Comoros Islands. Twenty-three percent (37/162) were up-to-date on their mandatory vaccinations, 45% (73/162) were not and 32% (52/162) had unknown vaccination status. There was no difference in relation to their origin. Some vaccinations were strictly followed (MMR, Hepatitis B…) others were not (HiB, meningitides…). The vaccination coverage rate and its traceability are altogether lacking whatever the age or origin of patients. Efforts must be made in order to increase the vaccination coverage rate among people who, from our experience, do not oppose vaccination in any way.
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Affiliation(s)
- C Pascal
- SMIT, CHU de Clermont-Ferrand, site Gabriel, Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
| | - O Lesens
- SMIT, CHU de Clermont-Ferrand, site Gabriel, Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
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Pascal C, Lesens O, Arquembourg J. Y-a-t’il eut une intelligence collective face à l’émergence du SRAS-Cov2 en France ? Med Mal Infect 2020. [PMCID: PMC7442151 DOI: 10.1016/j.medmal.2020.06.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction Dès le début de l’arrivée du virus en France, la transmission d’information entre médecins s’est transformée avec la mise en place spontanée de nouveaux réseaux de communication entre médecins face à l’épidémie. L’objectif de ce travail est d’étudier la réalité de l’intelligence collective médicale au cours de la pandémie de Covid-19 en analysant l’émergence et la diffusion de quatre informations médicales nouvelles durant la quarantaine. Matériels et méthodes Nous avons étudié les différents messages d’information circulant entre médecins puis leur reprise dans la presse écrite nationale durant l’épidémie de COVID-19 en France pendant la période de confinement pour quatre informations médicales : anosmie/agueusie, l’atteinte dermatologique, le lien entre tabagisme et COVID19 et enfin l’intérêt du traitement par hydroxychloroquine. Le corpus était constitué des messages d’alertes COVID du 14 mars 2020 au 11 mai 2020, reçus par SMS, messages WhatsApp, mails, publications des sociétés savantes et enfin, les publications scientifiques. Les articles de presse écrite ont été recherchés par le moteur de recherche Europresse et les articles scientifiques par PubMed. Résultats (a) Lésions dermatologiques liée au COVID : onze alertes ont circulé entre médecins dès le 2 avril 2020 (3 mails, 5 messages WhatsApp et 3 articles scientifiques le premier publié le 15/04/20). Un seul article évoque cette alerte dans la presse généraliste française publié le 8 avril 2020 dans le Point. (b)Symptômes d’anosmie agueusie : 21 alertes entre médecins ont circulé dès le 20 mars 2020 (4 mails, 1 SMS, 1 message WhatsApp, 11 articles scientifiques dont le 1er publié le 26/03/20) et 28 articles dans la presse nationale généraliste dès le 20 mars 2020. (c) Lien entre tabac et COVID : 7 alertes ont circulées entre médecins (7 articles scientifiques dès le 02/04/20 dont 1 article d’une équipe française mis en ligne sur une plateforme en accès libre le 21 avril 2020) suivis par 25 articles dans la presse écrite nationale dès le 13 avril 2020. (d) Traitement par chloroquine : nombreuses alertes entre médecins ont été publiées (4 mails, 918 articles scientifiques), 3278 articles y sont consacrés dans la presse écrite nationale dont le premier publié le 18 février 2020 dans le Monde. À titre comparatif une recherche dans la presse nationale généraliste avec les mots clés « Anticorps monoclonaux », « Tocilizumab », « azithromycine », « Remdesivir » donnent respectivement, 61, 123, 281 et 493 résultats. Conclusion Au vu de cette analyse, les réseaux sociaux ont relayé avec efficacité les messages d’alerte pendant l’épidémie, à un moment où les médecins n’avaient pas forcément du temps de lire la littérature scientifique quotidienne. Néanmoins, si la diffusion a été large par ces canaux, le gain de temps a été faible puisque les messages ont presque tous été relayés de manière simultanée dans la presse généraliste et scientifique à quelques jours d’intervalle.
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Poncet-Megemont L, Paris P, Tronchere A, Salazard JP, Pereira B, Dallel R, Aumeran C, Beytout J, Jacomet C, Laurichesse H, Lesens O, Mrozek N, Vidal M, Moisset X. High Prevalence of Headaches During Covid-19 Infection: A Retrospective Cohort Study. Headache 2020; 60:2578-2582. [PMID: 32757419 PMCID: PMC7436456 DOI: 10.1111/head.13923] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023]
Abstract
Objectives To document the prevalence of new headaches in patients with Covid‐19 infection and the potential association with other neuro‐sensorial symptoms (anosmia and ageusia). The persistence of these symptoms 1 month after recovery was also documented. Background Headaches are a very common symptom of viral infections. Surprisingly, early Chinese studies reported a relatively low prevalence (12‐15%) of headaches associated with Covid‐19. Methods All the patients with laboratory‐confirmed or chest‐CT‐confirmed Covid‐19 infection, diagnosed between February 27th and April 15th, 2020 in the dedicated laboratory of Clermont‐Ferrand University Hospital were followed for 1 month after recovery. Results A total of 139 consecutive patients (mean [SD] age, 48.5 [15.3] years; 87 women [62.6%]) were interviewed 1 month after disappearance of fever and dyspnea (semi‐structured phone interview). Overall, 59.0% (82/139) of people with Covid‐19 had mild disease, 36.7% (51/139) had severe disease, and 4.3% (6/139) had critical illness. Eighty‐two (59.0%; 95% CI: 50.3 to 67.3) reported new headaches during the acute phase and 3.6% (5/139) had persistent headaches 1 month after fever and dyspnea remission. Anosmia and ageusia were also very common, occurring in 60.4% (84/139) and 58.3% (81/139) of the patients, respectively. These 2 symptoms persisted in 14.4% (20/139) and 11.5% (16/139) of Covid‐19 patients 1 month after recovery. Headaches were neither clearly associated with anosmia, nor with ageusia, and were not associated with disease severity (ie, requiring hospitalization or intensive care unit). Conclusion This specific study highlights the high prevalence of new headaches during Covid‐19 infection in French patients. Further studies are needed to refine the characterization of patients with Covid‐19‐associated headaches.
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Affiliation(s)
- Louis Poncet-Megemont
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Pauline Paris
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Amélie Tronchere
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Pascal Salazard
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Radhouane Dallel
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Claire Aumeran
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean Beytout
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Christine Jacomet
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Henri Laurichesse
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Olivier Lesens
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Natacha Mrozek
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Magali Vidal
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Xavier Moisset
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
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Becker A, Kreitmann L, Triffaut-Fillit C, Valour F, Mabrut E, Forestier E, Lesens O, Cazorla C, Descamps S, Boyer B, Chidiac C, Lustig S, Montbarbon E, Batailler C, Ferry T. Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with a debridement, antibiotics and implant retention (DAIR): a retrospective multicenter study in France. J Bone Jt Infect 2020; 5:28-34. [PMID: 32117687 PMCID: PMC7045531 DOI: 10.7150/jbji.40333] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/12/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction: In patients undergoing a « debridement, antibiotics, and implant retention » (DAIR) procedure for acute staphylococcal prosthetic joint infection (PJI), post-operative treatment with rifampin has been associated with a higher probability of success.(1,2) However, it is not known whether it is the total dose, delay of introduction or length of therapy with rifampin that is most strongly associated with the observed improved outcomes. Methods: A multicentric, retrospective cohort study of patients with acute staphylococcal hip and knee PJI treated with DAIR between January 2011 and December 2016. Failure of the DAIR procedure was defined as persistent infection, need for another surgery or death. We fitted logistic and Cox regression multivariate models to identify predictors of DAIR failure. We compared Kaplan-Meier estimates of failure probability in different levels of the 3 variables of interest - total dose, delay of introduction or length of therapy with rifampin - with the log-rank test. Results: 79 patients included (median age 71 years [63.5-81]; 55 men [70%]), including 54 (68%) DAIR successes and 25 (32%) DAIR failures. Patients observed for a median of 435 days [IQR 107.5-834]. Median ASA score significantly lower in DAIR successes than in DAIR failures (2 vs. 3, respectively p = 0.011). Bacterial cultures revealed 65 (82.3%) S. aureus and 16 (20.3%) coagulase negative staphylococci, with 2 patients being infected simultaneously with S. aureus and CNS. Among S. aureus isolates, 7 (10.8%) resistant to methicillin; 2 (3.1 %) resistant to rifampin. Median duration of antimicrobial therapy was 85 days [IQR 28.5-97.8]. Fifty-eight patients (73.4%) received rifampin at a median dose of 14.6 mg/kg/day |IQR 13-16.7], started at a median delay of 8.5 days [IQR, 4-7.5] after debridement surgery. Twenty-one patients (26.6%) developed a drug-related adverse event, leading to rifampin interruption in 6 of them (7.6% of total cohort). Determinants of DAIR failure were rifampin use (HR 0.17, IC [0.06, 0.45], p-value <0.001), association of rifampin with a fluoroquinolone (HR 0.19, IC [0.07, 0.53], p-value = 0.002) and duration of rifampin therapy (HR 0.97, IC [0.95, 1], p-value = 0.022). We did not observe a significant difference between DAIR successes and failures in rifampin use, dose and delay of introduction. In a multivariate Cox model, only duration of rifampin therapy was significantly associated with DAIR failure. Kaplan Meier estimate of DAIR failure probability was significantly higher in patients receiving less than 14 days of rifampin in comparison with those receiving more than 14 days of rifampin (p = 0.0017). Conclusion: Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with DAIR.
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Affiliation(s)
- A Becker
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - L Kreitmann
- Service de Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - C Triffaut-Fillit
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - F Valour
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Inserm U1111, Centre international de recherche en Infectiologie (CIRI), Université Claude-Bernard Lyon 1, Lyon, France
| | - E Mabrut
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - E Forestier
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier Métropole Savoie, Chambéry (France)
| | - O Lesens
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) Gabriel Montpied, Clermont-Ferrand (France)
| | - C Cazorla
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de Saint-Etienne (France)
| | - S Descamps
- Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) Gabriel Montpied, Clermont-Ferrand (France)
| | - B Boyer
- Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de Saint-Etienne (France)
| | - C Chidiac
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France
| | - S Lustig
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France)
| | - E Montbarbon
- Service de Chirurgie Orthopédique, Centre hospitalier Métropole Savoie, Chambéry (France)
| | - C Batailler
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France)
| | - T Ferry
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Inserm U1111, Centre international de recherche en Infectiologie (CIRI), Université Claude-Bernard Lyon 1, Lyon, France
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Letertre-Gibert P, Vourc'h G, Lebert I, Rene-Martellet M, Corbin-Valdenaire V, Portal-Martineau D, Beytout J, Lesens O. Lyme snap: A feasibility study of on-line declarations of erythema migrans in a rural area of France. Ticks Tick Borne Dis 2019; 11:101301. [PMID: 31653585 DOI: 10.1016/j.ttbdis.2019.101301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/21/2019] [Revised: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 11/16/2022]
Abstract
The incidence of Lyme borreliosis remains a matter of debate, but it can be estimated using the incidence of erythema migrans (EM), which is pathognomonic of the first phase. The aim of this prospective pilot study was to assess the feasibility of the on-line declaration of EM in rural areas where the incidence of Lyme borreliosis was previously estimated at 85 per 100,000 inhabitants per year. The study was limited to a rural area (Les Combrailles, Auvergne) of approximately 52,800 inhabitants and was preceded by an information campaign for the inhabitants and the healthcare professionals. Patients who sent a photo of the suspected EM by email or MMS message between April 2017 and April 2018 and who accepted to answer a questionnaire were included in the study. Two physicians then evaluated the quality of the photographs and the probability of EM. In parallel, the number of EM seen by physicians and pharmacists in the area over the given period was recorded. Out of the 113 emails and MMS messages received, 73 people were outside of the trial area or period and 9 did not complete the questionnaire. The photos of the remaining 31 people were analysed. The median age was 51.5 years old ([38-58] IQR) and 18 (58%) were women. Seven people (25%) stated that they did not have a smartphone and in 9 cases (29%) the photo was sent by a third party. The quality of the photos was considered very good in 22 (71%) cases, good in 7 (23%) cases, and average in 2 (6%) cases. The probability of EM was determined to be strong or possible in 12 (38%) cases, i.e. an estimated incidence of 22.7 per 100,000 inhabitants. Over the study period, 40 physicians and 20 pharmacists were contacted on a monthly basis. A median of 5 physicians [3;7] and 4 pharmacists [3 ;7] answered each month for a total of 18 and 36 declared EM respectively. The EM (strong probability/possible) collected by on-line declaration and those declared by healthcare professionals were all sent between April and October 2017. The total time spent on the information campaign and collection has been estimated at 265 h (divided between 10 people) for an overall cost of 10,669 Euros. The incidence of EM recorded by on-line self-declaration in our study seems to be lower than in previous studies, the under-reporting was probably linked to the low use of new technologies in the rural areas. Increasing the human resources and finances appears difficult to achieve in practice over a longer time period but the development of an application for the automatic recognition of EM could be one method for a more exhaustive collection in the long term and at lower cost.
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Affiliation(s)
- P Letertre-Gibert
- Service de Maladies Infectieuses et Tropicales, CHU de Clermont-Ferrand, France; Département de Recherche Clinique, CHU de Clermont-Ferrand, France; Laboratoire Microorganismes: Génome Environnement (LMGE) UMR 6023, Université Clermont Auvergne, Clermont-Ferrand, France.
| | - G Vourc'h
- Institut national de la Recherche Agronomique, Theix, France
| | - I Lebert
- Institut national de la Recherche Agronomique, Theix, France
| | | | - V Corbin-Valdenaire
- Service de Maladies Infectieuses et Tropicales, CHU de Clermont-Ferrand, France
| | | | - J Beytout
- Service de Maladies Infectieuses et Tropicales, CHU de Clermont-Ferrand, France
| | - O Lesens
- Service de Maladies Infectieuses et Tropicales, CHU de Clermont-Ferrand, France; Laboratoire Microorganismes: Génome Environnement (LMGE) UMR 6023, Université Clermont Auvergne, Clermont-Ferrand, France
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Couturier A, Chabaud A, Desbiez F, Descamps S, Petrosyan E, Letertre-Gilbert P, Mrozek N, Vidal M, Tauveron I, Maqdasy S, Lesens O. Comparison of microbiological results obtained from per-wound bone biopsies versus transcutaneous bone biopsies in diabetic foot osteomyelitis: a prospective cohort study. Eur J Clin Microbiol Infect Dis 2019; 38:1287-1291. [PMID: 30980264 DOI: 10.1007/s10096-019-03547-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
Transcutaneous bone biopsy (TCB) is the gold standard for taking microbiological specimens in diabetic foot osteomyelitis (DFO), but this technique is not widely used in diabetic foot care centers. We aimed to evaluate the reliability of per-wound bone biopsy (PWB) cultures by comparing them with concomitant TCB cultures obtained through healthy skin. This is a prospective monocentric study including patients seen in consultation for clinical and radiological diabetic foot osteomyelitis with positive probe-bone tests between April 2015 and May 2018. Two bone biopsies were performed on each consenting patient: TCB through a cutaneous incision in healthy skin, and PWB, after careful debridement of the wound. A total of 46 paired cultures were available from 43 eligible patients. Overall, 16 (42%) of the PWB and TCB pairs had identical culture results, but the TCB cultures were sterile in 8 (17%) cases. For 38 paired cultures with positive TCB, the correlation between PWB results and TCB results was 58.4%. PWB revealed all microorganisms found in the transcutaneous specimen in 26/38 samples (68.5%). In patients with DFO, the culture results of specimens taken by per-wound biopsies did not correlate well with those obtained by TCB. PWB should be reserved for cases where the transcutaneous biopsy is sterile or not feasible.
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Affiliation(s)
- Alice Couturier
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France.
| | - Aurore Chabaud
- Department of Physical Medicine and Rehabilitation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRA, 63000, Clermont-Ferrand, France
| | | | - Stéphane Descamps
- Department of Orthopedic Surgery and Traumatology, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Evelina Petrosyan
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - Paule Letertre-Gilbert
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - Natacha Mrozek
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - Magali Vidal
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - Igor Tauveron
- Department of Endocrinology, CHU, Clermont-Ferrand, France
| | - Salwan Maqdasy
- Department of Endocrinology, CHU, Clermont-Ferrand, France
| | - Olivier Lesens
- Department of Infectious and Tropical Diseases, CRIOAc, CHU Clermont-Ferrand, Université Clermont Auvergne UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
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Nourrisson C, Vidal-Roux M, Cayot S, Jacomet C, Bothorel C, Ledoux-Pilon A, Anthony-Moumouni F, Lesens O, Poirier P. Invasive Infections Caused by Nannizziopsis spp. Molds in Immunocompromised Patients. Emerg Infect Dis 2019; 24:549-552. [PMID: 29460742 PMCID: PMC5823334 DOI: 10.3201/eid2403.170772] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We report 2 new cases of invasive infections caused by Nannizziopsis spp. molds in France. Both patients had cerebral abscesses and were immunocompromised. Both patients had recently spent time in Africa.
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Becker A, Triffault-Fillit C, Forestier E, Lesens O, Boyer B, Descamps S, Chidiac C, Lustig S, Montbarbon E, Batailler C, Cazorla C, Ferry T. 1210. Staphylococcal Acute Post-Operative Prosthetic Joint Infection (PJI) Treated With “DAIR” (Debridement and Implant Retention) and Impact of Rifampin: A Retrospective Cohort Study in France. Open Forum Infect Dis 2018. [PMCID: PMC6252675 DOI: 10.1093/ofid/ofy210.1043] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Staphylococci are the most frequent bacteria in PJI. In patients with acute PJI (i.e., <1 month following the implantation), DAIR with exchange of removal components followed by a combination of antibiotics including rifampin (RMP) (particularly RMP + fluoroquinolone) are recommended. Unfortunately, some patients could not receive RMP due to drug–drug interaction or stopped it due to an adverse event. Finally, it is unclear whether the dose and the duration of RMP influenced the prognosis. Methods Retrospective cohort study in four hospitals including patients with staphylococcal acute post-operative PJI treated with DAIR in 2011–2016. Univariate and multivariate Cox analysis and Kaplan–Meier curves were used to determine the risk factors for treatment failure. Results Seventy-nine patients were included (median age: 71 years [IQR 53–89]; 55 men [69.6%]; median ASA score: 2 [IQR 2–3]). Cultures revealed 65 (82%) S. aureus and 15 (19%) coagulase negative staphylococci infections, including 14 methicillin-resistant strains (18%). Among all isolates, only two (3%) were resistant to RMP and 16 (20%) were resistant to fluoroquinolone. The median duration of antimicrobial therapy was 92 days (IQR 31–152). Only 59 patients received RMP (75%), and 35 (44%) the combination RMP + fluoroquinolone. Median duration of RMP was 57 days (IQR 16–86) and median dose 14.6 mg/kg/d (IQR 13–17). Forty patients (51%) received RMP in the first 2 weeks and 43 patients (54%) received at least 2 weeks of RMP. Six patients (8%) developed an adverse event leading to RMP interruption. During a median follow-up of 443 days (IQR 220–791), 21 patients (27%) experienced a treatment failure including 12 persistence of the initial pathogen (57%) and nine superinfections (43%). An ASA score >2 (OR 2.8; 95% CI 1.26–6.15), the use of RMP (OR 0.4; 95% CI 0.71–0.95) and the duration of RMP treatment (OR 0.83; 95% CI 0.75–0.92 per week of treatment) were significant determinants of the outcome (but not methicillin-resistance). Receiving >2 weeks of RMP prevented the failure, but an introduction during the first 2 weeks did not influence the outcome. Conclusion In patients with staphylococcal acute PJI, the use of RMP and its duration strongly influenced the prognosis. As 25% of patients could not receive RMP, new drugs with anti-biofilm activity are required. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Agathe Becker
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | | | | | - Olivier Lesens
- Maladies Infectieuses, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Bertrand Boyer
- Chirurgie Orthopédique Et Traumatologique, CHU de Saint Etienne, Saint Etienne, France
| | - Stéphane Descamps
- Chirurgie Orthopédique Et Traumatologique, CHU de Clermont Ferrand, Clermont Ferrand, France
| | - Christian Chidiac
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Orthopaedic Surgery, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | - Eric Montbarbon
- Chirurgie Orthopédique Et Traumatologique, CH de Chambéry, Chambéry, France
| | - Cécile Batailler
- Chirurgie Orthopédique Et Traumatologique, CHU de Lyon, Lyon, France
| | | | - Tristan Ferry
- Inserm 1111, UCBL1, Hospices Civils de Lyon, Lyon, France
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Lesens O, Ferry T, Forestier E, Botelho-Nevers E, Pavese P, Piet E, Pereira B, Montbarbon E, Boyer B, Lustig S, Descamps S. Should we expand the indications for the DAIR (debridement, antibiotic therapy, and implant retention) procedure for Staphylococcus aureus prosthetic joint infections? A multicenter retrospective study. Eur J Clin Microbiol Infect Dis 2018; 37:1949-1956. [PMID: 30083889 DOI: 10.1007/s10096-018-3330-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022]
Abstract
To evaluate factors associated with failure in patients treated with DAIR (debridement, antibiotic therapy, and implant retention) for Staphylococcus aureus prosthetic joint infections (PJIs). We retrospectively analyzed consecutive patients with stable PJI due to S. aureus treated with DAIR at six hospitals between 2010 and 2014. Cox proportional hazards regression was used to study factors associated with treatment failure at 2 years. Of 154 eligible patients, 137 were included (mean age 73 ± 13 years; male 56%). The estimated success rate according to the Kaplan-Meier method was 76.2 [95% CI 68-83] at 2 years of follow-up. In multivariate analysis, longer duration of treatment (hazard ratio (HR) 0.78 [0.69-0.88]; p < 0.001) and combination therapy including rifampin (HR 0.08 [0.018-0.36]; p = 0.001) were independently associated with success, whereas active smoking was independently associated with failure (HR 3.6 [1.09-11.84]; p = 0.036). When the analysis was restricted to patients with early infection onset (< 3 months), early acute infection was also predictive of a better prognosis (HR 0.25 [0.09-0.7]; p = 0.009). Failure was not associated with time from prosthesis insertion to debridement, nor with duration of symptoms > 3 weeks and type of prosthesis (hip or knee). These results remained unchanged when the 14 patients under immunosuppressive therapy were removed from analysis. These data suggest that DAIR can be performed even if infection and symptoms are delayed but reserved to patients who are able to follow rifampin-based combination therapy for a prolonged duration that should not be different for hip and knee PJI.
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Affiliation(s)
- O Lesens
- Service des Maladies Infectieuses et Tropicales, Hôpital Gabriel Montpied, CRIOAc, CHU, Clermont-Ferrand, France.
- Laboratoire Microorganismes: Génome Environnement (LMGE) UMR 6023, Université Clermont Auvergne, Clermont-Ferrand, France.
| | - T Ferry
- Hospices Civils de Lyon, CRIOAc Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - E Forestier
- Service de Maladies Infectieuses, CH Métropole Savoie, Chambéry, France
| | - E Botelho-Nevers
- Service d'Infectiologie, CIC1408-Inserm, CRIOAc Saint-Etienne, Hôpital Nord-CHU Saint Etienne, 42055, Saint-Etienne, France
| | - P Pavese
- Service de Maladies Infectieuses, CHU Grenoble Alpes, Grenoble, France
| | - E Piet
- Service d'Infectiologie, CH Annecy Genevois, 74000, Annecy, France
| | - B Pereira
- CHU Clermont-Ferrand, DRCI-Biostatistique, Clermont-Ferrand, France
| | - E Montbarbon
- Service d'Orthopédie-Traumatologie, CH Metropole Savoie, Chambéry, France
| | - B Boyer
- Service Orthopédie, CRIOAc Saint-Etienne, Hôpital Nord-CHU Saint-Etienne, Saint-Etienne, France
| | - S Lustig
- Hospices Civils de Lyon, CRIOAc Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - S Descamps
- Université Clermont- Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, 63000, Clermont-Ferrand, France
- Institut de Chimie de Clermont-Ferrand (ICCF), UMR 6296, 24, avenue Blaise-Pascal, 63178, Aubiere, France
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Levoyer T, Petrosyan E, Sauvat L, Lesens O. Tuberculose des villes, tuberculose des champs. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.289] [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: 10/14/2022]
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Touzet M, Ingold A, Laurenson C, Dessenne P, Baril P, Jacomet C, Lesens O. TRODs VIH et VHC en zone rurale : la prévention et le dépistage, ce n’est pas qu’en ville ! Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.013] [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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Sauvat L, Letertre-Gibert P, Lesens O, Vidal-Roux M, Laurichesse H. Exanthème maculopapuleux et méningocoque. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nourrisson C, Vidal-Roux M, Cayot S, Jacomet C, Bothorel C, Ledoux-Pilon A, Anthony-Moumouni F, Lesens O, Poirier P. Infections invasives à Nannizziopsis obscura : à propos de 2 cas survenus au CHU de Clermont-Ferrand. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.040] [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: 10/18/2022]
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Chabaud A, Tetard M, Descamps S, Nguyen C, Aubreton S, Plan-Paquet A, Rannou F, Tournadre A, Lesens O, Coudeyre E. Therapeutic algorithm for native septic arthritis rehabilitation of the knee. Ann Phys Rehabil Med 2017. [DOI: 10.1016/j.rehab.2017.07.195] [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: 11/25/2022]
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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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Touzet M, Berrier C, Deschamps M, Gorse D, Lesens O, Aumeran C, Vidal M. Ressenti du port du masque systématique par les professionnels de santé non vaccinés pendant la période épidémique grippale. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.371] [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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Petrosyan E, Ferry T, Forestier E, Botelho-Nevers E, Maillet M, Piet E, Pereira B, Lustig S, Descamps S, Lesens O. Pronostic des infections de prothèses orthopédiques à S. aureus traitées par lavage : étude rétrospective multicentrique. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.034] [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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Letertre-Gibert P, Diallo I, Pereira B, Coban D, Heng A, Lesens O, Laurichesse H, Drabo Y, Jacomet C. Atteintes rénales chez les personnes vivant avec le VIH traitées en Afrique par une combinaison antirétrovirale comprenant du tenofovir disoproxil fumarate. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fiquet S, Desbiez F, Tauveron I, Mrozek N, Vidal M, Lesens O. Happy@feet application for the management of diabetic foot osteomyelitis. Med Mal Infect 2016; 46:419-423. [PMID: 27692828 DOI: 10.1016/j.medmal.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/26/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to develop and implement an application that could improve the management of patients presenting with diabetic foot osteomyelitis. PATIENTS AND METHODS Physicians from the multidisciplinary diabetic foot infection team and a software engineer first assessed the needs required for the infection management and application. An experimental version was then designed and progressively improved. A final version was implemented in clinical practice in 2013 by the multidisciplinary diabetic foot infection team of our university hospital. RESULTS The application, known as Happy@feet, helps gather and allows access to all required data for patient management, dispenses prescriptions (antibiotics, nursing care, blood tests), and helps follow the evolution of the wound. At the end of the consultation, a customizable letter is generated and may be directly sent to the persons concerned. This application also facilitates clinical and economic research. In 2014, Happy@feet was used to follow 83 patients during 271 consultations, 88 of which were day care hospitalizations. CONCLUSION The Happy@feet application is useful to manage these complex patients. Once the learning period is over, the time required for data collection is compensated by the rapid dispense of prescriptions and letters. Happy@feet can be used for research projects and will be used in a remote patient management project.
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Affiliation(s)
- S Fiquet
- Service des maladies infectieuses et tropicales, hôpital Gabriel-Montpied, centre hospitalier universitaire, 63000 Clermont-Ferrand, France
| | - F Desbiez
- Service d'endocrinologie, hôpital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - I Tauveron
- Service d'endocrinologie, hôpital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - N Mrozek
- Service des maladies infectieuses et tropicales, hôpital Gabriel-Montpied, centre hospitalier universitaire, 63000 Clermont-Ferrand, France
| | - M Vidal
- Service des maladies infectieuses et tropicales, hôpital Gabriel-Montpied, centre hospitalier universitaire, 63000 Clermont-Ferrand, France; Service d'endocrinologie, hôpital Gabriel-Montpied, 63000 Clermont-Ferrand, France; Laboratoire « Microorganismes : génome et environnement », Clermont université, université Blaise-Pascal, BP 10448, 63000 Clermont-Ferrand, France
| | - O Lesens
- Service des maladies infectieuses et tropicales, hôpital Gabriel-Montpied, centre hospitalier universitaire, 63000 Clermont-Ferrand, France; Laboratoire « Microorganismes : génome et environnement », Clermont université, université Blaise-Pascal, BP 10448, 63000 Clermont-Ferrand, France; UMR 6023, LMGE, CNRS, 63171 Aubière, France.
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Jacomet C, Illes G, Kwiatkowski F, Vidal M, Mrozek N, Aumeran C, Corbin V, Lesens O, Laurichesse H, Bailly P. Prevalence of aortic valve dystrophy and insufficiency in a cohort of 255 HIV-positive patients followed-up in a cardiology department between 2012 and 2014. Int J Cardiol 2016; 220:82-6. [PMID: 27372049 DOI: 10.1016/j.ijcard.2016.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/26/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To study valve appearance and the presence of valve disease in a cohort of people living with HIV (PLHIV). DESIGN A prospective study of PLHIV examined at the cardiology department of the Clermont Ferrand university hospital group (CHU) between January 1, 2012, and December 31, 2014. Were excluded those with a history of infection associated with a possible endocarditis. METHODS Demographic, medical characteristics and cardiovascular disease risk factors at time of cardiovascular examination and Doppler-echocardiography were recorded and analyzed. RESULTS In total, 903 PLHIV were examined in the infectious diseases department, 255 of whom were included. These consisted of 67 women (26.3%) and 188 men, of a mean age of 51.2±9.7years, in whom coronary artery disease was diagnosed in 18 patients (7.0%), two women and 16 men, representing a prevalence of 3.0% in females and 8.5% in males. The appearance of the aortic cusps was considered dystrophic in 14.1% of cases (36/255), dysplastic in two cases (0.8%), exhibiting a bicuspid deformity in one case. The prevalence of aortic valve abnormality was therefore 6.0% in the women (4/67) and 17.0% in the men (32/188). On facing off this data with the Kora Monica study findings, an increase in prevalence appears only to truly manifest after 50years of age. We registered 35 aortic insufficiency cases (13.7%), representing a higher incidence than that of the Framingham cohort, with age and masculine gender being the determining factors. CONCLUSION Valve disease, along with coronary artery disease, should be closely monitored in PLHIV.
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Affiliation(s)
- C Jacomet
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - G Illes
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - F Kwiatkowski
- Clermont-Ferrand University Hospital, Statistics Department, F-63000 Clermont Ferrand, France.
| | - M Vidal
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - N Mrozek
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - C Aumeran
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - V Corbin
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - O Lesens
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - H Laurichesse
- Clermont-Ferrand University Hospital, Infectious Diseases Department, F-63000 Clermont Ferrand, France.
| | - P Bailly
- Clermont-Ferrand University Hospital, Cardiology Department and Centre Jean Perrin, Surgical Thoracic Department, F-63000 Clermont Ferrand, France.
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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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Lesens O, Hansmann Y, Brannigan E, Hopkins S, Meyer P, O'Connel B, Prévost G, Bergin C, Christmann D. Healthcare-AssociatedStaphylococcus aureusBacteremia and the Risk for Methicillin Resistance: Is the Centers for Disease Control and Prevention Definition for Community-Acquired Bacteremia Still Appropriate? Infect Control Hosp Epidemiol 2016; 26:204-9. [PMID: 15756893 DOI: 10.1086/502527] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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: 11/03/2022]
Abstract
AbstractObjective:To evaluate a new classification for bloodstream infections that differentiates hospital acquired, healthcare associated, and community acquired in patients with blood cultures positive forStaphylococcus aureus.Design:Prospective, observational study.Setting:Three tertiary-care, university-affiliated hospitals in Dublin, Ireland, and Strasbourg, France.Patients:Two hundred thirty consecutive patients older than 18 years with blood cultures positive forS. aureus.Methods:S. aureusbacteremia (SAB) was defined as hospital acquired if the first positive blood culture was performed more than 48 hours after admission. Other SABs were classified as healthcare associated or community acquired according to the definition proposed by Friedman et al. When available, strains of methicillin-resistantStaphylococcus aureus(MRSA) were analyzed by pulsed-field gel electrophoresis (PFGE).Results:Eighty-two patients were considered as having community-acquired bacteremia according to the Centers for Disease Control and Prevention (CDC) classification. Of these 82 patients, 56% (46) had healthcare-associated SAB. MRSA prevalence was similar in patients with hospital-acquired and healthcare-associated SAB (41% vs 33%;P> .05), but significantly lower in the group with community-acquired SAB (11%;P< .03). PFGE of MRSA strains showed that most community-acquired and healthcare-associated MRSA strains were similar to hospital-acquired MRSA strains. On multivariate analysis, Friedman's classification was more effective than the CDC classification for predicting MRSA.Conclusion:These results support the call for a new classification for community-acquired bacteremia that would account for healthcare received outside the hospital by patients with SAB.
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Affiliation(s)
- Olivier Lesens
- Service des Maladies Infectieuses et Tropicales, Hôtel-Dieu, Clermont-Ferrand, France.
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Outh R, Vidal M, Albaret J, Mrozek N, Laurichesse H, Beytout J, Lesens O. ENDO-05 - Impact et pronostic de l’insuffisance rénale aiguë au cours de l’endocardite infectieuse. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30374-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Laurichesse G, Casanova S, Corbin V, Mirand A, Henquell C, Lesens O, Jacomet C, Beytout J, Laurichesse H. HEP-06 - Nouveaux antiviraux oraux contre le virus de l’hépatite C chez des patients co-infectés VIH-VHC : remarquables résultats des combinaisons orales sans interféron, 2014-2015. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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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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Corbin V, Blanche S, Runel Belliard C, Lalande M, Roussey M, Moukagni M, Mazingue F, Dollfus C, Jacomet C, Lesens O. VIH-05 - Infection VIH chez les enfants adoptés internationalement en France : où en sommes-nous ? Résultats d’une étude multicentrique. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30550-9] [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: 10/21/2022]
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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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Vidal M, Genillon J, Forestier E, Trouiller S, Pereira B, Mrozek N, Aumeran C, Lesens O. Outcome of totally implantable venous-access port-related infections. Med Mal Infect 2016; 46:32-8. [DOI: 10.1016/j.medmal.2015.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/02/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
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Lesens O, Desbiez F, Theïs C, Ferry T, Bensalem M, Laurichesse H, Tauveron I, Beytout J, Aragón Sánchez J. Staphylococcus aureus–Related Diabetic Osteomyelitis. INT J LOW EXTR WOUND 2014; 14:284-90. [DOI: 10.1177/1534734614559931] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and can be treated medically or by surgery. We investigated the outcome of consecutive patients with a diagnosis of S aureus DFO retrospectively in 4 hospitals according to the type of management, medical (including debridement at bedside) or surgical. The outcome was classified as either favorable or failure (relapse, impaired wound healing, or amputation). Seventy-four patients with S aureus DFO, including 26 with methicillin-resistant S aureus, were included with a mean duration of follow-up of 21 ± 1 months. As part of the initial treatment, 47% underwent bone surgery followed with a short course of antibiotic. Others were treated with antibiotic therapy alone with bedside debridement. The outcome was favorable for 84% of these patients, with similar rates in the surgical and medical groups (80% vs 87%, P > .05). Patients in the medical group were less frequently hospitalized (49% vs 94%, P < .001) and had a shorter length of hospital stay (17 ± 3 vs 50 ± 12 days, P = .004). Patients in the surgery group received a shorter course of antibiotic therapy (10 ± 2 vs 11 ± 1 weeks, P = .001) with fewer side effects (9% vs 33%, P = .01). The type of management was not associated with subsequent new episode of noncontiguous DFO, which developed in 32% of cases. In conclusion, except significant differences in duration of hospitalization and antibiotic therapy, medical and surgical management of S aureus DFO had similar outcomes with a cure rate >80%.
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Affiliation(s)
- Olivier Lesens
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Françoise Desbiez
- Service d’endocrinologie Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Clément Theïs
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Tristant Ferry
- University of Lyon Claude Bernard, Lyon, France
- Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Henri Laurichesse
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | | | - Jean Beytout
- Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied, Clermont-Ferrand, France
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Sciauvaud J, Rigal E, Pascal J, Nourrisson C, Poirier P, Poirier V, Vidal M, Mrozek N, Laurichesse H, Beytout J, Labbe A, Lesens O. Transmission of infectious diseases from internationally adopted children to their adoptive families. Clin Microbiol Infect 2014; 20:746-51. [DOI: 10.1111/1469-0691.12454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 11/05/2013] [Accepted: 11/07/2013] [Indexed: 11/28/2022]
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Kabore JL, Desbiez F, Balayssac D, Fiquet S, Audibert M, Lesens O. COL08-03 : Évaluation des coûts directs médicaux dans les infections du pied diabétique. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70076-9] [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: 11/26/2022]
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Fiquet S, Desbiez F, Kessler L, Lefebvre N, Lesens O. G-08: Développement et mise en place d’Happy@feet, logiciel pour la prise en charge et le suivi des infections du pied diabétique. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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