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Bailleul A, Fulgencio JP, Vimont S, Mordelet C, Ray B, Lassel L, Lapidus N, Quesnel C, Garnier M. Risk factors and prognostic significance of infection of totally implantable vascular access port in solid tumor patients: A prospective cohort study. Infect Dis Now 2023; 53:104766. [PMID: 37543258 DOI: 10.1016/j.idnow.2023.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES Totally implantable venous access ports (TIVAP) are devices mainly used to deliver antineoplastic chemotherapies, of which the insertion may be complicated by TIVAP-related infection (TIVAP-RI). This study aims to provide data on the risk factors for TIVAP-RI and its influence on patient prognosis. PATIENTS AND METHODS Prospective observational study including adult patients with solid tumors, in whom a TIVAP was inserted to deliver antineoplastic chemotherapy between January 2018 and October 2019. Factors associated with TIVAP-RI and one-year mortality were determined using multiple logistic regressions. RESULTS More than a thousand (1014) patients were included, among whom 48 (4.7%) presented with TIVAP-RI. Gram-positive cocci and Gram-negative bacilli represented 51% and 41% of the pathogens isolated, respectively. Young age (odds ratio [OR] 0.67; 95% Confidence Interval [0.53-0.83] per 10-year increase), WHO performance status ≥ 1 (OR 3.24 [1.52-7.79]), chemotherapy administration in the month before TIVAP placement (OR 2.26 [1.17-4.26]), and radiation therapy of the homolateral chest wall (OR 3.28 [1.51-6.67]) were independently associated with TIVAP-RI occurrence. During the year following TIVAP insertion, 287 (28%) patients died. TIVAP-RI was not associated with one-year mortality (OR 1.56 [0.75-3.19]). CONCLUSION TIVAP insertion in adult patients with solid tumors is associated with a low infection rate, which did not influence one-year mortality. In addition to young age and impaired health status, TIVAP insertion in the month following initiation of the antineoplastic chemotherapy and TIVAP insertion in an irradiated area are two newly reported preventable TIVAP-RI risk factors.
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Affiliation(s)
- Amaury Bailleul
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France
| | - Jean-Pierre Fulgencio
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France
| | - Sophie Vimont
- Département de Bactériologie, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, - 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; Sorbonne Université, INSERM UMR S_1155, Hôpital Tenon, Paris, France
| | - Cécile Mordelet
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France
| | - Benoit Ray
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France
| | - Ludovic Lassel
- Sorbonne Université, AP-HP, DMU 3ID, Hôpital Tenon, Service des Maladies Infectieuses et Tropicales - 4 rue de la Chine, 75020 Paris, France
| | - Nathanaël Lapidus
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Saint-Antoine Hospital, Public Health Department, 75012 Paris, France
| | - Christophe Quesnel
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France
| | - Marc Garnier
- Sorbonne Université, AP-HP, GRC29, DMU DREAM, Hôpital Tenon, Service d'Anesthésie-Réanimation et Médecine Périopératoire - 4 rue de la Chine, 75020 Paris, France; Université Clermont-Auvergne, CHU de Clermont-Ferrand, Service d'Anesthésie-Réanimation et Médecine Périopératoire, 58 rue Montalembert, 63000 Clermont-Ferrand, France.
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Daudon M, Petay M, Vimont S, Deniset A, Tielens F, Haymann JP, Letavernier E, Frochot V, Bazin D. Urinary tract infection inducing stones: some clinical and chemical data. CR CHIM 2022. [DOI: 10.5802/crchim.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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de Cacqueray N, Hirt D, Zheng Y, Bille E, Leger PL, Rambaud J, Toubiana J, Chosidow A, Vimont S, Callot D, Chouchana L, Béranger A, Tréluyer JM, Benaboud S, Oualha M. Cefepime population pharmacokinetics and dosing regimen optimization in critically ill children with different renal function. Clin Microbiol Infect 2022; 28:1389.e1-1389.e7. [PMID: 35605841 DOI: 10.1016/j.cmi.2022.05.007] [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: 03/24/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cefepime is commonly used in pediatric intensive care units (PICUs), where unpredictable variations in the patients' pharmacokinetic (PK) variables may require drug dose adjustments. The objectives of the present study were to build a population PK model for cefepime in critically ill children and to optimize individual initial dosing regimens. METHODS Children (aged from 1 month to 18 years; bodyweight >3 kg) receiving cefepime were included. Cefepime total plasma concentrations were measured using high performance liquid chromatography. Data were modelled using non-linear, mixed-effect modeling software, and Monte Carlo simulations were performed with a PK target of 100% fT > MIC. RESULTS Fifty-nine patients (median (range) age: 13.5 months (1.1 month-17.6 years)) and 129 cefepime concentration measurements were included. The cefepime concentration data were best fitted by a one-compartment model. The selected covariates were body weight with allometric scaling and estimated glomerular filtration rate on clearance. Mean population values for clearance and volume were 1.21 L.h-1 and 4.8 L, respectively. According to the simulations, a regimen of 100 mg.kg-1.day-1 q12 h over 30 min or 100 mg.kg-1.day-1 as a continuous infusion was more likely to achieve the PK target in patients with renal failure and in patients with normal or augmented renal clearance, respectively. CONCLUSIONS Appropriate cefepime dosing regimens should take renal function into account. Continuous infusions are required in critically ill children with normal or augmented renal clearance, while intermittent infusions are adequate for children with acute renal failure. Close therapeutic drug monitoring is mandatory, given cefepime's narrow therapeutic window.
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Affiliation(s)
- Noémie de Cacqueray
- Department of Pediatric Intensive Care Unit, Necker Enfants Malades Hospital, Université de Paris, AP-HP, France.
| | - Déborah Hirt
- Department of Clinical Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France; Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Université de Paris, France
| | - Yi Zheng
- Department of Clinical Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France
| | - Emmanuelle Bille
- Microbiological Laboratory, Necker Enfants Malades Hospital, Université de Paris, France
| | - Pierre Louis Leger
- Department of Pediatric Intensive Care Unit, Armand Trousseau Hospital, Université de Paris, AP-HP, France
| | - Jérôme Rambaud
- Department of Pediatric Intensive Care Unit, Armand Trousseau Hospital, Université de Paris, AP-HP, France
| | - Julie Toubiana
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker Enfants Malades Hospital
| | - Anais Chosidow
- Department of General Pediatrics, Armand Trousseau Hospital, Université de Paris, AP-HP, France
| | - Sophie Vimont
- Department of Bacteriology, Hôpital Saint Antoine, Université de Paris, AP-HP, France; Sorbonne University, UPMC, UMR S 1155, Paris, France; INSERM, UMR S 1155, Paris, France
| | - Delphine Callot
- Regional Center of Pharmacovigilance, Department of Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France
| | - Laurent Chouchana
- Regional Center of Pharmacovigilance, Department of Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France
| | - Agathe Béranger
- Department of Pediatric Cardiac Intensive Care Unit, Necker Enfants Malades Hospital, Université de Paris, AP-HP, France; Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Université de Paris, France
| | - Jean Marc Tréluyer
- Department of Pediatric Intensive Care Unit, Necker Enfants Malades Hospital, Université de Paris, AP-HP, France; Department of Clinical Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France; Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Université de Paris, France
| | - Sihem Benaboud
- Department of Clinical Pharmacology, Cochin Hospital, Université de Paris, AP-HP, France
| | - Mehdi Oualha
- Department of Pediatric Intensive Care Unit, Necker Enfants Malades Hospital, Université de Paris, AP-HP, France; Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Université de Paris, France
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Romain AS, Guedj R, Chosidow A, Mediamolle N, Schnuriger A, Vimont S, Ferrandiz C, Robin N, Odièvre MH, Grimprel E, Lorrot M. Procalcitonin at 12-36 hours of fever for prediction of invasive bacterial infections in hospitalized febrile neonates. Front Pediatr 2022; 10:968207. [PMID: 36245739 PMCID: PMC9557106 DOI: 10.3389/fped.2022.968207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
AIM We aimed to investigate the performance of procalcitonin (PCT) assay between 12 and 36 h after onset of fever (PCT H12-H36) to predict invasive bacterial infection (IBI) (ie, meningitis and/or bacteremia) in febrile neonates. METHODS We retrospectively included all febrile neonates hospitalized in the general pediatric department in a teaching hospital from January 2013 to December 2019. PCT assay ≤ 0.6 ng/ml was defined as negative. The primary outcome was to study the performance of PCT H12-H36 to predict IBI. RESULTS Out of 385 included neonates, IBI was ascertainable for 357 neonates (92.7%). We found 16 IBI: 3 meningitis and 13 bacteremia. Sensitivity and specificity of PCT H12-H36 in the identification of IBI were, respectively, 100% [95% CI 82.9-100%] and 71.8% [95% CI 66.8-76.6%], with positive and negative predictive values of 14.3% [95% CI 8.4-22.2%] and 100% [95% CI 98.8-100%] respectively. Of the 259 neonates who had a PCT assay within the first 12 h of fever (< H12) and a PCT assay after H12-H36, 8 had IBI. Two of these 8 neonates had a negative < H12 PCT but a positive H12-H36 PCT. CONCLUSIONS PCT H12-H36 did not miss any IBI whereas < H12 PCT could missed IBI diagnoses. PCT H12-H36 might be included in clinical decision rule to help physicians to stop early antibiotics in febrile neonates.
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Affiliation(s)
- Anne-Sophie Romain
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Romain Guedj
- Department of Pediatrics Emergency, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.,Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS) INSERM UMR1153, Paris, France
| | - Anais Chosidow
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Nicolas Mediamolle
- Department of Pediatrics Emergency, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Aurélie Schnuriger
- Department of Virology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.,Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint Antoine (CRSA), Paris, France
| | - Sophie Vimont
- Department of Bacteriology, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.,INSERM UMR_S 1155, Hôpital Tenon, Paris, France
| | - Charlène Ferrandiz
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Nicolas Robin
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Marie-Hélène Odièvre
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.,Biologie intégrée du globule rouge, UMR_S1134, INSERM, Université de Paris, Paris, France
| | - Emmanuel Grimprel
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Mathie Lorrot
- Department of General Pediatrics, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
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Garnier M, Gallah S, Vimont S, Benzerara Y, Labbe V, Constant AL, Siami S, Guerot E, Compain F, Mainardi JL, Montil M, Quesnel C. Multicentre randomised controlled trial to investigate usefulness of the rapid diagnostic βLACTA test performed directly on bacterial cell pellets from respiratory, urinary or blood samples for the early de-escalation of carbapenems in septic intensive care unit patients: the BLUE-CarbA protocol. BMJ Open 2019; 9:e024561. [PMID: 30782909 PMCID: PMC6367973 DOI: 10.1136/bmjopen-2018-024561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 11/23/2018] [Accepted: 11/29/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The dramatic increase of the incidence of infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) has led to an increase of 50% of carbapenem consumption all around Europe in only 5 years. This favours the spread of carbapenem-resistant Gram-negative bacilli (GNB), causing life-threatening infections. In order to limit use of carbapenems for infections actually due to ESBL-PE, health authorities promote the use of rapid diagnostic tests of bacterial resistance. The objective of this work conducted in the intensive care unit (ICU) is to determine whether an early de-escalation of empirical carbapenems guided by the result of the βLACTA test is not inferior to the reference strategy of de-escalating carbapenems after the antibiogram result has been rendered. METHODS AND ANALYSIS This multicentre randomised controlled open-label non-inferiority clinical trial will include patients suffering from respiratory and/or urinary and/or bloodstream infections documented with GNB on direct examination and empirically treated with carbapenems. Empirical carbapenems will be adapted before the second dose depending on the results of the βLACTA test performed directly on the microbiological sample (intervention group) or after 48-72 hours depending on the definite antibiogram (control group). The primary outcome will combine 90-day mortality and percentage of infection recurrence during the ICU stay. The secondary outcomes will include the number of carbapenems defined daily doses and carbapenem-free days after inclusion, the proportion of new infections during ICU stay, new colonisation of patients' digestive tractus with multidrug-resistant GNB, ICU and hospital length of stay and cost-effectiveness ratio. ETHICS AND DISSEMINATION This protocol has been approved by the ethics committee of Paris-Ile-de-France IV, and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03147807.
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Affiliation(s)
- Marc Garnier
- Anesthesiology and Intensive Care Medicine Department, APHP—Tenon University Hospital, Paris, France
- Medico-surgical Intensive Care Unit, APHP—Tenon University Hospital, Paris, France
- Paris 6 School of Medicine, Sorbonne University, Paris, France
| | - Salah Gallah
- APHP—GHUEP—Microbiology Department, Paris, France
| | - Sophie Vimont
- Paris 6 School of Medicine, Sorbonne University, Paris, France
- APHP—GHUEP—Microbiology Department, Paris, France
| | | | - Vincent Labbe
- Medico-surgical Intensive Care Unit, APHP—Tenon University Hospital, Paris, France
| | - Anne-Laure Constant
- Cardio-thoracic Surgical Intensive Care Unit, APHP—European Georges Pompidou University Hospital, Paris, France
| | - Shidasp Siami
- Polyvalent Intensive Care Unit, Sud Essonne Hospital, Etampes, France
| | - Emmanuel Guerot
- APHP—European Georges Pompidou University Hospital, Medical Intensive Care Unit, Paris, France
| | - Fabrice Compain
- Microbiology Department, APHP—European Georges Pompidou University Hospital, Paris, France
| | - Jean-Luc Mainardi
- Microbiology Department, APHP—European Georges Pompidou University Hospital, Paris, France
| | - Mélissa Montil
- APHP—Clinical Research Platform (URCEst-CRCEst-CRB), St Antoine Hospital, Paris, France
| | - Christophe Quesnel
- Anesthesiology and Intensive Care Medicine Department, APHP—Tenon University Hospital, Paris, France
- Paris 6 School of Medicine, Sorbonne University, Paris, France
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Gallah S, Benzerara Y, Tankovic J, Woerther PL, Bensekri H, Mainardi JL, Arlet G, Vimont S, Garnier M. β LACTA test performance for detection of extended-spectrum β-lactamase-producing Gram-negative bacilli directly on bronchial aspirates samples: a validation study. Clin Microbiol Infect 2018; 24:402-408. [DOI: 10.1016/j.cmi.2017.07.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/08/2017] [Accepted: 07/26/2017] [Indexed: 01/15/2023]
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Djibré M, Fedun S, Le Guen P, Vimont S, Hafiani M, Fulgencio JP, Parrot A, Denis M, Fartoukh M. Universal versus targeted additional contact precautions for multidrug-resistant organism carriage for patients admitted to an intensive care unit. Am J Infect Control 2017; 45:728-734. [PMID: 28285725 DOI: 10.1016/j.ajic.2017.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although additional contact precautions (ACPs) are routinely used to reduce cross-transmission of multidrug-resistant organisms (MDROs), the relevance of isolation precautions remains debated. We hypothesized that the collection of recognized risk factors for MDRO carriage on intensive care unit (ICU) admission might be helpful to target ACPs without increasing MDRO acquisition during ICU stays, compared with universal ACPs. MATERIALS AND METHODS This is a sequential single-center observational study performed in consecutive patients admitted to a French medical and surgical ICU. During the first 6-month period, screening for MDRO carriage and ACPs were performed in all patients. During the second 6-month period, screening was maintained, but ACP use was guided by the presence of at least 1 defined risk factor for MDRO. RESULTS During both periods, 33 (10%) and 30 (10%) among 327 and 297 admissions were, respectively, associated with a positive admission MDRO carriage. During both periods, a second screening was performed in 147 (45%) and 127 (43%) patients. Altogether, the rate of acquired MDRO (positive screening or clinical specimen) was similar during both periods (10% [n = 15] and 11.8% [n = 15], respectively; P = .66). CONCLUSIONS The results of our study contribute to support the safety of an isolation-targeted screening policy on ICU admission compared with universal screening and isolation regarding the rate of ICU-acquired MDRO colonization or infection.
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Bataille A, Wetzstein M, Hertig A, Vimont S, Rondeau E, Galichon P. Evidence of dipstick superiority over urine microscopy analysis for detection of hematuria. BMC Res Notes 2016; 9:435. [PMID: 27608628 PMCID: PMC5015255 DOI: 10.1186/s13104-016-2240-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an unresolved debate on the best screening method for hematuria as a symptom of glomerulonephritis or urological malignancies. The urinary dipstick is generally considered as an imperfect surrogate for urine microscopy analysis. RESULTS We designed a study to compare urine microscopy analysis, urinary dipstick and flow cytometry, using controlled dilutions of blood in urine samples from volunteers collected in two different physiologically-relevant conditions (basal state and hyperhydration). We found that although all techniques were 100 % effective in detecting hematuria at basal state, these results were variably reproduced when testing the same final amount of hematuria in urine collected after hyperhydration. Our data shows a variable sensitivity for the detection of hematuria by urine microscopy analysis or flow cytometry, but not by urinary dipstick. CONCLUSIONS Urinary dipstick qualifies as a better screening test for hematuria than urine microscopy analysis or flow cytometry, as it is sensitive and performs better in unstandardized conditions. It is universally available and also faster and cheaper than cytometric techniques.
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Affiliation(s)
| | | | - Alexandre Hertig
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France
| | - Sophie Vimont
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France.,Service de Bactériologie, Hôpital Tenon, Paris, France.,Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France
| | - Eric Rondeau
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France.,Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France
| | - Pierre Galichon
- Inserm UMR_S 1155, Hôpital Tenon, Paris, France. .,Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France. .,Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, Paris, France.
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Morgand M, Vimont S, Bleibtreu A, Boyd A, Thien HV, Zahar JR, Denamur E, Arlet G. Extended-spectrum beta-lactamase-producing Escherichia coli infections in children: are community-acquired strains different from nosocomial strains? Int J Med Microbiol 2014; 304:970-6. [PMID: 25023074 DOI: 10.1016/j.ijmm.2014.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 03/21/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 11/29/2022] Open
Abstract
Infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are an important cause of morbidity and mortality, especially in children. We compared 58 epidemiologically unrelated ESBL-producing E. coli strains that caused infections. They were isolated between 2008 and 2012 in two Parisian pediatric hospitals and grouped according to their origin into either community-acquired (CA) (n=37) or nosocomially acquired (NA) (n=21) strains. Molecular characteristics of the ESBLs, phylogenetic traits of the strains including their belonging to clone O25b-ST131, prevalence of associated virulence genes, growth capacities in different media, metabolic phenotype and biofilm formation abilities were studied. ESBL type, associated resistance and distribution of phylogenetic groups were similar in the CA and NA groups. More than 60% of the B2 phylogroup strains in both groups belonged to the ST131 clone. Interestingly, CA strains possessed more genes encoding virulence factors and the distribution of these genes differed significantly between the two groups: fyuA, hlyC, papC and papGII were more frequent in the CA group, whereas iroN was more frequent in the NA group. CA strains also showed enhanced growth capacities in Luria Bertani rich medium. They tended to produce more biofilm but the difference was not significant. This study confirms the wide spread of clone ST131 among infected children, regardless of whether their infections were community- or nosocomially acquired. It highlights genotypic and phenotypic differences according to the origin of the strains that could indicate adaptability of these multi-resistant bacteria to specific environmental and host factors.
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Affiliation(s)
- Marjolaine Morgand
- Université Pierre et Marie Curie, Faculté de Médecine, Département de Bactériologie, F-75012 Paris, France
| | - Sophie Vimont
- Université Pierre et Marie Curie, Faculté de Médecine, Département de Bactériologie, F-75012 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaire de l'Est Parisien, Département de Bactériologie, F-75012 Paris, France
| | - Alexandre Bleibtreu
- IAME, UMR 1137, INSERM, F-75018 Paris, France; IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France
| | | | - Hoang Vu Thien
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaire de l'Est Parisien, Département de Bactériologie, F-75012 Paris, France
| | - Jean-Ralph Zahar
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Unité d'hygiène et de lutte contre les infections nosocomiales, F-75015 Paris, France
| | - Erick Denamur
- IAME, UMR 1137, INSERM, F-75018 Paris, France; IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France
| | - Guillaume Arlet
- Université Pierre et Marie Curie, Faculté de Médecine, Département de Bactériologie, F-75012 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaire de l'Est Parisien, Département de Bactériologie, F-75012 Paris, France.
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Bens M, Vimont S, Ben Mkaddem S, Chassin C, Goujon JM, Balloy V, Chignard M, Werts C, Vandewalle A. Flagellin/TLR5 signalling activates renal collecting duct cells and facilitates invasion and cellular translocation of uropathogenic Escherichia coli. Cell Microbiol 2014; 16:1503-17. [PMID: 24779433 DOI: 10.1111/cmi.12306] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/03/2014] [Accepted: 04/18/2014] [Indexed: 12/11/2022]
Abstract
Uropathogenic Escherichia coli (UPEC) colonizing kidneys is the main cause of acute pyelonephritis. TLR5 that senses flagellin was shown to be highly expressed in the bladder and to participate in host defence against flagellated UPEC, although its role in kidneys still remains elusive. Here we show that TLR5 is expressed in renal medullary collecting duct (MCD) cells, which represent a preferential site of UPEC adhesion. Flagellin, like lipopolysaccharide, stimulated the production of the chemoattractant chemokines CXCL1 and CXCL2, and subsequent migration capacity of neutrophils in cultured wild-type (WT) and Tlr4(-/-) MCDs, but not in Tlr5(-/-) MCDs. UPEC can translocate across intact MCD layers without altering tight junctions. Strikingly, the invasion capacity and transcellular translocation of the UPEC strain HT7 were significantly lower in Tlr5(-/-) than in WT MCDs. The non-motile HT7ΔfliC mutant lacking flagellin also exhibited much lower translocation capacities than the HT7 isolates. Finally, Tlr5(-/-) kidneys exhibited less infiltrating neutrophils than WT kidneys one day after the transurethral inoculation of HT7, and greater delayed renal bacterial loads in the day 4 post-infected Tlr5(-/-) kidneys. Overall, these findings indicate that the epithelial TLR5 participates to renal antibacterial defence, but paradoxically favours the translocation of UPEC across intact MCD cell layers.
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Affiliation(s)
- Marcelle Bens
- Centre de Recherche sur l'Inflammation (CRI), UMRS 1149, Université Denis Diderot - Paris 7, Paris, France; Groupe ATIP-AVENIR INSERM, Université Denis Diderot - Paris 7, Paris, France
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11
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Thibault J, Cordel H, Vimont S, Verdet C, Denis M, Pialoux G, Arlet G, Debrix I, Guessant S. CPC-067 Impact of a Multidisciplinary Team on the Proper Use of Carbapenems: Before/After Survey at Tenon Hospital. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.524] [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: 11/04/2022] Open
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12
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Vimont S, Boyd A, Bleibtreu A, Bens M, Goujon JM, Garry L, Clermont O, Denamur E, Arlet G, Vandewalle A. The CTX-M-15-producing Escherichia coli clone O25b: H4-ST131 has high intestine colonization and urinary tract infection abilities. PLoS One 2012; 7:e46547. [PMID: 23029548 PMCID: PMC3460912 DOI: 10.1371/journal.pone.0046547] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 09/02/2012] [Indexed: 12/13/2022] Open
Abstract
Increasing numbers of pyelonephritis-associated uropathogenic Escherichia coli (UPEC) are exhibiting high resistance to antibiotic therapy. They include a particular clonal group, the CTX-M-15-producing O25b:H4-ST131 clone, which has been shown to have a high dissemination potential. Here we show that a representative isolate of this E. coli clone, referred to as TN03, has enhanced metabolic capacities, acts as a potent intestine- colonizing strain, and displays the typical features of UPEC strains. In a modified streptomycin-treated mouse model of intestinal colonization where streptomycin was stopped 5 days before inoculation, we show that TN03 outcompetes the commensal E. coli strains K-12 MG1655, IAI1, and ED1a at days 1 and 7. Using an experimental model of ascending UTI in C3H/HeN mice, we then show that TN03 colonized the urinary tract. One week after the transurethral inoculation of the TN03 isolates, the bacterial loads in the bladder and kidneys were significantly greater than those of two other UPEC strains (CFT073 and HT7) belonging to the same B2 phylogenetic group. The differences in bacterial loads did not seem to be directly linked to differences in the inflammatory response, since the intrarenal expression of chemokines and cytokines and the number of polymorphonuclear neutrophils attracted to the site of inflammation was the same in kidneys colonized by TN03, CFT073, or HT7. Lastly, we show that in vitro TN03 has a high maximum growth rate in both complex (Luria-Bertani and human urine) and minimum media. In conclusion, our findings indicate that TN03 is a potent UPEC strain that colonizes the intestinal tract and may persist in the kidneys of infected hosts.
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Affiliation(s)
- Sophie Vimont
- AP-HP, Hôpitaux Universitaires Est Parisien - site Tenon, Service de Bactériologie, Paris, France.
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13
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Rafat C, Vimont S, Ancel P, Xu-Dubois Y, Mesnard L, Ouali N, Denis M, Vandewalle A, Rondeau E, Hertig A. Ofloxacin: new applications for the prevention of urinary tract infections in renal graft recipients. Transpl Infect Dis 2011; 13:344-52. [DOI: 10.1111/j.1399-3062.2011.00602.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [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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14
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Mnif B, Vimont S, Boyd A, Bourit E, Picard B, Branger C, Denamur E, Arlet G. Molecular characterization of addiction systems of plasmids encoding extended-spectrum beta-lactamases in Escherichia coli. J Antimicrob Chemother 2010; 65:1599-603. [PMID: 20507859 DOI: 10.1093/jac/dkq181] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Escherichia coli producing CTX-M-type extended-spectrum beta-lactamases (ESBLs) are spreading worldwide. The aim of this work was to investigate the addiction systems carried by the replicons involved in the emergence and spread of ESBLs in relation to ESBL and replicon types. METHODS A collection of 125 TEM, SHV and CTX-M ESBL-producing E. coli isolates and their 125 transconjugants or transformants was analysed. Five plasmid protein antitoxin-regulated systems and three plasmid antisense RNA-regulated systems were sought by PCR. RESULTS Two hundred and ninety-eight plasmid addiction systems were detected in the parental strains (mean 2.38, range 0-6 per strain) and 86 were detected in the recipient strains (mean 0.69, range 0-5 per strain). PemKI, CcdAB, Hok-Sok and VagCD were the most frequently represented systems in both recipient and parental strains. The parental SHV and CTX-M ESBL-producing strains had more addiction systems than the TEM ESBL producers. In the recipient strains, the frequency of addiction systems was significantly higher in IncF plasmids. Among the IncF replicons carrying CTX-M-type enzymes, the frequency of addiction systems was significantly higher in IncF plasmids carrying CTX-M-15 (mean 3.5) or CTX-M-9 (mean 4) than in those carrying CTX-M-14 (mean 0.6). CONCLUSIONS In E. coli producing CTX-M-15 or CTX-M-9 ESBLs, plasmids bearing the bla(CTX-M) gene have multiple addiction systems that could contribute to their maintenance in host strains.
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Affiliation(s)
- Basma Mnif
- Université Pierre et Marie Curie-Paris-6, Faculté de Médecine, Site Saint-Antoine, Laboratoire de Bactériologie, ER8 Paris, France
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15
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Clermont O, Dhanji H, Upton M, Gibreel T, Fox A, Boyd D, Mulvey MR, Nordmann P, Ruppé E, Sarthou JL, Frank T, Vimont S, Arlet G, Branger C, Woodford N, Denamur E. Rapid detection of the O25b-ST131 clone of Escherichia coli encompassing the CTX-M-15-producing strains. J Antimicrob Chemother 2009; 64:274-7. [PMID: 19474064 DOI: 10.1093/jac/dkp194] [Citation(s) in RCA: 298] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Recently, a CTX-M-15 extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli O25b-ST131 clone, belonging to the B2 phylogenetic group and with a high virulence potential, has been reported all over the world, representing a major public health problem. The present study was carried out to develop a rapid and simple detection assay that identifies members of this clone. METHODS A total of 627 E. coli isolates of which 373 produced an ESBL, collected across four continents, were screened using a O25b-ST131 clone allele-specific PCR for the pabB gene. RESULTS One hundred and forty-three ESBL isolates were found positive with the assay. These isolates were all of O25b type and, when studied by multilocus sequence typing (25 cases), were all of ST131. The O25b-ST131 clone was found to produce ESBLs other than CTX-M-15, specifically CTX-M-2, -3, -14, -27, -32 and -61 as well as TEM-24. This clone represents 3% of non-ESBL B2 isolates originating from urinary tract infections in Paris. CONCLUSIONS We have developed a PCR-based assay that easily identifies a clone with high likelihood of producing ESBLs, including CTX-M-15.
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Affiliation(s)
- Olivier Clermont
- INSERM U722 and Université Paris 7, Faculté de Médecine, Site Xavier Bichat, 75018 Paris, France
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16
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Vimont S, Mnif B, Fevre C, Brisse S. Comparison of PFGE and multilocus sequence typing for analysis of Klebsiella pneumoniae isolates. J Med Microbiol 2008; 57:1308-1310. [PMID: 18809566 DOI: 10.1099/jmm.0.2008/003798-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sophie Vimont
- Service de Bactériologie-Hygiène, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75970 Paris Cedex 20, France
| | - Basma Mnif
- Service de Bactériologie-Hygiène, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 Rue de la Chine, 75970 Paris Cedex 20, France
| | - Cindy Fevre
- Institut Pasteur, Genotyping of Pathogens and Public Health, 28 Rue du Dr Roux, 75724 Paris Cedex 15, France
| | - Sylvain Brisse
- Institut Pasteur, Genotyping of Pathogens and Public Health, 28 Rue du Dr Roux, 75724 Paris Cedex 15, France
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17
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Chassin C, Vimont S, Cluzeaud F, Bens M, Goujon JM, Fernandez B, Hertig A, Rondeau E, Arlet G, Hornef MW, Vandewalle A. TLR4 facilitates translocation of bacteria across renal collecting duct cells. J Am Soc Nephrol 2008; 19:2364-74. [PMID: 18753256 DOI: 10.1681/asn.2007121273] [Citation(s) in RCA: 41] [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: 01/30/2023] Open
Abstract
Uropathogenic Escherichia coli (UPEC) are the most frequent causes of urinary tract infections and pyelonephritis. Renal medullary collecting duct (MCD) cells are the intrarenal site to which UPEC strains prefer to adhere and initiate an inflammatory response, but the ability of UPEC strains to translocate across impermeant MCD cells has not been demonstrated definitively. Here, several UPEC strains adhered to the apical surface and translocated across confluent murine inner MCD cells grown on filters. UPEC strains expressing cytolytic and vacuolating cytotoxins disrupted the integrity of cell layers, whereas noncytolytic UPEC strains passed through the cell layers without altering tight junctions. Apical-to-basal transcellular translocation was dramatically reduced after extinction of Toll-like receptor 4 (TLR4) and the lipid raft marker caveolin-1 by small interfering RNA. Furthermore, disruption of lipid raft integrity by filipin III and methyl-beta-cyclodextrin significantly reduced both the transcellular translocation of UPEC across murine inner MCD cell layers and the stimulation of proinflammatory mediators. Bacterial translocation was also significantly reduced in primary cultures of TLR4-deficient mouse MCD cells compared with MCD cells from wild-type mice. Benzyl alcohol, an anesthetic that enhances membrane fluidity, favored the recruitment of caveolin-1 in lipid rafts and increased the translocation of UPEC across cultured TLR4-deficient MCD cells. These findings demonstrate that the transcellular translocation of UPEC strains across impermeant layers of MCD cells may occur through lipid rafts via a TLR4-facilitated process.
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Affiliation(s)
- Cécilia Chassin
- INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, BP 416, Paris, France
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18
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Pialoux G, Vimont S, Moulignier A, Buteux M, Abraham B, Bonnard P. Effect of HIV infection on the course of syphilis. AIDS Rev 2008; 10:85-92. [PMID: 18615119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Syphilis has been a public health problem for centuries. Syphilis and HIV form a dangerous combination: syphilis significantly increases the risk of contracting HIV infection, and HIV can alter the natural course of syphilis. Despite a better understanding of the interaction between these two diseases, many controversies persist. The incidence of syphilis has increased among HIV-infected patients both in Europe and in the USA, and especially in the homosexual/bisexual transmission group. We discuss the interaction between HIV/AIDS and syphilis in a review of the most recent literature, focusing particularly on the diagnosis, treatment, and follow-up of HIV-infected patients with syphilis. Early diagnosis of syphilis in HIV-infected patients requires awareness among both patients and clinicians. Early treatment of syphilis is crucial as it reduces the risk of transmission.
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Affiliation(s)
- Gilles Pialoux
- APHP, Dept. of Infectious and Tropical Diseases, Tenon Hospital, Paris, France.
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19
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Clermont O, Lavollay M, Vimont S, Deschamps C, Forestier C, Branger C, Denamur E, Arlet G. The CTX-M-15-producing Escherichia coli diffusing clone belongs to a highly virulent B2 phylogenetic subgroup. J Antimicrob Chemother 2008; 61:1024-8. [PMID: 18334490 DOI: 10.1093/jac/dkn084] [Citation(s) in RCA: 234] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES A clone of CTX-M-15-producing Escherichia coli has recently been reported to be spreading through Europe and Africa. The aim of this work was to thoroughly characterize this clone. MATERIALS AND METHODS Representative isolates of this clone were subjected to multilocus sequence typing, O typing, virulence gene detection, adhesion assay on human cells, biofilm production assay and mouse lethality assay. RESULTS The clone: (i) belongs to a unique B2 phylogenetic subgroup encompassing the pyelonephritogenic diffusely adhering EC7372 strain; (ii) exhibits a specific O25b molecular subtype; (iii) is identical to the E. coli clone O25:H4-ST131 producing CTX-M-15; (iv) produces biofilm; and (v) is highly virulent in mice despite lacking classical extraintestinal pathogenicity islands (except for high pathogenicity island) and the afa/dra gene. CONCLUSIONS The CTX-M-15-producing E. coli diffusing clone is associated with a high level of antibiotic resistance and with high virulence, showing that, under certain selective pressures, the previously observed trade-off between resistance and virulence may not apply.
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Affiliation(s)
- Olivier Clermont
- INSERM U722 and Université Denis Diderot-Paris 7, Faculté de Médecine, Site Xavier Bichat, Paris, France
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20
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Chassin C, Hornef MW, Bens M, Lotz M, Goujon JM, Vimont S, Arlet G, Hertig A, Rondeau E, Vandewalle A. Hormonal control of the renal immune response and antibacterial host defense by arginine vasopressin. ACTA ACUST UNITED AC 2007; 204:2837-52. [PMID: 17967904 PMCID: PMC2118508 DOI: 10.1084/jem.20071032] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [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] [Indexed: 12/16/2022]
Abstract
Ascending urinary tract infection (UTI) and pyelonephritis caused by uropathogenic Escherichia coli (UPEC) are very common infections that can cause severe kidney damage. Collecting duct cells, the site of hormonally regulated ion transport and water absorption controlled by vasopressin, are the preferential intrarenal site of bacterial adhesion and initiation of inflammatory response. We investigated the effect of the potent V2 receptor (V2R) agonist deamino-8-D-arginine vasopressin (dDAVP) on the activation of the innate immune response using established and primary cultured collecting duct cells and an experimental model of ascending UTI. dDAVP inhibited Toll-like receptor 4–mediated nuclear factor κB activation and chemokine secretion in a V2R-specific manner. The dDAVP-mediated suppression involved activation of protein phosphatase 2A and required an intact cystic fibrosis transmembrane conductance regulator Cl− channel. In vivo infusion of dDAVP induced a marked fall in proinflammatory mediators and neutrophil recruitment, and a dramatic rise in the renal bacterial burden in mice inoculated with UPECs. Conversely, administration of the V2R antagonist SR121463B to UPEC-infected mice stimulated both the local innate response and the antibacterial host defense. These findings evidenced a novel hormonal regulation of innate immune cellular activation and demonstrate that dDAVP is a potent modulator of microbial-induced inflammation in the kidney.
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Affiliation(s)
- Cécilia Chassin
- Institut National de la Santé et de la Recherche Médicale, U773, Centre de Recherche Biomédicale Bichat-Beaujon, BP 416, 75018 Paris, France
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21
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Vimont S, Aubert D, Mazoit JX, Poirel L, Nordmann P. Broad-spectrum beta-lactams for treating experimental peritonitis in mice due to Escherichia coli producing plasmid-encoded cephalosporinases. J Antimicrob Chemother 2007; 60:1045-50. [PMID: 17804425 DOI: 10.1093/jac/dkm317] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the correlation between in vitro activity and in vivo efficacy of broad-spectrum beta-lactams for treating experimental infections due to Escherichia coli expressing two types of plasmid-mediated AmpC-type beta-lactamases, LAT-1 and FOX-1. METHODS Susceptibility testing and time-kill curves were determined for piperacillin/tazobactam, ceftazidime, cefepime and imipenem. A mouse model of peritonitis was developed to determine 50% effective doses (ED(50)s) of beta-lactams against E. coli clinical strains producing recombinant plasmids pLAT-1 and pFOX-1. RESULTS MIC and MBC values correlated with the ED(50)s for ceftazidime, cefepime and imipenem. Among the beta-lactams tested, both cefepime and imipenem were effective for treating peritonitis caused by E. coli strains harbouring pLAT-1 or pFOX-1, whereas ceftazidime was effective only against E. coli (pLAT-1). Piperacillin/tazobactam was not effective for treating infections with either of these two strains. CONCLUSIONS Piperacillin/tazobactam was not efficacious for treating infections due to E. coli producing plasmid-mediated AmpC-type beta-lactamases, whereas cefepime and imipenem were efficacious.
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Affiliation(s)
- Sophie Vimont
- Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine de Paris-Sud, 94275 K.-Bicêtre, France
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22
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Pellé G, Vimont S, Levy PP, Hertig A, Ouali N, Chassin C, Arlet G, Rondeau E, Vandewalle A. Acute pyelonephritis represents a risk factor impairing long-term kidney graft function. Am J Transplant 2007; 7:899-907. [PMID: 17286620 DOI: 10.1111/j.1600-6143.2006.01700.x] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Urinary tract infections (UTIs) and acute pyelonephritis (APN) often occur after renal transplantation, but their impact on graft outcome is unclear. One hundred and seventy-seven consecutive renal transplantations were investigated to evaluate the impact of UTIs and APN on graft function. The cumulative incidence of UTIs was 75.1% and that of APN was 18.7%. UTIs occurred mainly during the first year after transplantation and Escherichia coli, Pseudomonas aeruginosa and Enteroccocus sp. were the most frequent pathogens identified. The risk of developing APN was higher in female (64%) than in male recipients, and was correlated with the frequency of recurrent UTIs (p < 0.0001) and rejection episodes (p = 0.0003). APN did not alter graft or recipient survival, however, compared to patients with uncomplicated UTIs, patients with APN exhibited both a significant increase in serum creatinine and a decrease in creatinine clearance, already detected after 1 year (aMDRD-GFR: APN: 39.5 +/- 12.5; uncomplicated UTI: 54.6 +/- 21.7 mL/min/1.73 m(2), p < 0.01) and still persistent ( approximately - 50%) 4 years after transplantation. Multivariate analysis revealed that APN represents an independent risk factor associated with the decline of renal function (p = 0.034). Therefore, APN may be associated with an enduring decrease in renal graft function.
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Affiliation(s)
- G Pellé
- Service des Urgences Néphrologiques et Transplantation Rénale, Hôpital Tenon, Paris, France
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23
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Mamlouk K, Boutiba-Ben Boubaker I, Gautier V, Vimont S, Picard B, Ben Redjeb S, Arlet G. Emergence and outbreaks of CTX-M beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae strains in a Tunisian hospital. J Clin Microbiol 2006; 44:4049-56. [PMID: 16957046 PMCID: PMC1698301 DOI: 10.1128/jcm.01076-06] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sixty-two isolates of Enterobacteriaceae (35 Escherichia coli and 27 Klebsiella pneumoniae isolates) producing CTX-M-type beta-lactamases were collected between March 2000 and June 2003 in different wards of Charles Nicolle Hospital in Tunis (Tunisia). Sequencing identified the bla(CTX-M-15) determinant in 55 isolates and bla(CTX-M-16) in 7 isolates. The CTX-M-15-producing strains were isolated in several wards and consisted mainly of two successive clonal groups of E. coli and a major clonal group of K. pneumoniae. The second clonal group of E. coli belonged to phylogenetic group B2 and harbored more virulence factors than the first clonal group. Among the 22 transconjugants or electroporants obtained with selected E. coli and K. pneumoniae CTX-M-15-producing strains, a predominant plasmid restriction pattern was obtained with 17 isolates. The four CTX-M-16-producing strains of E. coli yielded the same pulsed-field gel electrophoresis (PFGE) pattern, while the three CTX-M-16-producing strains of K. pneumoniae yielded two different PFGE patterns. All of the CTX-M-16-producing isolates were recovered in the pediatric ward and had the same plasmid restriction pattern.
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Affiliation(s)
- Kelthoum Mamlouk
- Laboratoire Résistance aux Antibiotiques, Département de Microbiologie, Faculté de Medecine, Tunis, Tunisia
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24
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Kassis-Chikhani N, Vimont S, Asselat K, Trivalle C, Minassian B, Sengelin C, Gautier V, Mathieu D, Dussaix E, Arlet G. CTX-M beta-lactamase-producing Escherichia coli in long-term care facilities, France. Emerg Infect Dis 2004; 10:1697-8. [PMID: 15503413 PMCID: PMC3320274 DOI: 10.3201/eid1009.030969] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Guillaume Arlet
- Hôpital Tenon, Paris, France
- Université Paris VI, Paris, France
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25
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Abstract
OBJECTIVES To characterize the beta-lactamase gene content of Erwinia rhapontici. METHODS The beta-lactamase gene was cloned, sequenced and expressed in Escherichia coli. RESULTS The cloned gene conferred a resistance pattern of an Ambler class C beta-lactamase in E. coli. The AmpC-type enzyme had a pI value of 8.6 and shared 62% amino acid sequence identity with that of Escherichia fergusonii. The ampC gene was associated with a regulatory ampR gene and beta-lactamase production was inducible. CONCLUSIONS This work provides further evidence of the molecular heterogeneity of beta-lactamases in Erwinia spp. and that plant-pathogenic enterobacterial species may constitute a reservoir of antibiotic resistance genes.
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Affiliation(s)
- Thierry Naas
- Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France.
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26
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Abstract
Vibrio cholerae, the causative agent of cholera, is a normal inhabitant of aquatic environments, where it survives in a wide range of conditions of pH and salinity. In this work, we investigated the role of three Na+/H+ antiporters on the survival of V. cholerae in a saline environment. We have previously cloned the Vc-nhaA gene encoding the V. cholerae homolog of Escherichia coli. Here we identified two additional antiporter genes, designated Vc-nhaB and Vc-nhaD, encoding two putative proteins of 530 and 477 residues, respectively, highly homologous to the respective antiporters of Vibrio species and E. coli. We showed that both Vc-NhaA and Vc-NhaB confer Na+ resistance and that Vc-NhaA displays an antiport activity in E. coli, which is similar in magnitude, kinetic parameters, and pH regulation to that of E. coli NhaA. To determine the roles of the Na+/H+ antiporters in V. cholerae, we constructed nhaA, nhaB, and nhaD mutants (single, double, and triple mutants). In contrast to E. coli, the inactivation of the three putative antiporter genes (Vc-nhaABD) in V. cholerae did not alter the bacterial exponential growth in the presence of high Na+ concentrations and had only a slight effect in the stationary phase. In contrast, a pronounced and similar Li+-sensitive phenotype was found with all mutants lacking Vc-nhaA during the exponential phase of growth and also with the triple mutant in the stationary phase of growth. By using 2-n-nonyl-4-hydroxyquinoline N-oxide, a specific inhibitor of the electron-transport-linked Na+ pump NADH-quinone oxidoreductase (NQR), we determined that in the absence of NQR activity, the Vc-NhaA Na+/H+ antiporter activity becomes essential for the resistance of V. cholerae to Na+ at alkaline pH. Since the ion pump NQR is Na+ specific, we suggest that its activity masks the Na+/H+ but not the Li+/H+ antiporter activities. Our results indicate that the Na+ resistance of the human pathogen V. cholerae requires a complex molecular system involving multiple antiporters and the NQR pump.
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Affiliation(s)
- Katia Herz
- Department of Microbial and Molecular Ecology, Institute of Life Sciences, The Hebrew University of Jerusalem, 91904 Jerusalem, Israel
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Vimont S, Poirel L, Naas T, Nordmann P. Identification of a chromosome-borne expanded-spectrum class a beta-lactamase from Erwinia persicina. Antimicrob Agents Chemother 2002; 46:3401-5. [PMID: 12384342 PMCID: PMC128706 DOI: 10.1128/aac.46.11.3401-3405.2002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
From whole-cell DNA of an enterobacterial Erwinia persicina reference strain that displayed a penicillinase-related antibiotic-resistant phenotype, a beta-lactamase gene was cloned and expressed in Escherichia coli. It encoded a clavulanic-acid-inhibited Ambler class A beta-lactamase, ERP-1, with a pI value of 8.1 and a relative molecular mass of ca. 28 kDa. ERP-1 shared 45 to 50% amino acid identity with the most closely related enzymes, the chromosomally encoded enzymes from Citrobacter koseri, Kluyvera ascorbata, Kluyvera cryocrescens, Klebsiella oxytoca, Proteus vulgaris, Proteus penneri, Rahnella aquatilis, Serratia fonticola, Yersinia enterocolitica, and the plasmid-mediated enzymes CTX-M-8 and CTX-M-9. The substrate profile of the noninducible ERP-1 was similar to that of these beta-lactamases. ERP-1 is the first extended-spectrum beta-lactamase from an enterobacterial species that is plant associated and plant pathogenic.
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Affiliation(s)
- Sophie Vimont
- Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre, France
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28
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Abstract
Vibrio cholerae, the agent of cholera, is a normal inhabitant of aquatic environments, in which it survives under a wide range of conditions of pH and salinity. In this work, we identified the nhaA gene in a wild-type epidemic strain of V. cholerae O1. nhaA encodes a protein of 382 amino acids that is very similar to the proteins NhaA of Vibrio parahaemolyticus, Vibrio alginolyticus ( approximately 87% identity), and Escherichia coli (56% identity). V. cholerae NhaA complements an E. coli nhaA mutant, enabling it to grow in 700 mM NaCl, pH 7.5, indicating functional homology to E. coli NhaA. However, unlike E. coli, the growth of a nhaA-inactivated mutant of V. cholerae was not restricted at various pH and NaCl concentrations, although it was inhibited in the presence of 120 mM LiCl at pH 8.5. Nevertheless, using a nhaA'-lacZ transcriptional fusion, we observed induction of nhaA transcription by Na(+), Li(+), and K(+). These results strongly suggest that NhaA is an Na(+)/H(+) antiporter contributing to the Na(+)/H(+) homeostasis of V. cholerae. nhaA-related sequences were detected in all strains of V. cholerae from the various serogroups. This gene is presumably involved in the survival and persistence of free-living bacteria in their natural habitat.
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Affiliation(s)
- S Vimont
- Institut National de la Santé et de la Recherche Médicale (INSERM U411), CHU Necker-Enfants-Malades, 75730 Paris Cedex 15, France
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Vimont S, Gaillot O. [Molecular epidemiology of strains of Staphylococcus aureus resistant to methicillin, sensitive to aminoglycosides]. Pathol Biol (Paris) 1999; 47:805-11. [PMID: 10573700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Twenty methicillin-resistant Staphylococcus aureus (MRSA) isolates surprisingly susceptible to all aminoglycosides, macrolides, sulfonamides and tetracycline were recovered from 20 elderly patients (mean age, 77) hospitalized in 4 neighbouring facilities between 1996 and 1998. Molecular typing of the isolates performed by restriction fragment length polymorphism of the coagulase gene (PCR-RFLP) and pulsed-field gel electrophoresis (PFGE) of Sma I macrorestriction fragments of total DNA, demonstrated the existence of distinct bacterial clones. Epidemic spreading was demonstrated for at least 2 clones, while others were responsible for sporadic cases. Most of the isolates of this study appeared to be genetically related to strains of MRSA resistant to aminoglycosides and macrolides included as controls, suggesting that multiresistant MRSA may have evolved recently in a manner that resulted in greater susceptibility to certain antibiotics.
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Affiliation(s)
- S Vimont
- Service de Biologie, Hôpital Corentin Celton, Issy-les-Moulineaux, France
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30
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Abstract
We analyzed the rfaD locus of the novel epidemic Vibrio cholerae strain O139, a putative region of rearrangement. This region includes 4 orfs in the same orientation. Two orfs, rfaD(O139) and orf2(O139) were almost identical to those described in V. cholerae O1. In contrast, the two other orfs upstream from rfaD(O139), designated orfA(O139) and orfB(O139), were absent from V. cholerae O1, but present in environmental strains of V. cholerae O22, O141 and O155. These results suggest that a chromosomal rearrangement might have occurred in the vicinity of rfaD in V. cholerae O1, resulting in the emergence of V. cholerae O139. The putative source of exogenous DNA might have been V. cholerae O22, O141 and O155.
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Affiliation(s)
- S Vimont
- INSERM U.411, Faculté de Médecine Necker-Enfants Malades, Paris, France
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