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Kou Y, Kumaran D, Howell A, Ramirez-Arcos S. Comparable bacterial growth in platelet concentrates suspended in plasma and platelet additive solution and improved detection of bacterial contamination using a new generation automated culture system. Transfusion 2024; 64:665-673. [PMID: 38456520 DOI: 10.1111/trf.17772] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Microbial screening of platelet concentrates (PC) with automated culture methods is widely implemented to reduce septic transfusion reactions. Herein, detection of bacterial contamination in PC was compared between units prepared in plasma and a mix of plasma and platelet additive solution (PAS) and between the BACT/ALERT 3D and next generation BACT/ALERT VIRTUO systems. STUDY DESIGN/METHODS Double apheresis units were split into single units, diluted in either PAS (PAS-PC) or plasma (plasma-PC), and tested for in vitro quality and sterility prior to spiking with ~30 CFU/unit of Staphylococcus epidermidis, Staphylococcus aureus, Serratia marcescens, and Klebsiella pneumoniae or ~10 CFU/mL of Cutibacterium acnes. Spiked PC were sampled for BACT/ALERT testing (36 and 48 h post-spiking) and colony counts (24, 36, and 48 h post-spiking). Times to detection (TtoD) and bacterial loads were compared between PC products and BACT/ALERT systems (N = 3). RESULTS Bacterial growth was similar in plasma-PC and PAS-PC. No significant differences in TtoD were observed between plasma-PC and PAS-PC at the 36-h sampling time except for S. epidermidis which grew faster in plasma-PC and C. acnes which was detected earlier in PAS-PC (p < .05). Detection of facultative bacteria was 1.3-2.2 h sooner in VIRTUO compared with 3D (p < .05) while TtoD for C. acnes was not significantly different between the two systems. DISCUSSION Comparable bacterial detection was observed in plasma-PC and PAS-PC with PC sampling performed at 36-h post blood collection. PC sampling at ≤36 h could result in faster detection of facultative pathogenic organisms with the VIRTUO system and improved PC safety.
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Affiliation(s)
- Yuntong Kou
- Product & Process Development, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Dilini Kumaran
- Product & Process Development, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Anita Howell
- Product & Process Development, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Sandra Ramirez-Arcos
- Product & Process Development, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
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2
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Coudereau R, Bodinier M, Lukaszewicz AC, Py BF, Argaud L, Cour M, Bidar F, Cerrato E, Garnier L, Gossez M, Venet F, Monneret G. Persistent NLRP3 inflammasome activation is associated with delayed immunosuppression in septic patients. J Leukoc Biol 2024; 115:706-713. [PMID: 38146798 DOI: 10.1093/jleuko/qiad161] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/24/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
Sepsis triggers a complex response marked by the simultaneous presence of proinflammatory and immunosuppressive elements, disrupting the mechanisms intended to maintain homeostasis. While the NLRP3 inflammasome has been demonstrated to contribute to the inflammatory side, its connection with delayed sepsis-induced immunosuppression remains unexplored. The present objective was to concomitantly and prospectively assess NLRP3 activation (IL-1β, IL-18, and soluble receptors) and features of immune failure (IL-10, mHLA-DR, myeloid-derived suppressor cells) in septic patients. To validate our findings, we conducted a transcriptomic analysis of mRNA of NLRP3-related genes (IL-18R1, IL-1R2) on an additional cohort of 107 patients. Two distinct endotypes were identified. One cluster displayed moderate inflammation rapidly returning to normal values, while the other exhibited a higher inflammatory response persisting until day 28, which was associated with persistent marked immunosuppression and higher 28-d mortality. Identifying endotypes with different pro/anti-inflammatory trajectories could hold important clinical implications for the management of sepsis.
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Affiliation(s)
- Rémy Coudereau
- Hospices Civils de Lyon, Edouard Herriot Hospital, Immunology Laboratory, Place d'Arsonval, 69437 Lyon, France
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
| | - Maxime Bodinier
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
| | - Anne-Claire Lukaszewicz
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
- Hospices Civils de Lyon, Edouard Herriot Hospital, Anesthesia and Critical Care Medicine Department, Place d'Arsonval, 69437 Lyon, France
| | - Bénédicte F Py
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Laurent Argaud
- Hospices Civils de Lyon, Edouard Herriot Hospital, Medical Intensive Care Department, Place d'Arsonval, 69437 Lyon, France
| | - Martin Cour
- Hospices Civils de Lyon, Edouard Herriot Hospital, Medical Intensive Care Department, Place d'Arsonval, 69437 Lyon, France
| | - Frank Bidar
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
- Hospices Civils de Lyon, Edouard Herriot Hospital, Anesthesia and Critical Care Medicine Department, Place d'Arsonval, 69437 Lyon, France
| | - Elisabeth Cerrato
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
| | - Lorna Garnier
- Hospices Civils de Lyon, CH Lyon-Sud, Immunology Laboratory, 69310 Pierre Bénite, France
| | - Morgane Gossez
- Hospices Civils de Lyon, Edouard Herriot Hospital, Immunology Laboratory, Place d'Arsonval, 69437 Lyon, France
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Fabienne Venet
- Hospices Civils de Lyon, Edouard Herriot Hospital, Immunology Laboratory, Place d'Arsonval, 69437 Lyon, France
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Guillaume Monneret
- Hospices Civils de Lyon, Edouard Herriot Hospital, Immunology Laboratory, Place d'Arsonval, 69437 Lyon, France
- EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux), Joint Research Unit HCL-bioMérieux, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, France
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3
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Pereira GM, Manuli ER, Coulon L, Côrtes MF, Ramundo MS, Dromenq L, Larue-Triolet A, Raymond F, Tourneur C, Lázari CDS, Brasil P, Filippis AMBD, Paranhos-Baccalà G, Banz A, Sabino EC. Performance Evaluation of VIDAS ® Diagnostic Assays Detecting Anti-Chikungunya Virus IgM and IgG Antibodies: An International Study. Diagnostics (Basel) 2023; 13:2306. [PMID: 37443699 DOI: 10.3390/diagnostics13132306] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Chikungunya (CHIK) is a debilitating mosquito-borne disease with an epidemiology and early clinical symptoms similar to those of other arboviruses-triggered diseases such as dengue or Zika. Accurate and rapid diagnosis of CHIK virus (CHIKV) infection is therefore challenging. This international study evaluated the performance of the automated VIDAS® anti-CHIKV IgM and IgG assays compared to that of manual competitor IgM and IgG ELISA for the detection of anti-CHIKV IgM and IgG antibodies in 660 patients with suspected CHIKV infection. Positive and negative agreements of the VIDAS® CHIKV assays with ELISA ranged from 97.5% to 100.0%. The sensitivity of the VIDAS® CHIKV assays evaluated in patients with a proven CHIKV infection confirmed reported kinetics of anti-CHIKV IgM and IgG response, with a positive detection of 88.2-100.0% for IgM ≥ 5 days post symptom onset and of 100.0% for IgG ≥ 11 days post symptom onset. Our study also demonstrated the superiority of ELISA and VIDAS® assays over rapid diagnostic IgM/IgG tests. The analytical performance of VIDAS® anti-CHIKV IgM and IgG assays was excellent, with a high precision (coefficients of variation ≤ 7.4%) and high specificity (cross-reactivity rate ≤ 2.9%). This study demonstrates the suitability of the automated VIDAS® anti-CHIKV IgM and IgG assays to diagnose CHIKV infections and supports its applicability for epidemiological surveillance and differential diagnosis in regions endemic for CHIKV.
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Affiliation(s)
- Geovana M Pereira
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Erika R Manuli
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
- Faculdade de Medicina da Universidade Municipal de São Caetano do Sul, São Paulo 09521-160, Brazil
- Laboratório de Investigação Médica/Parasitologia LIM/46, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
| | | | - Marina F Côrtes
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Mariana S Ramundo
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | | | | | | | | | - Carolina Dos Santos Lázari
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Patricia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro 21040-360, Brazil
| | - Ana Maria Bispo de Filippis
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro 21040-360, Brazil
| | - Glaucia Paranhos-Baccalà
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
- bioMérieux, 69280 Marcy l'Etoile, France
| | - Alice Banz
- bioMérieux, 69280 Marcy l'Etoile, France
| | - Ester C Sabino
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
- Faculdade de Medicina da Universidade Municipal de São Caetano do Sul, São Paulo 09521-160, Brazil
- Laboratório de Investigação Médica/Parasitologia LIM/46, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
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4
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Solis M, Benotmane I, Gallais F, Caillard S, Fafi-Kremer S. Torque teno virus viral load predicts SARS-CoV-2 vaccine response in kidney transplant recipients. J Med Virol 2023; 95:e28936. [PMID: 37404001 DOI: 10.1002/jmv.28936] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/17/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Abstract
Transplant recipients display poor responses to SARS-CoV-2 mRNA vaccines. In this retrospective study, we investigate torque teno virus (TTV) viral load (VL), a ubiquitous virus reflecting global immune response levels, as a predictive factor of vaccine response in kidney transplant recipients (KTR). Four hundred and fifty-nine KTR having received two SARS-CoV-2 mRNA vaccine doses were enrolled, and 241 of them subsequently received a third vaccine dose. Antireceptor-binding domain (RBD) IgG response was assessed after each vaccine dose and TTV VL was measured in pre-vaccine samples. Prevaccine TTV VL > 6.2 log10 copies (cp)/mL was independently associated with nonresponse to two doses (odds ratio (OR) = 6.17, 95% confidence interval (CI95) = 2.42-15.78) as well as to three doses (OR = 3.62, 95% CI95 = 1.55-8.49). In nonresponders to the second dose, high TTV VL in prevaccine samples or measured before the third dose were equally predictive of lower seroconversion rates and antibody titers. High TTV VL before and during SARS-CoV-2 vaccination schedules are predictive of poor vaccine response in KTR. This biomarker should be further evaluated regarding other vaccine responses.
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Affiliation(s)
- Morgane Solis
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM, UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Ilies Benotmane
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM, UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
- Département de Néphrologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Floriane Gallais
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM, UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Sophie Caillard
- INSERM, UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
- Département de Néphrologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Samira Fafi-Kremer
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM, UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
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5
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von Groote T, Meersch M, Romagnoli S, Ostermann M, Ripollés-Melchor J, Schneider AG, Vandenberghe W, Monard C, De Rosa S, Cattin L, Rahmel T, Adamzik M, Parise D, Candela-Toha A, Haaker JG, Göbel U, Bernard A, Lumlertgul N, Fernández-Valdes-Bango P, Romero Bhathal I, Suarez-de-la-Rica A, Larmann J, Villa G, Spadaro S, Wulf H, Arndt C, Putensen C, García-Álvarez R, Brandenburger T, Siniscalchi A, Ellerkmann R, Espeter F, Porschen C, Sadjadi M, Saadat-Gilani K, Weiss R, Gerss J, Kellum J, Zarbock A. Biomarker-guided intervention to prevent acute kidney injury after major surgery (BigpAK-2 trial): study protocol for an international, prospective, randomised controlled multicentre trial. BMJ Open 2023; 13:e070240. [PMID: 36972972 PMCID: PMC10069589 DOI: 10.1136/bmjopen-2022-070240] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Previous studies demonstrated that the implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guideline-based bundle, consisting of different supportive measures in patients at high risk for acute kidney injury (AKI), might reduce rate and severity of AKI after surgery. However, the effects of the care bundle in broader population of patients undergoing surgery require confirmation. METHODS AND ANALYSIS The BigpAK-2 trial is an international, randomised, controlled, multicentre trial. The trial aims to enrol 1302 patients undergoing major surgery who are subsequently admitted to the intensive care or high dependency unit and are at high-risk for postoperative AKI as identified by urinary biomarkers (tissue inhibitor of metalloproteinases 2*insulin like growth factor binding protein 7 (TIMP-2)*IGFBP7)). Eligible patients will be randomised to receive either standard of care (control) or a KDIGO-based AKI care bundle (intervention). The primary endpoint is the incidence of moderate or severe AKI (stage 2 or 3) within 72 hours after surgery, according to the KDIGO 2012 criteria. Secondary endpoints include adherence to the KDIGO care bundle, occurrence and severity of any stage of AKI, change in biomarker values during 12 hours after initial measurement of (TIMP-2)*(IGFBP7), number of free days of mechanical ventilation and vasopressors, need for renal replacement therapy (RRT), duration of RRT, renal recovery, 30-day and 60-day mortality, intensive care unit length-of-stay and hospital length-of-stay and major adverse kidney events. An add-on study will investigate blood and urine samples from recruited patients for immunological functions and kidney damage. ETHICS AND DISSEMINATION The BigpAK-2 trial was approved by the Ethics Committee of the Medical Faculty of the University of Münster and subsequently by the corresponding Ethics Committee of the participating sites. A study amendment was approved subsequently. In the UK, the trial was adopted as an NIHR portfolio study. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and will guide patient care and further research. TRIAL REGISTRATION NUMBER NCT04647396.
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Affiliation(s)
- Thilo von Groote
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Melanie Meersch
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Stefano Romagnoli
- Department of Health Sciences, Section of Anesthesiology, Intensive Care and Pain Medicine, University of Florence; Department of Anesthesia and Intensive Care, Section of Oncological Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Guy's and St Thomas' Hospitals NHS Trust, London, London, UK
| | | | | | - Wim Vandenberghe
- Department of Intensive Care Medicine, Universiteit Gent, Gent, Belgium
| | - Céline Monard
- Service d'Anesthésie-Réanimation, Hôpital Edouard Herriot, Lyon, Rhône-Alpes, France
| | - Silvia De Rosa
- Department of Anesthesiology and Intensive Care Medicine, San Bortolo Hospital of Vicenza, Vicenza, Veneto, Italy
- Department of Intensive Care Medicine, Centre for Medical Sciences, CISMed, University of Trento, Trento, Trentino-Alto Adige, Italy
| | - Lucia Cattin
- Department of Anesthesiology and Intensive Care Medicine, San Bortolo Hospital of Vicenza, Vicenza, Veneto, Italy
| | - Tim Rahmel
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Michael Adamzik
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Diego Parise
- Department of Anesthesiology and Critical Care, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
| | - Angel Candela-Toha
- Department of Anesthesiology and Critical Care, Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain
| | - Jan Gerrit Haaker
- Department of Anesthesiology and Intensive Care, St Franziskus-Hospital Münster GmbH, Munster, Nordrhein-Westfalen, Germany
| | - Ulrich Göbel
- Department of Anesthesiology and Intensive Care, St Franziskus-Hospital Münster GmbH, Munster, Nordrhein-Westfalen, Germany
| | - Alice Bernard
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, University of Tübingen, Tubingen, Baden-Württemberg, Germany
| | - Nuttha Lumlertgul
- Department of Critical Care, King's College London, Guy's and St Thomas' Hospitals NHS Trust, London, London, UK
- Division of Nephrology, Excellence Centre for Critical Care Nephrology, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Bangkok, Thailand
| | | | - Irene Romero Bhathal
- Department of Anaesthesiology and Intensive Care Medicine, Consorci Parc de Salut MAR de Barcelona, Barcelona, Catalunya, Spain
| | - A Suarez-de-la-Rica
- Department of Anesthesiology and Critical Care, Hospital Universitario Marques de Valdecilla, Santander, Spain
- Department of Anaesthesiology, Hospital Universitario La Paz, Madrid, Madrid, Spain
| | - Jan Larmann
- Department of Anaesthesia, Heidelberg University Hospital, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Gianluca Villa
- Department of Health Sciences, Section of Anesthesiology, Intensive Care and Pain Medicine, University of Florence; Department of Anesthesia and Intensive Care, Section of Oncological Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Savino Spadaro
- Department of Translational Medicine and for Romagna, St. Anne's Archbishop Hospital, University of Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Hinnerk Wulf
- Anesthesiology and Intensive Care Medicine, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Germany
| | - Christian Arndt
- Anesthesiology and Intensive Care Medicine, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Germany
| | - Christian Putensen
- Department of Anesthesiology and Surgical Intensive Care Medicine, Division of Intensive Care Medicine, Universitätsklinikum Bonn, Bonn, Germany
| | - Raquel García-Álvarez
- Department of Anesthesia and Intensive Care, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, Spain
| | - Timo Brandenburger
- Anesthesiology and Critical Care Medicine, Heinrich Heine University Düsseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
| | - Antonio Siniscalchi
- Postoperative and Abdominal Organ Transplant Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Emilia-Romagna, Italy
| | - Richard Ellerkmann
- Department of Anesthesiology, Intensive Care, Pain Medicine and Palliative Care Medicine, Hospital Dortmund, Dortmund, Germany
| | - Florian Espeter
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | - Christian Porschen
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Mahan Sadjadi
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Khaschayar Saadat-Gilani
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Raphael Weiss
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
| | - Joachim Gerss
- Institute of Biostatistics and Clinical Research, University of Münster, Munster, Nordrhein-Westfalen, Germany
| | - John Kellum
- Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alexander Zarbock
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Munster, North Rhine-Westphalia, Germany
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6
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Saeed K, Ahmad-Saeed N, Annett R, Barlow G, Barrett L, Boyd SE, Boran N, Davies P, Hughes H, Jones G, Leach L, Lynch M, Nayar D, Maloney RJ, Marsh M, Milburn O, Mitchell S, Moffat L, Moore LSP, Murphy ME, O'Shea SA, O'Sullivan F, Peach T, Petridou C, Reidy N, Selvaratnam M, Talbot B, Taylor V, Wearmouth D, Aldridge C. A multicentre evaluation and expert recommendations of use of the newly developed BioFire Joint Infection polymerase chain reaction panel. Eur J Clin Microbiol Infect Dis 2023; 42:169-176. [PMID: 36474096 PMCID: PMC9836977 DOI: 10.1007/s10096-022-04538-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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Septic arthritis is a serious condition with significant morbidity and mortality, routinely diagnosed using culture. The FDA has recently approved the rapid molecular BioFire® Joint Infection Panel (BJIP) for synovial fluid. We aimed to evaluate the BJIP compared to culture and its potential use in patient management. A multicentre retrospective evaluation of BJIP was conducted in the UK and Ireland. Positive percent agreement (PPA) and negative percent agreement (NPA) were calculated between the BJIP and routine culture. A multidisciplinary team (MDT) discussion addressing the optimal or potential case use of the assay practice was facilitated. Three hundred ninety-nine surplus synovial fluid samples (~ 70% from native joints) from eight centres were processed using BJIP in addition to routine culture. An increased yield of positive results was detected using BJIP compared to routine culture (98 vs 83), giving an overall PPA of 91.6% and overall NPA of 93% for the BJIP compared to culture results. The BJIP detected resistant markers and additional organisms that could influence antibiotic choices including Neisseria gonorrhoeae and Kingella kingae. The MDT agreed that the assay could be used, in addition to standard methods, in adult and children patients with specialist advice use based on local needs. Rapid results from BJIP were assessed as having potential clinical impact on patient management. Organisms not included in the panel may be clinically significant and may limit the value of this test for PJI.
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Affiliation(s)
- Kordo Saeed
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
| | - Nusreen Ahmad-Saeed
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rachel Annett
- Public Health Wales Department of Microbiology, University Hospital of Wales, Cardiff, Wales, UK
| | - Gavin Barlow
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Hull, UK
- Experimental Medicine & Biomedicine, York Biomedical Research Institute, Hull York Medical School, University of York, Heslington, UK
| | | | - Sara E Boyd
- Chelsea and Westminster NHS Foundation Trust, London, UK
- Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Imperial College London, Du Cane Road, London, UK
- Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, L69 3GE, UK
| | - Nicola Boran
- Department of Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Peter Davies
- Department of Microbiology, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, New Lister Building, Alexandra Parade, Glasgow, UK
| | - Harriet Hughes
- Public Health Wales Department of Microbiology, University Hospital of Wales, Cardiff, Wales, UK
| | - Gwennan Jones
- Public Health Wales Department of Microbiology, University Hospital of Wales, Cardiff, Wales, UK
| | - Laura Leach
- Oxford University Hospitals (OUH), Oxford, UK
| | - Maureen Lynch
- Department of Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Deepa Nayar
- Department of Microbiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Robert J Maloney
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Martin Marsh
- Department of Orthopaedics, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Olivia Milburn
- Department of Microbiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Shanine Mitchell
- Public Health Wales Department of Microbiology, University Hospital of Wales, Cardiff, Wales, UK
| | - Lynn Moffat
- Department of Microbiology, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, New Lister Building, Alexandra Parade, Glasgow, UK
| | - Luke S P Moore
- Chelsea and Westminster NHS Foundation Trust, London, UK
- Imperial College Healthcare NHS Trust, North West London Pathology, Fulham Palace Road, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections & Antimicrobial Resistance, Imperial College London, Du Cane Road, London, UK
| | - Michael E Murphy
- Department of Microbiology, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, New Lister Building, Alexandra Parade, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Shaan Ashk O'Shea
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Fionnuala O'Sullivan
- Department of Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Teresa Peach
- Health Protection and Infection Division, Capital Quarter, Public Health Wales, Cardiff, Wales, UK
| | - Christina Petridou
- Department of Infection, Hampshire Hospitals NHS Foundation Trust, Winchester, UK
| | - Niamh Reidy
- Department of Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Ben Talbot
- Department of Microbiology, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, New Lister Building, Alexandra Parade, Glasgow, UK
| | - Vanessa Taylor
- Public Health Wales Department of Microbiology, University Hospital of Wales, Cardiff, Wales, UK
| | - Deborah Wearmouth
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Catherine Aldridge
- Department of Microbiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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7
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Gavazzi G, Drevet S, Debray M, Bosson JL, Tidadini F, Paccalin M, de Wazieres B, Celarier T, Bonnefoy M, Vitrat V. Procalcitonin to reduce exposure to antibiotics and individualise treatment in hospitalised old patients with pneumonia: a randomised study. BMC Geriatr 2022; 22:965. [PMID: 36517740 PMCID: PMC9748380 DOI: 10.1186/s12877-022-03658-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Treating pneumonia in old patients remains challenging for clinicians. Moreover, bacterial antimicrobial resistance is a major public health threat. OBJECTIVE The PROPAGE study evaluated the interest of a strategy using serial measurements of procalcitonin (PCT) to reduce the duration of antibiotic therapy in old patients with pneumonia. METHODS PROPAGE took place from Dec.-2013 to Jun.-2016 in eight French geriatric units. It was a prospective, comparative, randomised, open-label study involving old patients (≥ 80 years) who had initiated antibiotic treatment for pneumonia in the previous 48 h. PCT was monitored in all patients and two decision-making PCT-based algorithms guided antibiotic therapy in patients from the PCT group. RESULTS 107 patients were randomised (PCT, n = 50; Control, n = 57). Antibiotic therapy exposure was reduced in the PCT group as compared to the Control group (median duration of antibiotic therapy, 8 vs. 10 days [rank-test, p = 0.001]; antibiotic persistence rates on Days 6 and 8, 54% and 44% vs. 91% and 72%) and no significant difference was found in recovery rate (84% vs. 89.5%; Pearson Chi² test, p = 0.402). CONCLUSION Although, the superiority of the strategy was not tested using a composite criterion combining antibiotic therapy duration and recovery rate was not tested due to the small sample size, the present study showed that monitoring associated with PCT-guided algorithm could help shorten antibiotic treatment duration in the very old patients without detrimental effects. Measuring PCT levels between Day 4 and Day 6 could be helpful when making the decision regarding antibiotic discontinuation. TRIAL REGISTRATION NCT02173613. This study was first registered on 25/06/2014.
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Affiliation(s)
- Gaëtan Gavazzi
- CHU Grenoble Alpes, B - Hôpital Nord, Av. des Maquis du Grésivaudan Service Universitaire de Gériatrie Clinique, La Tronche, 38700, Grenoble, France.
- T -Raig, TIMC-IMAG, UMR 5525 Université Grenoble Alpes, Grenoble, France.
- Gérontopole AURA, Saint-Etienne, France.
| | - Sabine Drevet
- CHU Grenoble Alpes, B - Hôpital Nord, Av. des Maquis du Grésivaudan Service Universitaire de Gériatrie Clinique, La Tronche, 38700, Grenoble, France
- T -Raig, TIMC-IMAG, UMR 5525 Université Grenoble Alpes, Grenoble, France
| | - Matthieu Debray
- Centre Hospitalier Annecy Genevois, Pringy Metz-Tessy, France
| | - Jean Luc Bosson
- MESP TIMC-IMAG UMR 5525, Université Grenoble Alpes/CNRS, Grenoble INP, Grenoble, France
- Pôle de Santé Publique, CHU Grenoble Alpes, Grenoble, France
| | - Fatah Tidadini
- Département de chirurgie générale et digestive, CHU Grenoble Alpes, Grenoble, France
| | - Marc Paccalin
- Pôle de Gériatrie, CHU de Poitiers, Poitiers, France
| | | | - Thomas Celarier
- Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France
- Service de Gérontologie Clinique, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marc Bonnefoy
- Service de médecine gériatrique, CHU Lyon, Groupement hospitalier Sud, Pierre-Bénite, France
- , Inserm 1060-CarMeN, Oullins, France
| | - Virginie Vitrat
- Centre Hospitalier Annecy Genevois, Pringy Metz-Tessy, France
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8
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Agbota G, Polman K, Wieringa FT, Campos-Ponce M, Accrombessi M, Yovo E, Roucher C, Ezinmègnon S, Marcos JY, Vachot L, Tissières P, Massougbodji A, Fievet N, Cot M, Briand V. Maternal malaria but not schistosomiasis is associated with a higher risk of febrile infection in infant during the first 3 months of life: A mother-child cohort in Benin. PLoS One 2019; 14:e0222864. [PMID: 31536589 PMCID: PMC6752763 DOI: 10.1371/journal.pone.0222864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/09/2019] [Indexed: 01/21/2023] Open
Abstract
Background Malaria and schistosomiasis represent two of the most prevalent and disabling parasitic infections in developing countries. Few studies have evaluated the effect of maternal schistosomiasis and malaria in the peri-conceptional period on infant’s risk of infection. Methods In Benin, women were followed from the preconception period until delivery. Subsequently, their children were followed from birth to 3 months of age. Pre-pregnancy malaria, malaria in pregnancy (MiP)—determined monthly using a thick blood smear—and urinary schistosomiasis—determined once before pregnancy and once at delivery using urine filtration—were the main maternal exposures. Infant’s febrile infection (fever with respiratory, gastrointestinal and/or cutaneous clinical signs anytime during follow-up) was the main outcome. In a secondary analysis, we checked the relation of malaria and schistosomiasis with infant’s hemoglobin (Hb) concentration. Both effects were separately assessed using logistic/mixed linear regression models. Results The prevalence of MiP was 35.7% with 10.8% occurring during the 1st trimester, and the prevalence of schistosomiasis was 21.8%. From birth to 3 months, 25.3% of infants had at least one episode of febrile infection. In multivariate analysis, MiP, particularly malaria in the 1st trimester, was significantly associated with a higher risk of infant’s febrile infection (aOR = 4.99 [1.1; 22.6], p = 0.03). In secondary results, pre-pregnancy malaria and schistosomiasis were significantly associated with a lower infant’s Hb concentration during the first 3 months. Conclusion We evidenced the deleterious effect of maternal parasitic infections on infant’s health. Our results argue in favor of the implementation of preventive strategies as early as in the peri-conception.
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Affiliation(s)
- Gino Agbota
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Bénin
- * E-mail:
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Section Infectious Diseases, Department of Health Sciences, VU Amsterdam, Amsterdam, The Netherlands
| | - Frank T. Wieringa
- Nutripass, UMR204, Institut de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
| | - Maiza Campos-Ponce
- Section Infectious Diseases, Department of Health Sciences, VU Amsterdam, Amsterdam, The Netherlands
| | | | - Emmanuel Yovo
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - Clémentine Roucher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sem Ezinmègnon
- Medical Diagnostic Discovery Department (MD3), bioMérieux, Marcy l’Etoile, France
- UMR 9198, Institut de biologie Intégrative de la Cellule, Université Paris Saclay, Paris, France
| | | | - Laurence Vachot
- Medical Diagnostic Discovery Department (MD3), bioMérieux, Marcy l’Etoile, France
| | - Pierre Tissières
- UMR 9198, Institut de biologie Intégrative de la Cellule, Université Paris Saclay, Paris, France
| | - Achille Massougbodji
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Bénin
| | - Nadine Fievet
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - Michel Cot
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
| | - Valérie Briand
- MERIT, IRD, Université Paris 5, Sorbonne Paris Cité, Paris, France
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