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Papadopoulos M, Mutalib M, Nikaki K, Volonaki E, Rybak A, Thapar N, Lindley K, Borrelli O, Das A, Crespi D, Cleeve S, Athanasakos E. Radiopaque marker colonic transit study in the pediatric population BSPGHAN Motility Working Group consensus statement. Neurogastroenterol Motil 2024; 36:e14776. [PMID: 38454312 DOI: 10.1111/nmo.14776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Functional constipation (FC) is a common condition in childhood in the United Kingdom and worldwide. Various radiological approaches have been established for diagnostic purposes. The radiopaque marker study (ROMS) is universally accepted and used to assess colonic transit time (CTT) in children with FC. Despite being widely used, there is a lack of standardization with various technical protocols, reproducibility of different populations, the purpose for using investigation, variance in the number of markers used, the amount of study days and calculations, the need to empty the colon before performing the test, and whether to perform on medication or off, or the use of specific diets. As part of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) motility working group (MWG), we decided to explore further into the evidence, in order to provide guidance regarding the use of ROMS in dealing with FC in the pediatric population.
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Affiliation(s)
- M Papadopoulos
- Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
| | - M Mutalib
- Department of Paediatric Gastroenterology, Evelina London Children's Hospital, St Thomas' Hospital, London, UK
| | - K Nikaki
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - E Volonaki
- Department of Paediatric Gastroenterology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A Rybak
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - N Thapar
- Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Centre for Child Nutrition Research, Queensland University of Technology, Brisbane, Queensland, Australia
- Stem Cells and Regenerative Medicine, UCL Institute of Child Health, London, UK
| | - K Lindley
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - O Borrelli
- Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - A Das
- Paediatric Department, Broomfield Hospital, Broomfield, UK
| | - D Crespi
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
| | - S Cleeve
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
| | - E Athanasakos
- Department of Paediatric Surgery, The Royal London Hospital, Barts Health NHS, London, UK
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Rybak A, Assad Z, Levy C, Bonarcorsi S, Béchet S, Werner A, Wollner A, Valtuille Z, Kaguelidou F, Angoulvant F, Cohen R, Varon E, Ouldali N. Age-Specific Resurgence in Invasive Pneumococcal Disease Incidence in the COVID-19 Pandemic Era and Its Association With Respiratory Virus and Pneumococcal Carriage Dynamics: A Time-Series Analysis. Clin Infect Dis 2024; 78:855-859. [PMID: 38059538 DOI: 10.1093/cid/ciad746] [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: 09/22/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
Using multiple national surveillance systems, we found an increase in the incidence of invasive pneumococcal disease during after the relaxation of non-pharmaceutical interventions against COVID-19, which strongly varied by age. Age groups with higher incidence of respiratory syncytial virus and influenza also experienced higher increase in invasive pneumococcal disease incidence, with no change in pneumococcal carriage.
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Affiliation(s)
- Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Pediatric Emergency Department, Trousseau Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
- Clinical Epidemiology Unit, Eceve Inserm UMR-S 1123, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
| | - Zein Assad
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Clinical Epidemiology Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est Créteil, France
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Stéphane Bonarcorsi
- Microbiology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - Andreas Werner
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Alain Wollner
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Zaba Valtuille
- Institut National de la Santé et de la Recherche Médicale, Centre of Clinical Investigations 1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florentia Kaguelidou
- Institut National de la Santé et de la Recherche Médicale, Centre of Clinical Investigations 1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Angoulvant
- Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale (Unité Mixte de Recherche S1138), Sorbonne Université, Université Paris Cité, Paris, France
- Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est Créteil, France
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Naïm Ouldali
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, Paris, France
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Rybak A, Ouldali N, Varon E, Taha MK, Bonacorsi S, Béchet S, Angoulvant F, Cohen R, Levy C. Vaccine-preventable Pediatric Acute Bacterial Meningitis in France: A Time Series Analysis of a 19-Year Prospective National Surveillance Network. Pediatr Infect Dis J 2024; 43:74-83. [PMID: 38108805 PMCID: PMC10723767 DOI: 10.1097/inf.0000000000004134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND In France, vaccination has been implemented against Hi serotype b (Hib), pneumococcus with pneumococcal conjugate vaccines (PCV), and Neisseria meningitidis serogroup C (MenC). These interventions with different coverage and uptake have disrupted the epidemiology of vaccine-preventable acute bacterial meningitis (ABM). METHODS We analyzed data from a French prospective surveillance network of ABM in children ≤15 years old enrolled by 259 pediatric wards (estimated national coverage: 61%). From 2001 to 2020, the effect of vaccine implementation was estimated with segmented linear regression. RESULTS We analyzed 7,186 cases, mainly due to meningococcus (35.0%), pneumococcus (29.8%), and Hi (3.7%). MenC ABM incidence decreased (-0.12%/month, 95% CI: -0.17 to -0.07, P < 0.001) with no change for the overall meningococcal ABM when comparing the pre-MenC vaccination and the post-MenC vaccination trends. Despite a decreasing MenB ABM incidence without a vaccination program (-0.43%/month, 95% CI: -0.53 to -0.34, P < 0.001), 68.3% of meningococcal ABM involved MenB. No change in pneumococcal ABM incidence was observed after the PCV7 recommendation. By contrast, this incidence significantly decreased after the switch to PCV13 (-0.9%/month, 95% CI: -1.6 to -0.2%, P = 0.01). After May 2014, a rebound occurred (0.5%/month, 95% CI: 0.3-0.8%, P < 0.001), with 89.5% of non-PCV13 vaccine serotypes. Hib ABM incidence increased after June 2017. CONCLUSIONS PCV7 and MenC vaccine introduction in France, with slow vaccine uptake and low coverage, had no to little impact as compared to the switch from PCV7 to PCV13, which occurred when coverage was optimal. Our data suggest that MenB and next-generation PCVs could prevent a large part of the ABM incidence in France.
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Affiliation(s)
- Alexis Rybak
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- ECEVE, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables, UMR S-1123, INSERM, Université Paris Cité, Paris, Ile-de-France, France
- Department of Pediatric Emergency, Trousseau University Hospital, Sorbonne Université, Paris, Ile-de-France, France
| | - Naïm Ouldali
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
| | - Emmanuelle Varon
- Laboratory of Microbiology and National Reference Centre for Pneumococci, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus Influenzae, Institut Pasteur, Paris, Ile-de-France, France
| | - Stéphane Bonacorsi
- Laboratory of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Stéphane Béchet
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
- HeKA, Inria Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Robert Cohen
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
| | - Corinne Levy
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
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Assad Z, Valtuille Z, Rybak A, Kaguelidou F, Lazzati A, Varon E, Pham LL, Lenglart L, Faye A, Caseris M, Cohen R, Levy C, Vabret A, Gravey F, Angoulvant F, Koehl B, Ouldali N. Unique Changes in the Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Unravel the Role of Respiratory Pathogens: A Time Series Analysis. Chest 2024; 165:150-160. [PMID: 37544426 DOI: 10.1016/j.chest.2023.07.4219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Acute chest syndrome (ACS) is a life-threatening complication of sickle cell disease (SCD). Although respiratory pathogens are frequently detected in children with ACS, their respective role in triggering the disease is still unclear. We hypothesized that the incidence of ACS followed the unprecedented population-level changes in respiratory pathogen dynamics after COVID-19-related nonpharmaceutical interventions (NPIs). RESEARCH QUESTION What is the respective role of respiratory pathogens in ACS epidemiology? STUDY DESIGN AND METHODS This study was an interrupted time series analysis of patient records from a national hospital-based surveillance system. All children aged < 18 years with SCD hospitalized for ACS in France between January 2015 and May 2022 were included. The monthly incidence of ACS per 1,000 children with SCD over time was analyzed by using a quasi-Poisson regression model. The circulation of 12 respiratory pathogens in the general pediatric population over the same period was included in the model to assess the fraction of ACS potentially attributable to each respiratory pathogen. RESULTS Among the 55,941 hospitalizations of children with SCD, 2,306 episodes of ACS were included (median [interquartile range] age, 9 [5-13] years). A significant decrease was observed in ACS incidence after NPI implementation in March 2020 (-29.5%; 95% CI, -46.8 to -12.2; P = .001) and a significant increase after lifting of the NPIs in April 2021 (24.4%; 95% CI, 7.2 to 41.6; P = .007). Using population-level incidence of several respiratory pathogens, Streptococcus pneumoniae accounted for 30.9% (95% CI, 4.9 to 56.9; P = .02) of ACS incidence over the study period and influenza 6.8% (95% CI, 2.3 to 11.3; P = .004); other respiratory pathogens had only a minor role. INTERPRETATION NPIs were associated with significant changes in ACS incidence concomitantly with major changes in the circulation of several respiratory pathogens in the general population. This unique epidemiologic situation allowed determination of the contribution of these respiratory pathogens, in particular S pneumoniae and influenza, to the burden of childhood ACS, highlighting the potential benefit of vaccine prevention in this vulnerable population.
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Affiliation(s)
- Zein Assad
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), Paris Cité University, Paris, France.
| | - Zaba Valtuille
- Centre d'Investigation Clinique, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris Cité University, Paris, France
| | - Alexis Rybak
- INSERM UMR 1123, ECEVE, Paris Cité University, Paris, France; Urgences Pédiatriques, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France; Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), St Maur-des-Fossés, France
| | - Florentia Kaguelidou
- Centre d'Investigation Clinique, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris Cité University, Paris, France
| | - Andrea Lazzati
- Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Emmanuelle Varon
- National Reference Center for Pneumococci, Centre de Recherche Clinique et Biologique, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Luu-Ly Pham
- INSERM UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), Paris Cité University, Paris, France; Department of General Pediatrics, Jean Verdier University Hospital, Assistance Publique-Hôpitaux de Paris, Bondy, France
| | - Léa Lenglart
- INSERM UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), Paris Cité University, Paris, France; Service d'Accueil des Urgences Pédiatriques, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Albert Faye
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1123, ECEVE, Paris Cité University, Paris, France
| | - Marion Caseris
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), St Maur-des-Fossés, France; Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), St Maur-des-Fossés, France; Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Astrid Vabret
- Department of Virology, Caen University Hospital, Caen, France; Univ Caen Normandie, Univ Rouen Normandie, INSERM UMR 1311, DYNAMICURE, Caen, France
| | - François Gravey
- Univ Caen Normandie, Univ Rouen Normandie, INSERM UMR 1311, DYNAMICURE, Caen, France
| | - François Angoulvant
- Paris Sorbonne University, Centre de Recherche des Cordeliers, INSERM UMRS 1138, Paris, France
| | - Bérengère Koehl
- Department of Child Hematology, Reference Center for Sickle-Cell Disease, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR S1134, Integrated Biology of Red Blood Cells, Paris Cité University, Paris, France
| | - Naïm Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), Paris Cité University, Paris, France; INSERM UMR 1123, ECEVE, Paris Cité University, Paris, France
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Ouldali N, Le Roux E, Faye A, Leblanc C, Angoulvant F, Korb D, Delcour C, Caula C, Wohrer D, Rybak A, Delafoy M, Carrié C, Strullu M, Oualha M, Levy R, Mimoun C, Griffon L, Nuzzo A, Eyraud C, Levy M, Ellul P. Early formative objective structured clinical examinations for students in the pre-clinical years of medical education: A non-randomized controlled prospective pilot study. PLoS One 2023; 18:e0294022. [PMID: 38060541 PMCID: PMC10703252 DOI: 10.1371/journal.pone.0294022] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/12/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The value of formative objective structured clinical examinations (OSCEs) during the pre-clinical years of medical education remains unclear. We aimed to assess the effectiveness of a formative OSCE program for medical students in their pre-clinical years on subsequent performance in summative OSCE. METHODS We conducted a non-randomized controlled prospective pilot study that included all medical students from the last year of the pre-clinical cycle of the Université Paris-Cité Medical School, France, in 2021. The intervention group received the formative OSCE program, which consisted of four OSCE sessions, followed by debriefing and feedback, whereas the control group received the standard teaching program. The main objective of this formative OSCE program was to develop skills in taking a structured medical history and communication. All participants took a final summative OSCE. The primary endpoint was the summative OSCE mark in each group. A questionnaire was also administered to the intervention-group students to collect their feedback. A qualitative analysis, using a convenience sample, was conducted by gathering data pertaining to the process through on-site participative observation of the formative OSCE program. RESULTS Twenty students were included in the intervention group; 776 in the control group. We observed a significant improvement with each successive formative OSCE session in communication skills and in taking a structured medical history (p<0.0001 for both skills). Students from the intervention group performed better in a summative OSCE that assessed the structuring of a medical history (median mark 16/20, IQR [15; 17] versus 14/20, [13; 16], respectively, p = 0.012). Adjusted analyses gave similar results. The students from the intervention group reported a feeling of improved competence and a reduced level of stress at the time of the evaluation, supported by the qualitative data showing the benefits of the formative sessions. CONCLUSION Our findings suggest that an early formative OSCE program is suitable for the pre-clinical years of medical education and is associated with improved student performance in domains targeted by the program.
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Affiliation(s)
- Naïm Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- Infectious Diseases Division, CHU Sainte Justine - Montreal University, Montreal, Quebec, Canada
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Enora Le Roux
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Albert Faye
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Claire Leblanc
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - François Angoulvant
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Paris Cité University, Paris, France
- INSERM, Cordeliers Research Center, UMRS 1138, Sorbonne Université, Université Paris Cité, Paris, France
| | - Diane Korb
- Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris University, Paris, France
- Paris University, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Clémence Delcour
- Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris University, Paris, France
| | - Caroline Caula
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Delphine Wohrer
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Pediatric Emergency Department, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Manon Delafoy
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Claire Carrié
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Marion Strullu
- Department of Hematology, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Mehdi Oualha
- Pediatric Intensive Care Unit, Necker University Hospital, Paris Cité University, Paris, France
| | - Romain Levy
- Immunology-Hematology and Rheumatology Department, Necker University Hospital, Paris Cité University, Paris, France
| | - Camille Mimoun
- Department of Gynecology and Obstetrics, Lariboisiere Hospital, Paris Cité University, Paris, France
| | - Lucie Griffon
- Pediatric Non-Invasive Ventilation and Sleep Unit, Necker Hospital, Paris Cité University, Paris, France
| | - Alexandre Nuzzo
- Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Paris Cité University, Paris, France
| | - Clara Eyraud
- Paris Cité University, INSERM UMR 1137, IAME (Infection, Antimicrobials, Modelling, Evolution), Paris, France
| | - Michael Levy
- Pediatric Intensive Care Unit, Robert Debré University Hospital, Paris Cité University, Paris, France
| | - Pierre Ellul
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris Cité University, Paris, France
- INSERM, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne University, Paris, France
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Rybak A, Cohen R, Kramer R, Béchet S, Delobbe JF, Dagrenat V, Vié Le Sage F, Deberdt P, Wollner A, Bangert M, Levy C. Respiratory Syncytial Virus in Outpatient Children with Bronchiolitis: Continuous Virus Circulation During the Nonepidemic Period. Pediatr Infect Dis J 2023; 42:e488-e490. [PMID: 37967149 PMCID: PMC10629605 DOI: 10.1097/inf.0000000000004105] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 11/17/2023]
Abstract
We aimed to estimate the respiratory syncytial virus positivity rate among ambulatory children with bronchiolitis according to the bronchiolitis epidemic period as defined by the French Public Health Institute. The positivity rate was 28.9% during the nonepidemic period and 50.6% during the epidemic period, which suggests continuous virus circulation between bronchiolitis annual peaks.
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Affiliation(s)
- Alexis Rybak
- From the Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Assistance Publique-Hôpitaux de Paris, Department of Pediatric Emergency, Trousseau University Hospital, Sorbonne Université, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Association Française de Pédiatrie Ambulatoire, Paris, France
- Sanofi Pasteur, Lyon, France
| | - Robert Cohen
- From the Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Association Française de Pédiatrie Ambulatoire, Paris, France
- Research Center, Centre Hospitalier Intercommuncal de Créteil, Université Paris Est, Créteil, France
- Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Créteil, France
| | | | - Stéphane Béchet
- From the Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | | | | | | | - Patrice Deberdt
- Association Française de Pédiatrie Ambulatoire, Paris, France
| | - Alain Wollner
- From the Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Paris, France
| | | | - Corinne Levy
- From the Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Association Française de Pédiatrie Ambulatoire, Paris, France
- Research Center, Centre Hospitalier Intercommuncal de Créteil, Université Paris Est, Créteil, France
- Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Créteil, France
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Assad Z, Cohen R, Varon E, Levy C, Bechet S, Corrard F, Werner A, Ouldali N, Bonacorsi S, Rybak A. Antibiotic Resistance of Haemophilus influenzae in Nasopharyngeal Carriage of Children with Acute Otitis Media and in Middle Ear Fluid from Otorrhea. Antibiotics (Basel) 2023; 12:1605. [PMID: 37998807 PMCID: PMC10668799 DOI: 10.3390/antibiotics12111605] [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: 09/30/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
Haemophilus influenzae (Hi) is one of the leading bacteria implicated in childhood acute otitis media (AOM). Recent concerns have been raised about the emergence of Hi-resistant strains. We aimed to analyze the evolution of β-lactam resistance to Hi among strains isolated from nasopharyngeal carriage in children with AOM and in mild ear fluid (MEF) after the spontaneous perforation of the tympanic membrane (SPTM) in France. In this national ambulatory-based cohort study over 16 years, we analyzed the rate of Hi nasopharyngeal carriage and the proportion of β-lactam-resistant Hi strains over time using a segmented linear regression model. Among the 13,865 children (median [IQR] age, 12.7 [9.3-17.3] months; 7400 [53.4%] male) with AOM included from November 2006 to July 2022, Hi was isolated in 7311 (52.7%) children by nasopharyngeal sampling. The proportion of β-lactamase-producing and β-lactamase-negative, ampicillin-resistant (BLNAR) Hi strains in nasopharyngeal carriage remained stable during the study period. Among the 783 children (median [IQR] age, 20 [12.3-37.8] months; 409 [52.2%] male) with SPTM included from October 2015 to July 2022, Hi was isolated in 177 (22.6%) cases by MEF sampling. The proportions of β-lactamase-producing and BLNAR Hi strains did not significantly differ between nasopharyngeal (17.6% and 8.8%, respectively) and MEF (12.6% and 7.4%) samples. Accordingly, amoxicillin remains a valid recommendation as the first-line drug for AOM in France.
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Affiliation(s)
- Zein Assad
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France; (Z.A.); (N.O.)
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, 75018 Paris, France;
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
| | - Robert Cohen
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est, 94000 Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), 45000 Orléans, France
| | - Emmanuelle Varon
- National Reference Center for Pneumococci, Centre de Recherche Clinique et Biologique, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France;
| | - Corinne Levy
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est, 94000 Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), 45000 Orléans, France
| | - Stéphane Bechet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
- Association Française de Pédiatrie Ambulatoire (AFPA), 45000 Orléans, France
| | - François Corrard
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
- Association Française de Pédiatrie Ambulatoire (AFPA), 45000 Orléans, France
| | - Andreas Werner
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
- Association Française de Pédiatrie Ambulatoire (AFPA), 45000 Orléans, France
| | - Naïm Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France; (Z.A.); (N.O.)
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, 75018 Paris, France;
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
| | - Stéphane Bonacorsi
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, 75018 Paris, France;
- Department of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
| | - Alexis Rybak
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), 06200 Nice, France; (R.C.); (A.W.); (A.R.)
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), 94000 Créteil, France; (S.B.); (F.C.)
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Madhi F, Rybak A, Basmaci R, Romain AS, Werner A, Biscardi S, Dubos F, Faye A, Grimprel E, Raymond J, Ros B, Cohen R. Antimicrobial treatment of urinary tract infections in children. Infect Dis Now 2023; 53:104786. [PMID: 37730164 DOI: 10.1016/j.idnow.2023.104786] [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: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/22/2023]
Abstract
Urinary tract infections are the most frequently proven bacterial infections in pediatrics. The treatment options proposed in this guide are based on recommendations published by the Groupe de Pathologie Infectieuse de Pédiatrique (GPIP-SFP). Except in rare situations (newborns, neutropenia, sepsis), a positive urine dipstick for leukocytes and/or nitrites should precede a urine culture examination and any antibiotic therapy. After rising steadily between 2000 and 2012, the proportion of Escherichia coli strains resistant to extended-spectrum ß-lactamases (E-ESBL) has remained stable over the last ten years (between 7% and 10% in pediatrics). However, in many cases no oral antibiotic is active on E-ESBL leading either to prolonged parenteral treatment, or to use of a non-orthodox combination such as cefixime + clavulanate. With the aim of avoiding penem antibiotics and encouraging outpatient management, this guide favors initial treatment of febrile urinary tract infections (suspected or actual E-ESBL infection), with amikacin. Amikacin remains active against the majority of E-ESBL strains. It could be prescribed as monotherapy for patients in pediatric emergency departments or otherwise hospitalized patients.
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Affiliation(s)
- Fouad Madhi
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; General Pediatrics Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Alexis Rybak
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Pediatric Emergency, Hôpital Robert Debré, Paris, France
| | - Romain Basmaci
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Department of Pediatrics, Hôpital Louis Mourier, Colombes, France
| | - Anne-Sophie Romain
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Pediatric Emergency, Hôpital Trousseau, Paris, France
| | - Andréas Werner
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Outpatient Pediatrician, Villeneuve-lès-Avignon, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - Sandra Biscardi
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Pediatric Emergency, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - François Dubos
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Pediatric Emergencies & Infectious Diseases, CHRU Lille & University of Lille, Lille, France
| | - Albert Faye
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Department of Pediatrics, Robert Debré Hospital, Paris, France
| | - Emmanuel Grimprel
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; University of Paris 6, Department of Pediatrics, Trousseau Hospital, Paris, France
| | - Josette Raymond
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Microbiology Department, Kremlin Bicêtre Hospital, Paris
| | - Barbara Ros
- Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Pediatric Emergency, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Robert Cohen
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society (GPIP), France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France; Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Créteil, France.
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9
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Cohen R, Tauzin M, Rybak A, Ouldali N, Grimprel E. Definitions and implications of the pharmacokinetic-pharmacodynamic parameters of antibiotics in pediatric clinical practice. Infect Dis Now 2023; 53:104781. [PMID: 37714412 DOI: 10.1016/j.idnow.2023.104781] [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: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/17/2023]
Abstract
Knowledge of infectious diseases and their treatments is constantly evolving. New infectious agents are regularly discovered, mainly due to improvement of identification techniques, especially the development of molecular biology and mass spectrometry. While changes in the epidemiology of infectious diseases are not always predictable or readily understood, several factors regularly enter into consideration, such as not only the natural history of diseases, the impact of vaccinations, but also the excessive and irrational use of antibiotics. Antibiotic resistance is now recognized as one of the major challenges for humanity, especially since few new molecules have been put on the market in recent years. These molecules are reserved for serious infections caused by bacteria resistant to other antibiotics and should only be prescribed by infectious diseases specialists trained in their use. Rationalization of antibiotic therapy is therefore one of the keys to reducing antibiotic resistance and the spread of resistant bacteria. In this guide, for each clinical situation, the bacterial target(s) of antibiotic treatment, the preferred antibiotic choice, and the therapeutic alternatives will be specified. Comments on the diagnosis and treatment of the infection will be added if necessary.
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Affiliation(s)
- Robert Cohen
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France.
| | - Manon Tauzin
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Neonatal Intensive Care Unit, CHI Créteil, Créteil, France
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Sorbonne University, Paris, France; Emergency Department, Armand-Trousseau Hospital, Paris, France
| | - Naim Ouldali
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré Hospital, Paris, France; IAME UMR 1137, Paris Cité University, Paris, France
| | - Emmanuel Grimprel
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; General Pediatrics, Armand-Trousseau Hospital, Paris, France
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10
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Cohen R, Grimprel E, Rybak A, Hau I, Madhi F, Ouldali N, Raymond J. The principles of curative antibiotic treatments. Infect Dis Now 2023; 53:104780. [PMID: 37716410 DOI: 10.1016/j.idnow.2023.104780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
Knowledge of infectious diseases and their treatments is constantly evolving. New infectious agents are regularly discovered, due mainly to improvement of identification techniques, especially the development of molecular biology and mass spectrometry. While changes in the epidemiology of infectious diseases are not always predictable or readily understood, several factors regularly enter into consideration, such as not only the natural history of diseases and the impact of vaccinations, but also the excessive and irrational use of antibiotics. Antibiotic resistance is now recognized as one of the major challenges for humanity, especially since few new molecules have been put on the market in recent years. These molecules are reserved for serious infections caused by bacteria resistant to other antibiotics and should be prescribed only by infectious disease specialists trained in their use. Rationalization of antibiotic therapy is therefore one of the keys to reducing antibiotic resistance and the spread of resistant bacteria. In this guide, with regard to each clinical situation, the bacterial target(s) of antibiotic treatment, the preferred antibiotic choice, and the therapeutic alternatives will be specified. Comments on diagnosis and treatment of the infection will be added if necessary.
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Affiliation(s)
- Robert Cohen
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Centre Hospitalier Intercommunal de Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France.
| | - Emmanuel Grimprel
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Sorbonne University, Paris, France; General Pediatrics Departement, Armand-Trousseau Hospital, Paris, France
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Sorbonne University, Paris, France; General Pediatrics Departement, Armand-Trousseau Hospital, Paris, France
| | - Isabelle Hau
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil, France
| | - Fouad Madhi
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil, France
| | - Naim Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; General Pediatrics Department, Jean Verdier Hospital, Bobigny, France; General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré Hospital, Paris, France; IAME UMR 1137, Paris Cité University, Paris, France
| | - Josette Raymond
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; University of Paris Descartes, Bicêtre Hospital, Paris, France
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Cohen JF, Rybak A, Werner A, Kochert F, Cahn-Sellem F, Gelbert N, Vié Le Sage F, Batard C, Béchet S, Corbaux H, Frandji B, Levy C, Cohen R. Surveillance of noninvasive group A Streptococcus infections in French ambulatory pediatrics before and during the COVID-19 pandemic: a prospective multicenter study from 2018-2022. Int J Infect Dis 2023; 134:135-141. [PMID: 37290573 DOI: 10.1016/j.ijid.2023.06.003] [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: 03/08/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES We evaluated the burden of noninvasive group A Streptococcus (GAS) infections in ambulatory pediatrics before and during the COVID-19 pandemic in France. METHODS We analyzed data from a national network of ambulatory pediatricians between 2018 and 2022. Clinicians evaluating children ≤15 years old for tonsillopharyngitis, perianal infections, paronychia/blistering dactylitis, and scarlet fever were invited to perform a rapid antigen detection test (RADT) for GAS. Monthly incidence of noninvasive GAS infections per 10,000 visits was modeled using time series analysis, considering two breakpoints: March 2020 (first national lockdown) and March 2022 (end of mandatory mask-wearing in schools). RESULTS Over the study period, 125 pediatricians recorded 271,084 infectious episodes. GAS-related illnesses represented 4.3% of all infections. In March 2020, the incidence of GAS diseases decreased by 84.5% (P <0.001), with no significant trend until March 2022. After March 2022, the incidence significantly increased (+23.8% per month, P <0.001), with similar patterns across all monitored GAS-related diseases. CONCLUSION By using routine clinical data and RADTs, we have monitored changes in the incidence of noninvasive GAS infections in ambulatory pediatrics. COVID-19 mitigation measures have had a major impact on the epidemiology of noninvasive GAS infections, but their relaxation was followed by a surge above baseline levels.
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Affiliation(s)
- Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker-Enfants malades, AP-HP, Université Paris Cité, Paris, France; Centre of Research in Epidemiology and Statistics (Inserm UMR 1153), Université Paris Cité, Paris, France
| | - Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Pediatric Emergency Department, Hôpital Trousseau, AP-HP, Sorbonne Université, Paris, France; Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE, Inserm UMR S-1123), Université Paris Cité, Paris, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France.
| | - Andreas Werner
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France
| | | | - Nathalie Gelbert
- Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France
| | | | - Christophe Batard
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - Hippolyte Corbaux
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France; Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France; Groupe de Recherche Clinique-Groupe d'Etudes des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Institut Mondor de Recherches Biomédicale, Créteil, France.
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France; Association Française de Pédiatrie Ambulatoire (AFPA), Paris, France; Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France; Groupe de Recherche Clinique-Groupe d'Etudes des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Institut Mondor de Recherches Biomédicale, Créteil, France
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Rybak A, Levy C, Ouldali N, Bonacorsi S, Béchet S, Delobbe JF, Batard C, Donikian I, Goldrey M, Assouline J, Cohen R, Varon E. Dynamics of Antibiotic Resistance of Streptococcus pneumoniae in France: A Pediatric Prospective Nasopharyngeal Carriage Study from 2001 to 2022. Antibiotics (Basel) 2023; 12:1020. [PMID: 37370339 DOI: 10.3390/antibiotics12061020] [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: 04/28/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Epidemiological surveillance of nasopharyngeal pneumococcal carriage is important for monitoring serotype distribution and antibiotic resistance, particularly before and after the implementation of pneumococcal conjugate vaccines (PCVs). With a prospective surveillance study in France, we aimed to analyze the dynamics of pneumococcal carriage, antibiotic susceptibility and serotype distribution in children aged 6 to 24 months who had acute otitis media between 2001 and 2022 with a focus on the late PCV13 period from May 2014 to July 2022. Trends were analyzed with segmented linear regression with autoregressive error. For the 17,136 children enrolled, overall pneumococcal carriage was stable during the study. During the late PCV13 period, the five most frequent serotypes were all non-PCV13 serotypes: 15B/C (14.3%), 23B (11.0%), 11A (9.6%), 15A (7.4%) and 35B (6.5%). During the same period, we observed a rebound of penicillin non-susceptibility (+0.15% per month, 95% confidence interval, +0.08 to 0.22, p < 0.001). Five serotypes accounted for 64.4% of the penicillin non-susceptible strains: 11A (17.5%), 35B (14.9%), 15A (13.9%), 15B/C (9.9%) and 19F (8.2%); non-PCV13/PCV15 accounted for <1%, and non-PCV15/PCV20 accounted for 28%. The next generation PCVs, particularly PCV20, may disrupt nasopharyngeal carriage and contribute to decreasing the rate of antibiotic resistance among pneumococci.
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Affiliation(s)
- Alexis Rybak
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- Pediatric Emergency Department, Trousseau Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
- Clinical Epidemiology Unit, Eceve Inserm UMR-S 1123, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
| | - Corinne Levy
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, 06200 Nice, France
- CRC, Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Naïm Ouldali
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
- IAME, Infection, Antimicrobials, Modelling, Evolution, Inserm UMR 1137, Paris University, 75018 Paris, France
| | - Stéphane Bonacorsi
- Microbiology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75019 Paris, France
| | - Stéphane Béchet
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
| | | | - Christophe Batard
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Isabelle Donikian
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Marie Goldrey
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Jessica Assouline
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Robert Cohen
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, 06200 Nice, France
- CRC, Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Emmanuelle Varon
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, 94000 Créteil, France
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13
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Smolarska A, Pruszynska I, Wasylko W, Godlewska K, Markowska M, Rybak A, Botther J, Kucharzewska P, Nowakowska J, Szeliga J, Kubiak M, Gorczak M, Krol M. Targeted therapies for glioblastoma treatment. J Physiol Pharmacol 2023; 74. [PMID: 37661178 DOI: 10.26402/jpp.2023.3.01] [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] [Received: 01/21/2023] [Accepted: 06/30/2023] [Indexed: 09/05/2023]
Abstract
Glioblastoma, the most common and aggressive type of brain tumor in adults, poses significant challenges in terms of treatment. Conventional approaches including surgery, chemotherapy, and radiotherapy have yielded limited success, with a median survival of approximately 15 months. However, extensive research into the biology of glioblastoma has identified molecular targets that can be exploited by newly developed drugs, leading to the emergence of precise personalized therapies. Several innovative treatment strategies are currently under development, aiming to enhance effectiveness while minimizing side effects. Clinical trials are underway to evaluate the efficacy of monoclonal antibodies that target glioblastoma cells, either by blocking specific receptors or by modifying molecular interactions that impede cell proliferation. Another promising avenue involves the use of oncolytic viruses designed to selectively infect glioblastoma cells. Additionally, the review explores the utilization of nanocarriers capable of surmounting the formidable obstacle of the blood-brain barrier, enabling efficient drug delivery. Cell therapies represent another promising approach, with dendritic cells, chimeric antigen receptor-T cells, and macrophages emerging as potential treatment modalities. By summarizing recent advances in targeted therapies against glioblastoma, this review aims to provide a comprehensive overview of ongoing efforts to discover effective and safe methods for treating glioblastoma patients. The ultimate goal is to improve patient outcomes and transform the landscape of glioblastoma treatment.
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Affiliation(s)
- A Smolarska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - I Pruszynska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - W Wasylko
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - K Godlewska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - M Markowska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - A Rybak
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - J Botther
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - P Kucharzewska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - J Nowakowska
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - J Szeliga
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - M Kubiak
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - M Gorczak
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland
| | - M Krol
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Warsaw, Poland.
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14
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Lignieres G, Rybak A, Levy C, Birgy A, Bechet S, Bonacorsi S, Cohen R, Madhi F. Meningitis caused by extended-spectrum β-lactamase-producing Escherichia coli in infants in France: a case series. JAC Antimicrob Resist 2023; 5:dlad042. [PMID: 37051190 PMCID: PMC10083514 DOI: 10.1093/jacamr/dlad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
Objectives We report the first case series focusing on clinical and biological characteristics of meningitis caused by ESBL-producing Escherichia coli in infants. Methods Between 2001 and 2020, data on all cases of E. coli meningitis were prospectively collected from a network of 259 paediatric wards and 168 microbiology laboratories in France. We analysed the clinical and biological characteristics, short-term complications and long-term sequelae of ESBL-producing E. coli meningitis cases in patients <6 months old. Results In total, 548 cases of E. coli paediatric meningitis were reported. ESBL-producing E. coli represented 12 (2.2%) cases. We included 10 patients aged <6 months old. Eight (80%) patients presented at least one sign of clinical severity: six needed mechanical ventilation, three presented signs of shock and one was in a coma. The overall short-term prognosis was good, with only one meningitis-attributed death in the first hours of care. All surviving children received carbapenems for a median of 21 days (range 9-28). Two relapses occurred, including one in a patient who received only 14 days of imipenem. We reported no long-term sequelae at a median follow-up of 20 months. Conclusions Meropenem seems to be the treatment of choice for ESBL-producing E. coli meningitis in children and needs to be given as early as possible (<48 h) and for at least 21 days. Maternal colonization or infection with ESBL-producing Enterobacteriaceae needs to be reported to the neonatal or paediatric ICU team, in order to adapt the empirical antibiotic therapy.
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Affiliation(s)
- Gabriel Lignieres
- Service de Pédiatrie Générale, Maladies Infectieuses et Médecine Interne, CHU Robert Debré, APHP, Paris, France
- Sorbonne Université, Paris, France
| | - Alexis Rybak
- Service des Urgences Pédiatriques, CHU Robert Debré, APHP, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP) de la Société Française de Pédiatrie (SFP), Paris, France
| | - Corinne Levy
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP) de la Société Française de Pédiatrie (SFP), Paris, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Centre de Recherche Clinique (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - André Birgy
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP) de la Société Française de Pédiatrie (SFP), Paris, France
- Service de Microbiologie, CHU Robert Debré, APHP, Centre National de Référence (CNR) associé Escherichia coli, Paris, France
| | - Stéphane Bechet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - Stéphane Bonacorsi
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP) de la Société Française de Pédiatrie (SFP), Paris, France
- Service de Microbiologie, CHU Robert Debré, APHP, Centre National de Référence (CNR) associé Escherichia coli, Paris, France
| | - Robert Cohen
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP) de la Société Française de Pédiatrie (SFP), Paris, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Unité Court Séjour, Petits nourrissons, Service de Néonatalogie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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15
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Cohen R, Levy C, Rybak A, Angoulvant F, Ouldali N, Grimprel E. Immune debt: Recrudescence of disease and confirmation of a contested concept. Infect Dis Now 2023; 53:104638. [PMID: 36535583 PMCID: PMC9756601 DOI: 10.1016/j.idnow.2022.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Département femme-mère-enfant, CHU, Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - Naim Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - Emmanuel Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Trousseau Hospital, APHP Paris, France, Sorbonne University, France
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16
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Lenglart L, Ouldali N, Honeyford K, Bognar Z, Bressan S, Buonsenso D, Da Dalt L, De T, Farrugia R, Maconochie IK, Moll HA, Oostenbrink R, Parri N, Roland D, Rose K, Akyüz Özkan E, Angoulvant F, Aupiais C, Barber C, Barrett M, Basmaci R, Castanhinha S, Chiaretti A, Durnin S, Fitzpatrick P, Fodor L, Gomez B, Greber-Platzer S, Guedj R, Hey F, Jankauskaite L, Kohlfuerst D, Mascarenhas I, Musolino AM, Pučuka Z, Reis S, Rybak A, Salamon P, Schaffert M, Shahar-Nissan K, Supino MC, Teksam O, Turan C, Velasco R, Nijman RG, Titomanlio L. Respective roles of non-pharmaceutical interventions in bronchiolitis outbreaks: an interrupted time-series analysis based on a multinational surveillance system. Eur Respir J 2023; 61:13993003.01172-2022. [PMID: 36356971 DOI: 10.1183/13993003.01172-2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/23/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Bronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries. METHODS We conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling. RESULTS In total, 42 916 children were included. We observed an overall cumulative 78% (95% CI -100- -54%; p<0.0001) reduction in bronchiolitis cases following NPI implementation. The decrease varied between countries from -97% (95% CI -100- -47%; p=0.0005) to -36% (95% CI -79-7%; p=0.105). Full lockdown (incidence rate ratio (IRR) 0.21 (95% CI 0.14-0.30); p<0.001), secondary school closure (IRR 0.33 (95% CI 0.20-0.52); p<0.0001), wearing a mask indoors (IRR 0.49 (95% CI 0.25-0.94); p=0.034) and teleworking (IRR 0.55 (95% CI 0.31-0.97); p=0.038) were independently associated with reducing bronchiolitis. CONCLUSIONS Several NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis.
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Affiliation(s)
- Lea Lenglart
- Paediatric Emergency Department, Robert Debré University Hospital, AP-HP, Université de Paris, Paris, France
- L. Lenglart and N. Ouldali contributed equally to this work
| | - Naim Ouldali
- Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, AP-HP, Université de Paris, Paris, France
- Infectious Diseases Division, CHU Sainte Justine, Montreal University, Montreal, QC, Canada
- Paris University, INSERM UMR 1123, ECEVE, Paris, France
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, St Maur-des-Fossés, France
- L. Lenglart and N. Ouldali contributed equally to this work
| | - Kate Honeyford
- Health Informatics Team, Division of Clinical studies, Institute of Cancer Research, London, UK
| | - Zsolt Bognar
- Paediatric Emergency Department, Heim Pal National Paediatric Institute, Budapest, Hungary
| | - Silvia Bressan
- Division of Paediatric Emergency Medicine, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Liviana Da Dalt
- Division of Paediatric Emergency Medicine, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Tisham De
- Section of Paediatric Infectious Diseases, Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Ruth Farrugia
- Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta
| | - Ian K Maconochie
- Department of Paediatric Emergency Medicine, Division of Medicine, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
- Centre for Paediatrics and Child Health, Faculty of Medicine, Imperial College London, London, UK
| | - Henriette A Moll
- Department of General Paediatrics, ErasmusMC - Sophia, Rotterdam, The Netherlands
| | - Rianne Oostenbrink
- Department of General Paediatrics, ErasmusMC - Sophia, Rotterdam, The Netherlands
| | - Niccolo Parri
- Emergency Department and Trauma Center, Ospedale Paediatrico Meyer Firenze, Florence, Italy
| | - Damian Roland
- SAPPHIRE Group, Health Sciences, Leicester University, Leicester, UK
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospitals, Leicester, UK
| | - Katy Rose
- Department of Paediatric Emergency Medicine, Division of Medicine, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
| | - Esra Akyüz Özkan
- Paediatric Emergency Department, Ondokuz Mayıs University, Samsun, Turkey
| | - François Angoulvant
- Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, AP-HP, Université de Paris, Paris, France
| | - Camille Aupiais
- Paris University, INSERM UMR 1123, ECEVE, Paris, France
- Paediatric Emergency Department, Jean Verdier Hospital, AP-HP, Sorbonne Paris Cité, Bondy, France
| | - Clarissa Barber
- Paediatric Emergency Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Michael Barrett
- Paediatric Emergency Department, Children's Health Ireland at Crumlin, Dublin, Ireland
- Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland
| | - Romain Basmaci
- Paediatric Emergency Department, Louis Mourier Hospital, AP-HP, Université de Paris, Colombes, France
| | - Susana Castanhinha
- Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Antonio Chiaretti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sheena Durnin
- Department of Paediatric Emergency Medicine, Children's Health Ireland at Tallaght, Dublin, Ireland
| | - Patrick Fitzpatrick
- Paediatric Emergency Department, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Laszlo Fodor
- Paediatric Emergency Department, Szent Gyorgy University Teaching Hospital of Fejer County, Szekesfehervar, Hungary
| | - Borja Gomez
- Paediatric Emergency Department, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Susanne Greber-Platzer
- Clinical Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Romain Guedj
- Paediatric Emergency Department, Armand Trousseau Hospital, AP-HP, Sorbonne Université, CRESS Inserm U-1153 Paris, Epopé Team, Paris, France
| | - Florian Hey
- Pediatric Intensive Care Unit and Emergency Department, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lina Jankauskaite
- Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
| | - Daniela Kohlfuerst
- Department of General Paediatrics, Medical University of Graz, Graz, Austria
| | - Ines Mascarenhas
- Departamento da Criança e do Jovem, Urgencia Pediatrica, Hospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal
| | | | - Zanda Pučuka
- Paediatric Emergency Department, Children's Clinical University Hospital, Riga Stradins University, Riga, Latvia
| | - Sofia Reis
- Paediatric Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Alexis Rybak
- Paediatric Emergency Department, Robert Debré University Hospital, AP-HP, Université de Paris, Paris, France
- Paris University, INSERM UMR 1123, ECEVE, Paris, France
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, St Maur-des-Fossés, France
| | - Petra Salamon
- Paediatric Emergency Department, Heim Pal National Paediatric Institute, Budapest, Hungary
| | - Matthias Schaffert
- Department of Pediatrics and Department of Paediatric and Adolescent Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Keren Shahar-Nissan
- Paediatric Emergency Department, Schneider Children's Medical Center of Israel and Sackler Faculty of Medicine, Petach Tikva, Israel
| | | | - Ozlem Teksam
- Division of Paediatric Emergency Medicine, Department of Paediatrics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Caner Turan
- Department of Paediatrics, Division of Emergency Medicine, Mersin City Training and Research Hospital, Toroslar, Turkey
| | - Roberto Velasco
- Paediatric Emergency Unit, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Ruud G Nijman
- Section of Paediatric Infectious Diseases, Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
- Department of Paediatric Emergency Medicine, Division of Medicine, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, UK
- Centre for Paediatrics and Child Health, Faculty of Medicine, Imperial College London, London, UK
- R.G. Nijman and L. Titomanlio contributed equally to this work
| | - Luigi Titomanlio
- Paediatric Emergency Department, Robert Debré University Hospital, AP-HP, Université de Paris, Paris, France
- Paris University, INSERM U1141, DHU Protect, Paris, France
- R.G. Nijman and L. Titomanlio contributed equally to this work
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17
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Cohen PR, Rybak A, Werner A, Béchet S, Desandes R, Hassid F, André JM, Gelbert N, Thiebault G, Kochert F, Cahn-Sellem F, Vié Le Sage F, Angoulvant PF, Ouldali N, Frandji B, Levy C. Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France. Lancet Reg Health Eur 2022; 22:100497. [PMID: 36034052 PMCID: PMC9398201 DOI: 10.1016/j.lanepe.2022.100497] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Covid-19 pandemic control has imposed several non-pharmaceutical interventions (NPIs). Strict application of these measures has had a dramatic reduction on the epidemiology of several infectious diseases. As the pandemic is ongoing for more than 2 years, some of these measures have been removed, mitigated, or less well applied. The aim of this study is to investigate the trends of pediatric ambulatory infectious diseases before and up to two years after the onset of the pandemic. Methods We conducted a prospective surveillance study in France with 107 pediatricians specifically trained in pediatric infectious diseases. From January 2018 to April 2022, the electronic medical records of children with an infectious disease were automatically extracted. The annual number of infectious diseases in 2020 and 2021 was compared to 2018-2019 and their frequency was compared by logistic regression. Findings From 2018 to 2021, 185,368 infectious diseases were recorded. Compared to 2018 (n=47,116) and 2019 (n=51,667), the annual number of cases decreased in 2020 (n=35,432) by about a third. Frequency of scarlet fever, tonsillopharyngitis, enteroviral infections, bronchiolitis, and gastroenteritis decreased with OR varying from 0·6 (CI95% [0·5;0·7]) to 0·9 (CI95% [0·8;0·9]), p<0·001. In 2021, among the 52,153 infectious diagnoses, an off-season rebound was observed with increased frequency of enteroviral infections, bronchiolitis, gastroenteritis and otitis with OR varying from 1·1 (CI95% [1·0;1·1]) to 1·5 (CI95% [1·4;1·5]), p<0·001. Interpretation While during NPIs strict application, the overall frequency of community-acquired infections was reduced, after relaxation of these measures, a rebound of some of them (enteroviral infections, bronchiolitis, gastroenteritis, otitis) occurred beyond the pre-pandemic level. These findings highlight the need for continuous surveillance of infectious diseases, especially insofar as future epidemics are largely unpredictable. Funding ACTIV, AFPA, GSK, MSD, Pfizer and Sanofi.
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18
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Cohen R, Aupiais C, Filleron A, Cahn-Sellem F, Romain O, Béchet S, Auvrignon A, Batard C, Virey B, Jung C, Rybak A, Levy C. Diagnostic accuracy of SARS-CoV-2 rapid antigen test from self-collected anterior nasal swabs in children compared to rapid antigen test and RT-PCR from nasopharyngeal swabs collected by healthcare workers: A multicentric prospective study. Front Pediatr 2022; 10:980549. [PMID: 36210936 PMCID: PMC9532740 DOI: 10.3389/fped.2022.980549] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Testing for SARS-CoV-2 is central to COVID-19 management. Rapid antigen test from self-collected anterior nasal swabs (SCANS-RAT) are often used in children but their performance have not been assessed in real-life. We aimed to compare this testing method to the two methods usually used: reverse transcription polymerase chain reaction from nasopharyngeal swabs collected by healthcare workers (HCW-PCR) and rapid antigen test from nasopharyngeal swabs collected by healthcare workers (HCW-RAT), estimating the accuracy and acceptance, in a pediatric real-life study. From September 2021 to January 2022, we performed a manufacturer-independent cross-sectional, prospective, multicenter study involving 74 pediatric ambulatory centers and 5 emergency units throughout France. Children ≥6 months to 15 years old with suggestive symptoms of COVID-19 or children in contact with a COVID-19-positive patient were prospectively enrolled. We included 836 children (median 4 years), 774 (92.6%) were symptomatic. The comparators were HCW-PCR for 267 children, and HCW-RAT for 593 children. The sensitivity of the SCANS-RAT test compared to HCW-RAT was 91.3% (95%CI 82.8; 96.4). Sensitivity was 70.4% (95%CI 59.2; 80.0) compared to all HCW-PCR and 84.6% (95%CI 71.9; 93.1) when considering cycle threshold <33. The specificity was always >97%. Among children aged ≥6 years, 90.9% of SCANS-RAT were self-collected without adult intervention. On appreciation rating (from 1, very pleasant, to 10, very unpleasant), 77.9% of children chose a score ≤3. SCANS-RAT have good sensitivity and specificity and are well accepted by children. A repeated screening strategy using these tests can play a major role in controlling the pandemic.
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Affiliation(s)
- Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Créteil, France
| | - Camille Aupiais
- Assistance Publique–Hôpitaux de Paris, Clinical Epidemiology Unit, Robert Debré University Hospital, ECEVE INSERM UMR 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Pediatric Department, Jean Verdier University Hospital, Université Sorbonne Paris Nord, Bondy, France
| | - Anne Filleron
- Department of Pediatrics, CHU Nîmes, University of Montpellier, Nîmes, France
| | | | - Olivier Romain
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Assistance Publique–Hôpitaux de Paris, Neonatalogy Department, Antoine Béclère University Hospital, Université Paris Saclay, Clamart, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Anne Auvrignon
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Christophe Batard
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Brigitte Virey
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Camille Jung
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Assistance Publique–Hôpitaux de Paris, Clinical Epidemiology Unit, Robert Debré University Hospital, ECEVE INSERM UMR 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Créteil, France
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19
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Rybak A, Aupiais C, Cotillon M, Basmaci R, de Pontual L, Bonacorsi S, Mariani P, Landraud L, Brichler S, Poilane I, Ouldali N, Titomanlio L. Reassessing the Performance of the "Step-By-Step" Approach to Febrile Infants 90 Days of Age and Younger in the Context of the COVID-19 Pandemic: A Multicentric Retrospective Study. Pediatr Infect Dis J 2022; 41:e365-e368. [PMID: 35703301 PMCID: PMC9359674 DOI: 10.1097/inf.0000000000003614] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Infants with COVID-19 can often present with fever without source, which is a challenging situation in infants <90 days old. The "step-by-step" algorithm has been proposed to identify children at high risk of bacterial infection. In the context of the COVID-19 pandemic, we aimed to reassess the diagnostic performance of this algorithm. METHODS We performed a multicentric retrospective study in 3 French pediatric emergency departments between 2018 and 2020. We applied the "step-by-step" algorithm to 4 clinical entities: COVID-19, febrile urinary tract infections (FUTI), invasive bacterial infection (IBI), and enterovirus infections. The main outcome was the proportion of infants classified at high risk (ill-appearing, ≤21 days old, with leukocyturia or procalcitonin level ≥0.5 ng/mL). RESULTS Among the 199 infants included, 40 had isolated COVID-19, 25 had IBI, 60 had FUTI, and 74 had enterovirus infection. All but 1 infant with bacterial infection were classified at high risk (96% for IBI and 100% for FUTI) as well as 95% with enterovirus and 82% with COVID-19. Infants with COVID-19 were classified at high risk because an ill-appearance (72%), an age ≤21 days (27%), or leukocyturia (19%). All these infants had procalcitonin values <0.5 ng/mL and only 1 had C-reactive protein level >20 mg/L. CONCLUSIONS The "step-by-step" algorithm remains effective to identify infants with bacterial infection but misclassifies most infants with COVID-19 as at high risk of bacterial infection leading to unnecessary cares. An updated algorithm based adding viral testing may be needed to discriminate fever related to isolated COVID-19 in infants <90 days old.
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Affiliation(s)
- Alexis Rybak
- From the Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Camille Aupiais
- INSERM, Unité Mixte de Recherche 1123 Epidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables (ECEVE), Université de Paris, Paris, France
| | - Marie Cotillon
- Department of Pediatrics, Louis Mourier University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Colombes, France
| | - Romain Basmaci
- Department of Pediatrics, Louis Mourier University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Colombes, France
| | - Loïc de Pontual
- Department of Pediatrics, Jean Verdier University Hospital, Assistance Publique—Hôpitaux de Paris, Université Sorbonne Paris Nord, Bondy, France
| | - Stéphane Bonacorsi
- INSERM, Unité Mixte de Recherche 1137 Infection-Antimicrobials-Modelling-Evolution (IAME), Université de Paris, Paris, France
| | - Patricia Mariani
- Department of Microbiology, Robert Debré University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Paris, France
| | - Luce Landraud
- Department of Microbiology, Louis Mourier University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Colombes, France
| | - Ségolène Brichler
- Department of Clinical Microbiology, Paris-Seine-Saint-Denis University Hospitals, Université Sorbonne Paris Nord, Assistance Publique—Hôpitaux de Paris, Bobigny, France
| | - Isabelle Poilane
- Department of Clinical Microbiology, Paris-Seine-Saint-Denis University Hospitals, Université Sorbonne Paris Nord, Assistance Publique—Hôpitaux de Paris, Bobigny, France
| | - Naïm Ouldali
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - Luigi Titomanlio
- From the Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Assistance Publique—Hôpitaux de Paris, Paris, France
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20
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Cohen R, Rybak A, Ouldali N, Angoulvant F, Béchet S, Gajdos V, Hau I, Sellam A, El Aouane El Ghomari I, Elmerich F, Batard C, Auvrignon A, Grimprel E, Favier M, Jung C, Levy C. From the original SARS-CoV-2 strain to the Omicron variant: predictors of COVID-19 in ambulatory symptomatic children. Infect Dis Now 2022; 52:432-440. [PMID: 36116761 PMCID: PMC9477611 DOI: 10.1016/j.idnow.2022.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the predictors of a positive SARS-CoV-2 test in a pediatric ambulatory setting. PATIENTS AND METHODS We performed a cross-sectional prospective study (November 2020-February 2022) of 93 ambulatory settings in France. We included symptomatic children < 15 years old tested for SARS-CoV-2. For each period corresponding to the spread of the original strain and its variants (period 1: original strain; period 2: Alpha, period 3: Delta; period 4: Omicron), we used a multivariate analysis to estimate adjusted odds ratios (aORs) associated with COVID-19 among age, signs, symptoms or contact, and 95 % confidence intervals (95CIs). RESULTS Of 5,336 children, 13.9 % (95CI 13.0-14.8) had a positive test. During the first three periods, the positivity rate ranged from 5.6 % (95CI 4.6-6.7) to 12.6 % (95CI 10.8-14.6). The main factors associated with a positive test were contact with an infected adult at home or outside the home (aOR 11.5 [95CI 4.9-26.9] to 38.9 [95CI 19.3-78.7]) or an infected household child (aOR 15.0 [95CI 4.8-47.1] to 28.4 [95CI 8.7-92.6]). By contrast, during period 4, aORs for these predictors were substantially lower (2.3 [95CI 1.1-4.5] to 5.5 [95CI 3.2-7.7]), but the positivity rate was 45.7 % (95CI 42.3-49.2). CONCLUSIONS In pediatric ambulatory settings, before the Omicron period, the main predictor of a positive test was contact with an infected person. During the Omicron period, the odds of these predictors were substantially lower while the positivity rate was higher. An accurate diagnostic strategy should only rely on testing and not on age, signs, symptoms or contact.
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Affiliation(s)
- R Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - A Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France.
| | - N Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France
| | - F Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - S Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - V Gajdos
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Centre for Research in Epidemiology and Population Health, INSERM UMR1018, Villejuif, France; Assistance Publique-Hôpitaux de Paris, Pediatric Department, Antoine Béclère University Hospital, Université de Paris Saclay, Clamart, France
| | - I Hau
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - A Sellam
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | | | - F Elmerich
- CHU Reims, Urgences Pédiatriques, France
| | - C Batard
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - A Auvrignon
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - E Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Hôpital Trousseau, Paris, France
| | - M Favier
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Urgences Pédiatriques CHU de Bordeaux, Bordeaux, France
| | - C Jung
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - C Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
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21
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Rybak A, Levy C, Angoulvant F, Auvrignon A, Gembara P, Danis K, Vaux S, Levy-Bruhl D, van der Werf S, Béchet S, Bonacorsi S, Assad Z, Lazzati A, Michel M, Kaguelidou F, Faye A, Cohen R, Varon E, Ouldali N. Association of Nonpharmaceutical Interventions During the COVID-19 Pandemic With Invasive Pneumococcal Disease, Pneumococcal Carriage, and Respiratory Viral Infections Among Children in France. JAMA Netw Open 2022; 5:e2218959. [PMID: 35763298 PMCID: PMC9240903 DOI: 10.1001/jamanetworkopen.2022.18959] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IMPORTANCE An association between pneumococcal nasopharyngeal carriage and invasive pneumococcal disease (IPD) has been previously established. However, it is unclear whether the decrease in IPD incidence observed after implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic was associated with concomitant changes in pneumococcal carriage and respiratory viral infections. OBJECTIVE To assess changes in IPD incidence after the implementation of NPIs during the COVID-19 pandemic and examine their temporal association with changes in pneumococcal carriage rate and respiratory viral infections (specifically respiratory syncytial virus [RSV] and influenza cases) among children in France. DESIGN, SETTING, AND PARTICIPANTS This cohort study used interrupted time series analysis of data from ambulatory and hospital-based national continuous surveillance systems of pneumococcal carriage, RSV and influenza-related diseases, and IPD between January 1, 2007, and March 31, 2021. Participants included 11 944 children younger than 15 years in France. EXPOSURES Implementation of NPIs during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES The estimated fraction of IPD change after implementation of NPIs and the association of this change with concomitant changes in pneumococcal carriage rate and RSV and influenza cases among children younger than 15 years. The estimated fraction of change was analyzed using a quasi-Poisson regression model. RESULTS During the study period, 5113 children (median [IQR] age, 1.0 [0.6-4.0] years; 2959 boys [57.9%]) had IPD, and 6831 healthy children (median [IQR] age, 1.5 [0.9-3.9] years; 3534 boys [51.7%]) received a swab test. Data on race and ethnicity were not collected. After NPI implementation, IPD incidence decreased by 63% (95% CI, -82% to -43%; P < .001) and was similar for non-13-valent pneumococcal conjugate vaccine serotypes with both high disease potential (-63%; 95% CI, -77% to -48%; P < .001) and low disease potential (-53%; 95% CI, -70% to -35%; P < .001). The overall pneumococcal carriage rate did not significantly change after NPI implementation (-12%; 95% CI, -37% to 12%; P = .32), nor did the carriage rate for non-PCV13 serotypes with high disease potential (-26%; 95% CI, -100% to 52%; P = .50) or low disease potential (-7%; 95% CI, -34% to 20%; P = .61). After NPI implementation, the estimated number of influenza cases decreased by 91% (95% CI, -74% to -97%; P < .001), and the estimated number of RSV cases decreased by 74% (95% CI, -55% to -85%; P < .001). Overall, the decrease in influenza and RSV cases accounted for 53% (95% CI, -28% to -78%; P < .001) and 40% (95% CI, -15% to -65%; P = .002) of the decrease in IPD incidence during the NPI period, respectively. The decrease in IPD incidence was not associated with pneumococcal carriage, with carriage accounting for only 4% (95% CI, -7% to 15%; P = .49) of the decrease. CONCLUSIONS AND RELEVANCE In this cohort study of data from multiple national continuous surveillance systems, a decrease in pediatric IPD incidence occurred after the implementation of NPIs in France; this decrease was associated with a decrease in viral infection cases rather than pneumococcal carriage rate. The association between pneumococcal carriage and IPD was potentially modified by changes in the number of RSV and influenza cases, suggesting that interventions targeting respiratory viruses, such as immunoprophylaxis or vaccines for RSV and influenza, may be able to prevent a large proportion of pediatric IPD cases.
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Affiliation(s)
- Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Assistance Publique–Hôpitaux de Paris, Service d'Accueil des Urgences Pédiatriques, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - François Angoulvant
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Unité Mixte de Recherche Scientifique 1138, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Anne Auvrignon
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Piotr Gembara
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
| | - Kostas Danis
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Sophie Vaux
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Sylvie van der Werf
- Centre National de Référence des Infections Respiratoires, Institut Pasteur, Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
| | - Stéphane Bonacorsi
- Assistance Publique–Hôpitaux de Paris, Service de Microbiologie, Robert Debré University Hospital, Université de Paris, Paris, France
- Infection Antimicrobials Modelling Evolution, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1137, Université de Paris, Paris, France
| | - Zein Assad
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
- Service de Pédiatrie Médicale, Centre Hospitalier Universitaire Caen-Normandie, Caen, France
| | - Andréa Lazzati
- Chirurgie Générale, Digestive et de l'Obésité, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, L’Institut Mondor de Recherche Biomédicale, Unité 955, Université Paris-Est Créteil, Créteil, France
| | - Morgane Michel
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
| | - Florentia Kaguelidou
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Centre d’Investigation Clinique 1426, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Albert Faye
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Néonatalogie et Réanimation Néonatale, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Emmanuelle Varon
- Université Paris Est, Institut Mondor de Recherche Biomédicale, Groupe d'Etude de Maladies Infectieuses Néonatales et Infantiles, Créteil, France
- Microbiologie et Centre National de Référence du Pneumocoque, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Naïm Ouldali
- Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Assistance Publique–Hôpitaux de Paris, Robert Debré University Hospital, Epidémiologie Clinique–Évaluation Économique Appliqué aux Populations Vulnérables, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1123, Université de Paris, Paris, France
- Assistance Publique–Hôpitaux de Paris, Service de Pédiatrie Générale, Robert Debré University Hospital, Université de Paris, Paris, France
- Service des Maladies Infectieuses Pédiatriques, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Québec, Canada
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22
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Rybak A, Varon E, Masson E, Etchevers A, Levy-Brühl D, Ouldali N, Levy C, Cohen R. Investigation of Concurrent Pneumococcal Meningitis in Two Children Attending the Same Day-Care Center. Front Pediatr 2022; 10:945767. [PMID: 35928689 PMCID: PMC9344131 DOI: 10.3389/fped.2022.945767] [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: 05/16/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Only a few clusters of invasive pneumococcal disease have been described globally in children, and most of these cases occurred before pneumococcal vaccination implementation. Two unusual cases of pneumococcal meningitis, occurring in the same daycare center over a 3-day period, were reported. Both cerebrospinal fluid (CSF) were sent to the National reference center for pneumococci. In addition, we decided to perform a pneumococcal carriage study on all children and staff of the daycare center to analyze the pneumococcal serotypes circulating in this DCC and to discuss an antibiotic chemoprophylaxis. CSF culture was positive for pneumococcus, and serotype 25A was identified by latex agglutination. The second case had negative CSF culture, but CSF antigen test and gene amplification results were positive for Streptococcus pneumoniae. Serotype 12F was identified by using molecular biology. The absence of correlation between these strains was confirmed by multi-locus sequence typing. In the carriage study, we included 29 children (median age 1.9 years, interquartile range 1.4-2.5) and 10 adults. Among the children, 24 carried Streptococcus pneumoniae (83%). The main serotypes isolated were 23A for 6 children and 25A for 5 children; serotypes were non-typeable for 3 children. Only 1 of 10 adults tested carried Streptococcus pneumoniae (serotype 12F). Despite this temporo-spatial pattern, the cases were unrelated and not due to carriage of a particular serotype. No specific action has been taken for the other children attending this DCC, and no other case of bacterial meningitis occurred.
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Affiliation(s)
- Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France.,Assistance Publique-Hôpitaux de Paris, Clinical Epidemiology Unit, Robert Debré University Hospital, ECEVE INSERM UMR 1123, Université de Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Emmanuelle Varon
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Elodie Masson
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Bicêtre University Hospital, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Anne Etchevers
- The National Public Health institute, Saint-Maurice, France
| | | | - Naïm Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Assistance Publique-Hôpitaux de Paris, Clinical Epidemiology Unit, Robert Debré University Hospital, ECEVE INSERM UMR 1123, Université de Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,Infectious Diseases Division, CHU Sainte Justine - Montreal University, Montreal, QC, Canada
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Neonates Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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23
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Rybak A, Ouldali N, Angoulvant F, Minodier P, Biscardi S, Madhi F, Hau I, Santos A, Bouvy E, Dubos F, Martinot A, Dommergues MA, Gras-Le Guen C, Launay E, Levieux K, Zenkhri F, Craiu I, Lorrot M, Gillet Y, Mezgueldi E, Faye A, Béchet S, Varon E, Cohen R, Levy C. Shift in Clinical Profile of Hospitalized Pneumonia in Children in the Non-pharmaceutical Interventions Period During the COVID-19 Pandemic: A Prospective Multicenter Study. Front Pediatr 2022; 10:782894. [PMID: 35391746 PMCID: PMC8980475 DOI: 10.3389/fped.2022.782894] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/31/2022] [Indexed: 01/13/2023] Open
Abstract
Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 were implemented in March 2020. These measures were followed by a major impact on viral and non-viral diseases. We aimed to assess the impact of NPI implementation in France on hospitalized community-acquired pneumonia (hCAP) frequency and the clinical and biological characteristics of the remaining cases in children. We performed a quasi-experimental interrupted time-series analysis. Between June 2014 and December 2020, eight pediatric emergency departments throughout France reported prospectively all cases of hCAP in children from age 1 month to 15 years. We estimated the impact on the monthly number of hCAP using segmented linear regression with autoregressive error model. We included 2,972 hCAP cases; 115 occurred during the NPI implementation period. We observed a sharp decrease in the monthly number of hCAP after NPI implementation [-63.0% (95 confidence interval, -86.8 to -39.2%); p < 0.001]. Children with hCAP were significantly older during than before the NPI period (median age, 3.9 vs. 2.3 years; p < 0.0001), and we observed a higher proportion of low inflammatory marker status (43.5 vs. 33.1%; p = 0.02). Furthermore, we observed a trend with a decrease in the proportion of cases with pleural effusion (5.3% during the NPI period vs. 10.9% before the NPI; p = 0.06). NPI implementation during the COVID-19 (coronavirus disease 2019) pandemic led not only to a strong decrease in the number of hCAP cases but also a modification in the clinical profile of children affected, which may reflect a change in pathogens involved.
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Affiliation(s)
- Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France.,INSERM, Unité Mixte de Recherche 1123 Epidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, Université de Paris, Paris, France
| | - Naïm Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,INSERM, Unité Mixte de Recherche 1123 Epidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, Université de Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
| | - François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France.,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
| | - Philippe Minodier
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, Centre Hospitalier Universitaire Nord, Marseille, France
| | - Sandra Biscardi
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Fouad Madhi
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Isabelle Hau
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Audrey Santos
- Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Emilie Bouvy
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Pediatric Emergency Unit and Infectious Diseases, Université de Lille, Centre Hospitalier Universitaire Lille, Lille, France
| | - François Dubos
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Pediatric Emergency Unit and Infectious Diseases, Université de Lille, Centre Hospitalier Universitaire Lille, Lille, France
| | - Alain Martinot
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Pediatric Emergency Unit and Infectious Diseases, Université de Lille, Centre Hospitalier Universitaire Lille, Lille, France
| | - Marie-Aliette Dommergues
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of General Pediatrics, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Christèle Gras-Le Guen
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatrics, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Elise Launay
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatrics, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Karine Levieux
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatrics, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Ferielle Zenkhri
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, Assistance Publique-Hôpitaux de Paris, Hôpital Le Kremlin-Bicêtre, Université Paris, Paris, France
| | - Irina Craiu
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, Assistance Publique-Hôpitaux de Paris, Hôpital Le Kremlin-Bicêtre, Université Paris, Paris, France
| | - Mathie Lorrot
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of General Pediatrics, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Université Sorbonne Paris Cité, Paris, France
| | - Yves Gillet
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, L'Hôpital Femme Mère Enfant Lyon, Lyon, France
| | - Ellia Mezgueldi
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Department of Pediatric Emergency, L'Hôpital Femme Mère Enfant Lyon, Lyon, France
| | - Albert Faye
- INSERM, Unité Mixte de Recherche 1123 Epidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, Université de Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
| | - Stéphane Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
| | - Emmanuelle Varon
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,National Reference Center for Pneumococci, Laboratoire de Microbiologie, Hôpital Intercommunal, Créteil, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Paris Est University, IMRB-GRC GEMINI, Créteil, France.,Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Neonates Department, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique, Paris, France.,Paris Est University, IMRB-GRC GEMINI, Créteil, France.,Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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24
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Cohen R, Ashman M, Taha MK, Varon E, Angoulvant F, Levy C, Rybak A, Ouldali N, Guiso N, Grimprel E. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Infect Dis Now 2021; 51:418-423. [PMID: 33991720 PMCID: PMC8114587 DOI: 10.1016/j.idnow.2021.05.004] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 12/24/2022]
Abstract
Since the beginning of the COVID-19 pandemic, reduced incidence of many viral and bacterial infections has been reported in children: bronchiolitis, varicella, measles, pertussis, pneumococcal and meningococcal invasive diseases. The purpose of this opinion paper is to discuss various situations that could lead to larger epidemics when the non-pharmaceutical interventions (NPI) imposed by the SARS-CoV-2 epidemic will no longer be necessary. While NPIs limited the transmission of SARS-CoV-2, they also reduced the spread of other pathogens during and after lockdown periods, despite the re-opening of schools since June 2020 in France. This positive collateral effect in the short term is welcome as it prevents additional overload of the healthcare system. The lack of immune stimulation due to the reduced circulation of microbial agents and to the related reduced vaccine uptake induced an "immunity debt" which could have negative consequences when the pandemic is under control and NPIs are lifted. The longer these periods of "viral or bacterial low-exposure" are, the greater the likelihood of future epidemics. This is due to a growing proportion of "susceptible" people and a declined herd immunity in the population. The observed delay in vaccination program without effective catch-up and the decrease in viral and bacterial exposures lead to a rebound risk of vaccine-preventable diseases. With a vaccination schedule that does not include vaccines against rotavirus, varicella, and serogroup B and ACYW Neisseria meningitidis, France could become more vulnerable to some of these rebound effects.
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Affiliation(s)
- Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Marion Ashman
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Centre Hospitalier Intercommunal de Créteil, France
| | - Muhamed-Kheir Taha
- Centre National de Référence des Méningocoques, Institut Pasteur, Paris, France
| | - Emmanuelle Varon
- Centre National de Référence des Pneumocoques, Centre Hospitalier Intercommunal de Créteil, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, Université de Paris, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Naim Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France; Assistance Publique-Hôpitaux de Paris, Department of general pediatrics, pediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France
| | | | - Emmanuel Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Centre Hospitalier Armand Trousseau, Paris, France
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25
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Angoulvant F, Ouldali N, Yang DD, Filser M, Gajdos V, Rybak A, Guedj R, Soussan-Banini V, Basmaci R, Lefevre-Utile A, Brun-Ney D, Beaujouan L, Skurnik D. Coronavirus Disease 2019 Pandemic: Impact Caused by School Closure and National Lockdown on Pediatric Visits and Admissions for Viral and Nonviral Infections-a Time Series Analysis. Clin Infect Dis 2021; 72:319-322. [PMID: 33501967 PMCID: PMC7314162 DOI: 10.1093/cid/ciaa710] [Citation(s) in RCA: 206] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
A time series analysis of 871 543 pediatric emergency visits revealed that the coronavirus disease 2019 (COVID-19) lockdown and school closures were associated with a significant decrease in infectious diseases disseminated through airborne or fecal-oral transmission: common cold, gastroenteritis, bronchiolitis, and acute otitis. No change was found for urinary tract infections.
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Affiliation(s)
- François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,Inserm, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Naïm Ouldali
- Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris, Clinical Epidemiology Unit, Robert Debré University Hospital, ECEVE Inserm UMR 1123, Université de Paris, Paris, France.,Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - David Dawei Yang
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,Inserm, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Mathilde Filser
- Assistance Publique-Hôpitaux de Paris, Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Vincent Gajdos
- Assistance Publique-Hôpitaux de Paris, Pediatric Department, Antoine Béclère University Hospital, Université de Paris Saclay, Clamart, France.,Centre for Research in Epidemiology and Population Health, Inserm UMR1018, Villejuif, France
| | - Alexis Rybak
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Romain Guedj
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Armand Trousseau University Hospital, Sorbonne Université, Paris, France.,Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Inserm UMR1153 , Université de Paris, Paris, France
| | - Valérie Soussan-Banini
- Assistance Publique-Hôpitaux de Paris, Service de Pédiatrie, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Romain Basmaci
- Assistance Publique-Hôpitaux de Paris, Service de Pédiatrie-Urgences, Hôpital Louis-Mourier, Université de Paris, Colombes, France.,IAME , Inserm UMR1137, Université de Paris, Paris, France
| | - Alain Lefevre-Utile
- Assistance Publique-Hôpitaux de Paris, General Pediatric and Pediatric Emergency Department, Jean Verdier Hospital, Bondy, France.,Inserm U976, Human Systems Immunology and Inflammatory Networks, Saint Louis Research Institute, Université de Paris, Paris, France
| | - Dominique Brun-Ney
- Assistance Publique-Hôpitaux de Paris, Strategy and Transformation Management Department-Emergencies and Intensive Cares, Paris, France.,Assistance Publique-Hôpitaux de Paris, Patient Quality Medical Organisation Departement-Health Crisis Management, Paris, France
| | - Laure Beaujouan
- Assistance Publique-Hôpitaux de Paris, Strategy and Transformation Management Department-Emergencies and Intensive Cares, Paris, France.,Assistance Publique-Hôpitaux de Paris, Patient Quality Medical Organisation Departement-Health Crisis Management, Paris, France
| | - David Skurnik
- Assistance Publique-Hôpitaux de Paris, Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,Inserm U1151, Equipe 11, Institut Necker-Enfants Malades, Université de Paris, Paris, France.,Division of Infectious Diseases, Harvard Medical School, Boston, Massachusetts, USA
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26
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Guenver C, Oualha M, Levy C, Antona D, Madhi F, Toubiana J, Lachaume N, Javouhey E, Lorrot M, Yang DD, Levy M, Caseris M, Galeotti C, Ovaert C, Wiedemann A, Girardin ML, Rybak A, Cohen R, Belot A, Angoulvant F, Ouldali N. Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System. Front Pediatr 2021; 9:745364. [PMID: 34765576 PMCID: PMC8576449 DOI: 10.3389/fped.2021.745364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C. Methods: We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening. Results: We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38). Conclusion: Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.
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Affiliation(s)
- Celia Guenver
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,Sorbonne Université, Université de Paris, Paris, France
| | - Mehdi Oualha
- Assistance Publique-Hôpitaux de Paris, Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Corinne Levy
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Denise Antona
- Santé Publique France, Agence nationale de Santé publique, Saint-Maurice, France
| | - Fouad Madhi
- Centre Hospitalier Intercommunal, Paediatric Department, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Julie Toubiana
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, Université de Paris, Paris, France.,Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Noémie Lachaume
- Assistance Publique-Hôpitaux de Paris, Paediatric Emergency Department, Louis Mourier University Hospital, Colombes, France
| | - Etienne Javouhey
- Hospices Civils de Lyon, Paediatric Intensive Care Unit, Hopital Femme, Mère Enfant, University of Lyon, Le Born, France.,EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", University Claude Bernard Lyon 1, Hospices Civils of Lyon, Lyon, France
| | - Mathie Lorrot
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatric, Armand Trousseau University Hospital, Sorbonne Université, Paris, France
| | - David Dawei Yang
- Assistance Publique-Hôpitaux de Paris, Paediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France
| | - Michael Levy
- Assistance Publique-Hôpitaux de Paris, Paediatric Intensive Care Unit, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Marion Caseris
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Caroline Galeotti
- Assistance Publique-Hôpitaux de Paris, Department of Paediatric Rheumatology, Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), Bicêtre University hospital, Université de Paris Saclay, Le Kremlin-Bicêtre, France
| | - Caroline Ovaert
- Assistance Publique-Hôpitaux de Marseille, Paediatric and Congenital Cardiology, Timone Hospital Marseille, University Hospital, Marseille, France.,INSERM, Marseille Medical Genetics, UMR 1251, Aix Marseille Université, Marseille, France
| | - Arnaud Wiedemann
- Children's Hospital, University Hospital of Nancy, Paediatric Department, Université de Lorraine, Vandoeuvre les Nancy, France.,INSERM UMRS 1256 NGERE, Nutrition, Genetics, and Environmental Risk Exposure, National Center of Inborn Errors of Metabolism, Université de Lorraine, Vandoeuvre les Nancy, France
| | - Marie-Laure Girardin
- Strasbourg University Hospital, Paediatric Intensive Care Unit, Hautepierre University Hospital, Strasbourg, France
| | - Alexis Rybak
- Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, Paris, France
| | - Robert Cohen
- Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - Alexandre Belot
- Hospices Civils de Lyon, Paediatric Nephrology, Rheumatology, Dermatology, Hopital Femme, Mère Enfant, & Centre International de Recherche en Infectiologie/INSERM U1111, Bron, France
| | - François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Naïm Ouldali
- Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Université de Paris, INSERM UMR 1123, ECEVE, Paris, France
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27
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Skurnik D, Rybak A, Yang DD, Pons S, Guedj R, Levy C, Cohen R, Gajdos V, Vasante L, Ouldali N, Angoulvant F. Unexpected lessons from the COVID-19 lockdowns in France: Low impact of school opening on common communicable pediatric airborne diseases. Clin Infect Dis 2020; 73:e2830-e2832. [PMID: 33373441 PMCID: PMC7799226 DOI: 10.1093/cid/ciaa1899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- David Skurnik
- Assistance Publique-Hôpitaux de Paris, Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,INSERM U1151-Equipe 11, Institut Necker-Enfants Malades, Université de Paris, Paris, France.,Division of Infectious Diseases, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alexis Rybak
- Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré university hospital, Université de Paris, Paris, France.,ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,INSERM, ECEVE, UMRS 1123, Université de Paris, Paris, France
| | - David Dawei Yang
- Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Stéphanie Pons
- Assistance Publique - Hôpitaux de Paris, Department of Anesthesiology and critical care, Pitié-Salpêtrière University Hospital, Sorbonne University, GRC 29, Paris, France
| | - Romain Guedj
- Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Armand Trousseau University Hospital, Sorbonne Université, Paris, France.,Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Inserm UMR1153, Université de Paris, Paris, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Vincent Gajdos
- Assistance Publique - Hôpitaux de Paris, Pediatric Department, Antoine Béclère University hospital, Université de Paris Saclay, Clamart, France.,Centre for Research in Epidemiology and Population Health, INSERM UMR1018, Villejuif, France
| | - Loganayagi Vasante
- Assistance Publique-Hôpitaux de Paris, Patient Quality Medical Organisation Departement - Health Crisis Management, Paris, France
| | - Naïm Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.,Assistance Publique-Hôpitaux de Paris, Department of general pediatrics, pediatric infectious disease and internal medicine, Robert Debré university hospital, Université de Paris, Paris, France
| | - François Angoulvant
- Assistance Publique - Hôpitaux de Paris, Pediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.,INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
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Rybak A, Vié le Sage F, Béchet S, Werner A, Thiebault G, Bakhache P, Virey B, Caulin E, Cohen R, Levy C. Timeliness of routine immunization in non-preterm children less than 2 years old using electronic data capture in an ambulatory setting in France in the context of vaccine hesitancy. Arch Pediatr 2019; 26:56-64. [DOI: 10.1016/j.arcped.2018.11.011] [Citation(s) in RCA: 7] [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] [Received: 08/01/2018] [Revised: 10/19/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
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Rybak A, Zarzecki M, Golabiewska E, Niechoda A, Holownia A. Sialidase Attenuates Epidermal Growth Factor Response and Abolishes Antiproliferative Effects of Erlotinib in A549Alveolar Epithelial Cells. Adv Exp Med Biol 2019; 1153:55-61. [PMID: 30729434 DOI: 10.1007/5584_2018_329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Erlotinib is a widely used, reversible tyrosine kinase inhibitor (TKI), targeting pro-proliferative signaling of epidermal growth factor receptor (EGFR). The drug is approved for the first-line treatment of patients with metastatic non-small cell lung cancer with EGFR mutations. Extracellular glycans can affect EGFR expression, dimerization, phosphorylation, and EGF binding. In this study we investigated the effects of EGF and erlotinib on the cell cycle of naive and sialidase (alpha-neuraminidase)-pretreated human A549 alveolar epithelial cells. A549 cells were labeled with propidium iodide, and fractions of cells in different phases of cycle were quantified by flow cytometry. We found that neither did desialilation nor EGF, as well as erlotinib treatment, increase the number of damaged cells (subG0/G1 cell fraction), while erlotinib did significantly increase the number of G0/G1 cells and decrease S + G2/M cell fractions. In naive cells, EGF increased proliferating cell numbers by more than 40%, and this effect was blocked by erlotinib. In desialylated cells, however, proliferation was significantly decreased by about 29%, and EGF and erlotinib did not exert significant effects. We conclude that changes in alveolar epithelial cell membrane glycosylation may affect function of growth-promoting receptors and erlotinib effectiveness.
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Affiliation(s)
- A Rybak
- Department of Pharmacology, Medical University of Bialystok, Bialystok, Poland.
| | - M Zarzecki
- Department of Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | - E Golabiewska
- Department of Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | - A Niechoda
- Department of Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | - A Holownia
- Department of Pharmacology, Medical University of Bialystok, Bialystok, Poland
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Szoka P, Lachowicz J, Cwiklińska M, Lukaszewicz A, Rybak A, Baranowska U, Holownia A. Cigarette Smoke-Induced Oxidative Stress and Autophagy in Human Alveolar Epithelial Cell Line (A549 Cells). Adv Exp Med Biol 2019; 1176:63-69. [PMID: 31016633 DOI: 10.1007/5584_2019_373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chronic exposure to cigarette smoke (CS) causes structural and functional changes in the respiratory tract. It is a major risk factor for cardiovascular and systemic pulmonary diseases. The aim of this study was to investigate the effect of acute CS exposure (2 h) on oxidative stress, heat shock protein 70 (HSP70) expression, autophagy (LC3 expression), and oxidative stress (DCF fluorescence) in human alveolar epithelial cell line A549. Cell culture medium was conditioned with CS using commercial cigarettes, and A549 cells were grown in modified media for 2 h. In some experiments, A549 cells were pretreated with 100 μM of L-buthionine-sulfoximine (BSO) for 24 h to induce glutathione (GSH) depletion. In the cells grown in CS-conditioned medium, GSH was depleted by more than 30%, and reactive oxygen species were increased. Moreover, there was a considerable overexpression of HSP70 and a substantial accumulation of LC3. Similar changes were found when the cells were pretreated with BSO. We conclude that the short-term exposure of epithelial cells to CS increases oxidative stress that entails enhanced autophagy activity.
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Affiliation(s)
- P Szoka
- Department of Pharmacology, Medical University, Bialystok, Poland.
| | - J Lachowicz
- Department of Pharmacology, Medical University, Bialystok, Poland
| | - M Cwiklińska
- Department of Pharmacology, Medical University, Bialystok, Poland
| | - A Lukaszewicz
- Department of Pharmacology, Medical University, Bialystok, Poland
| | - A Rybak
- Department of Pharmacology, Medical University, Bialystok, Poland
| | - U Baranowska
- Department of Pharmacology, Medical University, Bialystok, Poland
| | - A Holownia
- Department of Pharmacology, Medical University, Bialystok, Poland
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Maystrenko T, Gruzdev B, Belykh E, Rybak A. The succession of the plant community on a decontaminated radioactive meadow site. J Environ Radioact 2018; 192:687-697. [PMID: 29571956 DOI: 10.1016/j.jenvrad.2017.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 06/08/2023]
Abstract
Long-term observation of the succession in a plant community is considered a fundamental unit used to investigate the expected consequences of soil contamination by radionuclides and to understand restoration of technogeneously disturbed ecosystems. The development of arboreal willow meadow under remediation of a radioactively contaminated site has been studied for half a century. Succession stages in the formation of the de novo community were noted. Changes in the floristic composition, soil structure as well as radionuclide activity concentrations in topsoil were registered on each step. Technical recultivation of the area including covering radioactive wastes with a mixture of sand and gravel led to lower the radiation levels and was suitable for decontamination during first 5-8 years. This allowed the community to develop with maximal effectiveness on the initial steps. Than the covering layer lost its barrier functions but no adverse effects at dose rates up to 150 μGy/h on completion of the community formation were registered. Radioecological conditions and changes in the plant community development were registered simultaneously on the area studied that makes possible to follow main doseforming radionuclides migration and to determine main steps of the succession. The study results is a practical demonstration that edaphic niches, climatic conditions and сoenotic relationships between plants play a more important role in the evolution of the studied community than the contamination type and radiation exposure levels.
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Affiliation(s)
- T Maystrenko
- Institute of Biology, Komi Scientific Center, Ural Division RAS, Kommunisticheskaya 28, 167982 Syktyvkar, Russia.
| | - B Gruzdev
- Institute of Biology, Komi Scientific Center, Ural Division RAS, Kommunisticheskaya 28, 167982 Syktyvkar, Russia
| | - E Belykh
- Institute of Biology, Komi Scientific Center, Ural Division RAS, Kommunisticheskaya 28, 167982 Syktyvkar, Russia
| | - A Rybak
- Institute of Biology, Komi Scientific Center, Ural Division RAS, Kommunisticheskaya 28, 167982 Syktyvkar, Russia
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Ouldali N, Rybak A, Cohen R. [Allergy to penicillin in children: what reality and when to give up amoxicillin ?]. Rev Prat 2018; 68:355-358. [PMID: 30869377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Naïm Ouldali
- Association clinique et thérapeutique infantile du Val-de-Marne, Saint-Maurdes- Fossés, France. Groupe de pathologie infectieuse pédiatrique, Paris, France
| | - Alexis Rybak
- Association clinique et thérapeutique infantile du Val-de-Marne, Saint-Maurdes- Fossés, France. Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
| | - Robert Cohen
- Association clinique et thérapeutique infantile du Val-de-Marne, Saint-Maurdes- Fossés, France. Groupe de pathologie infectieuse pédiatrique, Paris, France. Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France. Service de pédiatrie générale et aval des urgences, hôpital Armand- Trousseau, Paris, France. Université Paris-Est, IMRB-GRC GEMINI, Créteil, France. Unité court séjour, petits nourrissons, service de néonatologie, centre hospitalier intercommunal de Créteil, France.Centre de recherche clinique, Centre hospitalier intercommunal de Créteil, France
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Rybak A, Grimprel E, Cohen R. [Antibiotic treatment for common childhood infections]. Rev Prat 2018; 68:7-17. [PMID: 30840379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Alexis Rybak
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, AFPA, Saint-Germainen- Laye, France
| | - Emmanuel Grimprel
- Service de pédiatrie générale et aval des urgences, hôpital Armand- Trousseau, Paris, France
- Groupe de pathologie infectieuse pédiatrique, GPIP, Paris, France
| | - Robert Cohen
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, AFPA, Saint-Germainen- Laye, France
- Groupe de pathologie infectieuse pédiatrique, GPIP, Paris, France
- Université Paris-Est, IMRB-GRC GEMINI, Créteil, France
- Unité court séjour, petits nourrissons, service de néonatologie, centre hospitalier intercommunal de Créteil, Créteil, France
- Centre de recherche clinique, centre hospitalier intercommunal de Créteil, Créteil, France
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Cohen R, Rybak A, Tauzin M, Levy C. [Pneumococcal conjugate vaccine in children]. Rev Prat 2017; 67:1056-1058. [PMID: 30512598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Robert Cohen
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
- Service de pédiatrie générale et aval des urgences, hôpital Armand- Trousseau, Paris, France
- Groupe de pathologie infectieuse pédiatrique, Paris, France
- Université Paris-Est, IMRB-GRC GEMINI, Créteil, France
- Unité court séjour, petits nourrissons, service de néonatologie, centre hospitalier intercommunal de Créteil, Créteil, France
- Centre de recherche clinique, centre hospitalier intercommunal de Créteil, Créteil, France
| | - Alexis Rybak
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
| | - Manon Tauzin
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
| | - Corinne Levy
- Association clinique et thérapeutique infantile du Val-de-Marne, ACTIV, Saint-Maurdes- Fossés, France
- Association française de pédiatrie ambulatoire, Saint-Germainen- Laye, France
- Groupe de pathologie infectieuse pédiatrique, Paris, France
- Université Paris-Est, IMRB-GRC GEMINI, Créteil, France
- Centre de recherche clinique, centre hospitalier intercommunal de Créteil, Créteil, France
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Leblanc C, Baron M, Desselas E, Phan MH, Rybak A, Thouvenin G, Lauby C, Irtan S. Congenital pulmonary airway malformations: state-of-the-art review for pediatrician's use. Eur J Pediatr 2017; 176:1559-1571. [PMID: 29046943 DOI: 10.1007/s00431-017-3032-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/30/2017] [Accepted: 10/04/2017] [Indexed: 02/06/2023]
Abstract
UNLABELLED Congenital pulmonary airway malformations or CPAM are rare developmental lung malformations, leading to cystic and/or adenomatous pulmonary areas. Nowadays, CPAM are diagnosed prenatally, improving the prenatal and immediate postnatal care and ultimately the knowledge on CPAM pathophysiology. CPAM natural evolution can lead to infections or malignancies, whose exact prevalence is still difficult to assess. The aim of this "state-of-the-art" review is to cover the recently published literature on CPAM management whether the pulmonary lesion was detected during pregnancy or after birth, the current indications of surgery or surveillance and finally its potential evolution to pleuro-pulmonary blastoma. CONCLUSION Surgery remains the cornerstone treatment of symptomatic lesions but the postnatal management of asymptomatic CPAM remains controversial. There are pros and cons of surgical resection, as increasing rate of infections over time renders the surgery more difficult after months or years of evolution, as well as risk of malignancy, though exact incidence is still unknown. What is known: • Congenital pulmonary airway malformations (CPAM) are rare developmental lung malformations mainly antenatally diagnosed. • While the neonatal management of symptomatic CPAM is clear and includes prompt surgery, controversies remain for asymptomatic CPAM due to risk of infections and malignancies. What is new: • Increased rate of infection over time renders the surgery more difficult after months or years of evolution and pushes for recommendation of early elective surgery. • New molecular or pathological pathways may help in the distinction of type 4 CPAM from type I pleuropulmonary blastoma.
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Affiliation(s)
- Claire Leblanc
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Marguerite Baron
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Emilie Desselas
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Minh Hanh Phan
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Alexis Rybak
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Guillaume Thouvenin
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France.,UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, Sorbonne Universités, Paris, France
| | - Clara Lauby
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Sabine Irtan
- UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, Sorbonne Universités, Paris, France. .,Department of Pediatric Surgery, APHP Hôpital Armand Trousseau, 26 avenue du Dr Arnold Netter, 75012, Paris, France.
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Rybak A, Maisin A, Peuchmaur M, Hogan J, Baudouin V, Ulinski T, Deschênes G, Niel O. Cytomegalovirus prophylaxis after kidney transplantation in children: Longer is better. Arch Pediatr 2017. [DOI: 10.1016/j.arcped.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Levy C, Rybak A, Cohen R, Jung C. La loi Jardé, un nouvel encadrement législatif pour une simplification de la recherche clinique ? Arch Pediatr 2017; 24:571-577. [DOI: 10.1016/j.arcped.2017.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 11/27/2022]
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Borrelli O, Pescarin M, Saliakellis E, Tambucci R, Quitadamo P, Valitutti F, Rybak A, Lindley KJ, Thapar N. Sequential incremental doses of bisacodyl increase the diagnostic accuracy of colonic manometry. Neurogastroenterol Motil 2016; 28:1747-1755. [PMID: 27335210 DOI: 10.1111/nmo.12876] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Colonic manometry is the standard diagnostic modality for evaluating colonic motility in children. Intraluminal bisacodyl is routinely used to trigger high-amplitude propagating contractions (HAPCs), a feature of normal colonic motility. Usually, only a single dose (0.2 mg/kg) is suggested. We retrospectively explored whether the use of an additional higher (0.4 mg/kg) dose of bisacodyl increases the yield of colonic manometry. METHODS In 103 children (median age: 8.8 years, range 3.2-15.7 years) with a diagnosis of slow transit constipation, colonic motility was recorded for 1 h before and 1 h after each of two incremental doses of bisacodyl (low, L, dose: 0.2 mg/kg, max 10 mg; high, H, dose: 0.4 mg/kg, max 20 mg) and the characteristics of HAPCs analyzed. KEY RESULTS High-amplitude propagating contractions were seen in 85 children. H dose significantly increased the proportion of patients with fully propagated HAPCs (H dose: 57/103 [55%], L dose: 27/103 [26%], p < 0.001), paralleling the significant decrease in the proportion with partially propagated HAPCs (H dose: 29/103 [28%], L dose: 47/103 [46%], p < 0.01). Mean HAPC number significantly increased throughout the colon at H compared to L dose (7.2 ± 5.05 vs 5.6 ± 5.1, p < 0.05). Finally, the proportion of patients with normal pressure wave morphology of HAPCs significantly increased with higher dose (H dose: 55/85 [65%], L dose: 27/85 [32%], p < 0.001). CONCLUSIONS & INTERFERENCES An additional higher dose of bisacodyl during colonic manometry improves colonic neuromuscular function suggesting its use might improve interpretation and decision making in children with slow transit constipation.
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Affiliation(s)
- O Borrelli
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK.
| | - M Pescarin
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - E Saliakellis
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - R Tambucci
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - P Quitadamo
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - F Valitutti
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - A Rybak
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK.,Department of Gastroenterology, Hepatology, Nutrition Disorders and Pediatrics, Children's Memorial Health Institute, Warsaw, Poland
| | - K J Lindley
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - N Thapar
- Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, UK.,Stem Cells and Regenerative Medicine, UCL Institute of Child Health, London, UK
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Zhernakova A, Stahl EA, Trynka G, Raychaudhuri S, Festen E, Franke L, Fehrmann RSN, Kurreeman FAS, Thomson B, Gupta N, Romanos J, McManus R, Ryan AW, Turner G, Remmers EF, Greco L, Toes R, Grandone E, Mazzilli MC, Rybak A, Cukrowska B, Li Y, de Bakker PIW, Gregersen PK, Worthington J, Siminovitch KA, Klareskog L, Huizinga TWJ, Wijmenga C, Plenge RM. Meta-analysis of genome-wide association studies in celiac disease and rheumatoid arthritis identifies fourteen non-HLA shared loci. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.148965.20] [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]
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Briel D, Rybak A, Kronbach C, Unverferth K. Substituted 2-aminothiopen-derivatives: a potential new class of GluR6-antagonists. Eur J Med Chem 2010; 45:69-77. [PMID: 19819046 DOI: 10.1016/j.ejmech.2009.09.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 08/11/2009] [Accepted: 09/10/2009] [Indexed: 11/30/2022]
Abstract
In the course of search for new therapeutic agents against epilepsy new inhibitors for the kainate receptor subtypes GluR5 and GluR6 were synthesized. We were able to synthesize new substituted thieno[2,3-d]pyrimidines 3a,b, 4a,b, 5a,b as well as thiophene-3-carboxamides 2a-d and a multitude of substituted 4-methyl-5-phenylthiophene-3-carboxylic acids. All compounds described herein were tested for their antagonistic effect towards the kainate receptor subtypes GluR5 and GluR6. The highest activity was observed for ethyl 2-amino-4-methyl-5-phenylthiophene-3-carboxylate 1c with an IC50=0.75 microM at the GluR6 receptor.
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Affiliation(s)
- D Briel
- Pharmazeutische Chemie, Institut für Pharmazie, Fakultät für Biowissenschaften, Pharmazie und Psychologie, Universität Leipzig, Brüderstr. 34, 04103 Leipzig, Germany.
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Briel D, Rybak A, Mann S, Kronbach C, Unverferth K. Synthesis of thieno[2,3-d]oxazines and thieno[2,3-d]thiazines as subtype specific kainate receptor antagonists. Curr Med Chem 2009; 16:4704-11. [PMID: 19903139 DOI: 10.2174/092986709789878283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 11/23/2009] [Indexed: 11/22/2022]
Abstract
For the development of new antiepileptics the kainate receptors GluR6 and GluR5 are important targets. Based on the anticonvulsant effects of chinazolines and thieno[2,3-d]pyrimidines that are known from the literature, thieno[2,3-d][1.3]oxazines were synthesized and studied for their inhibitory properties at GluR6 and GluR5 receptors. The strongest inhibitor activity was observed with 5-methyl-6-phenyl-thieno[2,3-d][1.3]oxazines with C1 or C3-substituents in position 2 (3b-f). The 2-trihalide-methyl-substituted compounds 3c and 3d were the most active inhibitors at the GluR5-receptor (IC50=23.4 micromol, 16 microl). The 2-isopropyl-substituted compound 3f displayed the strongest activity at the GluR6-receptor (IC(50)=8.7 micromol). A number of thieno[2,3-d][1.3]thiazines and thieno[2,3-d] pyrimidines that were synthesized from the thieno[2,3][1.3]oxazines did not show any activity.
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Affiliation(s)
- D Briel
- Institute of Pharmacy, Faculty of Biosciences, Pharmacy and Psychology, University of Leipzig, Brüderstrasse 34, 04103 Leipzig, Germany.
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Briel D, Rybak A, Kronbach C, Unverferth K. [Thieno[2,3-d]pyrimidines as antagonists of the glutamate receptors]. Pharmazie 2008; 63:823-6. [PMID: 19069244] [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: 05/27/2023]
Abstract
Although the function of the kainate receptors in the brain is still not clear, they are increasingly defined as targets in the development of new classes of anti-epileptics. The thienopyrimidines described in this report were tested for their antagonistic effect at the kainate receptor subtypes GluR5 and GluR6. The highest effectiveness was obtained by a 4-ethoxy-thieno[2,3-d]pyrimidin with an IC50 = 68 microM at the GluR6 receptor.
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Affiliation(s)
- D Briel
- Pharmazeutische Chemie, Institut für Pharmazie, Fakultät für Biowissenschaften, Pharmazie und Psychologie, Universität Leipzig, Leipzig, Germany.
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Kapoor A, He L, Fan C, Rybak A, Cutz J, Tang D. MP-16.01: Reduction of the cytosolic Cdk11 protein expression in clear cell renal cell carcinoma. Urology 2007. [DOI: 10.1016/j.urology.2007.06.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Briel D, Drössler K, Rybak A, Holzer M, Dobner B. [Protected mercaptoalkylpyrimidinones: synthesis and test for immunostimulating activity]. Pharmazie 2005; 60:415-7. [PMID: 15997828] [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: 05/03/2023]
Abstract
Protected mercaptoalkylpyrimidinones: synthesis and test for immunostimulating activity 3-Hydroxyalkyl-pyrimidine 1 reacts with phosphoroxychloride and thioglycolic acid or thiourea to yield pyrimidin-3-ylalkylthioacetic acids 3 or pyrimidin-3-ylalkylthiouroniumsalts 5 respectively. Some of the pyrimidines 3 and 5 showed immunomodulatory activity.
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Affiliation(s)
- D Briel
- Fakultät für Biowissenschaften der Universität Leipzig, Germany
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Korczowski B, Bijoś A, Rybak A. [Procalcitonin in diagnosis of purulent and aseptic meningitis in children]. Pol Merkur Lekarski 2000; 9:755-7. [PMID: 11204322] [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: 02/19/2023]
Abstract
UNLABELLED Procalcitonin (PCT) is a new indicator of the systemic response to severe infections. To evaluate clinical usefulness of serum procalcitonin measurements in the differential diagnosis of purulent versus aseptic meningitis in children was the aim of the study. Fifteen children (aged 1 month-14 years) with purulent meningitis and 12 children (aged 6 months-12 years) with aseptic meningitis were included into the study. Serum PCT concentration was measured on admission by immunoluminometric assay. Thirty healthy controls (aged 3 months-14 years) were also enrolled into the study. Serum PCT concentration was above 0.5 ng/ml in 14 out of 15 children with purulent meningitis (range 0.0-95.2 ng/ml; arrhythmetic mean--28.2 ng/ml). In all children with aseptic meningitis (range 0.0-0.3 ng/ml; mean--0.1 ng/ml) as well as in healthy controls (range 0.0-0.3 ng/ml; mean--0.1 ng/ml) serum PCT was below 0.5 ng/ml. CONCLUSION Elevated serum PCT concentration in child with meningitis suggests bacterial aetiology.
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Affiliation(s)
- B Korczowski
- Oddziału Dzieciecego Szpitala Wojewódzikego nr 2 w Rzeszowie
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Nizankowska-Błaz T, Korczowski R, Zyś K, Rybak A. [Level of magnesium in blood serum in children from the province of Rzesz'ow]. Wiad Lek 1993; 46:120-2. [PMID: 8266691] [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: 01/29/2023]
Abstract
In 142 girls and 107 boys aged 5-15 years serum magnesium level was determined by the colorimetric method. Decreased values were found in 24 children including 7 boys and 17 girls. In 21 of them neurotic reactions or concentration disturbances were observed.
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Affiliation(s)
- T Nizankowska-Błaz
- Kliniki Pediatrii Instytutu Medycyny Klinicznej w Rzeszowie Ak. Med., Krakowie
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Spławinska B, Furmaga W, Nieszpaur M, Ziembicki W, Kuzniar J, Dłuska Z, Rybak A, Spławinski J. Formation of prostacyclin-sensitive platelet aggregates in human whole blood in vitro. Part I. The occurrence of the phenomenon in healthy male volunteers. Scand J Clin Lab Invest 1987; 47:119-24. [PMID: 2953062 DOI: 10.1080/00365518709168879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
When unstirred citrated blood of young males was left to stand at 21 degrees C, the number of free platelets decreased as measured with a whole blood platelet counter. This decrease indicated spontaneous platelet aggregation (SPA) since it was accompanied by the time-dependent increase in platelet micro-aggregates and plasma beta-thromboglobulin while lactate dehydrogenase level did not change significantly. Addition of PGI2 to whole blood increased free platelet count and decreased the number of platelet micro-aggregates. The de-aggregatory effect of PGI2 (measured as a percentage increase in free platelet number) was correlated with the initial amount of platelet micro-aggregates. Blood storage enhanced SPA and de-aggregatory effect of prostacyclin. Immediately after blood collection de-aggregatory effect of prostacyclin was absent. Our results favour an assumption that prostacyclin-sensitive platelet aggregates in blood of young volunteers are formed in vitro rather than in vivo.
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Kuźniar J, Piela A, Skret A, Szmigiel Z, Palczak R, Rybak A. [Plasma volume and its effect on the fate of the fetus in pregnancy complicated by hypertension]. Ginekol Pol 1987; 58:248-53. [PMID: 3653745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Rybak A. [Serum magnesium level in chronic alcoholics]. Pol Tyg Lek 1973; 28:53-5. [PMID: 4686454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Taubenslag L, Casellas JM, Farinati A, Rybak A, Munich S, Troianovsky A. [New experiences with nalidixic acid in childhood urinary infections]. Prensa Med Argent 1971; 58:1710-3. [PMID: 5129858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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