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Pozzetto B, Grard G, Durand G, Paty MC, Gallian P, Lucas-Samuel S, Diéterlé S, Fromage M, Durand M, Lepelletier D, Chidiac C, Hoen B, Nicolas de Lamballerie X. Arboviral Risk Associated with Solid Organ and Hematopoietic Stem Cell Grafts: The Prophylactic Answers Proposed by the French High Council of Public Health in a National Context. Viruses 2023; 15:1783. [PMID: 37766192 PMCID: PMC10536626 DOI: 10.3390/v15091783] [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: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/29/2023] Open
Abstract
Diseases caused by arboviruses are on the increase worldwide. In addition to arthropod bites, most arboviruses can be transmitted via accessory routes. Products of human origin (labile blood products, solid organs, hematopoietic stem cells, tissues) present a risk of contamination for the recipient if the donation is made when the donor is viremic. Mainland France and its overseas territories are exposed to a complex array of imported and endemic arboviruses, which differ according to their respective location. This narrative review describes the risks of acquiring certain arboviral diseases from human products, mainly solid organs and hematopoietic stem cells, in the French context. The main risks considered in this study are infections by West Nile virus, dengue virus, and tick-borne encephalitis virus. The ancillary risks represented by Usutu virus infection, chikungunya, and Zika are also addressed more briefly. For each disease, the guidelines issued by the French High Council of Public Health, which is responsible for mitigating the risks associated with products of human origin and for supporting public health policy decisions, are briefly outlined. This review highlights the need for a "One Health" approach and to standardize recommendations at the international level in areas with the same viral epidemiology.
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Affiliation(s)
- Bruno Pozzetto
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- GIMAP Team, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet de Saint-Etienne, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, 42023 Saint-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Gilda Grard
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
| | - Guillaume Durand
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
| | - Marie-Claire Paty
- Santé Publique France, The French Public Health Agency, 94410 Saint-Maurice, France;
| | - Pierre Gallian
- Etablissement Français du Sang, 93218 Saint-Denis, France;
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), 13385 Marseille, France
| | | | | | - Muriel Fromage
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), 93200 Saint-Denis, France;
| | - Marc Durand
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
| | - Didier Lepelletier
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
| | - Christian Chidiac
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- Department of Infectious and Tropical Diseases, University Hospital of Lyon, 69002 Lyon, France
| | - Bruno Hoen
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- Department of Infectious Diseases, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Xavier Nicolas de Lamballerie
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), 13385 Marseille, France
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Parraud D, Maucotel AL, Bouscambert M, Morfin F, Bitker L, Chidiac C, De Castro N, Frobert E, Gaymard A. SARS-CoV-2 N-Antigen Quantification in Respiratory Tract, Plasma and Urine: Kinetics and Association with RT-qPCR Results. Viruses 2023; 15:v15051041. [PMID: 37243128 DOI: 10.3390/v15051041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Qualitative SARS-CoV-2 antigen assays based on immunochromatography are useful for mass diagnosis of COVID-19, even though their sensitivity is poor in comparison with RT-PCR assays. In addition, quantitative assays could improve antigenic test performance and allow testing with different specimens. Using quantitative assays, we tested 26 patients for viral RNA and N-antigen in respiratory samples, plasma and urine. This allowed us to compare the kinetics between the three compartments and to compare RNA and antigen concentrations in each. Our results showed the presence of N-antigen in respiratory (15/15, 100%), plasma (26/59, 44%) and urine (14/54, 28.9%) samples, whereas RNA was only detected in respiratory (15/15, 100%) and plasma (12/60, 20%) samples. We detected N-antigen in urine and plasma samples until the day 9 and day 13 post-inclusion, respectively. The antigen concentration was found to correlate with RNA levels in respiratory (p < 0.001) and plasma samples (p < 0.001). Finally, urinary antigen levels correlated with plasma levels (p < 0.001). Urine N-antigen detection could be part of the strategy for the late diagnosis and prognostic evaluation of COVID-19, given the ease and painlessness of sampling and the duration of antigen excretion in this biological compartment.
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Affiliation(s)
- Delphine Parraud
- Laboratoire de Virologie, Institut des Agents Infectieux, Laboratoire Associé Au Centre National de Référence des Virus des Infections Respiratoires, Hospices Civils de Lyon, F-69317 Lyon, France
| | - Anne-Lise Maucotel
- Laboratoire de Virologie, Institut des Agents Infectieux, Laboratoire Associé Au Centre National de Référence des Virus des Infections Respiratoires, Hospices Civils de Lyon, F-69317 Lyon, France
| | - Maude Bouscambert
- CIRI, Centre International de Recherche en Infectiologie, Team VirPath, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Florence Morfin
- CIRI, Centre International de Recherche en Infectiologie, Team VirPath, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Laurent Bitker
- Service de Médecine Intensive-Réanimation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix Rousse, CEDEX 04, F-69317 Lyon, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Université Claude Bernard Lyon 1, F-69317 Lyon, France
| | - Nathalie De Castro
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, APHP, F-75010 Paris, France
| | - Emilie Frobert
- CIRI, Centre International de Recherche en Infectiologie, Team VirPath, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Alexandre Gaymard
- CIRI, Centre International de Recherche en Infectiologie, Team VirPath, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
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Chaix ML, Leturque N, Gabassi A, Charreau I, Minier M, Pialoux G, Cua É, Chidiac C, Raffi F, Tremblay C, Meyer L, Molina JM, Delaugerre C. Prevalence and incidence of HEV among men using HIV pre-exposure prophylaxis: A sub-study of the ANRS IPERGAY trial. J Clin Virol 2023; 160:105380. [PMID: 36638749 DOI: 10.1016/j.jcv.2023.105380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Men who have sex with men (MSM) have an increased risk of infection by pathogens transmitted by the oro-fecal route. Here, we investigated the seroprevalence and incidence of hepatitis E virus (HEV) infection in 416 MSM included in the ANRS IPERGAY PrEP trial. RESULTS Among the 62 (14.9% (95% CI: [11.6%-18.7%]) seropositive for HEV at inclusion, the only factor associated with testing seropositive for HEV was older age. Geographical origin, use of recreational drugs, number of sexual partners, status for HAV and bacterial sexually transmitted infection (STI) at inclusion were not associated. Among the 342 HEV-seronegative patients with available samples, 9 seroconverted after a median of follow-up of 2.1 years (IQR (interquartile range): [1.6; 3.0]). CONCLUSION Overall, the HEV incidence was 1.19% per 100 person-years [95% CI: 0.54%; 2.26%]. Sexual transmission does not seem to be a major route of HEV infection in MSM, unlike HAV.
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Affiliation(s)
- Marie-Laure Chaix
- Virologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U944, CNRS UMR 7212, Institut Universitaire d'Hématologie, Université Paris Cité, Hôpital Saint Louis, 75010 Paris, France.
| | | | - Audrey Gabassi
- Virologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Marine Minier
- Virologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Gilles Pialoux
- Maladies infectieuses, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Éric Cua
- Maladies infectieuses, Hôpital de l'Archet, Centre Hospitalier de Nice, France
| | - Christian Chidiac
- Maladies infectieuses, Hôpital de la Croix Rousse, Centre Hospitalier et Universitaire de Lyon, France
| | - François Raffi
- Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, INSERM, Nantes, France
| | - Cécile Tremblay
- Maladies infectieuses, Centre Hospitalier de l'Université de Montréal, Canada
| | - Laurence Meyer
- INSERM SC10 US19, Villejuif, France; Université Paris-Sud, Université Paris-Saclay, France
| | - Jean-Michel Molina
- INSERM U944, CNRS UMR 7212, Institut Universitaire d'Hématologie, Université Paris Cité, Hôpital Saint Louis, 75010 Paris, France; Maladies infectieuses, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Constance Delaugerre
- Virologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U944, CNRS UMR 7212, Institut Universitaire d'Hématologie, Université Paris Cité, Hôpital Saint Louis, 75010 Paris, France
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4
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Launay O, Cachanado M, Luong LB, Ninove L, Lachâtre M, Ghezala IB, Bardou M, Schmidt-Mutter C, Lacombe K, Laine F, Allain JS, Botelho-Nevers E, Tavolacci MP, Chidiac C, Pavese P, Dussol B, Priet S, Deplanque D, Touati A, Curci L, Konate E, Hamouda NB, Besbes A, Nubret E, Capelle F, Berard L, Rousseau A, Tartour E, Simon T, Lamballerie XD, Felten R, SURGERS L. 1954. Immunogenicity against SARS CoV-2 ancestral strain and variants of two new COVID-19 recombinant adjuvanted vaccines compared to BNT162b2 as a third dose following two doses of BNT162b2: a single-blinded multicenter randomized controlled trial. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
New adjuvanted recombinant protein vaccines against coronavirus disease 2019 (COVID-19) as heterologous boosters could maximize the benefits of vaccination against SARS CoV-2.
Methods
In this randomized, single-blinded, multicenter trial, adults who had received two doses of Pfizer-BioNTech mRNA vaccine (BNT162b2) 3–7 months before were randomly assigned to receive a boost of BNT162b2, Sanofi/GSK SARS-CoV-2 adjuvanted recombinant protein MV D614 (monovalent parental formulation) or SARS-CoV-2 adjuvanted recombinant protein MV B.1.351 vaccine (monovalent Beta formulation). The primary endpoint was the percentage of subjects with a ≥ 10-fold increase in neutralizing antibody titers for the Wuhan (D614) and B.1.351 (Beta) SARS-CoV-2 viral strains between D0 and D15.
Results
The percentages of participants whose neutralizing antibody titers against the Wuhan (D614) SARS-CoV-2 strain increased by a factor ≥ 10 between Day 0 and Day 15 was 55.3% (95% CI 43.4-66.7) in MV(D614) group (n=76), 76.1% (64.5-85.4) in MV(Beta) group (n=71) and 63.2% (51.3-73.9) in BNT162b2 group (n=76). These percentages were 44.7% (33.3-56.6), 84.5% (74.0-92.0) and 51.3% (39.6-63.0) for the B.1.351 (Beta) viral strain, respectively. Higher neutralizing antibodies rates against Delta and Omicron BA.1 variants were also elicited after Sanofi/GSK MV(Beta) vaccine compared to the other vaccines. Comparable reactogenicity profile was observed the three vaccines. Table 1.Characteristics of patients at inclusion (per-protocol population).Figure 2.Neutralizing antibodies against D614 (wild-type; Wuhan) SARS-CoV-2 and variants Beta, Delta and Omicron BA.1 at D0, D15 and D28 after the boost dose (“post D3”)with Sanofi/GSK-D614, Sanofi/GSK-B.1.351 or BNT162b2 (per-protocol population); dotted line represents the positivity threshold.Figure 4.Rates and grades of severity of solicited adverse events reported from D0 to D7 by participants from the three randomized groups of the safety population (G1, Sanofi/GSK-D614; G2, Sanofi/GSK-B.1.351; G3, BNT162b2) according to the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials (Modified FDA scale/September 2007)
Conclusion
All three vaccines boosted antibodies and neutralizing response after BNT162b2 initial course. Heterologous boosting with the Sanofi/GSK SARS-CoV-2 adjuvanted recombinant protein vaccine B.1.351 (Beta formulation) provided higher neutralizing antibodies response rates against variants, including Omicron BA.1, compared with the mRNA BNT162b2 vaccine.
Disclosures
Odile Launay, MD, PhD, AstraZeneca: Financial|GlaxoSmithKline: Advisor/Consultant|GlaxoSmithKline: Grant/Research Support|Johnson & Johnson: Advisor/Consultant|Johnson & Johnson: Grant/Research Support|MD: Advisor/Consultant|Moderna: Advisor/Consultant|MSD: Data safety monitoring board|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Sanofi Pasteur: Advisor/Consultant|Sanofi Pasteur: Grant/Research Support|Sanofi Pasteur: Data safety monitoring board Liem Binh Luong, MD, Pfizer: Advisor/Consultant|Pfizer: Honoraria Karine Lacombe, MD, PhD, Gilead: Advisor/Consultant|Janssen: Grant/Research Support|MSD: Grant/Research Support|ViiV Healthcare: Grant/Research Support Elisabeth Botelho-Nevers, MD, PHD, Janssen: Board Member|Pfizer: Board Member|Sanofi Pasteur: Board Member.
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Affiliation(s)
- Odile Launay
- Université Paris Cité; Inserm F-CRIN , I-REIVAC; Assistance Publique Hôpitaux de Paris, Paris, Ile-de-France , France
| | - Marine Cachanado
- Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB) , APHP, Hôpital St Antoine, Paris, France, Paris, Ile-de-France , France
| | - Liem Binh Luong
- AP-HP, Hôpital Cochin; Inserm CIC 1417 , Paris , France ; , France, Paris, Ile-de-France , France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC , Paris , France ; , France, Paris, Ile-de-France , France
| | - Laetitia Ninove
- Unité des Virus Emergents, UVE : Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection , 13005, Marseille, France, Marseille, Provence-Alpes-Cote d'Azur , France
| | - Marie Lachâtre
- AP-HP, Hôpital Cochin; Inserm CIC 1417 , Paris , France ; , France, Paris, Ile-de-France , France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC , Paris , France ; , France, Paris, Ile-de-France , France
| | - Inès Ben Ghezala
- Inserm, CIC 1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, University Hospital , Dijon , France ; , France, Dijon, Bourgogne , France
- F-CRIN, I REIVAC/COVIREIVAC , Dijon , France ; , France, Dijon, Bourgogne , France
| | - Marc Bardou
- Inserm, CIC 1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, University Hospital , Dijon , France ; , France, Dijon, Bourgogne , France
- F-CRIN, I REIVAC/COVIREIVAC , Dijon , France ; , France, Dijon, Bourgogne , France
| | - Catherine Schmidt-Mutter
- CIC Inserm 1434, Hôpitaux Universitaires de Strasbourg , France ; , France, Strasbourg, Alsace , France
- F-CRIN, I REIVAC/COVIREIVAC , France ; , France, Strasbourg, Alsace , France
| | - Karine Lacombe
- Sorbonne Inserm UMR-S1136, Hôpital St Antoine , AP-HP, Paris , France ; , France, Paris, Ile-de-France , France
- F-CRIN, I REIVAC/COVIREIVAC , AP-HP, Paris , France ; , France, Paris, Ile-de-France , France
| | - Fabrice Laine
- INSERM, CIC1414 , CHU Rennes, Rennes , France ; , France, Rennes, Bretagne , France
- F-CRIN, I REIVAC/COVIREIVAC , CHU Rennes, Rennes , France ; , France, Rennes, Bretagne , France
| | - Jean-Sébastien Allain
- INSERM, CIC1414 , CHU Rennes, Rennes , France ; , France, Rennes, Bretagne , France
- F-CRIN, I REIVAC/COVIREIVAC , CHU Rennes, Rennes , France ; , France, Rennes, Bretagne , France
| | - Elisabeth Botelho-Nevers
- Service d’infectiologie , CIC1408, Inserm, CHU de Saint-Etienne, 42055 Saint-Etienne , France ; , France, Saint Etienne, Auvergne , France
- F-CRIN, I REIVAC/COVIREIVAC , CIC1408, Inserm, CHU de Saint-Etienne, 42055 Saint-Etienne , France ; , France, Saint Etienne, Auvergne , France
| | - Marie-Pierre Tavolacci
- Normandie Univ , UNIROUEN, U1073, CHU Rouen, and CIC-CRB 1404, F-76000 Rouen , France ; , France, Rouen, Haute-Normandie , France
- F-CRIN, I REIVAC/COVIREIVAC , UNIROUEN, U1073, CHU Rouen, and CIC-CRB 1404, F-76000 Rouen , France ; , France, Rouen, Haute-Normandie , France
| | - Christian Chidiac
- 13. Maladies Infectieuses, GHN Croix Rousse, Hospices Civils de Lyon, UFR de Médecine et Maïeutique Lyon Sud Université Claude Bernard Lyon1, Université de Lyon , CIRI PHE3ID, Inserm U1111 UMR5308 - ENS Lyon; F-CRIN, I REIVAC/COVIREIVAC, France, Lyon, Rhone-Alpes , France
| | - Patricia Pavese
- Maladies infectieuses et tropicales , CHU de Grenoble Alpes , France ; , France, Grenoble, Rhone-Alpes , France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC , CHU de Grenoble Alpes , France ; , France, Grenoble, Rhone-Alpes , France
| | - Bertrand Dussol
- CIC 14-09, INSERM - Aix Marseille Université – Hôpitaux Universitaires de Marseille; Inserm, F-CRIN, I REIVAC/COVIREIVAC , France, Marseille, Provence-Alpes-Cote d'Azur , France
| | - Stéphane Priet
- Unité des Virus Émergents, UVE: Aix Marseille Univ , IRD 190, INSERM 1207, Marseille, France, Marseille, Provence-Alpes-Cote d'Azur , France
| | - Dominique Deplanque
- Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre d’investigation clinique , F-59000 Lille , France ; , France, Lille, Nord-Pas-de-Calais , France
- F-CRIN, I REIVAC/COVIREIVAC , F-59000 Lille , France ; , France, Lille, Nord-Pas-de-Calais , France
| | - Amel Touati
- Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB) , APHP, Hôpital St Antoine, Paris, France, Paris, Ile-de-France , France
| | - Laureen Curci
- AP-HP, Hôpital Cochin; Inserm CIC 1417 , Paris , France ; , France, Paris, Ile-de-France , France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC , Paris , France ; , France, Paris, Ile-de-France , France
| | - Eleine Konate
- AP-HP, Hôpital Cochin; Inserm CIC 1417 , Paris , France ; , France, Paris, Ile-de-France , France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC , Paris , France ; , France, Paris, Ile-de-France , France
| | - Nadine Ben Hamouda
- Service d’Immunologie Biologique, APHP, Hôpital Européen Georges Pompidou , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
- PARCC, INSERM U970, Université de Paris , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
| | - Anissa Besbes
- Service d’Immunologie Biologique, APHP, Hôpital Européen Georges Pompidou , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
- PARCC, INSERM U970, Université de Paris , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
| | - Eunice Nubret
- APHP, Direction de la Recherche Clinique et de l’Innovation (DRCI) , Paris, France, Paris, Ile-de-France , France
| | - Florence Capelle
- Département des Essais Cliniques de l’AGEPS, DRCI-APHP , Paris, France, Paris, Ile-de-France , France
| | - Laurence Berard
- Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB) , APHP, Hôpital St Antoine, Paris, France, Paris, Ile-de-France , France
| | - Alexandra Rousseau
- Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB) , APHP, Hôpital St Antoine, Paris, France, Paris, Ile-de-France , France
| | - Eric Tartour
- Service d’Immunologie Biologique, APHP, Hôpital Européen Georges Pompidou , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
- PARCC, INSERM U970, Université de Paris , 75015 Paris , France ; , 75006 Paris, France, Paris, Ile-de-France , France
| | - Tabassome Simon
- Department of Clinical Pharmacology and Clinical Research Platform Paris-East (URCEST-CRC-CRB) , APHP, Hôpital St Antoine, Paris, France, Paris, Ile-de-France , France
| | - Xavier De Lamballerie
- Unité des Virus Émergents, UVE: Aix Marseille Univ , IRD 190, INSERM 1207, Marseille, France, Marseille, Provence-Alpes-Cote d'Azur , France
| | - Renaud Felten
- Inserm CIC 1434, CHU Strasbourg, Strasbourg, F-CRIN, I REIVAC/COVIREIVAC , Strasbourg, Alsace , France
| | - Laure SURGERS
- Sorbonne Université, IPLESP Inserm UMR-S1136, Hôpital St Antoine , AP-HP, Paris, France - F-CRIN, I REIVAC/COVIREIVAC, Paris, Ile-de-France , France
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5
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Lepelletier D, Chidiac C, Mansour Z, Chauvin F. New French guidelines to adapt the "Isolate/Detect/Trace" strategy for COVID-19 adult peoples or contacts considering the exponential spread of Omicron variant. Health Sci Rep 2022; 5:e612. [PMID: 36254238 PMCID: PMC9561356 DOI: 10.1002/hsr2.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The objectives were to elaborate new recommendations for the French Government taking into account the new epidemiological situation due to Omicron variant of SARS-CoV-2 virus and to maintain essential functions of the State through socioeconomic and health life. METHOD Two self-decision matrix were built for isolation (cases) and quarantine (contacts) and for citizen testing, respectively. The recommendations included in the two matrix were validated internally by experts and scientists from the scientist literature. RESULTS A strategic breakdown into five phases corresponding to the possible phases of Omicron variants spread was built. Exceptional and transitory derogation for essential activities was proposed in fully vaccinated professionals. Suspension of quarantine period for fully vaccinated contacts and professionals was proposed with routine self-testing program. CONCLUSION These new HCSP guidelines aims to preserve public health as a whole and to minimize the socioeconomic and health consequences linked to the emergence of the Omicron variant by making trade-offs/adaptations in dependent scientist contexts. PATIENT OR PUBLIC CONTRIBUTION HCSP scientists and experts were in charge of drafting the recommendations and promoting them to the Government for their application by regulatory decree voted by law.
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Affiliation(s)
- Didier Lepelletier
- High Council for Public HealthMinistry of HealthParisFrance,Hospital Hygiene DepartmentNantes University Hospital, France; UR 1155 – Nantes University, IICiMed, Institut de Recherche en Santé 2NantesFrance
| | - Christian Chidiac
- High Council for Public HealthMinistry of HealthParisFrance,Department of Infectious and Tropical DiseasesLyon University HospitalLyonFrance,CIRI équipe PH3ID‐INSERM‐U1111‐Université Claude Bernard Lyon 1‐CNRS ‐ UMR5308‐ENS de LyonLyonFrance
| | - Zeina Mansour
- High Council for Public HealthMinistry of HealthParisFrance,Regional Committee for Health EducationProvence Alpes Côte d'Azur (PACA)France
| | - Franck Chauvin
- High Council for Public HealthMinistry of HealthParisFrance,Centre Hygée, Institut Presage, CIC‐EC Inserm 1408University of Saint‐EtienneSaint‐EtienneFrance
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Lepelletier D, Pozzetto B, Chauvin F, Chidiac C. Management of patients with monkeypox virus (MPXV) infection and contacts in the community and in healthcare settings: A French position paper. Clin Microbiol Infect 2022; 28:1572-1577. [PMID: 36058544 PMCID: PMC9534082 DOI: 10.1016/j.cmi.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022]
Abstract
Scope Since April 2022, a large number of monkeypox (MPX) cases have emerged across the globe in regions that are known to be totally free of zoonotic reservoir. The High Council for Public Health is a national institute commissioned to provide guidelines to the French Ministry of Health. The objective of these guidelines and recommendations is to inform the public, people at risk of severe MPX infection, infected patients and their families and contacts and healthcare workers in charge of infected patients. Methods A review of the literature from the MEDLINE database was carried out using the single keyword ‘monkeypox’, including recent and older articles from January 2000 to June 2022. There was no filter for the type of study, except English language. The titles and summaries of all the articles were read by the experts to select articles of interest. The High Council for Public Health brought together specialists with expertise in the field to analyse the scientific literature and international recommendations. Recommendations were classified with clinical practice methodology using four levels (strong recommendation, recommendation, optional recommendation and no recommendation) without grading the level of evidence. To develop and methodologically validate the recommendations, the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE-II)chart was partially used. Questions addressed by the guidelines and recommendations (a) What are the therapeutic management measures for hospitalized patients with severe forms of MPX infection, and what are the preventive measures to protect healthcare professionals? (b) What are the isolation and prevention measures in the community for patients with mild or moderate severity MPX infection? (c) what are the preventive measures for contacts of an MPX-infected person? (d) Who should be vaccinated? (e) What are the specific prevention measures for children and schools?
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Affiliation(s)
- Didier Lepelletier
- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015.
| | - Bruno Pozzetto
- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015
| | - Franck Chauvin
- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015
| | - Christian Chidiac
- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015
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- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015
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- High Council for Public Health, Ministry of Solidarity and Health, Paris, FR-75015
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Launay O, Cachanado M, Luong Nguyen LB, Ninove L, Lachâtre M, Ben Ghezala I, Bardou M, Schmidt-Mutter C, Lacombe K, Laine F, Allain JS, Botelho-Nevers E, Tavolacci MP, Chidiac C, Pavese P, Dussol B, Priet S, Deplanque D, Touati A, Curci L, Konate E, Ben Hamouda N, Besbes A, Nubret E, Capelle F, Berard L, Rousseau A, Tartour E, Simon T, de Lamballerie X. Immunogenicity and Safety of Beta-Adjuvanted Recombinant Booster Vaccine. N Engl J Med 2022; 387:374-376. [PMID: 35767474 PMCID: PMC9258749 DOI: 10.1056/nejmc2206711] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Fabrice Laine
- Centre Hospitalier Universitaire (CHU) Rennes, Rennes, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eunice Nubret
- Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | - Eric Tartour
- Hôpital Européen Georges Pompidou, Paris, France
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Janssen C, Cachanado M, Ninove L, Lachatre M, Michon J, Epaulard O, Maakaroun-Vermesse Z, Chidiac C, Laviolle B, Aumaitre H, Assaf A, Lacombe K, Schmidt-Mutter C, Botelho-Nevers E, Briere M, Boisson T, Loubet P, Bienvenu B, Bouchaud O, Touati A, Pereira C, Rousseau A, Berard L, Montil M, de Lamballerie X, Simon T, Launay O. Immunogenicity and reactogenicity of heterologous and homologous mRNA-1273 and BNT162b2 vaccination: A multicenter non-inferiority randomized trial. EClinicalMedicine 2022; 48:101444. [PMID: 35582124 PMCID: PMC9098199 DOI: 10.1016/j.eclinm.2022.101444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although effective mRNA vaccines for SARS-CoV-2 infection have been deployed worldwide, their interchangeability could facilitate the scale-up of vaccination programs. The objective of the trial was to assess whether the immune response induced by a heterologous SARS-CoV-2 mRNA primo vaccination is non-inferior to that of a homologous mRNA vaccination. METHODS We conducted a multicenter, randomized, open-label trial in adults 18 years of age and older who received a first dose of SARS-CoV-2 mRNA vaccine. Participants were randomly assigned in a 1:1 ratio to receive a second dose of BNT162b2 or mRNA-1273, 28 to 49 days after the first dose. Randomization was stratified on the vaccine received at the first vaccination. The primary endpoint was the anti-spike IgG antibodies titer measured 28 days after the second vaccine dose. This study is registered with ClinicalTrials.gov, Trial, NCT04900467. FINDINGS Of the 414 randomized participants recruited from May 28 to July 2, 2021, 390 were included in the per protocol analysis: 94 participants in group 1 (BNT162b2/BNT162b2), 96 in group 2 (BNT162b2/mRNA-1273), 97 in group 3 (mRNA-1273/mRNA-1273), and 103 in group 4 (mRNA-1273/BNT162b2). The geometric mean titers ratios of anti-spike IgG antibodies for each heterologous regimen relative to the corresponding homologous regimen were 1·37 (two-sided 95% CI, 1·10 to 1·72) in the groups 1 and 2 and 0·67 (two-sided 95% CI, 0·55 to 0·82) in the groups 3 and 4. Levels of neutralizing antibodies to the main circulating SARS-Cov-2 viral strains were higher with the vaccine regimen containing mRNA-1273. Participants who received mRNA-1273 as a second dose experienced a higher rate of local adverse reactions and general symptoms than those who received BNT162b2 (p < 0·0001). INTERPRETATION The two SARS-CoV-2 mRNA vaccines could be used with flexibility for the second dose of COVID-19 primo vaccination. Tolerance remains good regardless of vaccine sequence although mRNA-1273 was more reactogenic. FUNDING French Ministries of Solidarity and Health and Research. BNT162b2 was provided by Pfizer/BioNTech. mRNA-1273 was provided by Moderna.
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Affiliation(s)
- Cécile Janssen
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, Annecy 74370, France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
| | - Marine Cachanado
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
| | - Laetitia Ninove
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, Marseille 13005, France
| | - Marie Lachatre
- Centre d'Investigations Cliniques (CIC 1417) Cochin Pasteur, AP-HP, Hôpital Cochin, Paris, France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
| | - Jocelyn Michon
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Service Des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, Caen 14000, France
| | - Olivier Epaulard
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Service des maladies Infectieuses, CHU Grenoble Alpes, CIC1406 Inserm - CHUGA - Université Grenoble Alpes, Grenoble, France
| | - Zoha Maakaroun-Vermesse
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Centre de vaccination, CHU de Tours, CIC 1415 CHU de Tours, France
| | - Christian Chidiac
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Service des Maladies Infectieuses et Tropicales GHN HCL - CIRI Équipe PH3ID - INSERM - U1111- UCBL Lyon 1 - CNRS - UMR5308 - ENS de Lyon, France
| | - Bruno Laviolle
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes, Service de Pharmacologie Clinique), Irset (Institut de Recherche en Santé, Environnement et Travail) UMR S 1085, Rennes F-35000, France
| | - Hugues Aumaitre
- SMIT Perpignan - Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Ady Assaf
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- CHU Lille, Service de Maladies Infectieuses, University Lille, CNRS, Inserm, CHU Lille, Institute Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille F-59000, France
| | - Karine Lacombe
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- IPLESP - AP-HP, Service des Maladies Infectieuses et Tropicales, Hôpital St Antoine, Sorbonne Université, Paris, France
| | - Catherine Schmidt-Mutter
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Centre d'Investigation Clinique CIC INSERM 1434, CHU de Strasbourg, France
| | - Elisabeth Botelho-Nevers
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Service d'infectiologie, CIC1408, CHU de Saint-Etienne, Saint-Etienne 42055, France
- Team GIMAP, CIRI, Inserm, U1111, CNRS, UMR530, Univ Lyon, Université Jean Monnet, F42023 Saint-Etienne
| | - Magali Briere
- Maison de la Médecine Préventive, Service de Médecine interne, Maladies Infectieuses, hématologie, Centre Hospitalier Bretagne Atlantique, 20, boulevard Maurice Guillaudot, Vannes 56000, France
| | - Thomas Boisson
- Service de Médecine Interne, Centre Hospitalier Alpes Léman, Contamine Sur Arve, France
| | - Paul Loubet
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Department of Tropical and Infectious Diseases, Virulence Bactérienne et Infection Chronique INSERM U1047, University Montpellier, CHU Nîmes, Nîmes, France
| | - Boris Bienvenu
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Médecine Interne, Hôpital Saint Joseph, CEDEX 08, Marseille 13285, France
| | - Olivier Bouchaud
- AP-HP, Service des Maladies Infectieuses et Tropicales, Hôpital Avicenne, Université Paris-13, Bobigny, France
| | - Amel Touati
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
| | - Christine Pereira
- Centre d'Investigations Cliniques (CIC 1417) Cochin Pasteur, AP-HP, Hôpital Cochin, Paris, France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
| | - Alexandra Rousseau
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
| | - Laurence Berard
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
| | - Melissa Montil
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, Marseille 13005, France
| | - Tabassome Simon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint Antoine, Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (Unité de Recherche Clinique (URCEST), Centre de Recherche Clinique (CRCEST), Centre de Ressources Biologiques (CRB.APHP-SU), Paris, France
- Service de Pharmacologie, Sorbonne Université, Paris, France
| | - Odile Launay
- Centre d'Investigations Cliniques (CIC 1417) Cochin Pasteur, AP-HP, Hôpital Cochin, Paris, France
- Inserm, F-CRIN, I REIVAC/COVIREIVAC, France
- Faculté de Médecine, Inserm, CIC 1417, F CRIN I-REIVAC, Université de Paris, Paris, France
- Corresponding author.
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Vignier N, Halley des Fontaines V, Billette de Villemeur A, Cazenave-Roblot F, Hoen B, Chauvin F, Lepelletier D, Chidiac C, Billaud E. Public health issues and health rendezvous for migrants from conflict zones in Ukraine: A French practice guideline. Infect Dis Now 2022; 52:193-201. [PMID: 35483634 PMCID: PMC9040487 DOI: 10.1016/j.idnow.2022.04.006] [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] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/17/2022]
Abstract
Given the number of people leaving the war zone in Ukraine and arriving in France, the French high council for public health (HCSP) has drawn up a number of recommendations. The experts have taken into account the vulnerability of migrant populations, which is exacerbated by (a) promiscuity that increases the risk of exposure to infectious agents; (b) the psychological consequences of conflict, family separation and exile; (c) prevalence in Ukraine of communicable diseases such as (possibly multi-resistant) tuberculosis, HIV and HCV; (d) low vaccination coverage (risk of circulation of poliovirus) and (e) the risk of spreading infectious diseases (Covid-19, measles…). Consequently, experts recommend that priority be given to: (i) Initial (immediate) reception, which will help to provide emergency care and to assess immediate needs (psychological disorders, risk of medication breakdown and risk of infection); (ii) Other priority measures (vaccination catch-up, including vaccination against SARS-CoV-2 and mandatory vaccination for children's entry into school, screening for post-traumatic stress disorder and tuberculosis) must be implemented as soon as feasible. At this stage, it is imperative: To ensure coordination and access to information throughout the country, by providing medico-social support (opening of social rights and access to care); To digitize medical data for the purposes of traceability; To use professional interpreting and/or health facilitators, or else, if necessary, digital translation tools. (iii) Finally, experts stress the need for vigilance in terms of management, conservation of social rights and continuity of care after the initial period, and organization of a "health rendezvous" within four months of a migrant's entering the country.
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Affiliation(s)
- N Vignier
- Société de pathologie infectieuse de langue française, Paris, France; Centre d'investigation clinique Antilles-Guyane, CIC INSERM 1424, DRISP, centre hospitalier de Cayenne, Cayenne, French Guyana; Centre hospitalier universitaire Avicenne, AP-HP, hôpitaux universitaires Paris Seine-Saint-Denis, université Sorbonne Paris Nord, UFR SMBH, Bobigny, France; Institut convergences et migration, Aubervilliers, France.
| | | | | | - F Cazenave-Roblot
- Société de pathologie infectieuse de langue française, Paris, France; Haut Conseil de la santé publique, Paris, France; Centre hospitalier universitaire de Poitiers, Poitiers, France
| | - B Hoen
- Haut Conseil de la santé publique, Paris, France; Institut Pasteur de Paris, Paris, France
| | - F Chauvin
- Haut Conseil de la santé publique, Paris, France
| | - D Lepelletier
- Haut Conseil de la santé publique, Paris, France; Centre hospitalier universitaire de Nantes, Nantes, France
| | - C Chidiac
- Haut Conseil de la santé publique, Paris, France; Centre hospitalier universitaire de Lyon, UFR de médecine et maïeutique Lyon Sud, université Claude-Bernard-Lyon 1, université de Lyon, CIRI PHE3ID Inserm U1111, UMR5308-ENS Lyon, Lyon, France
| | - E Billaud
- Haut Conseil de la santé publique, Paris, France; Centre hospitalier universitaire de Nantes, Nantes, France
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Picot S, Perpoint T, Chidiac C, Sigal A, Javouhey E, Gillet Y, Jacquin L, Douplat M, Tazarourte K, Argaud L, Wallon M, Miossec C, Bonnot G, Bienvenu AL. Diagnostic accuracy of fluorescence flow-cytometry technology using Sysmex XN-31 for imported malaria in a non-endemic setting. Parasite 2022; 29:31. [PMID: 35638753 PMCID: PMC9153516 DOI: 10.1051/parasite/2022031] [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] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Malaria diagnosis based on microscopy is impaired by the gradual disappearance of experienced microscopists in non-endemic areas. Aside from the conventional diagnostic methods, fluorescence flow cytometry technology using Sysmex XN-31, an automated haematology analyser, has been registered to support malaria diagnosis. The aim of this prospective, monocentric, non-interventional study was to evaluate the diagnostic accuracy of the XN-31 for the initial diagnosis or follow-up of imported malaria cases compared to the reference malaria tests including microscopy, loop mediated isothermal amplification, and rapid diagnostic tests. Over a one-year period, 357 blood samples were analysed, including 248 negative and 109 positive malaria samples. Compared to microscopy, XN-31 showed sensitivity of 100% (95% CI: 97.13–100) and specificity of 98.39% (95% CI: 95.56–100) for the initial diagnosis of imported malaria cases. Moreover, it provided accurate species identification asfalciparumor non-falciparumand parasitaemia determination in a very short time compared to other methods. We also demonstrated that XN-31 was a reliable method for patient follow-up on days 3, 7, and 28. Malaria diagnosis can be improved in non-endemic areas by the use of dedicated haematology analysers coupled with standard microscopy or other methods in development, such as artificial intelligence for blood slide reading. Given that XN-31 provided an accurate diagnosis in 1 min, it may reduce the time interval before treatment and thus improve the outcome of patient who have malaria.
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Affiliation(s)
- Stéphane Picot
- Service de Parasitologie et Mycologie Médicale, Groupement Hospitalier Nord, Hospices Civils de Lyon,69004 Lyon,France - Université de Lyon, Université Lyon 1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246,69100 Villeurbanne,France
| | - Thomas Perpoint
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon,69004 Lyon,France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon,69004 Lyon,France - CIRI Équipe PH3ID - INSERM - U1111- UCBL Lyon 1 - CNRS - UMR5308 - ENS de Lyon,69007 Lyon,France
| | - Alain Sigal
- Service d'accueil des urgences, Hôpital de la Croix-Rousse, Hospices Civils de Lyon,69004 Lyon,France
| | - Etienne Javouhey
- Service de Réanimation et Urgences Pédiatriques, Hôpital Femme-Mere-Enfant, Hospices Civils de Lyon,69500 Lyon,France
| | - Yves Gillet
- Service de Réanimation et Urgences Pédiatriques, Hôpital Femme-Mere-Enfant, Hospices Civils de Lyon,69500 Lyon,France
| | - Laurent Jacquin
- Service d'accueil des urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon,69008 Lyon,France
| | - Marion Douplat
- Service d'accueil des urgences, Hôpital Lyon Sud, Hospices Civils de Lyon,69310 Lyon,France - Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425,69008 Lyon,France
| | - Karim Tazarourte
- Service d'accueil des urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon,69008 Lyon,France - Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425,69008 Lyon,France
| | - Laurent Argaud
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation,69008 Lyon,France
| | - Martine Wallon
- Service de Parasitologie et Mycologie Médicale, Groupement Hospitalier Nord, Hospices Civils de Lyon,69004 Lyon,France
| | - Charline Miossec
- Service de Parasitologie et Mycologie Médicale, Groupement Hospitalier Nord, Hospices Civils de Lyon,69004 Lyon,France
| | - Guillaume Bonnot
- Université de Lyon, Université Lyon 1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246,69100 Villeurbanne,France
| | - Anne-Lise Bienvenu
- Université de Lyon, Université Lyon 1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246,69100 Villeurbanne,France - Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon,69004 Lyon,France
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12
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque AM, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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13
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Zeggagh J, Bauer R, Delaugerre C, Carette D, Fressard L, Charreau I, Chidiac C, Pialoux G, Tremblay C, Cua E, Robineau O, Raffi F, Capitant C, Spire B, Meyer L, Molina JM. Incidence and risk factors for recurrent sexually transmitted infections among men who have sex with men on HIV pre-exposure prophylaxis. AIDS 2022; 36:1129-1134. [PMID: 35142708 DOI: 10.1097/qad.0000000000003187] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High rates of sexually transmitted infections (STIs) have been reported among PrEP users. We wished to assess the incidence and risk factors for recurrent STIs. DESIGN The ANRS IPERGAY trial was a prospective study investigating PrEP among MSM and transgender women in outpatient clinics in France and Canada. In all, 429 participants were enrolled, offered up to four years of PrEP and screened for bacterial STIs (syphilis, chlamydia, and gonorrhea) at baseline and every 6 months. METHODS STIs incidence was calculated yearly. Cox proportional hazards model regression was used to explore associations between participants characteristics at baseline and recurrent STI during follow-up. RESULTS Over a median follow-up of 23 months, bacterial STI incidence was 75, 33, 13, 32 and 30 per 100 person-years (PY) for all STIs, rectal STIs, syphilis, gonorrhoea and chlamydia, respectively. STI incidence significantly increased from the first year to the fourth year of the study (55 vs. 90 per 100 PY, p < 0.001). During the study period, 167 participants (39%) presented with more than one bacterial STIs which accounted for 86% of all STIs. Baseline risk factors associated with recurrent STIs in a multivariate analysis were an STI at baseline (HR: 1.48 (95% CI: 1.06-2.07, p = 0.02), more than 8 sexual partners in prior 2 months (HR: 1.72 (95% CI: 1.21-2.43, p = 0.002), and the use of GHB (HR: 1.66 (95% CI: 1.16-2.38, p = 0.005). CONCLUSIONS STI incidence was high and increased over time. Most STIs were concentrated in a high-risk group that should be targeted for future interventions.
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14
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Gras J, Pillet M, Antoni G, Cua E, Charreau I, Raffi F, Chidiac C, Chas J, Tremblay C, Spire B, Delaugerre C, Meyer L, Molina JM. Risk factors for HIV infection among men who have sex with men in the ANRS IPERGAY PrEP trial. Sex Transm Infect 2021; 98:383-386. [PMID: 34663696 DOI: 10.1136/sextrans-2021-055199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/18/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We aimed to assess among men who have sex with men (MSM) risk factors for HIV infection, to identify those who require urgent pre-exposure prophylaxis (PrEP) prescription. METHODS All participants enrolled in the placebo arm of the ANRS IPERGAY trial, or infected between screening and day 0, were included. Baseline characteristics were described and HIV incidence rate ratios (RRs) were estimated with their 95% CIs. RESULTS 203 MSM were included with a median follow-up of 9 months. During the study period, 16 participants acquired HIV infection while not receiving tenofovir disoproxil and emtricitabin (TDF/FTC) over 212.4 person-years (PYs) of follow-up (incidence rate 7.5/100 PYs, 95% CI: 4.3 to 12.2). Being enrolled in Paris was associated with a significant increased risk of HIV infection (RR: 4.1; 95% CI: 1.1 to 28.3). A high number of sexual partners in prior 2 months (≥10 vs <5) and of condomless receptive anal sex episodes in prior 12 months (>5 vs <5) were strong predictors for HIV acquisition (RR: 10.6 (2 to 260.2) and 3.3 (1.2 to 10.2), respectively). Those who reported more often or only receptive sexual practices were also at increased risk (RR: 9.8 (2.0 to 246.6)). The use of recreational drugs in prior 12 months, especially gamma hydroxybutarate/gamma butyrolactone (RR: 5.9; 95% CI: 2 to 21.7), was associated with a significantly increased risk of HIV acquisition even after adjustment for sexual practices. CONCLUSIONS MSM who have frequent condomless receptive anal sex and multiple partners, or use recreational drugs should be targeted in priority for PrEP prescription especially if they live in an area with a high prevalence of HIV infection.
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Affiliation(s)
- Julien Gras
- Infectious Diseases Department, Saint-Louis Hospital, Paris, France .,INSERM U944 « Biology of Emerging Viruses » team, Saint Louis Research Institute, Paris, France
| | | | | | - Eric Cua
- Department of Infectious Diseases, CHU Nice, Nice, France
| | | | - F Raffi
- Infectious Diseases Department, CHU Nantes, Nantes, France
| | | | - Julie Chas
- Infectious Diseases Department, Tenon Hospital, Paris, France
| | - Cécile Tremblay
- Microbiology, Montreal Sacre-Coeur Hospital, Montreal, Quebec, Canada
| | - Bruno Spire
- INSERM UMR 912 SESSTIM, Aix-Marseille University, Marseille, France
| | - Constance Delaugerre
- INSERM U944 « Biology of Emerging Viruses » team, Saint Louis Research Institute, Paris, France.,Virology Department, Saint-Louis Hospital, Paris, France
| | | | - Jean-Michel Molina
- Infectious Diseases Department, Saint-Louis Hospital, Paris, France.,INSERM U944 « Biology of Emerging Viruses » team, Saint Louis Research Institute, Paris, France
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15
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Pozzetto B, Leparc-Goffard I, Laperche S, Chidiac C. [Gestion of arboviral alerts: Experience feedback from the Secproch working group of the French "Haut Conseil de la santé publique" (2019-2021)]. Transfus Clin Biol 2021; 28:334-343. [PMID: 34562626 DOI: 10.1016/j.tracli.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Secproch working group (for "sécurité des produits issus du corps humain") was created in 2019 within the « Haut Conseil de la santé publique » (HCSP) for addressing all the questions related to labile blood products, organs, tissues, cells (OTC) and gametes issued from human body. It is notably in charge of the management of alerts regarding arbovirus infections. These infections due to arthropod-transmitted viruses are responsible for emergence and reemergence, notably in the context of global warming. This review relates the alerts taken into consideration by the Secproch group between 2019 and 2021 following three pathologies due to Flaviviridae : dengue, West Nile virus (WNV) infection and tick-borne encephalitis (TBE). The dengue alerts have occurred in French Indies where the virus is endemic/epidemic, Reunion Island where the population was naïve until 2018 towards the virus, and the metropole where foci of autochthonous cases are observed sporadically. The WNV infection was responsible of both human and equine cases in 2019 in the South of France but with intensity much less than in 2018. At last, the TBE virus was at the origin of a cluster of about 40 cases in the Ain department following a contamination by crude non-pasteurized goat cheese. This review offers the opportunity to reevaluate the risks linked to these three viruses through blood products and organs/tissues/cells and to precise the means recommended by HCSP to secure these products.
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Affiliation(s)
- B Pozzetto
- Service des agents infectieux et d'hygiène, CHU de Saint-Étienne, Saint-Étienne, France.
| | - I Leparc-Goffard
- Centre national de référence des Arbovirus, Institut de recherche biomédicale des armées, Marseille, France
| | - S Laperche
- Institut national de transfusion sanguine, Paris, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, CHU de Lyon, Lyon, France
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16
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Pham TT, Mabrut E, Cochard P, Chardon P, Serrier H, Valour F, Huot L, Tod M, Leboucher G, Chidiac C, Ferry T. Cost of off-label antibiotic therapy for bone and joint infections: a 6-year prospective monocentric observational cohort study in a referral centre for management of complex osteo-articular infections. J Bone Jt Infect 2021; 6:337-346. [PMID: 34513571 PMCID: PMC8428084 DOI: 10.5194/jbji-6-337-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction:
Costs related to bone and joint infection (BJI) management are increasing
worldwide, particularly due to the growing use of off-label antibiotics that are expensive treatments (ETs), in conjunction with increasing incidence of multi-drug-resistant pathogens. The aim of this study was to evaluate the whole costs related to these treatments during the patient route, including those attributed to the rehabilitation centre (RC) stay in one regional referral centre in France. The total annual cost of ETs for managing complex BJIs in France was then estimated. Material and methods:
A prospective monocentric observational study was conducted from 2014 to 2019 in a referral centre for BJI management (CRIOAc – Centre de Référence des Infections OstéoArticulaires complexes). Costs related to expensive treatments (“old” ETs, i.e. ceftaroline, ertapenem, daptomycin, colistin, tigecycline, and linezolid and “new” ETs, defined as those used since 2017, including ceftobiprole, ceftazidime-avibactam, ceftolozane-tazobactam, tedizolid, and dalbavancin) were prospectively recorded. In all cases, the use of these ETs was validated during multidisciplinary meetings. Results:
Of the 3219 patients treated, 1682 (52.3 %) received at least one ET, and 21.5 % of patients who received ET were managed in RCs. The overall cost of ETs remained high but stable (EUR 1 033 610 in 2014; EUR 1 129 862 in 2019), despite the increase of patients treated by ETs (from 182 in 2014 to 512 in 2019) and in the cumulative days of treatment (9739 to 16 191 d). Daptomycin was the most prescribed molecule (46.2 % of patients in 2014 and 56.8 % in 2019, with 53.8 % overall), but its cost has decreased since this molecule was genericized in 2018; the same trend was observed for linezolid. Thus, costs for old ETs decreased overall, from EUR 1 033 610 in 2014 to EUR 604 997 in 2019, but global costs remained stable due to new ET utilization accounting for 46.5 % of overall costs in 2019. Tedizolid, used as suppressive antimicrobial therapy, represented 77.5 % of total new ET costs. In our centre, dalbavancin was never used. The cost paid by RCs for ETs and the duration of ET remained stable overall between 2016 and 2019. Conclusions:
A high consumption of off-label ET is required to treat patients with BJIs in a CRIOAc, and the consequence is a high cost of antimicrobial therapy for these patients, estimated to be almost EUR 10 million in France annually. Costs associated with ET utilization remained stable over the years. On the one hand, the introduction of the generic drugs of daptomycin and linezolid has significantly decreased the share of old ETs, but, on the other hand, the need for new ETs to treat infections associated with more resistant pathogens has not led to decrease in the overall costs. A drastic price reduction of generic drugs is essential to limit the costs associated with more complex BJIs.
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Affiliation(s)
- Truong-Thanh Pham
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Eugénie Mabrut
- French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France
| | - Philippe Cochard
- Hauteville Public Hospital Centre, 01110 Hauteville-Lompnes, France
| | - Paul Chardon
- Val Rosay Rehabilitation Centre, 69370 Saint-Didier-Au-Mont-d'Or, France
| | - Hassan Serrier
- Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France.,Cellule Innovation, Département de la Recherche Clinique et de l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
| | - Florent Valour
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
| | - Laure Huot
- Pôle de Santé publique, Hospices Civils de Lyon, 69003 Lyon, France.,Cellule Innovation, Département de la Recherche Clinique et de l'innovation, Hospices Civils de Lyon, 69003 Lyon, France
| | - Michel Tod
- Service de Pharmacie, Hospices Civils de Lyon, Lyon, France
| | | | - Christian Chidiac
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
| | - Tristan Ferry
- Infectious Diseases Department, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France.,French Referral Centre for complex Bone and Joint Infections, CRIOAc Lyon, 69000 Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France
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17
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Perpoint T, Valour F, Ferry T, Arcuset C, Grisi B, Jaconelli M, Soupart D, Verhaeghe L, Chidiac C, Ader F. Conception et construction d’un bâtiment dédié aux maladies infectieuses et tropicales : huit années de travail concerté pour obtenir une structure innovante et modulable en fonction du risque épidémique. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Triffault-Fillit C, Mabrut E, Corbin K, Braun E, Becker A, Goutelle S, Chaudier P, Fessy MH, Dupieux C, Laurent F, Gunst S, Lustig S, Chidiac C, Ferry T, Valour F. Tolerance and microbiological efficacy of cefepime or piperacillin/tazobactam in combination with vancomycin as empirical antimicrobial therapy of prosthetic joint infection: a propensity-matched cohort study. J Antimicrob Chemother 2021; 75:2299-2306. [PMID: 32407512 DOI: 10.1093/jac/dkaa166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The use of piperacillin/tazobactam with vancomycin as empirical antimicrobial therapy (EAT) for prosthetic joint infection (PJI) has been associated with an increased risk of acute kidney injury (AKI), leading us to propose cefepime as an alternative since 2017 in our reference centre. OBJECTIVES To compare microbiological efficacy and tolerance of these two EAT strategies. METHODS All adult patients with PJI empirically treated with vancomycin+cefepime (n = 89) were enrolled in a prospective observational study and matched with vancomycin+piperacillin/tazobactam-treated historical controls (n = 89) according to a propensity score including age, baseline renal function and concomitant use of other nephrotoxic agents. The two groups were compared using Kaplan-Meier curve analysis, and non-parametric tests regarding the proportion of efficacious empirical regimen and the incidence of empirical therapy-related adverse events (AE). RESULTS Among 146 (82.0%) documented infections, the EAT was considered efficacious in 77 (98.7%) and 65 (98.5%) of the piperacillin/tazobactam- and cefepime-treated patients, respectively (P = 1.000). The rate of AE, particularly AKI, was significantly higher in the vancomycin+piperacillin/tazobactam group [n = 27 (30.3%) for all AE and 23 (25.8%) for AKI] compared with the vancomycin+cefepime [n = 13 (14.6%) and 6 (6.7%)] group (P = 0.019 and <0.001, respectively), leading to premature EAT discontinuation in 20 (22.5%) and 5 (5.6%) patients (P = 0.002). The two groups were not significantly different regarding their comorbidities, and AKI incidence was not related to vancomycin plasma overexposure. CONCLUSIONS Based on the susceptibility profile of bacterial isolates from included patients, microbiological efficacy of both strategies was expected to be similar, but vancomycin + cefepime was associated with a significantly lower incidence of AKI.
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Affiliation(s)
- C Triffault-Fillit
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - E Mabrut
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - K Corbin
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - E Braun
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - A Becker
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - S Goutelle
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service pharmaceutique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, ISPB Faculté de Pharmacie de Lyon, UMR CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, Lyon, France
| | - P Chaudier
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - M H Fessy
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - C Dupieux
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France.,Institut des agents infectieux, Laboratoire de bactériologie, Centre National de référence des staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - F Laurent
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France.,Institut des agents infectieux, Laboratoire de bactériologie, Centre National de référence des staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Gunst
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Lustig
- Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Service de chirurgie orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - T Ferry
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France
| | - F Valour
- Service des maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre interrégional de référence pour la prise en charge des infections ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI-Centre International de Recherche en Infectiologie, Inserm, U1111, Université´ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, F-69007, Lyon, France
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19
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Ferry T, Batailler C, Souche A, Cassino C, Chidiac C, Perpoint T, le Corvaisier C, Josse J, Gaillard R, Roger J, Kolenda C, Lustig S, Laurent F. Arthroscopic "Debridement and Implant Retention" With Local Administration of Exebacase (Lysin CF-301) Followed by Suppressive Tedizolid as Salvage Therapy in Elderly Patients for Relapsing Multidrug-Resistant S. epidermidis Prosthetic Knee Infection. Front Med (Lausanne) 2021; 8:550853. [PMID: 34055817 PMCID: PMC8163228 DOI: 10.3389/fmed.2021.550853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Exebacase, a recombinantly produced lysin has recently (i) reported proof-of-concept data from a phase II study in S. aureus bacteremia and (ii) demonstrated antibiofilm activity in vitro against S. epidermidis. In patients with relapsing multidrug-resistant (MDR) S. epidermidis prosthetic knee infection (PKI), the only surgical option is prosthesis exchange. In elderly patients who have undergone several revisions, prosthesis explantation could be associated with definitive loss of function and mortality. In our BJI reference regional center, arthroscopic debridement and implant retention with local administration of exebacase (LysinDAIR) followed by suppressive tedizolid as salvage therapy is proposed for elderly patients with recurrent MDR S. epidermidis PKI with no therapeutic option or therapeutic dead end (for whom revision or transfemoral amputation is not feasible and no other oral option is available). Each use was decided in agreement with the French health authority and in accordance with the local ethics committee. A written consent was obtained for each patient. Exebacase (75 mg/mL; 30 mL) was administered directly into the joint during arthroscopy. Four patients (79-89 years old) were treated with the LysinDAIR procedure. All had several previous prosthetic knee revisions without prosthesis loosening. Three had relapsing PKI despite suppressive antibiotics following open DAIR. Two had clinical signs of septic arthritis; the two others had sinus tract. After the LysinDAIR procedure, no adverse events occurred during arthroscopy; all patients received daptomycin 8 mg/kg and linezolid 600 mg bid (4-6 weeks) as primary therapy, followed by tedizolid 200 mg/day as suppressive therapy. At 6 months, recurrence of the sinus tract occurred in the two patients with sinus tract at baseline. After >1 year follow up, the clinical outcome was favorable in the last two patients with total disappearance of clinical signs of septic arthritis even if microbiological persistence was detected in one of them. Exebacase has the potential to be used in patients with staphylococci PKI during arthroscopic DAIR as salvage therapy to improve the efficacy of suppressive antibiotics and to prevent major loss of function.
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Affiliation(s)
- Tristan Ferry
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Cécile Batailler
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Aubin Souche
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de Bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Cara Cassino
- ContraFect Corporation, Yonkers, NY, United States
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Thomas Perpoint
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | | | - Jérôme Josse
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de Bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Romain Gaillard
- Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Julien Roger
- Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Camille Kolenda
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de Bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence Pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de Bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
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20
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Cotte L, Veyer D, Charreau I, Péré H, Cua E, Carette D, Chas J, Capitant C, Chidiac C, Fléjou JF, Fouéré S, Heard I, Meyer L, Puech J, Tremblay C, Delaugerre C, Molina JM. Prevalence and Incidence of Human Papillomavirus Infection in Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study: A Sub-study of the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" Trial. Clin Infect Dis 2021; 72:41-49. [PMID: 31907521 DOI: 10.1093/cid/ciaa002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/06/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is more frequent in men having sex with men (MSM) who are living with human immunodeficiency virus (HIV) than in MSM without HIV. There are currently no data regarding HPV infections in preexposure prophylaxis (PrEP)-using MSM. METHODS MSM living without HIV who were enrolled in the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales "Intervention Préventive de l'Exposition aux Risques avec et pour les hommes Gays" PrEP study were prospectively enrolled. Anal, penile, and oral samples were collected at baseline and every 6 months for HPV detection and genotyping. Anal swabs for cytology were obtained at baseline and at 24 months. RESULTS We enrolled 162 participants. The prevalences of any HPV genotypes at baseline were 92%, 32%, and 12% at the anal, penile, and oral sites, respectively. High-risk (HR) HPV genotypes were observed in 84%, 25%, and 10% of anal, penile, and oral baseline samples, respectively. Nonavalent HPV vaccine genotypes were observed in 77%, 22%, and 6% of anal, penile, and oral baseline samples, respectively. Multiple infections were observed in 76%, 17%, and 3% of cases at the anal, penile, and oral sites, respectively. The most frequent HR genotypes were HPV 53, 51, and 16 in anal samples; HPV 33, 39, and 73 in penile samples; and HPV 66 in oral samples. The incidence of any HPV genotype at the anal site was 86.2/1000 person-months and the incidence of HR-HPV genotypes was 72.3/1000 person-months. The baseline cytology was normal in 32% of cases and was classified as atypical squamous cells of undetermined significance, low-grade squamous intra-epithelial lesion, high-grade squamous intra-epithelial lesion (HSIL), and atypical squamous cells that cannot exclude HSIL in 23%, 40%, 5%, and 1% of cases, respectively. CONCLUSIONS PrEP users have a similar risk of HPV infection as MSM living with HIV and the risk is much higher than that previously reported in MSM living without HIV.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Institut National de la Santé et de la Recherche Médicale, Unité 1052, Lyon, France
| | - David Veyer
- Department of Virology, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Isabelle Charreau
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Hélène Péré
- Department of Virology, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Unité 970, Paris Centre de Recherche Cardiovasculaire, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Eric Cua
- Department of Infectious Diseases, Hôpital L'Archet, Nice, France
| | - Diane Carette
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Julie Chas
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Catherine Capitant
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France
| | - Christian Chidiac
- Department of Infectious Diseases, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Université Claude Bernard - Lyon 1, Lyon, France
| | - Jean-François Fléjou
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.,Sorbonne Université, Paris, France
| | - Sébastien Fouéré
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Isabelle Heard
- French Human Papillomavirus Reference Laboratory, Institut Pasteur, Paris, France.,Department of Endocrinology and Reproductive Medicine, Institut Endocrinologie, Maladies Métaboliques et Médecine Interne, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Laurence Meyer
- Institut National de la Santé et de la Recherche Médicale, Service Commun 10, Unité de Service 19, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Epidémiologie et Santé Publique, Unité 1018, Université Paris Sud, Paris Saclay, Le Kremlin-Bicêtre, France.,Department of Public Health, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Universitaire Paris Sud, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julien Puech
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 839, Institut du Fer à Moulin, Sorbonne Université, Paris, France
| | - Cécile Tremblay
- Département de Microbiologie, Infectiologie, et Immunologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Constance Delaugerre
- Department of Virology, Centre National de Référence du Virus de l'Immunodéficience Humaine , Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France.,Institut National de la Santé et de la Recherche Médicale, Unité 944, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7212, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France
| | - Jean-Michel Molina
- Institut National de la Santé et de la Recherche Médicale, Unité 944, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7212, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France.,Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
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21
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Alfaiate D, Giaché S, Pradat P, Cotte L, Chidiac C. Sexually transmitted infections knowledge in different populations attending a French University Hospital - A prospective observational study. Epidemiol Infect 2021; 149:1-18. [PMID: 33880990 PMCID: PMC8193766 DOI: 10.1017/s0950268821000881] [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] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/03/2022] Open
Abstract
We conducted a prospective study about sexually transmitted infections (STIs) knowledge in different populations attending Lyon's University Hospitals in order to estimate awareness on STIs. Pre-exposure prophylaxis (PrEP)-users (PrEP group), persons living with HIV (PLWH group) and persons undergoing free STI screening (screening group) filled an anonymous questionnaire evaluating STI knowledge. A composite STI knowledge score was calculated and was correlated with patients’ characteristics. A total of 756 patients were enrolled in three groups: screening (n = 509), PrEP (n = 103) and PLWH (n = 144). STI transmission knowledge was better for HIV than for other STIs. The median STI knowledge score was significantly higher in PrEP-users than in the screening and PLWH groups. PrEP use and a previous STI diagnosis were independently associated with a higher score. PrEP-users have better STI knowledge than PLWH and persons undergoing free STI screening. Sexual health promotion interventions routinely reserved to PrEP-users in France seem to be effective in raising the awareness of this group for STIs. Continuous efforts are justified for PLWH and the younger layers of the population.
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Affiliation(s)
- Dulce Alfaiate
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Susanna Giaché
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional Orléans La Source, Orléans, France
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Laurent Cotte
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
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22
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Néant N, Lingas G, Le Hingrat Q, Ghosn J, Engelmann I, Lepiller Q, Gaymard A, Ferré V, Hartard C, Plantier JC, Thibault V, Marlet J, Montes B, Bouiller K, Lescure FX, Timsit JF, Faure E, Poissy J, Chidiac C, Raffi F, Kimmoun A, Etienne M, Richard JC, Tattevin P, Garot D, Le Moing V, Bachelet D, Tardivon C, Duval X, Yazdanpanah Y, Mentré F, Laouénan C, Visseaux B, Guedj J. Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort. Proc Natl Acad Sci U S A 2021; 118:e2017962118. [PMID: 33536313 PMCID: PMC7929555 DOI: 10.1073/pnas.2017962118] [Citation(s) in RCA: 135] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The characterization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral kinetics in hospitalized patients and its association with mortality is unknown. We analyzed death and nasopharyngeal viral kinetics in 655 hospitalized patients from the prospective French COVID cohort. The model predicted a median peak viral load that coincided with symptom onset. Patients with age ≥65 y had a smaller loss rate of infected cells, leading to a delayed median time to viral clearance occurring 16 d after symptom onset as compared to 13 d in younger patients (P < 10-4). In multivariate analysis, the risk factors associated with mortality were age ≥65 y, male gender, and presence of chronic pulmonary disease (hazard ratio [HR] > 2.0). Using a joint model, viral dynamics after hospital admission was an independent predictor of mortality (HR = 1.31, P < 10-3). Finally, we used our model to simulate the effects of effective pharmacological interventions on time to viral clearance and mortality. A treatment able to reduce viral production by 90% upon hospital admission would shorten the time to viral clearance by 2.0 and 2.9 d in patients of age <65 y and ≥65 y, respectively. Assuming that the association between viral dynamics and mortality would remain similar to that observed in our population, this could translate into a reduction of mortality from 19 to 14% in patients of age ≥65 y with risk factors. Our results show that viral dynamics is associated with mortality in hospitalized patients. Strategies aiming to reduce viral load could have an effect on mortality rate in this population.
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Affiliation(s)
- Nadège Néant
- Université de Paris, INSERM, IAME, F-75018 Paris, France;
| | | | - Quentin Le Hingrat
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Jade Ghosn
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Ilka Engelmann
- Univ. Lille, Virology Laboratory, EA3610, Institute of Microbiology, Centre Hospitalier-Universitaire de Lille, F-59037 Lille Cedex, France
| | - Quentin Lepiller
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Besançon, F-25000 Besançon, France
| | - Alexandre Gaymard
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, F-69004 Lyon, France
- Centre National de Référence des Virus Respiratoires, Hospices Civils de Lyon, Groupement Hospitalier Nord, F-69004 Lyon, France
| | - Virginie Ferré
- Service de Virologie, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
| | - Cédric Hartard
- Laboratoire de Microbiologie, Centre Hospitalier-Universitaire de Nancy, F-54000 Nancy, France
- Université de Lorraine, CNRS, Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, F-54000 Nancy, France
| | - Jean-Christophe Plantier
- Normandie University, UNIROUEN Rouen, EA2656, Virology, Rouen University Hospital, F-76000 Rouen, France
| | - Vincent Thibault
- Virology, Pontchaillou University Hospital, F-35033 Rennes cedex, France
| | - Julien Marlet
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Bretonneau, F-37044 Tours, France
- INSERM UMR 1259, Université de Tours, F-37044 Tours, France
| | - Brigitte Montes
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Montpellier, F-34295 Montpellier, France
| | - Kevin Bouiller
- Infectious and Tropical Disease Department, Besancon University Hospital, F-25000 Besancon, France
- UMR CNRS 6249, Chrono Environnement, University of Bourgogne Franche-Comté, F-25000 Besancon, France
| | - François-Xavier Lescure
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Jean-François Timsit
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Service de Réanimation Médicale et Infectieuse, F-75018 Paris, France
| | - Emmanuel Faure
- Centre Hospitalier-Universitaire de Lille, Univ. Lille, Infectious Disease Department, CNRS, Inserm, U1019-UMR9017-CIIL, F-59000 Lille, France
| | - Julien Poissy
- Université de Lille, INSERM U1285, Centre Hospitalier-Universitaire de Lille, Pôle de réanimation, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Christian Chidiac
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, F-69004 Lyon, France
| | - François Raffi
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
- Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
| | - Antoine Kimmoun
- Université de Lorraine, Centre Hospitalier Régional Universitaire de Nancy, INSERM U1116, F-CRIN INICRCT, Service de Médecine Intensive et Réanimation Brabois, F-54000 Nancy, France
| | - Manuel Etienne
- Infectious Diseases Department, Rouen University Hospital, F-76000 Rouen, France
| | - Jean-Christophe Richard
- Lyon University, CREATIS, CNRS UMR5220, INSERM U1044, INSA, F-69000 Lyon, France
- Intensive Care Unit, Hospices Civils de Lyon, F-69002 Lyon, France
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, F-35000 Rennes, France
| | - Denis Garot
- Centre Hospitalier Régional Universitaire de Tours, Service de Médecine Intensive Réanimation, F-37044 Tours Cedex 9, France
| | - Vincent Le Moing
- Tropical and Infectious Diseases, Saint Eloi Hospital, Université de Montpellier, Medical School, Montpellier University Hospital, F-34295 Montpellier Cedex 5, France
| | - Delphine Bachelet
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Coralie Tardivon
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Xavier Duval
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, INSERM CIC-1425, F-75018 Paris, France
| | - Yazdan Yazdanpanah
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - France Mentré
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Cédric Laouénan
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Benoit Visseaux
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Jérémie Guedj
- Université de Paris, INSERM, IAME, F-75018 Paris, France
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23
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Landre S, Bienvenu AL, Miailhes P, Abraham P, Simon M, Becker A, Conrad A, Bonnot G, Kouakou YI, Chidiac C, Leboucher G, Rimmelé T, Argaud L, Picot S. Recrudescence of a high parasitaemia, severe Plasmodium falciparum malaria episode, treated by artesunate monotherapy. Int J Infect Dis 2021; 105:345-348. [PMID: 33636354 DOI: 10.1016/j.ijid.2021.02.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022] Open
Abstract
A patient presenting with severe malaria, with hyperparasitaemia, received 7-day artesunate monotherapy. A severe recrudescence was detected and attributed to hyperparasitaemia, monotherapy and a polyclonal infection without Kelch 13 gene mutation. A second treatment with artesunate, then quinine, followed by artemether-lumefantrine, was successful.
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Affiliation(s)
- Sophie Landre
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Anne-Lise Bienvenu
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
| | - Patrick Miailhes
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Paul Abraham
- Anesthesiology and Critical Care Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Marie Simon
- Service de Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03, France
| | - Agathe Becker
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Anne Conrad
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Guillaume Bonnot
- Univ Lyon, Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, 69100 Villeurbanne, France
| | - Yobouet Ines Kouakou
- Univ Lyon, Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, 69100 Villeurbanne, France; Institute of Parasitology and Medical Mycology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| | - Gilles Leboucher
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
| | - Thomas Rimmelé
- Anesthesiology and Critical Care Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Laurent Argaud
- Service de Médecine Intensive-Réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69437 Lyon Cedex 03, France
| | - Stephane Picot
- Univ Lyon, Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, 69100 Villeurbanne, France; Institute of Parasitology and Medical Mycology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France.
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24
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Chauvelot P, Ferry T, Tafani V, Diot A, Tasse J, Conrad A, Chidiac C, Braun E, Lustig S, Laurent F, Valour F. Bone and Joint Infection Involving Corynebacterium spp.: From Clinical Features to Pathophysiological Pathways. Front Med (Lausanne) 2021; 7:539501. [PMID: 33585497 PMCID: PMC7873945 DOI: 10.3389/fmed.2020.539501] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/22/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction: Corynebacteria represent often-neglected etiological agents of post-traumatic and/or post-operative bone and joint infection (BJI). We describe here clinical characteristics and bacteriological determinants of this condition. Methods: A retrospective cohort study described characteristics, outcome and determinants of treatment failure of all patients with proven Corynebacterium spp. BJI (i.e., ≥2 culture-positive gold-standard samples). Available strains were further characterized regarding their antibiotic susceptibilies, abilities to form early (BioFilm Ring Test®) and mature (crystal violet staining method) biofilms and to invade osteoblasts (gentamicin protection assay). Results: The 51 included BJI were mostly chronic (88.2%), orthopedic device-related (74.5%) and polymicrobial (78.4%). After a follow-up of 60.7 weeks (IQR, 30.1-115.1), 20 (39.2%) treatment failures were observed, including 4 Corynebacterium-documented relapses, mostly associated with non-optimal surgical management (OR 7.291; p = 0.039). Internalization rate within MG63 human osteoblasts was higher for strains isolated from delayed (>3 months) BJI (p < 0.001). Infection of murine osteoblasts deleted for the β1-integrin resulted in a drastic reduction in the internalization rate. No difference was observed regarding biofilm formation. Conclusions: Surgical management plays a crucial role in outcome of BJI involving corynebacteria, as often chronic and device-associated infections. Sanctuarisation within osteoblasts, implicating the β1 cellular integrin, may represent a pivotal virulence factor associated with BJI chronicity.
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Affiliation(s)
- Pierre Chauvelot
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Tristan Ferry
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Virginie Tafani
- International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Alan Diot
- International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Jason Tasse
- International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France.,BioFilm Control, Saint-Beauzire, France
| | - Anne Conrad
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Christian Chidiac
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
| | - Evelyne Braun
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,Orthopedic Surgery Unit, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France.,Laboratory of bacteriology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- Departement of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc), Hospices Civils de Lyon, Lyon, France.,International Centre for Research in Infectiology, INSERM U1111, Claude Bernard Lyon 1 University, Lyon, France
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25
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Voirin N, Allam C, Charre C, Fernandez C, Godinot M, Oria F, Pansu A, Chidiac C, Salord H, Cotte L. Optimizing Strategies for Chlamydia trachomatis and Neisseria gonorrhoeae Screening in Men Who Have Sex With Men: A Modeling Study. Clin Infect Dis 2021; 70:1966-1972. [PMID: 31198933 DOI: 10.1093/cid/ciz510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/13/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND International guidelines recommend the systematic screening for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections in all men who have sex with men (MSM) who have engaged in unprotected sex. However, the optimal screening strategy remains unclear. We developed a modeling approach to optimize NG/CT screening strategy in MSM. METHODS A compartmental model of NG/CT screening and infection was implemented. NG/CT anal, pharyngeal, and urine (APU) samples from MSM attending the sexually transmitted infections clinic were used to estimate the screening rate, prevalence, and incidence in a base case scenario. Different screening strategies (scenarios; S) were then evaluated: APU samples every 12 months (S1); APU samples every 3 months (S2); APU samples every 6 months (S3); anal and pharyngeal (AP) samples every 6 months (S4); and AP samples every 3 months (S5). RESULTS We analyzed 2973 triplet APU samples from 1255 patients. We observed 485 NG and 379 CT diagnoses. NG/CT prevalence and incidence estimates were 12.0/11.1% and 40/29 per 100 person-years, respectively, in the base case scenario. As compared to S2, the reference strategy, the proportions of missed NG/CT diagnoses were 42.0/41.2% with S1, 21.8/22.5% with S3, 25.6/28.3% with S4, and 6.3/10.5% with S5, respectively. As compared to S2, S1 reduced the cost of the analysis by 74%, S3 by 50%, S4 by 66%, and S5 by 33%. The numbers needed to screen for catching up the missed NG/CT diagnoses were 49/67 with S1, 62/82 with S3, 71/87 with S4, and 143/118 with S5. CONCLUSIONS S5 appears to be the best strategy, missing only 6.3/10.5% of NG/CT diagnoses, for a cost reduction of 33%.
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Affiliation(s)
- Nicolas Voirin
- EPIdemiology and MODelling of Infectious Diseases, Dompierre sur Veyle, Villeurbanne
| | - Camille Allam
- Bacteriology Laboratory, Hospices Civils de Lyon, Villeurbanne.,University of Lyon, Université Claude Bernard Lyon1, Villeurbanne.,Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Unité 1111, Centre National de la Recherche Scientifique, Unité Mixte de Recherche, Lyon, France
| | - Caroline Charre
- University of Lyon, Université Claude Bernard Lyon1, Villeurbanne.,Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Unité 1111, Centre National de la Recherche Scientifique, Unité Mixte de Recherche, Lyon, France.,Virology Laboratory, Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Christine Fernandez
- Centres Gratuits d'Information, de Dépistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Matthieu Godinot
- Centres Gratuits d'Information, de Dépistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Fatima Oria
- Centres Gratuits d'Information, de Dépistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Aymeric Pansu
- Centres Gratuits d'Information, de Dépistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Christian Chidiac
- University of Lyon, Université Claude Bernard Lyon1, Villeurbanne.,Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France
| | - Hélène Salord
- Bacteriology Laboratory, Hospices Civils de Lyon, Villeurbanne
| | - Laurent Cotte
- Centres Gratuits d'Information, de Dépistage et de Diagnostic Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.,Institut National de la Santé et de la Recherche Médicale, Lyon, France
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26
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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27
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Berçot B, Charreau I, Rousseau C, Delaugerre C, Chidiac C, Pialoux G, Capitant C, Bourgeois-Nicolaos N, Raffi F, Pereyre S, Le Roy C, Senneville E, Meyer L, Bébéar C, Molina JM. High Prevalence and High Rate of Antibiotic Resistance of Mycoplasma genitalium Infections in Men who Have Sex with Men. A Sub-Study of the ANRS Ipergay PrEP Trial. Clin Infect Dis 2020; 73:e2127-e2133. [PMID: 33305785 DOI: 10.1093/cid/ciaa1832] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Mycoplasma genitalium (MG) is an emerging pathogen among men who have sex with men (MSM) with raising rates of antibiotic resistance. In this study, we assessed the prevalence and incidence of MG infection in MSM enrolled in the open-label phase of the ANRS IPERGAY trial with on demand TDF/FTC for HIV prevention and the impact of doxycycline post-exposure prophylaxis (PEP). METHODS 210 subjects were tested at baseline and at 6 months by real-time PCR assays for MG detection in urine samples, oro-pharyngeal and anal swabs. Resistance to azithromycin (AZM), to fluoroquinolones (FQ) and to doxycycline were investigated in the French National Reference Centre of bacterial STI. RESULTS The all-site prevalence of MG at baseline was 10.5% [6.3% in urine samples, 4.3% in anal swabs and 0.5% in throat swabs] and remained unchanged at 6 months whether or not PEP was used: 9.9% overall, 10.2% with PEP and 9.6% without. The overall rate of MG resistance (prevalent and incident cases) to AZM and FQ was 67.6% and 9.1%, respectively, with no difference between arms. An in vivo mutation of the MG 16S rRNA which could be associated with tetracycline resistance was observed in 12.5% of specimens tested. CONCLUSIONS The prevalence of MG infection among MSM on PrEP was high and its incidence was not decreased by doxycycline prophylaxis with a similar high rate of AZM- and FQ-resistance, raising challenging issues for the treatment of this STI and supporting current recommendations to avoid testing or treatment of asymptomatic MG infection.
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Affiliation(s)
- Béatrice Berçot
- IAME, INSERM, Paris University; Associated Laboratory of the French National Center for Bacterial Sexually Transmitted Infections, Bacteriology Unit, St Louis Hospital, AP-HP, Paris, France
| | | | - Clotilde Rousseau
- IAME, INSERM, Paris University; Associated Laboratory of the French National Center for Bacterial Sexually Transmitted Infections, Bacteriology Unit, St Louis Hospital, AP-HP, Paris, France
| | - Constance Delaugerre
- INSERM UMR 941, Paris University, Virology Unit, Saint-Louis Hospital, APHP, Paris, France
| | - Christian Chidiac
- Department of Infectious Diseases, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Gilles Pialoux
- Department of Infectious Diseases, Hôpital Tenon, Paris, France
| | | | | | - François Raffi
- Department of Infectious Diseases, CHU Nantes and CIC 1413, INSERM, Nantes, France
| | - Sabine Pereyre
- Bacteriology Department, French National Center for Bacterial Sexually Transmitted Infections, CHU Bordeaux, and USC EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Chloé Le Roy
- Bacteriology Department, French National Center for Bacterial Sexually Transmitted Infections, CHU Bordeaux, and USC EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Eric Senneville
- Infectious Diseases Department, Gustave Dron Hospital, Tourcoing, France
| | - Laurence Meyer
- Inserm SC10-US19, Villejuif, France.,Paris Sud University, Paris Saclay, France
| | - Cécile Bébéar
- Bacteriology Department, French National Center for Bacterial Sexually Transmitted Infections, CHU Bordeaux, and USC EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Jean-Michel Molina
- INSERM UMR 941, Department of Infectious Diseases, University of Paris, Saint-Louis and Lariboisière Hospitals, APHP, Paris, France
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28
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Ferry T, Kolenda C, Batailler C, Gustave CA, Lustig S, Malatray M, Fevre C, Josse J, Petitjean C, Chidiac C, Leboucher G, Laurent F. Phage Therapy as Adjuvant to Conservative Surgery and Antibiotics to Salvage Patients With Relapsing S. aureus Prosthetic Knee Infection. Front Med (Lausanne) 2020; 7:570572. [PMID: 33304911 PMCID: PMC7701306 DOI: 10.3389/fmed.2020.570572] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: To report the management of three consecutive patients with relapsing Staphylococcus aureus prosthetic knee infection (PKI) for whom explantation was not feasible who received a phage therapy during a “Debridement Antibiotics and Implant Retention” (DAIR) procedure followed by suppressive antimicrobial therapy. Methods: Each case was discussed individually in our reference center and with the French National Agency (ANSM). The lytic activity of three phages targeting S. aureus, which was produced with a controlled and reproducible process, was assessed before surgery (phagogram). A hospital pharmacist extemporaneously assembled the phage cocktail (1 ml of 1 × 1010 PFU/ml for each phage) as “magistral” preparation (final dilution 1 × 109 PFU/ml), which was administered by the surgeon directly into the joint, after the DAIR procedure and joint closure (PhagoDAIR procedure). Results: Three elderly patients were treated with the PhagoDAIR procedure. Phagograms revealed a high susceptibility to at least two of the three phages. During surgery, all patients had poor local conditions including pus in contact to the implant. After a prolonged follow-up, mild discharge of synovial fluid persisted in two patients, for whom a subsequent DAIR was performed showing only mild synovial inflammation without bacterial persistence or super-infection. The outcome was finally favorable with a significant and impressive clinical improvement of the function. Conclusions: The PhagoDAIR procedure has the potential to be used as salvage for patients with relapsing S. aureus PKI, in combination with suppressive antibiotics to avoid considerable loss of function. This report provides preliminary data supporting the setup of a prospective multicentric clinical trial.
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Affiliation(s)
- Tristan Ferry
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Camille Kolenda
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Cécile Batailler
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Claude-Alexandre Gustave
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Matthieu Malatray
- Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service de Chirurgie Orthopédique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | - Jérôme Josse
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Gilles Leboucher
- Service de Pharmacie Hospitalière, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- Université Claude Bernard Lyon 1, Lyon, France.,Centre interrégional de Référence pour la prise en charge des Infections Ostéo-Articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.,Institut des Agents Infectieux, Laboratoire de bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
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29
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Di Ciaccio M, Sagaon-Teyssier L, Mimi M, Suzan-Monti M, Protiere C, Rojas Castro D, Meyer L, Tremblay C, Chidiac C, Capitant C, Préau M, Molina JM, Spire B. Changes in Sexual Behaviors in Men Who Have Sex with Men: A Comparison Between the Double-Blind and Open-Label Extension Phases of the ANRS-IPERGAY Trial. AIDS Behav 2020; 24:3093-3106. [PMID: 32306213 DOI: 10.1007/s10461-020-02864-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 12/17/2022]
Abstract
Pre-Exposure Prophylaxis (PrEP) is changing the landscape of HIV prevention, and may bring changes in sexual behaviors. The double-blind phase (DBP) and open-label extension (OLE) study of the ANRS-IPERGAY trial allowed us to assess changes in sexual behavior of men who have sex with men (MSM) taking sexual activity-based (i.e., on-demand) PrEP. Generalized Estimating Equation (GEE) models found a significant decrease in the number of sexual partners (Coefficient [CI95%], p value; - 0.37[- 0.70 to - 0.04], p = 0.03) between the DBP and OLE as well as in the number of sexual relations (- 0.25 [- 0.49 to 0.00], 0.04). GEE estimates also showed that respondents' most recent sexual relation was less likely to have been with an unknown casual partner during the OLE than during the DBP (Odds Ratio [CI95%], p value: 0.75[0.62-0.92], 0.005). Furthermore, they showed an increase in the proportion of condomless anal sex in the OLE (1.32[1.04-1.67], 0.02), a decrease in the proportion of 'suboptimal PrEP adherence' over time (0.75[0.58-0.97], p = 0.03), a decrease in PrEP only use (0.73[0.55-0.96], 0.03) and in both PrEP and condom use over time (0.70[0.51-0.95], 0.02) and finally, a decrease in alcohol consumption between the DBP and OLE (0.74[0.61-0.90], 0.002). We observed both protective and risky behaviors in terms of HIV and STI risk after on-demand PrEP uptake in the OLE phase. Our findings are consistent with results from previous PrEP trials.
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Affiliation(s)
- Marion Di Ciaccio
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France.
- Groupe de Recherche En Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France.
| | - Luis Sagaon-Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Mohamed Mimi
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marie Suzan-Monti
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Christel Protiere
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Daniela Rojas Castro
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Groupe de Recherche En Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
- AIDES (Mission Innovation Recherche Expérimentation), Pantin, France
- Coalition Internationale Sida, Pantin, France
| | | | - Cécile Tremblay
- Centre Hospitalier de l'Université de Montréal- Hôtel Dieu, Montréal, Canada
| | - Christian Chidiac
- Département Des Maladies Infectieuses, Hôpital de la Croix Rousse, Centre Hospitalier et Universitaire de Lyon, Lyon, France
| | - Catherine Capitant
- Département des maladies infectieuses, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot Paris 7, INSERM U941, Paris, France
| | - Marie Préau
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Groupe de Recherche En Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
| | - Jean Michel Molina
- Département des maladies infectieuses, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Université de Paris Diderot Paris 7, INSERM U941, Paris, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Shapiro JT, Leboucher G, Myard-Dury AF, Girardo P, Luzzati A, Mary M, Sauzon JF, Lafay B, Dauwalder O, Laurent F, Lina G, Chidiac C, Couray-Targe S, Vandenesch F, Flandrois JP, Rasigade JP. Metapopulation ecology links antibiotic resistance, consumption, and patient transfers in a network of hospital wards. eLife 2020; 9:54795. [PMID: 33106223 PMCID: PMC7690951 DOI: 10.7554/elife.54795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global threat. A better understanding of how antibiotic use and between-ward patient transfers (or connectivity) impact population-level AMR in hospital networks can help optimize antibiotic stewardship and infection control strategies. Here, we used a metapopulation framework to explain variations in the incidence of infections caused by seven major bacterial species and their drug-resistant variants in a network of 357 hospital wards. We found that ward-level antibiotic consumption volume had a stronger influence on the incidence of the more resistant pathogens, while connectivity had the most influence on hospital-endemic species and carbapenem-resistant pathogens. Piperacillin-tazobactam consumption was the strongest predictor of the cumulative incidence of infections resistant to empirical sepsis therapy. Our data provide evidence that both antibiotic use and connectivity measurably influence hospital AMR. Finally, we provide a ranking of key antibiotics by their estimated population-level impact on AMR that might help inform antimicrobial stewardship strategies.
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Affiliation(s)
- Julie Teresa Shapiro
- CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Lyon, France
| | | | - Anne-Florence Myard-Dury
- Pôle de Santé Publique, Département d'Information Médicale, Hospices Civils de Lyon, Lyon, France
| | - Pascale Girardo
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Anatole Luzzati
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Mélissa Mary
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | | | - Bénédicte Lafay
- Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, University of Lyon, Lyon, France
| | - Olivier Dauwalder
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Gerard Lina
- CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
| | - Sandrine Couray-Targe
- Pôle de Santé Publique, Département d'Information Médicale, Hospices Civils de Lyon, Lyon, France
| | - François Vandenesch
- CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Jean-Pierre Flandrois
- Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, University of Lyon, Lyon, France
| | - Jean-Philippe Rasigade
- CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308, Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
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31
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Cerioli M, Batailler C, Conrad A, Roux S, Perpoint T, Becker A, Triffault-Fillit C, Lustig S, Fessy MH, Laurent F, Valour F, Chidiac C, Ferry T. Pseudomonas aeruginosa Implant-Associated Bone and Joint Infections: Experience in a Regional Reference Center in France. Front Med (Lausanne) 2020; 7:513242. [PMID: 33195289 PMCID: PMC7649271 DOI: 10.3389/fmed.2020.513242] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 09/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background:P. aeruginosa implant-associated bone and joint infections (BJI) is considered to be one of the most difficult to treat BJI. The data focusing specifically on this pathogen are sparse, and it seems difficult to extrapolate the results obtained with Enterobacteriaceae. Methods: We performed a retrospective observation study of all P. aeruginosa implant-associated BJI diagnosed at our institution from 2011 to 2018. We defined failure as any type of relapse, including persistence of the same P. aeruginosa, superinfection by another organism(s) or any other cause of relapse such as the need for a subsequent surgery. Nonparametric statistical methods were used to compare the study groups and Kaplan-Meier curves and multivariate Cox analysis and were used to detect determinants associated with treatment failure. Results: A total of 90 patients (62% men, median age 60 years IQR 47–72) including 30 (33%) prosthetic-joint infections and 60 (66%) other implant-associated BJIs were studied. Most of them were acute (62%). During the prolonged follow-up, (median 20 months; IQR 9–37), 23 patients (26%) experienced treatment failure. Optimal surgical treatment (DAIR for acute forms, explantation, 1-stage or 2-stage exchange for others) was significantly associated with a higher success rate in the univariate analysis (p = 0.003). Sixty-four (71%) patients received effective initial treatment against P. aeruginosa administered and 81 of them (90%) did for at least 3 weeks: both these parameters correlated with a higher success rate. In the multivariate Cox-analysis optimal surgical treatment, IV effective treatment of at least 3 weeks and treatment with ciprofloxacin for at least 3 months proved to be independently associated to a better outcome in patients with P. aeruginosa implant-associated BJI. Conclusion:P. aeruginosa implant-associated BJI is one of the most difficult-to-treat BJI, with a strong impact on the prognosis of the surgical strategy. An effective initial IV antibiotic treatment for at least 3 weeks seems to be required, followed by oral ciprofloxacin for a total duration of 3 months.
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Affiliation(s)
| | - Cécile Batailler
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Anne Conrad
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Sandrine Roux
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Thomas Perpoint
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Agathe Becker
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Claire Triffault-Fillit
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Sebastien Lustig
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Michel-Henri Fessy
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Frederic Laurent
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Florent Valour
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Christian Chidiac
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Tristan Ferry
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
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Charre C, Icard V, Pradat P, Brochier C, Lina B, Chidiac C, Cotte L. Coronavirus disease 2019 attack rate in HIV-infected patients and in preexposure prophylaxis users. AIDS 2020; 34:1765-1770. [PMID: 32889852 PMCID: PMC7493781 DOI: 10.1097/qad.0000000000002639] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/19/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE A new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) emerged in China during late 2019 and resulted in the coronavirus disease 2019 (COVID-19) pandemic which peaked in France in March-April 2020. Immunodeficiency, precariousness and promiscuity could increase the risk of COVID-19 in HIV-infected patients and in preexposure prophylaxis (PrEP) users. No epidemiological data are available in these two populations. We report COVID-19 attack rate in HIV-infected patients and in PrEP users in the Rhône department, France, and compared it with the general population. DESIGN Retrospective analysis of a laboratory database. METHODS COVID-19 testing strategy in France was centered on symptomatic infections, hospitalized patients and symptomatic healthcare workers while most asymptomatic cases were not confirmed. SARS-CoV-2 positivity rate on PCR assays and COVID-19 attack rate were determined in HIV-infected patients and in PrEP users. COVID-19 attack rate in the general population was estimated from health authorities' database and demographic data. A corrected attack rate taking into account the laboratory representativeness was calculated. RESULTS From March to April 2020, 24 860 samples from 19 113 patients (HIV-infected 77, PrEP users 27, others 19 009) were assessed for SARS-CoV-2 PCR assay. The positivity rate appeared similar in HIV-infected patients (15.6%), in PrEP users (14.8%) and in other patients (19.1%). The crude/corrected COVID-19 attack rate appeared similar in HIV-infected patients (0.31/0.38%) and in PrEP users (0.38/0.42%), and of the same order as the estimated attack rate in the general population (0.24%). CONCLUSION The risk of symptomatic COVID-19 in France appeared similar in HIV-infected patients and in PrEP users compared with the general population.
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Affiliation(s)
- Caroline Charre
- Laboratoire de Virologie, Institut de Agents Infectieux, Centre National de Référence des Virus des Infections Respiratoires, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
- Université́ Claude Bernard
- INSERM U1052-CRCL (Centre de Recherche en Cancérologie)
| | - Vinca Icard
- Laboratoire de Virologie, Institut de Agents Infectieux, Centre National de Référence des Virus des Infections Respiratoires, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
| | - Pierre Pradat
- Centre de Recherche Clinique (CRC), Hospices Civils de Lyon
| | | | - Bruno Lina
- Laboratoire de Virologie, Institut de Agents Infectieux, Centre National de Référence des Virus des Infections Respiratoires, Hôpital de la Croix-Rousse, Hospices Civils de Lyon
- Université́ Claude Bernard
| | - Christian Chidiac
- Université́ Claude Bernard
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Laurent Cotte
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
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Ramière C, Charre C, Miailhes P, Bailly F, Radenne S, Uhres AC, Brochier C, Godinot M, Chiarello P, Pradat P, Cotte L, Augustin-Normand C, François B, Biron F, Boibieux A, Brochier C, Braun E, Brunel F, Charre C, Chiarello P, Chidiac C, Cotte L, Ferry T, Godinot M, Guillaud O, Koffi J, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Pradat P, Radenne S, Ramière C, Schlienger I, Scholtes C, Schuffenecker I, Tardy JC, Trabaud MA, Uhres AC. Patterns of Hepatitis C Virus Transmission in Human Immunodeficiency Virus (HIV)-infected and HIV-negative Men Who Have Sex With Men. Clin Infect Dis 2020; 69:2127-2135. [PMID: 30810158 DOI: 10.1093/cid/ciz160] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sexually transmitted acute hepatitis C virus (HCV) infections (AHIs) have been mainly described in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Cases in HIV-negative MSM are scarce. We describe the epidemic of AHI in HIV-infected and HIV-negative MSM in Lyon, France. METHODS All cases of AHI diagnosed in MSM in Lyon University Hospital from 2014 to 2017 were included. AHI incidence was determined in HIV-infected and in preexposure prophylaxis (PrEP)-using MSM. Transmission clusters were identified by construction of phylogenetic trees based on HCV NS5B (genotype 1a/4d) or NS5A (genotype 3a) Sanger sequencing. RESULTS From 2014 to 2017, 108 AHIs (80 first infections, 28 reinfections) were reported in 96 MSM (HIV-infected, 72; HIV-negative, 24). AHI incidence rose from 1.1/100 person-years (95 confidence interval [CI], 0.7-1.7) in 2014 to 2.4/100 person-years (95 CI, 1.1-2.6) in 2017 in HIV-infected MSM (P = .05) and from 0.3/100 person-years (95 CI, 0.06-1.0) in 2016 to 3.4/100 person-years (95 CI, 2.0-5.5) in 2017 in PrEP users (P < .001). Eleven clusters were identified. All clusters included HIV-infected MSM; 6 also included HIV-negative MSM. All clusters started with ≥1 HIV-infected MSM. Risk factor distribution varied among clusters. CONCLUSIONS AHI incidence increased in both HIV-infected and HIV-negative MSM. Cluster analysis suggests initial transmission from HIV-infected to HIV-negative MSM through chemsex and traumatic sexual practices, leading to mixed patterns of transmission regardless of HIV status and no overlap with the general population.
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Affiliation(s)
- Christophe Ramière
- Virology Laboratory, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,Centre International de Recherche en Infectiologie, INSERM, CNRS UMR, Lyon, France.,University of Lyon, Université Claude Bernard Lyon, Villeurbanne, France
| | - Caroline Charre
- Virology Laboratory, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,University of Lyon, Université Claude Bernard Lyon, Villeurbanne, France.,INSERM U1052, Lyon, France
| | - Patrick Miailhes
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - François Bailly
- Hepatology Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Sylvie Radenne
- Hepatology Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Anne-Claire Uhres
- Pharmacy, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Corinne Brochier
- Clinical Research Centre, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Matthieu Godinot
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Pierre Chiarello
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Pierre Pradat
- Clinical Research Centre, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Laurent Cotte
- Infectious Diseases Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.,INSERM U1052, Lyon, France
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Benech N, Bouscambert-Duchamp M, Valour F, Conrad A, Roux S, Ferry T, Ader F, Perpoint T, Lina B, Chidiac C. La négativité persistante des prélèvements nasopharyngés est-elle fiable pour éliminer une pneumonie au SARS-CoV-2 chez un patient en quarantaine post-exposition ? Med Mal Infect 2020. [PMCID: PMC7442062 DOI: 10.1016/j.medmal.2020.06.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
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Pouderoux C, Becker A, Goutelle S, Lustig S, Triffault-Fillit C, Daoud F, Fessy MH, Cohen S, Laurent F, Chidiac C, Valour F, Ferry T. Subcutaneous suppressive antibiotic therapy for bone and joint infections: safety and outcome in a cohort of 10 patients. J Antimicrob Chemother 2020; 74:2060-2064. [PMID: 31220276 DOI: 10.1093/jac/dkz104] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/14/2019] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Optimal treatment of prosthetic joint infection and chronic osteomyelitis consists of surgical removal of biofilm-embedded bacteria, followed by a 6-12 week course of antimicrobial therapy. However, when optimal surgery is not feasible, oral prolonged suppressive antibiotic therapy (PSAT) is recommended to prevent prosthesis loosening and/or relapse of infection. Since 2010, we have used infection salvage therapy using off-label subcutaneous (sc) injection of a β-lactam as PSAT for patients in whom oral PSAT is not possible. METHODS A single-centre prospective cohort study (2010-18) reporting treatment modalities, efficacy and safety in all patients receiving sc PSAT. NCT03403608. RESULTS The 10 included patients (median age 79 years) had polymicrobial (n = 5) or MDR bacterial (n = 4) prosthetic joint infection (knee, n = 4; hip, n = 3) or chronic osteomyelitis (n = 3). After initial intensive therapy, seven patients received ertapenem, three patients received ceftriaxone and one patient received ceftazidime by sc injection (one patient received 8 days of ceftriaxone before receiving ertapenem). In one patient, sc PSAT failed with recurrent signs of infection under treatment. In three patients, sc PSAT had to be discontinued due to side effects; in only one of these was the sc route implicated (skin necrosis following direct sc injection and not gravity infusion). Median treatment duration was 433 days. In six patients, sc PSAT was successful with favourable outcome at the time of writing. Interestingly, three patients with MDR bacterial carriage at baseline lost this under PSAT during follow-up. CONCLUSIONS As salvage therapy, sc PSAT delivered by gravity infusion is a safe and interesting alternative when an optimal surgical strategy is not feasible and no oral treatment is available.
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Affiliation(s)
- Cécile Pouderoux
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Agathe Becker
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Sylvain Goutelle
- Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service pharmaceutique, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service d'orthopédie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Claire Triffault-Fillit
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Fatiha Daoud
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Michel Henry Fessy
- Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Service d'orthopédie, Centre Hospitaliers Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Sabine Cohen
- Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire de Biochimie et Toxicologie, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Frédéric Laurent
- Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Christian Chidiac
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Centre de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
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Danis K, Epaulard O, Bénet T, Gaymard A, Campoy S, Botelho-Nevers E, Bouscambert-Duchamp M, Spaccaferri G, Ader F, Mailles A, Boudalaa Z, Tolsma V, Berra J, Vaux S, Forestier E, Landelle C, Fougere E, Thabuis A, Berthelot P, Veil R, Levy-Bruhl D, Chidiac C, Lina B, Coignard B, Saura C. Cluster of Coronavirus Disease 2019 (COVID-19) in the French Alps, February 2020. Clin Infect Dis 2020; 71:825-832. [PMID: 32277759 PMCID: PMC7184384 DOI: 10.1093/cid/ciaa424] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/09/2020] [Indexed: 01/18/2023] Open
Abstract
Background On 07/02/2020, French Health authorities were informed of a confirmed case of SARS-CoV-2 coronavirus in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission. Methods We defined as a confirmed case a person linked to the chalet with a positive RT-PCR sample for SARS-CoV-2. Results The index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, one tertiary case was detected in a symptomatic patient with a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored, including 73 tested negative for SARS-CoV-2. Conclusions The occurrence in this cluster of one asymptomatic case with similar viral load as a symptomatic patient, suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspect Covid-19 cases.
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Affiliation(s)
- Kostas Danis
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Olivier Epaulard
- Infectious Diseases Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Fédération d'infectiologie multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, Grenoble, France.,Unité Mixte de Recherche 5075 (UMR 5075), Institut de biologie structurale, Grenoble, France
| | - Thomas Bénet
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Alexandre Gaymard
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Séphora Campoy
- Regional Health Agency of Auvergne Rhône Alpes, Lyon, France
| | - Elisabeth Botelho-Nevers
- Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France
| | - Maude Bouscambert-Duchamp
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Guillaume Spaccaferri
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Florence Ader
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France
| | - Alexandra Mailles
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | | | - Violaine Tolsma
- Infectious Diseases Unit, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Julien Berra
- Regional Health Agency of Auvergne Rhône Alpes, Lyon, France
| | - Sophie Vaux
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Emmanuel Forestier
- Infectious Disease Department, Centre Hospitalier Metropole Savoie, Chambery, France
| | - Caroline Landelle
- Service d'Hygiène Hospitalière et de Gestion des Risques, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques, Applications, Grenoble, Unité Mixte de Recherche 5525 (TIMC-IMAG UMR5525), CNRS, Université Grenoble Alpes, Grenoble, France
| | - Erica Fougere
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Alexandra Thabuis
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Philippe Berthelot
- Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France
| | - Raphael Veil
- Public Health Emergency Operations Center, French Ministry of Health, Paris, France
| | - Daniel Levy-Bruhl
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Christian Chidiac
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.,Maladies Infectieuses et Tropicales, Université Claude Bernard Lyon 1 (UCBL1), Unité de formation et de recherche (UFR) Lyon Sud-Charles Mérieux, Lyon, France
| | - Bruno Lina
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Bruno Coignard
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Christine Saura
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
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Bricca R, Goutelle S, Roux S, Gagnieu MC, Becker A, Conrad A, Valour F, Laurent F, Triffault-Fillit C, Chidiac C, Ferry T. Genetic polymorphisms of ABCB1 (P-glycoprotein) as a covariate influencing daptomycin pharmacokinetics: a population analysis in patients with bone and joint infection. J Antimicrob Chemother 2020; 74:1012-1020. [PMID: 30629193 DOI: 10.1093/jac/dky541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/08/2018] [Accepted: 11/27/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Daptomycin has been recognized as a therapeutic option for the treatment of bone and joint infection (BJI). Gene polymorphism of ABCB1, the gene encoding P-glycoprotein (P-gp), may influence daptomycin pharmacokinetics (PK). OBJECTIVES We aimed to examine population PK of daptomycin and its determinants, including genetic factors, in patients with BJI. PATIENTS AND METHODS We analysed data from patients who received daptomycin for BJI between 2012 and 2016 in our regional reference centre and who had measured daptomycin concentrations and P-gp genotyping. A population approach was used to analyse PK data. In covariate analysis, we examined the influence of three single nucleotide variations (SNVs) of ABCB1 (3435C > T, 2677G > T/A and 1236C > T) and that of the corresponding haplotype on daptomycin PK parameters. Simulations performed with the final model examined the influence of covariates on the probability to achieve pharmacodynamic (PD) targets. RESULTS Data from 81 patients were analysed. Daptomycin body CL (CLDAP) correlated with CLCR and was 23% greater in males than in females. Daptomycin central V (V1) was allometrically scaled to body weight and was 25% lower in patients with homozygous CGC ABCB1 haplotype than in patients with any other genotype. Simulations performed with the model showed that sex and P-gp haplotype may influence the PTA for high MIC values and that a dosage of 10 mg/kg/24 h would optimize efficacy. CONCLUSIONS Daptomycin dosages higher than currently recommended should be evaluated in patients with BJI. Gender and P-gp gene polymorphism should be further examined as determinants of dosage requirements.
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Affiliation(s)
- Romain Bricca
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France
| | - Sylvain Goutelle
- Hospices Civils de Lyon, Groupement Hospitalier Nord, Service de Pharmacie, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France
| | - Sandrine Roux
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France
| | - Marie-Claude Gagnieu
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Laboratoire de Pharmacologie, Lyon, France
| | - Agathe Becker
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France
| | - Anne Conrad
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, International Centre for Research in Infectiology, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Florent Valour
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, International Centre for Research in Infectiology, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Frederic Laurent
- Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, International Centre for Research in Infectiology, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | | | - Christian Chidiac
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, International Centre for Research in Infectiology, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Tristan Ferry
- Hospices Civils de Lyon, Department of Infectious Diseases, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, ISPB - Facultés de Médecine et de Pharmacie de Lyon, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, International Centre for Research in Infectiology, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
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Abad L, Tafani V, Tasse J, Josse J, Chidiac C, Lustig S, Ferry T, Diot A, Laurent F, Valour F. Evaluation of the ability of linezolid and tedizolid to eradicate intraosteoblastic and biofilm-embedded Staphylococcus aureus in the bone and joint infection setting. J Antimicrob Chemother 2020; 74:625-632. [PMID: 30517641 DOI: 10.1093/jac/dky473] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/08/2018] [Accepted: 10/16/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Prolonged use of linezolid for bone and joint infection (BJI) is limited by its long-term toxicity. The better safety profile of tedizolid, a recently developed oxazolidinone, could offer an alternative. However, its efficacy against biofilm-embedded and intracellular Staphylococcus aureus, the two main bacterial reservoirs associated with BJI chronicity, is unknown. METHODS Using three S. aureus strains (6850 and two clinical BJI isolates), linezolid and tedizolid were compared regarding their ability: (i) to target the S. aureus intracellular reservoir in an in vitro model of osteoblast infection, using three concentrations increasing from the bone concentration reached with standard therapeutic doses (Cbone = 2.5 × MIC; Cplasm = 10 × MIC; Cmax = 40 × MIC); (ii) to eradicate mature biofilm [minimal biofilm eradication concentration (MBEC)]; and (iii) to prevent biofilm formation [biofilm MIC (bMIC) and confocal microscopy]. RESULTS Linezolid and tedizolid weakly reduced the intracellular inoculum of S. aureus in a strain-dependent manner despite the similar MICs for the tested strains, but improved cell viability even in the absence of an intracellular bactericidal effect. Conversely, linezolid and tedizolid were ineffective in eradicating mature biofilm formed in vitro, with MBEC >2000 and >675 mg/L, respectively. bMICs of tedizolid were 4-fold lower than those of linezolid for all strains. CONCLUSIONS Linezolid and tedizolid alone are not optimal candidates to target bacterial phenotypes associated with chronic forms of BJI. Despite weak intracellular activity, they both reduce infection-related cytotoxicity, suggesting a role in modulating intracellular expression of staphylococcal virulence factors. Although inactive against biofilm-embedded S. aureus, both-but particularly tedizolid-are able to prevent biofilm formation.
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Affiliation(s)
- Lélia Abad
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France.,Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Bacteriology, Institute for Infectious Agents, Hospices Civils de Lyon, Lyon, France
| | - Virginie Tafani
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France
| | - Jason Tasse
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France
| | - Jérôme Josse
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France
| | - Christian Chidiac
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France.,Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Lustig
- Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Orthopaedic Surgery, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France.,Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France
| | - Alan Diot
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France
| | - Frédéric Laurent
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France.,Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Bacteriology, Institute for Infectious Agents, Hospices Civils de Lyon, Lyon, France
| | - Florent Valour
- CIRI - Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France.,Regional Reference Centre for Complex Bone and Joint Infection (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France
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Conrad A, Perry M, Langlois ME, Labussière-Wallet H, Barraco F, Ducastelle-Leprêtre S, Larcher MV, Balsat M, Boccard M, Chidiac C, Ferry T, Roure-Sobas C, Salles G, Valour F, Ader F. Efficacy and Safety of Revaccination against Tetanus, Diphtheria, Haemophilus influenzae Type b and Hepatitis B Virus in a Prospective Cohort of Adult Recipients of Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:1729-1737. [PMID: 32428736 DOI: 10.1016/j.bbmt.2020.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/12/2020] [Accepted: 05/06/2020] [Indexed: 01/20/2023]
Abstract
Data on immunogenicity and safety of the recommended revaccination schedule against diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b (Hib), and hepatitis B in adult allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients are limited. This prospective single-center cohort study (April 2014 to March 2018) included adult allo-HSCT recipients referred to a dedicated vaccinology consultation and vaccinated with the pediatric combined diphtheria, tetanus, acellular pertussis, hepatitis B virus, inactivated poliovirus, and Haemophilus influenzae type b (DTaP(±HB)-IPV-Hib) vaccine (3 doses 1 month apart, booster dose 1 year later). The proportion of responders to tetanus, diphtheria, Hib, and hepatitis B vaccine and geometric mean concentrations (GMCs) of antibodies were assessed before and up to 24 months after vaccination. A total of 106 patients were vaccinated at a median (interquartile range) time of 12.4 (10 to 18.4) months post-transplant. At 5.3 (4.8 to 6.6) and 23.1 (21.1 to 25.1) months after vaccine initiation, high and sustained rates of protective antibody titers were achieved for tetanus (97.8% [95% confidence interval (95% CI), 92.4% to 99.7%], n = 91/93 and 100% [95% CI, 92% to 100%], n = 44/44), diphtheria (94.6% [95% CI, 87.9% to 98.2%], n = 88/93 and 90.9% [95% CI, 78.3% to 97.5%], n = 40/44), Hib (96.6% [95% CI, 90.4% to 99.3%], n = 85/88 and 93% [95% CI, 80.9% to 98.5%], n = 40/43), and hepatitis B (83.5% [95% CI, 73.5% to 90.9%], n = 66/79 and 81.1% [95% CI, 64.8% to 92%], n = 30/37). Underlying disease, stem cell source, chronic graft-versus-host-disease, and extracorporeal photopheresis differentially influenced GMCs of tetanus, diphtheria, and hepatitis B antibodies after 3 doses but not in the long term (24 months). Six (5.7%) patients experienced mild side effects. The pediatric DTaP(±HB)-IPV-Hib vaccine was safe and effective in eliciting a sustained protective humoral response in adult allo-HSCT recipients. Hepatitis B revaccination might be optimized by using higher antigen doses.
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Affiliation(s)
- Anne Conrad
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France; Centre International de Recherche en Infectiologie, INSERM U1111, Université́ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.
| | - Marielle Perry
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France
| | - Marie-Elodie Langlois
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France
| | - Hélène Labussière-Wallet
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Fiorenza Barraco
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Sophie Ducastelle-Leprêtre
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Marie-Virginie Larcher
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Marie Balsat
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Mathilde Boccard
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Centre International de Recherche en Infectiologie, INSERM U1111, Université́ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Christian Chidiac
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France
| | - Tristan Ferry
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France; Centre International de Recherche en Infectiologie, INSERM U1111, Université́ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Chantal Roure-Sobas
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Institut des Agents Infectieux, Lyon, France
| | - Gilles Salles
- Université Claude Bernard Lyon I, Villeurbanne, France; Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Hématologie Clinique, Pierre-Bénite, France
| | - Florent Valour
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France; Centre International de Recherche en Infectiologie, INSERM U1111, Université́ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Florence Ader
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service des Maladies Infectieuses et Tropicales, Lyon, France; Université Claude Bernard Lyon I, Villeurbanne, France; Centre International de Recherche en Infectiologie, INSERM U1111, Université́ Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France; INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris Cedex, France
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Clerc A, Zeller V, Marmor S, Senneville E, Marchou B, Laurent F, Lucht F, Desplaces N, Lustig S, Chidiac C, Ferry T. Hematogenous osteomyelitis in childhood can relapse many years later into adulthood: A retrospective multicentric cohort study in France. Medicine (Baltimore) 2020; 99:e19617. [PMID: 32443285 PMCID: PMC7254121 DOI: 10.1097/md.0000000000019617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To describe the epidemiological, clinical, laboratory, and radiological features and the management of adult patients who experienced a relapse between 2003 and 2015 of an acute hematogenous osteomyelitis acquired in childhood.A retrospective multicentric cohort study was conducted in 5 centers in France.Thirty-seven patients were included. The median age was 40 years (28-56), and 26 (70%) were male. The first site of infection was the distal femur (n = 23, 62%). The median time between the osteomyelitis in childhood and the relapse in adulthood was 26 years (13-45). Thirty-four (92%) patients reported inflammatory local clinical manifestations, 17 (46%) draining fistula, 10 (27%) fever. Most patients had intramedullary gadolinium deposition (with or without abscess) on magnetic resonance imaging. Most relapses were monomicrobial infections (82%). Staphylococcus aureus was the most commonly found microorganism (82%), expressing a small colony variant phenotype in 3 cases. Most patients (97%) had a surgical treatment, and the median duration of antibiotics for the relapse was 12 weeks. All patients had a favorable outcome, no patient died and no further relapse occurred. We count 2 femoral fractures on osteotomy site.Osteomyelitis in childhood can relapse later in adulthood, especially in patients with lack of care during the initial episode. Osteotomy and prolonged antimicrobial therapy are required for clinical remission.
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Affiliation(s)
- Axelle Clerc
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon - Hôpital de la Croix-Rousse Lyon, Cedex 04
- Université Claude Bernard 1, Lyon
| | - Valerie Zeller
- Service de Chirurgie Osseuse et Traumatologique, Groupe Hospitalier Diaconesses - Croix Saint-Simon, Paris
| | - Simon Marmor
- Service de Chirurgie Osseuse et Traumatologique, Groupe Hospitalier Diaconesses - Croix Saint-Simon, Paris
| | - Eric Senneville
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Gustave Dron, Tourcoing
| | - Bruno Marchou
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Toulouse, Toulouse
| | - Frederic Laurent
- Université Claude Bernard 1, Lyon
- Laboratoire de Bactériologie, Hospices Civils de Lyon - Hôpital de la Croix-Rousse, Lyon
| | - Frederic Lucht
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne
| | - Nicole Desplaces
- Laboratoire de Biologie Médicale, Groupe Hospitalier Diaconesses - Croix Saint-Simon, Paris
| | - Sebastien Lustig
- Service de Chirurgie Orthopédique, Hospices Civils de Lyon - Hôpital de la Croix-Rousse, Lyon, France
| | - Christian Chidiac
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon - Hôpital de la Croix-Rousse Lyon, Cedex 04
- Université Claude Bernard 1, Lyon
| | - Tristan Ferry
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon - Hôpital de la Croix-Rousse Lyon, Cedex 04
- Université Claude Bernard 1, Lyon
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41
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Couffignal C, Kolta S, Flamant M, Cazanave C, Haymann JP, Mentré F, Duval X, Leport C, Raffi F, Chêne G, Salamon R, Moatti JP, Pierret J, Spire B, Brun-Vézinet F, Fleury H, Masquelier B, Peytavin G, Garraffo R, Costagliola D, Dellamonica P, Katlama C, Meyer L, Salmon D, Sobel A, Cuzin L, Dupon M, Le Moing V, Marchou B, May T, Morlat P, Rabaud C, Waldner-Combernoux A, Hardel L, Reboud P, Couffin-Cadiergues S, Marchand L, Assuied A, Carrieri P, Habak S, Couturier F, Jadand C, Perrier A, Préau M, Protopopescu C, Schmit J, Chennebault J, Faller J, Magy-Bertrand N, Chirouze C, Humbert P, Longy-Boursier, Neau D, Granier P, Ansart S, Verdon R, Merrien D, Chevojon P, Sobel A, Levy Y, Piroth L, Perronne C, Froguel E, Ceccaldi J, Chidiac C, Grégoire V, Reynes J, Fuzibet JG, Arsac P, Bouvet E, Bricaire F, Monsonego J, Girard P, Guillevin L, Herson S, Molina J, Pialoux G, Sain O, Sellier P, Roblot F, Bani-Sadr F, Michelet C, Lucht F, Debord C, Martin T, De Jaureguiberry J, Bernard L. Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy. AIDS Res Hum Retroviruses 2020; 36:399-405. [PMID: 31891665 DOI: 10.1089/aid.2019.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm3. Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score (p = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.
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Affiliation(s)
- Camille Couffignal
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Sami Kolta
- Department of Rheumatology, University Hospital Cochin, Assistance Publique–Hôpitaux de Paris, INSERM UMR-1153, Paris, France
| | - Martin Flamant
- Department of Physiology, University Hospital Bichat, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Charles Cazanave
- Infectious Diseases Department, University Hospital Bordeaux, Bordeaux, France
| | - Jean-Philippe Haymann
- Department of Physiology, University Hospital Tenon, and INSERM UMR_S1155, Paris, France
| | - France Mentré
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, France
| | - Xavier Duval
- Infection, Antimicrobials, Modeling, Evolution (IAME) UMR 1137, INSERM and Université of Paris, Paris, and INSERM CIC1425, Paris, France
| | - Catherine Leport
- Unité COREB (Coordination du Risque Epidémique et Biologique), Assistance Publique–Hôpitaux de Paris, Paris, France
| | - François Raffi
- Infectious Diseases Department, University Hospital Hotel-Dieu, and INSERM CIC 1413, University of Nantes, Nantes, France
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42
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Lepelletier D, Grandbastien B, Romano-Bertrand S, Aho S, Chidiac C, Géhanno JF, Chauvin F. What face mask for what use in the context of COVID-19 pandemic? The French guidelines. J Hosp Infect 2020; 105:S0195-6701(20)30211-5. [PMID: 32348833 PMCID: PMC7194956 DOI: 10.1016/j.jhin.2020.04.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 11/18/2022]
Abstract
In the context of the COVID-19 pandemic, wearing a face mask has become usual and ubiquitous, in both hospitals and community. However, the general public is consuming surgical or filtering face piece (FFP) masks irrespective of their specificity, leading to global supply shortage for the most exposed persons, which are healthcare workers. This underlines the urgent need to clarify the indications of the different categories of mask, in order to rationalize their use. The study herein specifies the French position for the rational use of respiratory protective equipment for healthcare workers.
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Affiliation(s)
- Didier Lepelletier
- French Society for Hospital Hygiene, France; Bacteriology and Hospital Hygiene Department, Nantes University Hospital, Nantes, FR-44000; High Council for Public Health, French Ministry of Health.
| | - Bruno Grandbastien
- French Society for Hospital Hygiene, France; Infection Prevention and Control Team, Preventive medicine Department, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, CH-1011
| | - Sara Romano-Bertrand
- French Society for Hospital Hygiene, France; HydroSciences Montpellier, IRD, CNRS, Montpellier University, Montpellier, France; Hospital, Hygiene and Infection Control Team, University Hospital of Montpellier, Montpellier, FR-34000
| | - Serge Aho
- French Society for Hospital Hygiene, France; Epidemiology and Hospital Hygiene Department, Dijon University Hospital, Dijon, FR-21079
| | - Christian Chidiac
- High Council for Public Health, French Ministry of Health; Infectious and Tropical Diseases Department, Lyon University Hospital Hospices Civils de Lyon, Lyon FR-69000
| | - Jean-François Géhanno
- High Council for Public Health, French Ministry of Health; Department of Occupational Medicine, Rouen University Hospital, Rouen, FR-76000
| | - Franck Chauvin
- High Council for Public Health, French Ministry of Health; Public Health Department, St-Etienne University Hospital, St-Etienne, FR-42000
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43
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Marcellin F, Di Beo V, Aumaitre H, Mora M, Wittkop L, Duvivier C, Protopopescu C, Lacombe K, Esterle L, Berenger C, Gilbert C, Bouchaud O, Poizot-Martin I, Sogni P, Salmon-Ceron D, Carrieri P, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Lebrasseur-Longuet D, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar, J M, Paccalin F, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Binois R, Simonet-Lann A, Croisier-Bertin D, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Esterle L, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Tezkratt S, Barré T, Baudoin M, Santos M, Di Beo V, Nishimwe M, Wittkop L. Patient-reported symptoms during direct-acting antiviral treatment: A real-life study in HIV-HCV coinfected patients (ANRS CO13 HEPAVIH). J Hepatol 2020; 72:588-591. [PMID: 31924411 DOI: 10.1016/j.jhep.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de santé publique, F-33000 Bordeaux, France
| | - Claudine Duvivier
- AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, IHU Imagine, Université de Paris, INSERM, U1016, Institut Cochin, CNRS, UMR8104, Paris, France; Institut Pasteur, Medical Center of Institut Pasteur, Necker-Pasteur Infectiology Center, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France; UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Cyril Berenger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Publics Hospitals, Avicenne Hospital, Bobigny, France; Paris 13 Nord University, Bobigny, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U-1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France; Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Becker A, Kreitmann L, Triffaut-Fillit C, Valour F, Mabrut E, Forestier E, Lesens O, Cazorla C, Descamps S, Boyer B, Chidiac C, Lustig S, Montbarbon E, Batailler C, Ferry T. Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with a debridement, antibiotics and implant retention (DAIR): a retrospective multicenter study in France. J Bone Jt Infect 2020; 5:28-34. [PMID: 32117687 PMCID: PMC7045531 DOI: 10.7150/jbji.40333] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/12/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction: In patients undergoing a « debridement, antibiotics, and implant retention » (DAIR) procedure for acute staphylococcal prosthetic joint infection (PJI), post-operative treatment with rifampin has been associated with a higher probability of success.(1,2) However, it is not known whether it is the total dose, delay of introduction or length of therapy with rifampin that is most strongly associated with the observed improved outcomes. Methods: A multicentric, retrospective cohort study of patients with acute staphylococcal hip and knee PJI treated with DAIR between January 2011 and December 2016. Failure of the DAIR procedure was defined as persistent infection, need for another surgery or death. We fitted logistic and Cox regression multivariate models to identify predictors of DAIR failure. We compared Kaplan-Meier estimates of failure probability in different levels of the 3 variables of interest - total dose, delay of introduction or length of therapy with rifampin - with the log-rank test. Results: 79 patients included (median age 71 years [63.5-81]; 55 men [70%]), including 54 (68%) DAIR successes and 25 (32%) DAIR failures. Patients observed for a median of 435 days [IQR 107.5-834]. Median ASA score significantly lower in DAIR successes than in DAIR failures (2 vs. 3, respectively p = 0.011). Bacterial cultures revealed 65 (82.3%) S. aureus and 16 (20.3%) coagulase negative staphylococci, with 2 patients being infected simultaneously with S. aureus and CNS. Among S. aureus isolates, 7 (10.8%) resistant to methicillin; 2 (3.1 %) resistant to rifampin. Median duration of antimicrobial therapy was 85 days [IQR 28.5-97.8]. Fifty-eight patients (73.4%) received rifampin at a median dose of 14.6 mg/kg/day |IQR 13-16.7], started at a median delay of 8.5 days [IQR, 4-7.5] after debridement surgery. Twenty-one patients (26.6%) developed a drug-related adverse event, leading to rifampin interruption in 6 of them (7.6% of total cohort). Determinants of DAIR failure were rifampin use (HR 0.17, IC [0.06, 0.45], p-value <0.001), association of rifampin with a fluoroquinolone (HR 0.19, IC [0.07, 0.53], p-value = 0.002) and duration of rifampin therapy (HR 0.97, IC [0.95, 1], p-value = 0.022). We did not observe a significant difference between DAIR successes and failures in rifampin use, dose and delay of introduction. In a multivariate Cox model, only duration of rifampin therapy was significantly associated with DAIR failure. Kaplan Meier estimate of DAIR failure probability was significantly higher in patients receiving less than 14 days of rifampin in comparison with those receiving more than 14 days of rifampin (p = 0.0017). Conclusion: Duration of rifampin therapy is a key determinant of improved outcomes in early-onset acute prosthetic joint infection due to Staphylococcus treated with DAIR.
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Affiliation(s)
- A Becker
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - L Kreitmann
- Service de Réanimation Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - C Triffaut-Fillit
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - F Valour
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Inserm U1111, Centre international de recherche en Infectiologie (CIRI), Université Claude-Bernard Lyon 1, Lyon, France
| | - E Mabrut
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France)
| | - E Forestier
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier Métropole Savoie, Chambéry (France)
| | - O Lesens
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) Gabriel Montpied, Clermont-Ferrand (France)
| | - C Cazorla
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de Saint-Etienne (France)
| | - S Descamps
- Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) Gabriel Montpied, Clermont-Ferrand (France)
| | - B Boyer
- Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de Saint-Etienne (France)
| | - C Chidiac
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France
| | - S Lustig
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France)
| | - E Montbarbon
- Service de Chirurgie Orthopédique, Centre hospitalier Métropole Savoie, Chambéry (France)
| | - C Batailler
- Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Service de Chirurgie Orthopédique, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France)
| | - T Ferry
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier universitaire (CHU) de la Croix Rousse, Hospices Civils de Lyon (HCL), Lyon (France).,Centre de Référence des Infections Ostéo-Articulaires Complexes (CRIOAc) de Lyon (France).,Université Claude Bernard Lyon 1, Lyon, France.,Inserm U1111, Centre international de recherche en Infectiologie (CIRI), Université Claude-Bernard Lyon 1, Lyon, France
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Argemi X, Houze S, Noel H, Broca O, Chidiac C, Rapp C. Imported Plasmodium falciparum malaria following non-pharmaceutical forms of Artemisia annua prophylaxis. J Travel Med 2019; 26:5585495. [PMID: 31608402 DOI: 10.1093/jtm/taz073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/22/2019] [Accepted: 09/28/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Xavier Argemi
- Service des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 1 Place de l'Hôpital, 67000, Strasbourg, France
| | - Sandrine Houze
- Sorbonne Université, Institut de Recherche pour le Développement, AP-HP, Centre National de Référence du Paludisme, Hôpital Bichât Claude-Bernard, Paris, France
| | - Harold Noel
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Ophélie Broca
- Direction des Vaccins, des Médicaments Anti-infectieux, en Hépato-gastroentérologie, en Dermatologie, de Thérapie Génique et des Maladies Métaboliques Rares, Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), 143/147 bld Anatole, F-93285 Saint-Denis Cedex, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France; Centre International de Recherche en Infectiologie (CIRI), Inserm, U1111, Université Claude-Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Université Lyon, 69007 Lyon, France; Université Claude-Bernard Lyon 1, 69007 Lyon, France
| | - Christophe Rapp
- Service de maladies infectieuses et tropicales Hôpital Américain de Paris, 63 Bd Victor hugo, 92020 Neuilly sur Seine, France; Service de maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, 69 avenue de Paris, 94 160, Saint-Mandé, France
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Pietropaoli C, Cavalli Z, Jouanneau E, Tristan A, Conrad A, Ader F, Guyotat J, Chidiac C, Ferry T. Cerebral empyema and abscesses due to Cutibacterium acnes. Med Mal Infect 2019; 50:274-279. [PMID: 31668987 DOI: 10.1016/j.medmal.2019.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 09/18/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Cutibacterium acnes is a commensal bacterium of the skin, frequently reported in prosthetic shoulder or spinal implant infections, but rarely in cranial and intracranial infections. METHODS We retrospectively reviewed patients with intracranial samples positive to Cutibacterium acnes managed in the neurosurgical units of our hospital of Lyon, France, between 2008-2016. RESULTS We included 29 patients, of whom 23 had empyema (with or without abscess), 17 had cranial osteomyelitis, and six only had abscess. Prior neurosurgery was reported in 28 patients, and the remaining patient had four spontaneous abscesses. Twelve patients had polymicrobial infections, including methicillin-susceptible Staphylococcus in 11 cases. The clinical diagnosis was difficult because of indolent and delayed symptoms: a CT scan or MRI was required. Thirteen patients (52%) had material at the infection site. All patients with bone flap implant or bones from biological banks had a bone flap-associated infection. Drainage was surgically performed in 25 cases or by CT scan-guided aspiration in four cases. All patients received an adapted antibiotic therapy (from three weeks to six months). The outcome was favorable in 28 patients. Three patients relapsed during the antibiotic therapy, requiring further surgery. CONCLUSION Cutibacterium acnes can be responsible for postoperative empyema and cerebral abscesses, with particular indolent forms, which make their diagnosis difficult. They are often polymicrobial and associated with bone flap osteomyelitis. Their outcome is favorable after drainage and adapted antibiotic therapy.
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Affiliation(s)
- C Pietropaoli
- Department of Internal Medecine and Infectious Diseases, Hospital Center of Villefranche sur Saône, Hôpital Nord-Ouest, 39, plateau d'Ouilly-Gleizé, 69655 Villefranche-sur-Saône, France.
| | - Z Cavalli
- Department of Internal Medecine, Regional Hospital Center of Metz-Thionville, Metz, France
| | - E Jouanneau
- Department of Neurosurgery, hospices civils de Lyon, Lyon University Hospital, Bron, France
| | - A Tristan
- Department of Bacteriology, hospices civils de Lyon, Lyon University Hospital, Lyon, France
| | - A Conrad
- Department of Infectious Diseases, hospices civils de Lyon, Lyon University Hospital, Lyon, France
| | - F Ader
- Department of Infectious Diseases, hospices civils de Lyon, Lyon University Hospital, Lyon, France
| | - J Guyotat
- Department of Neurosurgery, hospices civils de Lyon, Lyon University Hospital, Bron, France
| | - C Chidiac
- Department of Infectious Diseases, hospices civils de Lyon, Lyon University Hospital, Lyon, France
| | - T Ferry
- Department of Infectious Diseases, hospices civils de Lyon, Lyon University Hospital, Lyon, France
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Triffault-Fillit C, Mabrut E, Corbin K, Becker A, Braun E, Tod M, Goutelle S, Henri Fessy M, Dupieux C, Laurent F, Lustig S, Chidiac C, Ferry T, Valour F. 400. Comparison of Tolerance and Microbiological Efficacy of Cefepime and Piperacillin/Tazobactam in Combination with Vancomycin as Empirical Antimicrobial Therapy of Prosthetic Joint Infection: A Propensity-Matched Cohort Study. Open Forum Infect Dis 2019. [PMCID: PMC6809934 DOI: 10.1093/ofid/ofz360.473] [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] [Indexed: 11/25/2022] Open
Abstract
Background The use of piperacillin/tazobactam with vancomycin as empirical antimicrobial therapy (EAT) for prosthetic joint infection (PJI) has been associated with an increased risk of acute kidney injury (AKI), leading to propose cefepime as an alternative since 2017 in our reference center. The present study compared microbiological efficacy and tolerance of these two EAT strategies. Methods All adult patients with PJI empirically treated by vancomycin-cefepime (n = 89) were enrolled in a prospective observational study, and matched with vancomycin-piperacillin/tazobactam-treated historical controls (n = 89) according to a propensity score including age, baseline renal function and concomitant use of other nephrotoxics. The two groups were compared using Kaplan–Meier curve analysis and non-parametric tests (Fisher exact test and Mann–Whitney U-test) regarding: (i) the proportion efficacious empirical regimen (i.e., at least one of the two molecules active against the identified organism(s) based on in vitro susceptibility testing); and (ii) the incidence of empirical therapy-related adverse events (AE), classified according to the Common terminology criteria for AE (CTCAE). Results Among the 146 (82.0%) documented infections, the EAT was considered as efficacious in 77 (98.7%) and 65 (98.5%) of the piperacillin–tazobactam and cefepim-treated patients, respectively (P = 1.000). The rate of AE, and in particular AKI, was significantly higher in the vancomycin–piperacillin/tazobactam (n = 27 [30.3%] and 23 [25.8%%]) compared with the vancomycin-cefepim (n = 13 [14.6%] and 6 [6.7%]) group (P = 0.019 and <0.001, respectively; figure), leading to a premature EAT discontinuation in 20 (22.5%) and 5 (5.6%) patients (P = 0.002). Of note, no significant differences were observed between the two groups regarding sex (91 males; 51.1%), median age (68-year-old; IQR, 59.3–75), main comorbidities including baseline renal function and proportion of patients receiving other nephrotoxics, and vancomycin plasmatic overload. Conclusion The empirical use of vancomycin-cefepim in PJI was as efficient as vancomycin–piperacillin/tazobactam, and was associated with a significantly lower incidence of AKI. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | | | | | | | | | - Michel Tod
- Hospices Civils de Lyon, LYON, Rhone-Alpes, France
| | | | | | | | | | | | | | | | - Florent Valour
- Infectious disease department, CRIOAc Lyon (reference center for complex BJI management), Claude Bernard Lyon 1 University/UCSF, Lyon, Rhone-Alpes, France
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Bricca R, Valour F, Anne C, Braun E, Jaby P, Bachelet JT, Breton P, Gleizal A, Laurent F, Chidiac C, Ferry T. 384. Denosumab-Related Osteonecrosis of the Jaw: an Emergent and Potentially Complex Bone and Joint Infection. Open Forum Infect Dis 2019. [PMCID: PMC6809727 DOI: 10.1093/ofid/ofz360.457] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Osteonecrosis of the jaw is a known complication of antiresorptive treatment, like bisphosphonate. More recently, denosumab was validated as a treatment in the osteoporosis and bone metastasis. Its mechanism is different from bisphosphonate but induces also a decrease of bone resorption and a risk of osteonecrosis of the jaw. In case of treatment failure by a dental surgeon or in complex cases, patients could be addressed to a bone and joint infection (BJI) reference center. The aim of this study was to analyze microbiology, as well as surgical and medical care of patients who present denosumab-related osteonecrosis of the jaw (DRONJ) and who were treated in a bone and join reference center. Methods All patients managed in our BJI reference center between January 2013 and December 2018 for a DRONJ were included in our retrospective observational monocentric cohort. Results Twelve patients (median age 71; ratio M/W 0.7) with a DRONJ (metastatic cancer, n = 10 (83%)) in grade 3 (n = 5), 2 (n = 4), 1 (n = 3) were included. Only 3 patients (25%) had a dental health control before initiating the treatment by denosumab and 7 patients (58%) had a dental surgical procedure done before the DRONJ. Eleven patients had a bone exposure, treated at least with a scaling and mucosal closure at the same time. All infections with bacterial cultures (n = 11 (91%)) were polymicrobial, including 8 (72%) with Streptococcus spp; 8 (72%) with anaerobia including 2 (18%) with Actinomyces; 5 (45%) with Staphylococcus spp; 5 (45%) with enterobacteria; 3 (27%) with Candida spp; 2 (17%) with a non-fermentative Gram-negative bacilli and 7 (64%) with others bacteria. All patients (n = 12) received a betalactam, 8 (66%) a lincosamide or a synergistin, 5 (41%) an antifungal, 5 (41%) metronidazole, 4 (33%) a fluoroquinolone, 3 (25%) a glycopeptide and 2 (17%) other antibiotics. The median follow-up was 6 months. Eight patients were cured after a medico-surgical care and a median duration of antibiotics of 97 days (including 28.5 days in intravenous). 2 patients required a suppressive antibiotic treatment, 1 relapsed at a distance of the treatment and 1 died from some other causes. Conclusion DRONJ is a potential complex BJI, for which some patients could benefit from medical care in a BJI reference center. Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | - Florent Valour
- Infectious disease department, CRIOAc Lyon (reference center for complex BJI management), Claude Bernard Lyon 1 University / UCSF, Lyon, Rhone-Alpes, France
| | - Conrad Anne
- Infectious diseases, Lyon, Rhone-Alpes, France
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Bricca R, Valour F, Conrad A, Braun E, Jaby P, Bachelet J, Breton P, Gleizal A, Chidiac C, Ferry T. Ostéonécrose de la mâchoire induite par le dénosumab : une infection ostéoarticulaire complexe émergente ? Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.216] [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: 10/26/2022]
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Dhelens C, Tall L, Boisrame J, Boibieux A, Chidiac C, Pirot F, Pivot C. Perfusion continue d’oxacilline en diffuseur élastomérique : quelle stabilité physico-chimique en pratique clinique ? Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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