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Mazuel M, Moulier V, Bourrel AS, Guillier C, Tazi A, Jarreau PH, Chollat C. Systematic culture of central catheters and infections related to catheters in a neonatal intensive care unit: an observational study. Sci Rep 2024; 14:8647. [PMID: 38622221 PMCID: PMC11018835 DOI: 10.1038/s41598-024-59371-2] [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: 12/12/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
Systematic culture of the tip of central lines is performed in many neonatal intensive care units (NICUs) to guide any subsequent antibiotic therapy. The clinical relevance of this procedure is debated, given the significant bacterial contamination during its removal. We aimed to describe infections related to catheters and assess the usefulness of central catheter systematic cultures for probabilistic antibiotic therapy in cases of suspicion of catheter-related infections in a NICU. A retrospective study in a NICU included all newborn patients hospitalized with a central catheter, between January 2018, and June 2019. The main outcome measures were bacterial catheter colonization, catheter-related infection rate, and simulation-based approach to antibiotic prescription. Three hundred and seventy-five newborns, with 634 central catheters were included. There were 273 (43%) catheters that were colonized by at least one microorganism. There were 183 cases of suspected sepsis, with 31 infections definitively related to the catheter. In our simulation antibiotic prescription approach, there was no significant difference in terms of the efficacy toward the microorganism(s) involved between the probabilistic antibiotic therapies proposed by the experts and those ultimately prescribed. Performing a catheter culture only if catheter-related infection is suspected could be an alternative to routine screening.
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Affiliation(s)
- Marie Mazuel
- Neonatal Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Robert Debré Children's Hospital, Paris, France
| | - Virginie Moulier
- University Department of Psychiatry, Centre d'Excellence Thérapeutique, Institut de Psychiatrie, Centre hospitalier du Rouvray, Sotteville-lès-Rouen, France
- Unité de Recherche Clinique, Etablissement Publique de Santé de Ville Evrard, 93332, Neuilly-sur-Marne, France
| | - Anne-Sophie Bourrel
- Department of Bacteriology, University Paris Cité, Assistance Publique-Hôpitaux de Paris, Cochin University Hospital, 75014, Paris, France
| | - Cyril Guillier
- Paediatric Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Armand Trousseau University Hospital, Sorbonne Université, Paris, France
| | - Asmaa Tazi
- Department of Bacteriology, University Paris Cité, Assistance Publique-Hôpitaux de Paris, Cochin University Hospital, 75014, Paris, France
| | - Pierre-Henri Jarreau
- Service de Médecine et Réanimation Néonatales de Port-Royal, Hôpital Cochin, APHP centre - Université Paris Cité, Paris, France
| | - Clément Chollat
- Department of Neonatal Paediatrics, APHP, Service de Néonatologie, Sorbonne Université, Hôpital Armand Trousseau, 26 Av. du Dr Arnold Netter, 75012, Paris, France.
- Université Paris Cité, INSERM, NeuroDiderot, 75019, Paris, France.
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Guillier C, Carrière D, Pansiot J, Maroni A, Billion E, Ringot M, Benoist JF, Jacques S, Matrot B, Jarreau PH, Vaiman D, Baud O, Zana-Taïeb E. Nebulized curcumin protects neonatal lungs from antenatal insult in rats. Am J Physiol Lung Cell Mol Physiol 2021; 321:L545-L552. [PMID: 34159801 DOI: 10.1152/ajplung.00195.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Intrauterine growth restriction (IUGR) increases the risk of bronchopulmonary dysplasia (BPD), one of the major complications of prematurity. Antenatal low-protein diet (LPD) exposure in rats induces IUGR and mimics BPD-related alveolarization disorders. Peroxisome proliferator-activated receptor-γ (PPARγ) plays a key role in normal lung development and was found deregulated following LPD exposure. The objective of this article was to investigate the effects of nebulized curcumin, a natural PPARγ agonist, to prevent IUGR-related abnormal lung development. We studied rat pups antenatally exposed to an LPD or control diet (CTL) and treated with nebulized curcumin (50 mg/kg) or vehicle from postnatal (P) days 1 to 5. The primary readouts were lung morphometric analyses at P21. Immunohistochemistry (P21) and microarrays (P6 and P11) were compared within animals exposed to LPD versus controls, with and without curcumin treatment. Quantitative morphometric analyses revealed that LPD induced abnormal alveolarization as evidenced by a significant increase in mean linear intercept (MLI) observed in P21 LPD-exposed animals. Early curcumin treatment prevented this effect, and two-way ANOVA analysis demonstrated significant interaction between diet and curcumin both for MLI [F(1,39) = 12.67, P = 0.001] and radial alveolar count at P21 [F(1,40) = 6.065, P = 0.0182]. Immunohistochemistry for fatty acid binding protein 4 (FABP4), a major regulator of PPARγ pathway, showed a decreased FABP4+ alveolar cell density in LPD-exposed animals treated by curcumin. Transcriptomic analysis showed that early curcumin significantly prevented the activation of profibrotic pathways observed at P11 in LPD-exposed animals. Nebulized curcumin appears to be a promising strategy to prevent alveolarization disorders in IUGR rat pups, targeting pathways involved in lung development.
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Affiliation(s)
- Cyril Guillier
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Médecine et Réanimation néonatales de Port-Royal, Paris, France.,Université Paris Descartes, Paris, France
| | - Diane Carrière
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Médecine et Réanimation néonatales de Port-Royal, Paris, France.,Université Paris Descartes, Paris, France
| | - Julien Pansiot
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Université Paris Diderot, Paris, France
| | - Arielle Maroni
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Université Paris Descartes, Paris, France
| | - Elodie Billion
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Médecine et Réanimation néonatales de Port-Royal, Paris, France.,Université Paris Descartes, Paris, France
| | - Maud Ringot
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Université Paris Diderot, Paris, France
| | - Jean-François Benoist
- Assistance Publique-Hôpitaux de Paris, Service de Biochimie-Hormonologie, Hôpital Robert Debré, Paris, France
| | - Sébastien Jacques
- Genom'ic. INSERM U1016, Centre National de la Recherche Scientifique (CNRS) Unite Mixte de Recherche (UMR) 8104, Paris, France
| | - Boris Matrot
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Université Paris Diderot, Paris, France
| | - Pierre-Henri Jarreau
- Assistance Publique-Hôpitaux de Paris, Service de Médecine et Réanimation néonatales de Port-Royal, Paris, France.,Université Paris Descartes, Paris, France.,Fondation PremUp, Paris, France.,Université de Paris, Epidemiology and Statistics Research Center (CRESS), INSERM, Institut national de la recherche agronomique (INRA), Paris, France
| | - Daniel Vaiman
- Institut Cochin, Inserm U1016-CNRS UMRS 104, Paris, France
| | - Olivier Baud
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Université Paris Diderot, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Réanimation et Pédiatrie néonatales, Hôpital Robert Debré, Paris, France.,Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva and University of Geneva, Geneva, Switzerland
| | - Elodie Zana-Taïeb
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1141, Paris, France.,Assistance Publique-Hôpitaux de Paris, Service de Médecine et Réanimation néonatales de Port-Royal, Paris, France.,Fondation PremUp, Paris, France
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Chollat C, Maroni A, Aubelle MS, Guillier C, Patkai J, Zana-Taïeb E, Keslick A, Torchin H, Jarreau PH. Efficacy and Safety Aspects of Remifentanil Sedation for Intubation in Neonates: A Retrospective Study. Front Pediatr 2019; 7:450. [PMID: 31788457 PMCID: PMC6853995 DOI: 10.3389/fped.2019.00450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/17/2019] [Indexed: 01/05/2023] Open
Abstract
Objective: To evaluate the efficacy and safety of remifentanil as a premedication in neonates undergoing elective intubation. Study Design: This retrospective study focused on neonates admitted to the Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, France, between June 2016 and November 2017, who received remifentanil before an elective intubation. First, atropine (10 μg/kg) was administered intravenously as a bolus, followed by remifentanil, which was administrated continuously. The dose of remifentanil was reduced twice during the study period in order to administer the minimum effective dose and thus reduce possible adverse events. Results: Fifty-four neonates were exposed to remifentanil and atropine. The intubating conditions were excellent or good for 46 procedures (85%) and the median Acute Pain in Newborn Infants score was 2 (IQ 25-75: 0-5) before the sedation, 1 (0-2) during the laryngoscopy, and 0 (0-0) after the intubation. The intubation was successful at the first attempt for 18 patients (33%). Chest wall rigidity occurred in 6 procedures (11%), other respiratory problems in 5 (9%), and laryngospasm in 1 (2%). Some of the procedures were complicated by bradycardia (23%) or desaturation (37%). Conclusions: Remifentanil and atropine prior to intubation provided satisfactory intubating conditions in neonates. Nevertheless, severe adverse effects (such as chest wall rigidity) are a potential risk, possibly related to the total dose received. These data do not support the safety of using remifentanil alone prior to intubation in neonates.
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Affiliation(s)
- Clément Chollat
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Arielle Maroni
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Marie-Stéphanie Aubelle
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Cyril Guillier
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Juliana Patkai
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Elodie Zana-Taïeb
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Aurélie Keslick
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Héloïse Torchin
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
| | - Pierre-Henri Jarreau
- Neonatal Intensive Care Unit of Port-Royal, Paris Centre University Hospitals, APHP, Paris Descartes University, Paris, France
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Tauzin M, Felix A, Michot C, Dedieu C, Aoust L, Fortas F, Guillier C, Ngo J, Wachter PY, Petermann L, Kermorvant-Duchemin E. Le monde des jumeaux : aspects épidémiologiques et génétiques, enjeux obstétricaux, risques spécifiques et devenir. Arch Pediatr 2017; 24:1299-1311. [DOI: 10.1016/j.arcped.2017.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/28/2017] [Accepted: 09/27/2017] [Indexed: 11/16/2022]
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Hamrita B, Nasr HB, Kabbage M, Hamann P, Kuhn L, Guillier C, Remadi S, Chaieb A, Khairi H, Chouchane L, Chahed K. [The therapeutic contribution of proteomic approaches in cancers]. Gynecol Obstet Fertil 2011; 39:87-93. [PMID: 21317010 DOI: 10.1016/j.gyobfe.2010.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 09/24/2010] [Indexed: 05/30/2023]
Abstract
Up to now, there are no protein tumor markers with a specificity and sensitivity sufficient to have a utility in prognosis and early diagnosis of cancer. Recent advances in proteomics approaches have led to the identification of novel tumor markers of cancer that may have a utility in screening strategies and treatment. The purpose of the current review is to describe the major advances in cancer proteomics, especially those related to the study of serum biomarkers, immune-related responses (autoantibodies) and alterations in cellular proteins.
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Affiliation(s)
- B Hamrita
- Laboratoire d'immuno-oncologie moléculaire, faculté de médecine de Monastir, 5019 Monastir, Tunisie.
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