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Torres-Maravilla E, Carvalho FA, Holowacz S, Delannoy J, Lenoir L, Jacouton E, Barbut F, Langella P, Bermúdez-Humarán LG, Waligora-Dupriet AJ. Screening of probiotic strains to improve visceral hypersensitivity in irritable bowel syndrome by using in vitro and in vivo approaches. Benef Microbes 2024:1-18. [PMID: 38677716 DOI: 10.1163/18762891-bja00006] [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] [Received: 06/20/2023] [Accepted: 03/27/2024] [Indexed: 04/29/2024]
Abstract
Oral administration of probiotics has been proposed as a promising biotherapy to prevent and treat different diseases related to gastrointestinal disorders, such as irritable bowel syndrome (IBS). Due to the increasing research area on the characterisation of new probiotic bacterial strains, it is necessary to perform suitable in vitro experiments, using pertinent cellular models, in order to establish appropriate readout profiles based on IBS symptoms and subtypes. In this work, a collection of 30 candidate strains, belonging mainly to the Lactobacillus and Bifidobacterium genera, were screened using three different sets of in vitro experiments with different readouts to identify promising probiotic strains with: (1) the ability to inhibit the synthesis of IL-8 production by TNF-α stimulated HT-29 cells, (2) immunomodulatory properties quantified as increased IL-10 levels in peripheral blood mononuclear cell (PBMCs), and (3) the ability to maintain epithelial barrier integrity by increasing the trans-epithelial/endothelial electrical resistance (TEER) values in Caco-2 cells. Based on these criteria, three strains were selected: Lactobacillus gasseri PI41, Lacticaseibacillus rhamnosus PI48 and Bifidobacterium animalis subsp. lactis PI50, and tested in a murine model of low-grade inflammation induced by dinitrobenzene sulfonic acid (DNBS), which mimics some of the symptoms of IBS. Among the three strains, L. gasseri PI41 improved overall host well-being by preventing body weight loss in DNBS-treated mice and restored gut homeostasis by normalising the intestinal permeability and reducing pro-inflammatory markers. Therefore, the potential of this strain was confirmed in a second murine model known to reproduce IBS symptoms: the neonatal maternal separation (NMS) model. The PI41 strain was effective in preventing intestinal permeability and reducing colonic hypersensitivity. In conclusion, the set of in vitro experiments combined with in vivo assessments allowed us to identify a promising probiotic candidate strain, L. gasseri PI41, in the context of IBS.
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Affiliation(s)
- E Torres-Maravilla
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
- Université Paris Cité, INSERM, UMRS 1139, 3PHM, 75006 Paris, France
| | - F A Carvalho
- INSERM U1107 NeuroDol, Université Clermont Auvergne, 3iHP, Clermont-Ferrand, France
| | - S Holowacz
- PiLeJe Laboratoire, 31-35 Rue de la Fédération, 75015 Paris, France
| | - J Delannoy
- Université Paris Cité, INSERM, UMRS 1139, 3PHM, 75006 Paris, France
| | - L Lenoir
- PiLeJe Laboratoire, 31-35 Rue de la Fédération, 75015 Paris, France
| | - E Jacouton
- PiLeJe Laboratoire, 31-35 Rue de la Fédération, 75015 Paris, France
| | - F Barbut
- Université Paris Cité, INSERM, UMRS 1139, 3PHM, 75006 Paris, France
- Service de Microbiologie de l'environnement, UHLIN (Unité d'Hygiène et de Lutte contre les Infections Nosocomiales), National Reference Laboratory for Clostridium difficile, Groupe Hospitalier de l'Est Parisien (HUEP) Site Saint-Antoine, 75012 Paris, France
| | - P Langella
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - L G Bermúdez-Humarán
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
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Benech N, Barbut F, Fitzpatrick F, Krutova M, Davies K, Druart C, Cordaillat-Simmons M, Heritage J, Guery B, Kuijper E. Update on microbiota-derived therapies for recurrent Clostridioides difficile infections. Clin Microbiol Infect 2024; 30:462-468. [PMID: 38101472 DOI: 10.1016/j.cmi.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Faecal microbiota transplantation (FMT) is the standard treatment for patients with multiple recurrent Clostridioides difficile infection (rCDI). Recently, new commercially developed human microbiota-derived medicinal products have been evaluated and Food and Drug Administration-approved with considerable differences in terms of composition, administration, and targeted populations. OBJECTIVES To review available data on the different microbiota-derived treatments at the stage of advanced clinical evaluation and research in rCDI in comparison with FMT. SOURCES Phase II or III trials evaluating a microbiota-derived medicinal product to prevent rCDI. CONTENT Two commercial microbiota-derived medicinal products are approved by the Food and Drug Administration: Rebyota (RBX2660 Ferring Pharmaceuticals, marketed in the United States) and VOWST (SER-109 -Seres Therapeutics, marketed in the United States), whereas VE303 (Vedanta Biosciences Inc) will be studied in phase III trial. RBX2660 and SER-109 are based on the processing of stools from healthy donors, whereas VE303 consists of a defined bacterial consortium originating from human stools and produced from clonal cell banks. All have proven efficacy to prevent rCDI compared with placebo in patients considered at high risk of recurrence. However, the heterogeneity of the inclusion criteria, and the time between each episode and CDI diagnostics makes direct comparison between trials difficult. The differences regarding the risk of recurrence between the treatment and placebo arms were lower than previously described for FMT (FMT: Δ = 50.5%; RBX2660-phase III: Δ = 13.1%; SER-109-phase III: Δ = 28%; high-dose VE303-phase-II: Δ = 31.7%). All treatments presented a good overall safety profile with mainly mild gastrointestinal symptoms. IMPLICATIONS Stool-derived products and bacterial consortia need to be clearly distinguished in terms of product characterization and their associated risks with specific long-term post-marketing evaluation similar to registries used for FMT. Their place in the therapeutic strategy for patients with rCDI requires further studies to determine the most appropriate patient population and administration route to prevent rCDI.
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Affiliation(s)
- Nicolas Benech
- French Fecal Transplant Group (GFTF), France; Hepato-Gastroenterology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, CRCL, Lyon, France; Lyon GEM Microbiota Study Group, Lyon, France; ESGHAMI (ESCMID Study Group for Host and Microbiota Interactions); ESGCD (ESCMID Study Group for Clostridioides difficile); Member of the European Fecal Microbiota Transplantation Network.
| | - Frédéric Barbut
- French Fecal Transplant Group (GFTF), France; ESGCD (ESCMID Study Group for Clostridioides difficile); National Reference Laboratory for Clostridioides difficile, AP-HP, Hôpital Saint-Antoine, Paris, France; Université Paris Cité, INSERM UMR-1139, Paris, France
| | - Fidelma Fitzpatrick
- ESGHAMI (ESCMID Study Group for Host and Microbiota Interactions); ESGCD (ESCMID Study Group for Clostridioides difficile); Departments of Clinical Microbiology, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
| | - Marcela Krutova
- ESGCD (ESCMID Study Group for Clostridioides difficile); Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kerrie Davies
- ESGCD (ESCMID Study Group for Clostridioides difficile); Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom
| | | | | | - John Heritage
- ESGCD (ESCMID Study Group for Clostridioides difficile); Patient representative, ESCMID Study Group for Clostridioides difficile; Faculty of Biological Sciences (retired), University of Leeds, Leeds, United Kingdom
| | - Benoît Guery
- ESGHAMI (ESCMID Study Group for Host and Microbiota Interactions); ESGCD (ESCMID Study Group for Clostridioides difficile); Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Member of the European Fecal Microbiota Transplantation Network
| | - Ed Kuijper
- ESGHAMI (ESCMID Study Group for Host and Microbiota Interactions); ESGCD (ESCMID Study Group for Clostridioides difficile); Department of Medical Microbiology, Center for Microbiota Analysis and Therapeutics at Leiden University Medical Centre, Albinusdreef 2, Leiden, The Netherlands; Member of the European Fecal Microbiota Transplantation Network
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Khanafer NL, Fitzpatrick F, Barbut F, Krutova M, Davies K, Guery B, Vanhems P. Heterogeneity in practices to reduce the risk of transmission of Clostridioides difficile in healthcare settings: a survey of ESCMID Study Group for Clostridioides difficile (ESGCD) members. Eur J Clin Microbiol Infect Dis 2024; 43:785-789. [PMID: 38332395 DOI: 10.1007/s10096-024-04767-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
Clostridioides difficile is a leading cause of healthcare-associated infections. The main objective was to assess the current landscape of CDI infection prevention and control (IPC) practices. An anonymous survey of IPC practices for CDI was conducted between July 25 and October 31, 2022. Precautions for symptomatic patients were applicable for 75.9% and were discontinued 48 h minimum after the resolution of diarrhea for 40.7% of respondents. Daily cleaning of CDI patients' rooms was reported by 23 (42.6%). There was unexpected heterogeneity in IPC practices regarding the hospital management of CDI.
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Affiliation(s)
- Nagham Léa Khanafer
- Infection Control Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), Lyon, France.
- PHE3ID team, Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, Lyon, France.
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland.
| | - Fidelma Fitzpatrick
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, The Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Frédéric Barbut
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Infection Control Unit, Assistance Publique - Hôpitaux de Paris, Paris, France
- National reference Laboratory for Clostridioides difficile, Paris, France
| | - Marcela Krutova
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kerrie Davies
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals, Leeds, UK
| | - Benoit Guery
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile - ESGCD, Basel, Switzerland
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Vanhems
- Infection Control Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon (HCL), Lyon, France
- PHE3ID team, Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, Lyon, France
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Stordeur F, Si Larbi AG, Le Neindre K, Ory J, Faibis F, Lawrence C, Barbut F, Lecointe D, Farfour E. A predictive score for the result of carbapenem-resistant Enterobacterales and vancomycin-resistant enterococci screening. J Hosp Infect 2024; 148:20-29. [PMID: 38490490 DOI: 10.1016/j.jhin.2024.02.024] [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: 11/12/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND The duration of extensively drug-resistant bacteria (XDR) carriage depends on several factors for which the information can be difficult to recover. AIM To determine whether past screening and clinical results of patients can predict the results of subsequent screening. METHODS In total, 256 patients were retrospectively included from 10 healthcare centres in France from January 2014 to January 2022. We created a predictive clearance score, ranging from -5 to +7, that included the number of XDR species and the type of resistance detected in the sample, as well as the time from the last positive sample, the number of previous consecutive negative samples, and obtaining at least one negative PCR result in the collection. This score could be used for the upcoming rectal screening of a patient carrying an XDR as soon as the last screening sample was negative. FINDINGS The negative predictive value was >99% for score ≤0. The median time to achieve XDR clearance was significantly shorter for a score of 0 (443 days (259-705)) than that based on previously published criteria. CONCLUSION This predictive score shows high performance for the assessment of XDR clearance. Relative to previous guidelines, it could help to lift specific infection prevention and control measures earlier. Nevertheless, the decision should be made according to other factors, such as antimicrobial use and adherence to hand hygiene.
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Affiliation(s)
- F Stordeur
- Structure interne de gestion des risques, hygiène, qualité (SIGRHYQ), Centre Hospitalier Poissy-Saint-Germain en Laye, Poissy, France; Unité de prévention du risque infectieux (UPRI), AP-HP Sorbonne Université - Site Saint-Antoine, Paris, France; Centre régional en Antibiothérapie (CRAtb) Ile-de-France, Paris, France.
| | - A-G Si Larbi
- Service d'hémovigilance, Hôpital Foch, Suresnes, France
| | - K Le Neindre
- Microbiologie de l'environnement, AP-HP Sorbonne Université - Site Saint-Antoine, Paris, France; Service de Prévention & Contrôle de l'Infection, département des Agents Infectieux, CHU Caen Normandie, Caen, France
| | - J Ory
- Service de microbiologie et hygiène hospitalière, CHU Nîmes, Nîmes, France
| | - F Faibis
- Microbiologie, Grand Hôpital de l'est francilien (GHEF), site Jossigny, France
| | - C Lawrence
- Structure interne de gestion des risques, hygiène, qualité (SIGRHYQ), Centre Hospitalier Poissy-Saint-Germain en Laye, Poissy, France; Equipe opérationnelle d'hygiène, AP-HP Université Paris Saclay, site Raymond-Poincaré, Garches, France; Equipe de prévention des infections, Centre Hospitalier François Quesnay, Mantes-la-Jolie, France
| | - F Barbut
- Unité de prévention du risque infectieux (UPRI), AP-HP Sorbonne Université - Site Saint-Antoine, Paris, France; Microbiologie de l'environnement, AP-HP Sorbonne Université - Site Saint-Antoine, Paris, France; Centre National de Référence du Clostridioïdes difficile, Paris, France; INSERM, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - D Lecointe
- Service d'hygiène, Prévention et Contrôle des Infections, Centre Hospitalier Sud Francilien (CHSF), Corbeil-Essonnes, France
| | - E Farfour
- Service de Biologie Clinique, hôpital Foch, Suresnes, France
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Granata G, Barbut F, Petrosillo N. Editorial: Clostridioides difficile infection. Front Med (Lausanne) 2024; 11:1372813. [PMID: 38468753 PMCID: PMC10925766 DOI: 10.3389/fmed.2024.1372813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Affiliation(s)
- Guido Granata
- Systemic and Immune Depression-Associated Infection Unit, National Institute for Infectious Diseases “L. Spallanzani”, IRCCS, Rome, Italy
| | - Frédéric Barbut
- National Reference Laboratory for Clostridioides Difficile, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nicola Petrosillo
- Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Durand C, Jolivet S, Le Neindre K, Couturier J, Lazare C, Montagne T, Nou G, Leplay C, Barbut F. Contamination of hospital drains and toilets by carbapenemase-producing Enterobacterales: a prevalence study apart from any outbreak context. J Hosp Infect 2024:S0195-6701(24)00037-9. [PMID: 38316258 DOI: 10.1016/j.jhin.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 02/07/2024]
Affiliation(s)
- C Durand
- Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - S Jolivet
- Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - K Le Neindre
- 3PHM, UMR 1139, INSERM, Université de Paris, Faculté de Pharmacie Paris, Paris, France; Service de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J Couturier
- 3PHM, UMR 1139, INSERM, Université de Paris, Faculté de Pharmacie Paris, Paris, France; Service de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Lazare
- Service de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - T Montagne
- Service de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - G Nou
- Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Leplay
- Pharmacie à Usage Intérieur, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - F Barbut
- Unité de prévention du risque infectieux, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France; 3PHM, UMR 1139, INSERM, Université de Paris, Faculté de Pharmacie Paris, Paris, France; Service de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Ferraris L, Delannoy J, Mazuet C, Diancourt L, Mesa-Schein V, Barbut F, Aires J. Clostridium neonatale antimicrobial susceptibility, genetic resistance determinants, and genotyping: a multicentre spatiotemporal retrospective analysis. J Antimicrob Chemother 2024; 79:271-279. [PMID: 38084883 PMCID: PMC10832599 DOI: 10.1093/jac/dkad369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Clostridium neonatale was isolated during an outbreak of neonatal necrotizing enterocolitis (NEC) in 2002. C. neonatale was validated as a new species within the genus Clostridium sensu stricto in 2018. In the present study, we evaluated the antimicrobial susceptibility, genetic determinants of resistance, and phylogenetic relationships of a collection of clinical isolates of C. neonatale. METHODS C. neonatale strains (n = 68) were isolated from the stools of preterm neonates who either developed NEC or were asymptomatic carriers of C. neonatale in different periods and in different hospitals. Antimicrobial susceptibility was determined by the disc diffusion method. The MICs of clindamycin, cefotaxime and tetracycline were determined. Genetic determinants of resistance were screened by PCR (n = 68) and WGS (n = 35). Genotyping of the isolates was performed by MLST. RESULTS Antimicrobial resistance was found to clindamycin (n = 24; 35%), cefotaxime (n = 7; 10%) and tetracycline (n = 1; 1%). One clindamycin-resistant isolate carried erm(B) by PCR. In addition, one isolate carrying tet(M) was tetracycline resistant (MIC = 16 mg/L) and 44 isolates carrying either tet(O), tet(32) or tet(M) were tetracycline susceptible (MICs < 16 mg/L). MLST showed that ST2 and ST15 were significantly associated with tet(32) (P < 0.0001) and tet(O) (P < 0.0001), respectively. From WGS, we identified aph(3')-IIa and blaTEM-116 genes and a blaCBP-1-like gene. CONCLUSIONS C. neonatale is susceptible to anti-anaerobic molecules but resistant to clindamycin, cefotaxime and tetracycline. Genes encoding tetracycline ribosomal protection, macrolide-lincosamide-streptogramin B rRNA methyltransferase, aminoglycoside 3'-phosphotransferase and β-lactamases have been identified in genomic regions flanked by mobile genetic elements.
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Affiliation(s)
- Laurent Ferraris
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Paris F-75006, France
| | - Johanne Delannoy
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Paris F-75006, France
| | - Christelle Mazuet
- Institut Pasteur, Université Paris Cité, Centre National de Référence des Bactéries anaérobies et Botulisme, Paris F-75015, France
| | - Laure Diancourt
- Institut Pasteur, Université Paris Cité, Centre National de Référence des Bactéries anaérobies et Botulisme, Paris F-75015, France
| | - Victoria Mesa-Schein
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Paris F-75006, France
| | - Frédéric Barbut
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Paris F-75006, France
| | - Julio Aires
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Paris F-75006, France
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Hunault L, England P, Barbut F, Iannascoli B, Godon O, Déjardin F, Thomas C, Dupuy B, Guo C, Macdonald L, Gorochov G, Sterlin D, Bruhns P. A monoclonal antibody collection for C. difficile typing ? Gut Pathog 2024; 16:4. [PMID: 38243246 PMCID: PMC10797914 DOI: 10.1186/s13099-023-00592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/20/2023] [Indexed: 01/21/2024] Open
Abstract
Clostridioides difficile is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis in adults. Various C. difficile strains circulate currently, associated with different outcomes and antibiotic resistance profiles. However, most studies still focus on the reference strain 630 that does not circulate anymore, partly due to the lack of immunological tools to study current clinically important C. difficile PCR ribotypes. The goal of this study was to generate monoclonal antibodies recognizing various epidemic ribotypes of C. difficile. To do so, we immunized mice expressing human variable antibody genes with the Low Molecular Weight (LMW) subunit of the surface layer protein SlpA from various C. difficile strains. Monoclonal antibodies purified from hybridomas bound LMW with high-affinity and whole bacteria from current C. difficile ribotypes with different cross-specificities. This first collection of anti-C. difficile mAbs represent valuable tools for basic and clinical research.
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Affiliation(s)
- Lise Hunault
- Antibodies in Therapy and Pathology, Institut Pasteur, Université Paris Cité, INSERM UMR1222, 75015, Paris, France
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM, CNRS, 75013, Paris, France
- Sorbonne Université, Collège doctoral, 75005, Paris, France
| | - Patrick England
- Plateforme de Biophysique Moléculaire, Institut Pasteur, Université Paris Cité, CNRS UMR3528, 75015, Paris, France
| | - Frédéric Barbut
- National Reference Laboratory for Clostridium difficile, 75012, Paris, France
- Université Paris Cité, INSERM UMR-1139, Paris, France
| | - Bruno Iannascoli
- Antibodies in Therapy and Pathology, Institut Pasteur, Université Paris Cité, INSERM UMR1222, 75015, Paris, France
| | - Ophélie Godon
- Antibodies in Therapy and Pathology, Institut Pasteur, Université Paris Cité, INSERM UMR1222, 75015, Paris, France
| | - François Déjardin
- Production and Purification of Recombinant Proteins Facility, Institut Pasteur, 75015, Paris, France
| | - Christophe Thomas
- Production and Purification of Recombinant Proteins Facility, Institut Pasteur, 75015, Paris, France
| | - Bruno Dupuy
- UMR-CNRS 6047, Laboratoire Pathogenèse des Bactéries Anaérobies, Institut Pasteur, Université Paris-Cité, 75015, Paris, France
| | | | | | - Guy Gorochov
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM, CNRS, 75013, Paris, France.
| | - Delphine Sterlin
- Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, INSERM, CNRS, 75013, Paris, France
| | - Pierre Bruhns
- Antibodies in Therapy and Pathology, Institut Pasteur, Université Paris Cité, INSERM UMR1222, 75015, Paris, France.
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Couturier J, Davies K, Barbut F. Ribotypes and New Virulent Strains Across Europe. Adv Exp Med Biol 2024; 1435:151-168. [PMID: 38175475 DOI: 10.1007/978-3-031-42108-2_8] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Clostridioides (formerly Clostridium) difficile is a major bacterial cause of post-antibiotic diarrhoea. The epidemiology of C. difficile infections (CDIs) has dramatically changed since the early 2000s, with an increasing incidence and severity across Europe. This trend is partly due to the emergence and rapid worldwide spread of the hypervirulent and epidemic PCR ribotype 027. Profiles of patients with CDI have also evolved, with description of community-acquired (CA) infections in patients with no traditional risk factors for CDI. However, epidemiological studies indicated that some European countries have successfully controlled the dissemination of the 027 clone whereas other countries reported the emergence of other virulent or unusual strains. The aims of this review are to summarize the current European CDI epidemiology and to describe the new virulent C. difficile strains circulating in Europe, as well as other potential emerging strains described elsewhere. Standardized typing methods and surveillance programmes are mandatory for a better understanding and monitoring of CDI in Europe.
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Affiliation(s)
- Jeanne Couturier
- National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Paris, France.
- Université Paris Cité, UMR INSERM 1139, Paris, France.
| | - Kerrie Davies
- Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for Clostridioides difficile (ESGCD), Basel, Switzerland
| | - Frédéric Barbut
- National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Paris, France
- Université Paris Cité, UMR INSERM 1139, Paris, France
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for Clostridioides difficile (ESGCD), Basel, Switzerland
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10
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Mesa V, Delannoy J, Ferraris L, Diancourt L, Mazuet C, Barbut F, Aires J. Core-genome multilocus sequence typing and core-SNP analysis of Clostridium neonatale strains isolated in different spatio-temporal settings. Microbiol Spectr 2023; 11:e0276623. [PMID: 37909758 PMCID: PMC10714970 DOI: 10.1128/spectrum.02766-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
IMPORTANCE Clostridium neonatale has been isolated from the fecal samples of asymptomatic neonates and cases of necrotizing enterocolitis (NEC). Taking advantage of a large collection of independent strains isolated from different spatio-temporal settings, we developed and established a cgMLST scheme for the molecular typing of C. neonatale. Both the cgMLST and cgSNP methods demonstrate comparable discrimination power. Results indicate geographic- and temporal- independent clustering of C. neonatale NEC-associated strains. No specific cgMLST clade of C. neonatale was genetically associated with NEC.
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Affiliation(s)
- Victoria Mesa
- Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Faculté de Pharmacie de Paris, Paris, France
| | - Johanne Delannoy
- Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Faculté de Pharmacie de Paris, Paris, France
| | - Laurent Ferraris
- Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Faculté de Pharmacie de Paris, Paris, France
| | - Laure Diancourt
- Institut Pasteur, Université de Paris Cité, Centre National de Référence des Bactéries anaérobies et Botulisme, Paris, France
| | - Christelle Mazuet
- Institut Pasteur, Université de Paris Cité, Centre National de Référence des Bactéries anaérobies et Botulisme, Paris, France
| | - Frédéric Barbut
- Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Faculté de Pharmacie de Paris, Paris, France
| | - Julio Aires
- Université Paris Cité, INSERM, UMR-S 1139 (3PHM), Faculté de Pharmacie de Paris, Paris, France
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11
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Salandre A, Delannoy J, Goudiaby MTB, Barbut F, Thomas M, Waligora-Dupriet AJ, Kapel N. A Simple In Vitro Test to Select Stools for Fecal Microbiota Transplantation to Limit Intestinal Carriage of Extensively Drug-Resistant Bacteria. Microorganisms 2023; 11:2753. [PMID: 38004765 PMCID: PMC10673217 DOI: 10.3390/microorganisms11112753] [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: 09/28/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Treatment options for multidrug-resistant bacterial infections are limited and often ineffective. Fecal microbiota transplantation (FMT) has emerged as a promising therapy for intestinal multidrug-resistant bacterial decolonization. However, clinical results are discrepant. The aim of our pilot study was to evaluate the screening performance of a simple diagnostic tool to select fecal samples that will be effective in decolonizing the intestine. Fecal samples from 10 healthy subjects were selected. We developed an agar spot test to evaluate their antagonistic activity toward the growth of VanA Enterococcus faecium and OXA-48-producing Klebsiella pneumoniae, two of the most serious and urgent threats of antibiotic resistance. Most fecal samples were able to limit the growth of both bacteria in vitro but with large inter-individual variation. The samples with the highest and lowest antagonistic activity were used for FMT in a mouse model of intestinal colonization. FMT was not successful in reducing intestinal colonization with VanA Enterococcus faecium, whereas FMT performed with the fecal sample showing the highest activity on the agar spot test was able to significantly reduce the intestinal colonization of mice with Klebsiella pneumoniae OXA-48. The agar spot test could thus serve as a reliable screening tool to select stool samples with the best potential to eradicate/reduce multidrug-resistant bacteria carriage after FMT.
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Affiliation(s)
- Angélique Salandre
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
| | - Johanne Delannoy
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
| | - Marie Thérèse Barba Goudiaby
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
| | - Frédéric Barbut
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
- Infection Control Unit, APHP, Saint-Antoine Hospital, F-75012 Paris, France
- Paris Center for Microbiome Medicine (PaCeMM), Fédération Hospitalo-Universitaire, F-75011 Paris, France;
| | - Muriel Thomas
- Paris Center for Microbiome Medicine (PaCeMM), Fédération Hospitalo-Universitaire, F-75011 Paris, France;
- Micalis Institute, AgroParisTech, INRAE, Université Paris-Saclay, F-78350 Jouy-en-Josas, France
| | - Anne-Judith Waligora-Dupriet
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
- Paris Center for Microbiome Medicine (PaCeMM), Fédération Hospitalo-Universitaire, F-75011 Paris, France;
| | - Nathalie Kapel
- INSERM UMR-S1139, Faculty of Pharmacy, Université Paris Cité, F-75006 Paris, France; (A.S.); (J.D.); (M.T.B.G.); (F.B.); (A.-J.W.-D.)
- Paris Center for Microbiome Medicine (PaCeMM), Fédération Hospitalo-Universitaire, F-75011 Paris, France;
- Department of Coprology, APHP, Pitié-Salpêtrière Hospital, F-75013 Paris, France
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12
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Aires J, Ilhan ZE, Nicolas L, Ferraris L, Delannoy J, Bredel M, Chauvire-Drouard A, Barbut F, Rozé JC, Lepage P, Butel MJ. Occurrence of Neonatal Necrotizing Enterocolitis in Premature Neonates and Gut Microbiota: A Case-Control Prospective Multicenter Study. Microorganisms 2023; 11:2457. [PMID: 37894115 PMCID: PMC10609581 DOI: 10.3390/microorganisms11102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) is still one of the leading causes of neonatal death. The present study reports the data from a French case-control prospective multicenter study. METHODS A total of 146 preterm neonates (PNs) with or without NEC were included. Bacterial 16S rRNA gene sequencing was performed on stool samples (n = 103). Specific culture media were used to isolate Escherichia coli, Clostridium butyricum, and Clostridium neonatale, and strains were phenotypically characterized. RESULTS The gut microbiota of PNs was dominated by Firmicutes and Proteobacteria, and five enterotypes were identified. The microbiota composition was similar between NEC cases and PN controls. However, differences were observed in the relative abundance of Lactobacillus genus, which was significantly lower in the NEC group, whereas that of the Clostridium cluster III was significantly higher (p < 0.05). Within enterotypes, several phylotypes were significantly more abundant in NEC cases (p < 0.05). Regarding perinatal factors, a statistical association was found between the gut microbiota and cesarean delivery and antifungal therapy. In NEC cases and PN controls, the carriage rates and virulence genes of uropathogenic E. coli were equivalent based on culture. No correlation was found between E. coli, C. butyricum, and C. neonatale carriages, beta-lactam resistance, and antibiotic treatment. CONCLUSIONS At disease onset, our data support a microbiota dysbiosis between NEC and control infants at the genus level. In addition, it provides valuable information on bacterial antimicrobial susceptibility.
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Affiliation(s)
- Julio Aires
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Zehra Esra Ilhan
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Lancelot Nicolas
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Laurent Ferraris
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Johanne Delannoy
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Maxime Bredel
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Anne Chauvire-Drouard
- Centre d’Investigation Clinique CIC 1413, INSERM, CHU de Nantes, 44093 Nantes, France;
| | - Frédéric Barbut
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
| | - Jean-Christophe Rozé
- Department of Neonatal Medicine, University Hospital of Nantes, 44093 Nantes, France;
| | - Patricia Lepage
- Micalis Institute, INRA, AgroParisTech, University Paris-Saclay, 91190 Paris, France; (Z.E.I.); (M.B.)
| | - Marie-José Butel
- Faculté de Pharmacie de Paris, Université Paris Cité, INSERM, UMR-S 1139 (3PHM), 75006 Paris, France (F.B.)
- FHU PREMA, Fighting Prematurity, 75014 Paris, France
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Faury HB, Awad Z, Jolivet S, Le Neindre K, Couturier J, Godmer A, Colle R, Levi LI, Cambau E, Barbut F. Investigation of a Mycobacterium fortuitum catheter-related bloodstream infection in an oncology unit. Infect Control Hosp Epidemiol 2023; 44:1342-1344. [PMID: 36804097 DOI: 10.1017/ice.2022.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
We describe a case of healthcare-associated bloodstream infection due to Mycobacterium fortuitum. Whole-genome sequencing showed that the same strain was isolated from the shared shower water of the unit. Nontuberculous mycobacteria frequently contaminate hospital water networks. Preventative actions are needed to reduce the exposure risk for immunocompromised patients.
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Affiliation(s)
- Hélène B Faury
- Unité de Prévention du Risque Infectieux, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Zeina Awad
- Service de Mycobactériologie Spécialisée et de Référence, Laboratoire Associé du Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Assistance Publique-Hôpitaux de Paris, GHU Nord, Hôpital Bichat, Paris, France
| | - Sarah Jolivet
- Unité de Prévention du Risque Infectieux, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Killian Le Neindre
- Laboratoire de Microbiologie de l'Environnement, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
- Université Paris Cité, INSERM S-1139, 3PHM, France
| | - Jeanne Couturier
- Laboratoire de Microbiologie de l'Environnement, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
- Université Paris Cité, INSERM S-1139, 3PHM, France
| | - Alexandre Godmer
- Département de Microbiologie, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Raphaël Colle
- Département d'Oncologie Médicale, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Laura I Levi
- Service des Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Emmanuelle Cambau
- Service de Mycobactériologie Spécialisée et de Référence, Laboratoire Associé du Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Assistance Publique-Hôpitaux de Paris, GHU Nord, Hôpital Bichat, Paris, France
- Université Paris Cité, INSERM UMR1137 IAME, Paris, France
| | - Frédéric Barbut
- Unité de Prévention du Risque Infectieux, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
- Laboratoire de Microbiologie de l'Environnement, Assistance Publique-Hôpitaux de Paris, GHU, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
- Université Paris Cité, INSERM S-1139, 3PHM, France
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14
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Jolivet S, Couturier J, Grohs P, Vilfaillot A, Zahar JR, Frange P, Casetta A, Moulin V, Lawrence C, Baune P, Bourgeois C, Bouffier A, Laussucq C, Sienzonit L, Picard S, Podglajen I, Kassis-Chikhani N, Barbut F. Prevalence and risk factors of toxigenic Clostridioides difficile asymptomatic carriage in 11 French hospitals. Front Med (Lausanne) 2023; 10:1221363. [PMID: 37547619 PMCID: PMC10402895 DOI: 10.3389/fmed.2023.1221363] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Clostridioides difficile infection (CDI) incidence has increased over the last 20 years. Studies suggest that asymptomatic carriers may be an important reservoir of C. difficile in healthcare settings. We conducted a point prevalence study to estimate the toxigenic C. difficile asymptomatic carriage rate and the associated risk factors in patients >3 years old. Between September 16, 2019 and January 15, 2020, all patients hospitalized in 11 healthcare facilities in the Paris urban area were included in the study. They were screened on the day of the survey for toxigenic C. difficile carriage by rectal swab and interviewed. Isolates were characterized by PCR ribotyping and multiplex PCR targeting toxin genes. A logistic regression model was used to determine the risk factors associated with toxigenic C. difficile asymptomatic carriage using uni- and multivariate analysis in the subpopulation of patients >3 years old. During the study period, 2,389 patients were included and screened. The median age was 62 years (interquartile range 35-78 years) and 1,153 were male (48.3%). Nineteen patients had a previous CDI (0.9%). Overall, 185/2389 patients were positive for C. difficile (7.7%), including 93 toxigenic strains (3.9%): 77 (82.8%) were asymptomatic (prevalence 3.2%) whereas 12 (12.9%) were diarrheic. Prevalences of toxigenic C. difficile were 3.5% in patients >3 years old and 7.0% in ≤3 years old subjects, respectively. Toxigenic strains mainly belonged to PCR ribotypes 106 (n = 14, 15.0%), 014 (n = 12, 12.9%), and 020 (n = 10, 10.8%). Among toxigenic strains, 6 (6.4%) produced the binary toxin. In multivariate analysis, two factors were positively associated with toxigenic C. difficile asymptomatic carriage in patients >3 years old: multidrug-resistant organisms co-carriage [adjusted Odd Ratio (aOR) 2.3, CI 95% 1.2-4.7, p = 0.02] and previous CDI (aOR 5.8, CI 95% 1.2-28.6, p = 0.03). Conversely, consumption of raw milk products were associated with reduced risk of toxigenic C. difficile colonization (aOR 0.5, CI 95% 0.2-0.9, p = 0.01). We showed that there was a low prevalence of asymptomatic toxigenic C. difficile carriage in hospitalized patients. Consumption of raw milk prevents toxigenic C. difficile colonization, probably due to the barrier effect of milk-associated bacteria.
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Affiliation(s)
- Sarah Jolivet
- Unité de prévention du risque infectieux, Hôpital Saint Antoine, Paris, France
| | - Jeanne Couturier
- Laboratoire de microbiologie de l’environnement, Hôpital Saint Antoine, Paris, France
- National Reference Laboratory for Clostridioides difficile, Paris, France
| | - Patrick Grohs
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Aurélie Vilfaillot
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France
- INSERM Centre d’Investigation Clinique 1418, Paris, France
| | - Jean-Ralph Zahar
- Unité de Prévention du Risque infectieux, Hôpitaux Avicenne, Bobigny/Jean Verdier, Bondy/René Muret, Sevran, France
| | - Pierre Frange
- Équipe de Prévention du Risque infectieux, Laboratoire de microbiologie clinique, Hôpital Necker – Enfants malades, Groupe hospitalier Assistance Publique – Hôpitaux de Paris (APHP) Centre – Université Paris Cité, Paris, France
| | - Anne Casetta
- Équipe de Prévention du Risque infectieux, Hôpital Cochin, Paris, France
| | - Véronique Moulin
- Équipe de Prévention du Risque infectieux, Hôpitaux Corentin Celton/Vaugirard, Issy-les-Moulineaux, France
| | - Christine Lawrence
- Équipe de Prévention du Risque infectieux, GHU Paris-Saclay site R. Poincaré, Garches, France
| | - Patricia Baune
- Équipe de Prévention du Risque infectieux, Hôpital Paul Brousse, Villejuif, France
| | - Cléo Bourgeois
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France
- INSERM Centre d’Investigation Clinique 1418, Paris, France
| | - Axel Bouffier
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France
- INSERM Centre d’Investigation Clinique 1418, Paris, France
| | - Claudine Laussucq
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Lydia Sienzonit
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Simon Picard
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Isabelle Podglajen
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Najiby Kassis-Chikhani
- Équipe de Prévention du Risque infectieux, Hôpital Européen Georges Pompidou, Paris, France
| | - Frédéric Barbut
- Unité de prévention du risque infectieux, Hôpital Saint Antoine, Paris, France
- Laboratoire de microbiologie de l’environnement, Hôpital Saint Antoine, Paris, France
- National Reference Laboratory for Clostridioides difficile, Paris, France
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15
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Marchandin H, Anjou C, Poulen G, Freeman J, Wilcox M, Jean-Pierre H, Barbut F. In vivo emergence of a still uncommon resistance to fidaxomicin in the urgent antimicrobial resistance threat Clostridioides difficile. J Antimicrob Chemother 2023:dkad194. [PMID: 37352110 DOI: 10.1093/jac/dkad194] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/02/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Fidaxomicin is a first-line treatment for Clostridioides difficile infections (CDIs). Fidaxomicin resistance has rarely been reported in this urgent antimicrobial resistance threat as defined by the CDC. OBJECTIVES To report a case of fidaxomicin-resistant C. difficile isolation in a patient treated by fidaxomicin, characterize the genetic determinant for resistance and the consequences on pathophysiological traits, and review the literature. PATIENT AND METHODS A 38-year-old male patient with several risk factors for CDI experienced three episodes of hospital-acquired CDI and received fidaxomicin for the first episode. The successive isolates were subjected to phenotypic characterization (antimicrobial susceptibility, growth, sporulation ability and toxin production) and WGS analysis to evaluate clonality and modifications associated with resistance. RESULTS Resistance to fidaxomicin arose in isolates from the recurrences of CDI (MIC: 16 mg/L). WGS analysis showed a close genetic link between strains suggestive of relapses in this patient. A T3428G mutation in the rpoB gene might be associated with fidaxomicin resistance. The resistance was associated with defects in growth, sporulation and production of toxins. A review of the literature found only three previous fidaxomicin-resistant C. difficile clinical strains. CONCLUSIONS Although rarely reported, resistance to fidaxomicin may quickly emerge in vivo after a single course of treatment. This observation supports the need for prospective surveillance of the susceptibility of C. difficile to treatment antibiotics. However, the clinical relevance of fidaxomicin resistance still needs to be elucidated, particularly due to its apparent rareness and associated fitness cost.
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Affiliation(s)
- Hélène Marchandin
- HydroSciences Montpellier, University of Montpellier, CNRS, IRD, Microbiology and Infection Control Laboratory, Nîmes University Hospital, Montpellier 34093, France
| | - Cyril Anjou
- Institut Pasteur Laboratory Pathogenesis of Bacterial Anaerobes, Université Paris Cité, Paris 75015, France
| | - Gaëtan Poulen
- Neurosurgery Department, Montpellier University Hospital, Montpellier 34295, France
| | - Jane Freeman
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile (ESGCD), Basel, Switzerland
- Healthcare Associated Infection Research Group, Leeds Teaching Hospitals National Health Service (NHS) Trust & University of Leeds, Leeds LS1 3EX, UK
| | - Mark Wilcox
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile (ESGCD), Basel, Switzerland
- Healthcare Associated Infection Research Group, Leeds Teaching Hospitals National Health Service (NHS) Trust & University of Leeds, Leeds LS1 3EX, UK
| | - Hélène Jean-Pierre
- Maladies Infectieuses et Vecteurs-Écologie, Génétique, Évolution et Contrôle, University of Montpellier, CNRS, IRD, Bacteriology Laboratory, Montpellier University Hospital, Montpellier 34295, France
| | - Frédéric Barbut
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Clostridioides difficile (ESGCD), Basel, Switzerland
- Infection Control Unit, Saint-Antoine Hospital, AP-HP, Paris 75012, France
- National Reference Laboratory for Clostridioides difficile, Saint-Antoine Hospital, AP-HP, Paris 75012, France
- Université Paris Cité, INSERM UMR-1139, Paris 75006, France
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16
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Krutova M, Davis K, Guery B, Barbut F. Faecal microbiota transplantation for first and second episodes of Clostridioides difficile infection. Lancet Gastroenterol Hepatol 2023; 8:111-112. [PMID: 36620980 DOI: 10.1016/s2468-1253(22)00388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Marcela Krutova
- Department of Medical Microbiology, 2nd Faculty of Medicine Charles University and Motol University Hospital, Prague 150 06, Czech Republic; The European Society of Clinical Microbiology and Infectious Diseases Study Group for C difficile, Basel, Switzerland.
| | - Kerrie Davis
- Healthcare Associated Infection Research Group, Leeds Teaching Hospitals National Health Service Trust and University of Leeds, Leeds, UK; The European Society of Clinical Microbiology and Infectious Diseases Study Group for C difficile, Basel, Switzerland
| | - Benoit Guery
- Department of Medicine, Infectious Diseases Service, University Hospital and University of Lausanne, Lausanne, Switzerland; The European Society of Clinical Microbiology and Infectious Diseases Study Group for C difficile, Basel, Switzerland
| | - Frédéric Barbut
- National Reference Laboratory for Clostridioides difficile, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France; The European Society of Clinical Microbiology and Infectious Diseases Study Group for C difficile, Basel, Switzerland
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17
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Torres-Maravilla E, Holowacz S, Delannoy J, Lenoir L, Jacouton E, Gervason S, Meynier M, Boucard AS, Carvalho FA, Barbut F, Bermúdez-Humarán LG, Langella P, Waligora-Dupriet AJ. Serpin-positive Bifidobacterium breve CNCM I-5644 improves intestinal permeability in two models of irritable bowel syndrome. Sci Rep 2022; 12:19776. [PMID: 36396717 PMCID: PMC9672316 DOI: 10.1038/s41598-022-21746-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
Probiotic supplementation can help to mitigate the pathogenesis of irritable bowel syndrome (IBS) by reinforcing the intestinal barrier, and reducing both inflammation and proteolytic activity. Here, a combination of in vitro tests was performed on 33 Bifidobacterium strains as probiotic candidates for IBS. In addition to the classical tests performed, the detection of the serine protease inhibitor (serpin) enzyme capable of decreasing the high proteolytic activity found in IBS patients was included. Three serpin-positive strains were selected: Bifidobacterium breve CNCM I-5644, Bifidobacterium longum subsp. infantis CNCM I-5645 and B. longum CNCM I-5646 for their immunomodulation properties and protection of intestinal epithelial integrity in vitro. Furthermore, we found that B. breve CNCM I-5644 strain prevented intestinal hyperpermeability by upregulating Cingulin and Tight Junction Protein 1 mRNA levels and reducing pro-inflammatory markers. The ability of CNCM I-5644 strain to restore intestinal hyperpermeability (FITC-dextran) was shown in the murine model of low-grade inflammation induced by dinitrobenzene sulfonic acid (DNBS). This effect of this strain was corroborated in a second model of IBS, the neonatal maternal separation model in mice. Altogether, these data suggest that serpin-positive B. breve CNCM I-5644 may partially prevent disorders associated with increased barrier permeability such as IBS.
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Affiliation(s)
- Edgar Torres-Maravilla
- grid.460789.40000 0004 4910 6535INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, 78350 Jouy-en-Josas, France ,grid.7429.80000000121866389Université Paris Cité, INSERM, 3PHM, F-75006 Paris, France
| | - Sophie Holowacz
- PiLeJe Laboratoire, 37 Quai de Grenelle, 75015 Paris Cedex 15, France
| | - Johanne Delannoy
- grid.7429.80000000121866389Université Paris Cité, INSERM, 3PHM, F-75006 Paris, France
| | - Loïc Lenoir
- PiLeJe Laboratoire, 37 Quai de Grenelle, 75015 Paris Cedex 15, France
| | - Elsa Jacouton
- PiLeJe Laboratoire, 37 Quai de Grenelle, 75015 Paris Cedex 15, France
| | - Sandie Gervason
- grid.494717.80000000115480420INSERM UMR 1107 NeuroDol, University of Clermont Auvergne, 63001 Clermont-Ferrand, France
| | - Maëva Meynier
- grid.494717.80000000115480420INSERM UMR 1107 NeuroDol, University of Clermont Auvergne, 63001 Clermont-Ferrand, France
| | - Anne-Sophie Boucard
- grid.460789.40000 0004 4910 6535INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, 78350 Jouy-en-Josas, France
| | - Frédéric A. Carvalho
- grid.494717.80000000115480420INSERM UMR 1107 NeuroDol, University of Clermont Auvergne, 63001 Clermont-Ferrand, France
| | - Frédéric Barbut
- grid.7429.80000000121866389Université Paris Cité, INSERM, 3PHM, F-75006 Paris, France ,grid.50550.350000 0001 2175 4109National Reference Laboratory for C. Difficile, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
| | - Luis G. Bermúdez-Humarán
- grid.460789.40000 0004 4910 6535INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, 78350 Jouy-en-Josas, France
| | - Philippe Langella
- grid.460789.40000 0004 4910 6535INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, 78350 Jouy-en-Josas, France
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18
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Leducq V, Couturier J, Granger B, Jolivet S, Morand-Joubert L, Robert J, Denis M, Salauze B, Goldstein V, Zafilaza K, Rufat P, Marcelin AG, Jary A, Barbut F. Investigation of healthcare-associated COVID-19 in a large French hospital group by whole-genome sequencing. Microbiol Res 2022; 263:127133. [PMID: 35901580 PMCID: PMC9306220 DOI: 10.1016/j.micres.2022.127133] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 04/29/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Despite the quick implementation of infection prevention and control procedures and the use of personal protective equipment within healthcare facilities, many cases of nosocomial COVID-19 transmission have been reported. We aimed to estimate the frequency and impact of healthcare-associated COVID-19 (HA-COVID-19) and evaluate the contribution of whole-genome sequencing (WGS) in cluster investigation. METHODS We estimated the frequency and mortality of HA-COVID-19 infections from September 1 to November 30, 2020, with a focus on the evolution of hospitalized community-associated COVID-19 (CA-COVID-19) cases and cases detected among healthcare workers (HCWs) within the Sorbonne University Hospital Group (Paris, France). We thoroughly examined 12 clusters through epidemiological investigations and WGS. RESULTS Overall, 209 cases of HA-COVID-19 were reported. Evolution of HA-COVID-19 incidence closely correlated with the incidence of CA-COVID-19 and COVID-19 among HCWs. During the study period, 13.9 % of hospitalized patients with COVID-19 were infected in the hospital and the 30-day mortality rate of HA-COVID-19 was 31.5 %. Nosocomial transmission of SARS-CoV-2 led to clusters involving both patients and HCWs. WGS allowed the exclusion of one-third of cases initially assigned to a cluster. CONCLUSIONS WGS analysis combined with comprehensive epidemiological investigations is essential to understand transmission routes and adapt the IPC response to protect both patients and HCWs.
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Affiliation(s)
- Valentin Leducq
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France.
| | - Jeanne Couturier
- Unité de Prévention du Risque Infectieux, Hôpital Saint-Antoine, GH Sorbonne Université, AP-HP, Paris, France
| | - Benjamin Granger
- Département de Santé Publique, Hôpital de la Pitié-Salpêtrière, GH Sorbonne Université, AP-HP, Paris, France
| | - Sarah Jolivet
- Unité de Prévention du Risque Infectieux, Hôpital Saint-Antoine, GH Sorbonne Université, AP-HP, Paris, France
| | - Laurence Morand-Joubert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, APHP, Hôpital Saint-Antoine, Département de Virologie, Paris, France
| | - Jérôme Robert
- Equipe Opérationnelle d'Hygiène, Hôpital de la Pitié-Salpêtrière, GH Sorbonne Université, AP-HP, Paris, France
| | - Michel Denis
- Equipe Opérationnelle d'Hygiène, Hôpital Tenon, GH Sorbonne Université, AP-HP, Paris, France
| | - Beatrice Salauze
- Equipe Opérationnelle d'Hygiène, Hôpitaux Trousseau et Rothschild, GH Sorbonne Université, AP-HP, Paris, France
| | - Valérie Goldstein
- Equipe Opérationnelle d'Hygiène Hôpital Charles Foix, GH Sorbonne Université, AP-HP, Ivry, France
| | - Karen Zafilaza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Pierre Rufat
- Département d'Information Médicale, Hôpital de la Pitié-Salpêtrière, GH Sorbonne Université, AP-HP, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Aude Jary
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - Frédéric Barbut
- Unité de Prévention du Risque Infectieux, Hôpital Saint-Antoine, GH Sorbonne Université, AP-HP, Paris, France
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19
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Grohs P, Vilfaillot A, Zahar JR, Barbut F, Frange P, Casetta A, Moulin V, Lawrence C, Baune P, Bourgeois C, Bouffier A, Laussucq C, Sienzonit L, Picard S, Podglajen I, Kassis-Chikhani N. Faecal carriage of multidrug-resistant bacteria and associated risk factors: results from a point prevalence study. J Antimicrob Chemother 2022; 77:2667-2678. [PMID: 36031727 DOI: 10.1093/jac/dkac289] [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] [Received: 03/22/2022] [Accepted: 08/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Since 2003, incidences of carbapenemase-producing Gram-negative bacilli (CP-GNB) and vancomycin-resistant Enterococcus faecium (VRE) have steadily increased in France. We therefore conducted a point prevalence study to estimate carriage rates of CP-GNB, VRE and ESBL-producing Enterobacterales (ESBL-PE) and associated risk factors. METHODS Between September 2019 and January 2020, all inpatients hospitalized on a given day in 11 teaching hospitals in the Paris urban area were eligible. Patient interviews and rectal swab screening results were recorded by dedicated nurses. The swabs were plated onto selective chromogenic media and processed using the GeneXpert® system. RESULTS Of 2396 patients, 364 (15.2%) yielded at least one multiresistant bacterial isolate, including 29 CP-GNB carriers (1.2%), 13 VRE carriers (0.5%) and 338 ESBL-PE carriers (14%). In 15 patients (4.4% of ESBL-PE carriers and 36.6% of CP-GNB/VRE carriers), concomitant CP-GNB/VRE and ESBL-PE carriage was observed. In 7/29 CP-GNB and 7/13 VRE carriers, carbapenemase production and vanA in the screening samples was only detected with Xpert® tests. The OXA-48 gene was predominant in 13/34 CP-GNB isolates from 29 carriers. From the 338 ESBL-PE carriers, 372 isolates were recovered, mainly Escherichia coli (61.2%). Among 379 children, 1.1% carried a CP-GNB/VRE strain, and 12.4% carried an ESBL strain. Previous hospitalization outside mainland France, previous antimicrobial treatment and previous ESBL-PE carriage were the main risk factors associated with CP-GNB and/or VRE carriage. CONCLUSIONS The low CP-GNB and VRE prevalence likely reflects the French policy to limit intrahospital spread of CP-GNB and VRE strains.
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Affiliation(s)
- Patrick Grohs
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Aurélie Vilfaillot
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Jean Ralph Zahar
- Equipe Opérationnelle en Hygiène, Hôpitaux Avicenne, Bobigny/Jean Verdier, Bondy/René Muret, Sevran, France
| | - Frédéric Barbut
- Equipe Opérationnelle en Hygiène, Hôpital St Antoine, Paris, France
| | - Pierre Frange
- Equipe Opérationnelle en Hygiène, Laboratoire de microbiologie clinique, Hôpital Necker - Enfants malades, Paris, France
| | - Anne Casetta
- Equipe Opérationnelle en Hygiène, Hôpital Cochin, Paris, France
| | - Véronique Moulin
- Equipe Opérationnelle en Hygiène, Hôpitaux Corentin Celton/Vaugirard, Issy-les-Moulineaux, France
| | - Christine Lawrence
- Equipe Opérationnelle en Hygiène, GHU Paris-Saclay site R, Poincaré, APHP, Garches, France
| | - Patricia Baune
- Equipe Opérationnelle en Hygiène, Hôpital Paul Brousse, Villejuif, France
| | - Cléo Bourgeois
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Axel Bouffier
- Unité de Recherche Clinique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Claudine Laussucq
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Lydia Sienzonit
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Simon Picard
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Isabelle Podglajen
- Laboratoire de microbiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Najiby Kassis-Chikhani
- Equipe Opérationnelle en Hygiène, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
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20
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Couturier J, Lepage P, Jolivet S, Delannoy J, Mesa V, Ancel PY, Rozé JC, Butel MJ, Barbut F, Aires J. Gut Microbiota Diversity of Preterm Neonates Is Associated With Clostridioides Difficile Colonization. Front Cell Infect Microbiol 2022; 12:907323. [PMID: 35873148 PMCID: PMC9296818 DOI: 10.3389/fcimb.2022.907323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
In adults, Clostridioides difficile infections are associated with alterations of the intestinal bacterial populations. Although preterm neonates (PN) are frequently colonized by C. difficile, limited data are available regarding the relationship between C. difficile and the intestinal microbiota of this specific population. Therefore, we studied the intestinal microbiota of PN from two multicenter cohorts using high-throughput sequencing of the bacterial 16S rRNA gene. Our results showed that alpha diversity was significantly higher in children colonized by C. difficile than those without colonization. Beta diversity significantly differed between the groups. In multivariate analysis, C. difficile colonization was significantly associated with the absence of postnatal antibiotherapy and higher gestational age. Taxa belonging to the Lachnospiraceae, Enterobacteriaceae, Oscillospiraceae families and Veillonella sp. were positively associated with C. difficile colonization, whereas Bacteroidales and Bifidobacterium breve were negatively associated with C. difficile colonization. After adjustment for covariables, Clostridioides, Rothia, Bifidobacterium, Veillonella, Eisenbergiella genera and Enterobacterales were more abundant in the gut microbiota of colonized children. There was no significant association between C. difficile colonization and necrotizing enterocolitis in PN. Our results suggest that C. difficile colonization in PN is related to the establishment of physiological microbiota.
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Affiliation(s)
- Jeanne Couturier
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
- National Reference Laboratory for Clostridioides difficile, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- *Correspondence: Jeanne Couturier,
| | - Patricia Lepage
- Paris-Saclay University, institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE) AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | - Sarah Jolivet
- Infection Control Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
| | - Johanne Delannoy
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
| | - Victoria Mesa
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
| | - Pierre-Yves Ancel
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Team (EPOPé), Center of Research in Epidemiology and Statistics (CRESS), Fédération hospitalo-universitaire (FHU) PREMA, Paris, France
- Unité de recherche clinique-Centre d'investigation clinique (URC-CIC) P1419, Hôpitaux universitaires Paris Centre (HUPC), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-Christophe Rozé
- Pediatric Intensive Care Unit, Mothers’ and children’s Hospital, Nantes Teaching Hospital, Nantes, France
| | - Marie-José Butel
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
| | - Frédéric Barbut
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
- National Reference Laboratory for Clostridioides difficile, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
- Infection Control Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France
| | - Julio Aires
- Université de Paris, Institut national de la santé et de la recherche médicale (INSERM) UMR S-1139 3PHM, Fédération hospitalo-universitaire (FHU) PREMA, F-75006, Paris, France
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21
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Boudjelal Y, Krutova M, Djebbar A, Sebaihia M, Bekara MEA, Rouabhia S, Couturier J, Syed-Zaidi R, Barbut F. Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals. J Infect Dev Ctries 2022; 16:1055-1063. [PMID: 35797301 DOI: 10.3855/jidc.16056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/15/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. METHODOLOGY Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes. RESULTS Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin. CONCLUSIONS Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.
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Affiliation(s)
- Youcef Boudjelal
- Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
| | - Marcela Krutova
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Abla Djebbar
- Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
| | - Mohammed Sebaihia
- Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria.
| | - Mohammed El Amine Bekara
- Laboratory of Molecular Biology, Genomics and Bioinformatics, Department of Biology, Faculty of Nature and Life Sciences, University Hassiba Benbouali of Chlef, Algeria
| | - Samir Rouabhia
- Department of Internal Medicine, University hospital Touhami Benflis, Batna, Algeria
| | - Jeanne Couturier
- National Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, France
| | - Rabab Syed-Zaidi
- National Reference Laboratory for C. difficile, Saint Antoine Hospital in Paris, AP-HP, France
| | - Frédéric Barbut
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for Clostridioides difficile (ESGCD)
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22
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Le Neindre K, Couturier J, Schnuriger A, Jolivet S, Gouot C, Majerholc M, Supplisson P, Tan C, Perrier M, Lazare C, Morand-Joubert L, Barbut F. Environmental severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contamination in hospital rooms during the first and third coronavirus disease 2019 (COVID-19) waves. Antimicrob Steward Healthc Epidemiol 2022; 2:e82. [PMID: 36483393 PMCID: PMC9726484 DOI: 10.1017/ash.2022.228] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 06/17/2023]
Abstract
We investigated the frequency, distribution, and risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination around infected patients during the first and third wave of the coronavirus disease 2019 pandemic. The shedding of SARS-CoV-2 in rooms of infected patients was limited in our hospital setting.
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Affiliation(s)
- Killian Le Neindre
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Jeanne Couturier
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Aurélie Schnuriger
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sarah Jolivet
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Gouot
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Mickaël Majerholc
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre Supplisson
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Céline Tan
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Marine Perrier
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
| | - Christelle Lazare
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
| | - Laurence Morand-Joubert
- Department of Virology, Saint-Antoine Tenon Trousseau Hospitals, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), France
- Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Frédéric Barbut
- Department of Environmental Microbiology, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
- Infection Control Unit, Saint-Antoine Hospital, Sorbonne Université, Assistance Publique – Hôpitaux de Paris (AP-HP), Paris, France
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23
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Gateau C, Melo GD, Uriac P, Tasseau O, Renault J, Blondel A, Gouault N, Barbut F, Minoprio P. Irreversible inhibitors of the proline racemase (PRAC) unveil innovative mechanism of action as antibacterial against Clostridioides difficile. Chem Biol Drug Des 2021; 99:513-526. [PMID: 34918458 DOI: 10.1111/cbdd.14005] [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: 09/24/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Abstract
Proline racemases (PRAC), catalyzing the L-proline and D-proline interconversion, are essential factors in eucaryotic pathogenes such as Trypanosoma cruzi, Trypanosoma vivax and Clostridioides difficile. If the discovery of irreversible inhibitors of Trypanosoma cruzi PRAC (TcPRAC) led to innovative therapy of the Chagas disease, no inhibitors of CdPRAC have been discovered to date. However, Clostridioides difficile, due to an increased incidence in recent years, is considered as a major cause of health threat. In this work, we have taken into account the similarity between TcPRAC and CdPRAC enzymes to design new inhibitors of CdPRAC. Starting from (E) 4-oxopent-2-enoic acid TcPRAC irreversible inhibitors, we synthesized 4-aryl substituted analogues and evaluated their CdPRAC enzymatic inhibition against eleven strains of Clostridioides difficile. This study resulted in promising candidates and allowed for identification of (E)-4-(3-bromothiophen-2-yl)-4-oxobut-2-enoic acid 20 that was chosen for complementary in vivo studies and did not reveal in vivo toxicity.
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Affiliation(s)
- Cécile Gateau
- AP-HP, Hôpital saint Antoine, National Reference Laboratory for Clostridioides difficile, 75012 Paris and Université de Paris, INSERM, UMR-S 1139, 3-PHM, F-75006, paris, France
| | - Guilherme D Melo
- Institut Pasteur, Département Santé Globale, Laboratoire des Processus Infectieux à Trypanosomatidés, 28 rue du Dr. Roux, 75015, Paris, France.,Institut Pasteur, Département Santé Globale, Unité Lyssavirus Epidemiologie et Neuropathologie, 28 rue du Dr. Roux, 75015, Paris, France
| | - Philippe Uriac
- Université de Rennes 1 - Faculté de Pharmacie, ISCR UMR CNRS 6226, Equipe CORINT, 2, Avenue du Pr. Léon Bernard, 35000, Rennes, France
| | - Olivier Tasseau
- Université de Rennes 1 - Faculté de Pharmacie, ISCR UMR CNRS 6226, Equipe CORINT, 2, Avenue du Pr. Léon Bernard, 35000, Rennes, France
| | - Jacques Renault
- Université de Rennes 1 - Faculté de Pharmacie, ISCR UMR CNRS 6226, Equipe CORINT, 2, Avenue du Pr. Léon Bernard, 35000, Rennes, France
| | - Arnaud Blondel
- Institut Pasteur, Département de Biologie Structurale et Chimie, Unité de Bioinformatique Structurale, CNRS, UMR 3528, 25 rue du Dr. Roux, 75015, Paris, France
| | - Nicolas Gouault
- Université de Rennes 1 - Faculté de Pharmacie, ISCR UMR CNRS 6226, Equipe CORINT, 2, Avenue du Pr. Léon Bernard, 35000, Rennes, France
| | - Frédéric Barbut
- AP-HP, Hôpital saint Antoine, National Reference Laboratory for Clostridioides difficile, 75012 Paris and Université de Paris, INSERM, UMR-S 1139, 3-PHM, F-75006, paris, France
| | - Paola Minoprio
- Institut Pasteur, Département Santé Globale, Laboratoire des Processus Infectieux à Trypanosomatidés, 28 rue du Dr. Roux, 75015, Paris, France.,Plateforme Scientifique Pasteur - USP, Av. Prof. Lucio Martins Rodrigues, 370, CEP 05508-020, Sao Paulo, Brazil
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24
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Levi LI, Barbut F, Chopin D, Rondeau P, Lalande V, Jolivet S, Badell E, Brisse S, Lacombe K, Surgers L. Cutaneous diphtheria: three case-reports to discuss determinants of re-emergence in resource-rich settings. Emerg Microbes Infect 2021; 10:2300-2302. [PMID: 34792439 PMCID: PMC8654395 DOI: 10.1080/22221751.2021.2008774] [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] [Indexed: 10/30/2022]
Abstract
Diphtheria is a re-emerging disease in resource-rich settings. We here report three cases of cutaneous diphtheria diagnosed and managed in our infectious disease department and discuss the determinants of its re-emergence. Migration, travel and vaccine scepticism are key factors not only for diphtheria re-emergence, but for the future of most preventable diseases.
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Affiliation(s)
- Laura I Levi
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Frédéric Barbut
- Unité de Prévention du Risque Infectieux, hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Dorothée Chopin
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Paul Rondeau
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Valérie Lalande
- Département de bactériologie, hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Sarah Jolivet
- Unité de Prévention du Risque Infectieux, hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France
| | - Edgar Badell
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Corynebacteria of the Diphtheriae Complex, Institut Pasteur, Paris, France
| | - Sylvain Brisse
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France.,National Reference Center for Corynebacteria of the Diphtheriae Complex, Institut Pasteur, Paris, France
| | - Karine Lacombe
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Laure Surgers
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, GHU APHP. Sorbonne Université, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
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25
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Derongs L, Druilhe C, Le Maréchal C, Barbut F, Heurtevent L, Buffet J, Martin L, Ziebal C, Poezevara T, Rouxel S, Houard E, Rabab SZ, Couturier J, Pourcher AM. Corrigendum to "Influence of operating conditions on the persistence of E. coli, enterococci, Clostridium perfringens and Clostridioides difficile in semi-continuous mesophilic anaerobic reactors" [Waste Manage. 134 (2021) 32-41]. Waste Manag 2021; 135:275. [PMID: 34560509 DOI: 10.1016/j.wasman.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Lorine Derongs
- INRAE, OPAALE Research Unit, CS 64427, F-35044 Rennes, France
| | - Céline Druilhe
- INRAE, OPAALE Research Unit, CS 64427, F-35044 Rennes, France
| | - Caroline Le Maréchal
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, BP53, F-22440 Ploufragan, France
| | - Frédéric Barbut
- National Reference Laboratory for Clostridium difficile, Saint-Antoine Hospital, Assistance Publique- Hôpitaux de Paris, 34 rue Crozatier, 75012 Paris, France; UMR INSERM S-1139, Faculté de Pharmacie de Paris, Université de Paris, France
| | | | - Julie Buffet
- INRAE, OPAALE Research Unit, CS 64427, F-35044 Rennes, France
| | - Laure Martin
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, BP53, F-22440 Ploufragan, France
| | | | - Typhaine Poezevara
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, BP53, F-22440 Ploufragan, France
| | - Sandra Rouxel
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, BP53, F-22440 Ploufragan, France
| | - Emmanuelle Houard
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, BP53, F-22440 Ploufragan, France
| | - Syed Zaidi Rabab
- National Reference Laboratory for Clostridium difficile, Saint-Antoine Hospital, Assistance Publique- Hôpitaux de Paris, 34 rue Crozatier, 75012 Paris, France; UMR INSERM S-1139, Faculté de Pharmacie de Paris, Université de Paris, France
| | - Jeanne Couturier
- National Reference Laboratory for Clostridium difficile, Saint-Antoine Hospital, Assistance Publique- Hôpitaux de Paris, 34 rue Crozatier, 75012 Paris, France; UMR INSERM S-1139, Faculté de Pharmacie de Paris, Université de Paris, France
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26
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Guillemard E, Poirel M, Schäfer F, Quinquis L, Rossoni C, Keicher C, Wagner F, Szajewska H, Barbut F, Derrien M, Malfertheiner P. A Randomised, Controlled Trial: Effect of a Multi-Strain Fermented Milk on the Gut Microbiota Recovery after Helicobacter pylori Therapy. Nutrients 2021; 13:nu13093171. [PMID: 34579049 PMCID: PMC8466689 DOI: 10.3390/nu13093171] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 06/15/2021] [Revised: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 12/21/2022] Open
Abstract
Helicobacter pylori (Hp) eradication therapy alters gut microbiota, provoking gastrointestinal (GI) symptoms that could be improved by probiotics. The study aim was to assess the effect in Hp patients of a Test fermented milk containing yogurt and Lacticaseibacillus (L. paracasei CNCM I-1518 and I-3689, L. rhamnosus CNCM I-3690) strains on antibiotic associated diarrhea (AAD) (primary aim), GI-symptoms, gut microbiota, and metabolites. A randomised, double-blind, controlled trial was performed on 136 adults under 14-day Hp treatment, receiving the Test or Control product for 28 days. AAD and GI-symptoms were reported and feces analysed for relative and quantitative gut microbiome composition, short chain fatty acids (SCFA), and calprotectin concentrations, and viability of ingested strains. No effect of Test product was observed on AAD or GI-symptoms. Hp treatment induced a significant alteration in bacterial and fungal composition, a decrease of bacterial count and alpha-diversity, an increase of Candida and calprotectin, and a decrease of SCFA concentrations. Following Hp treatment, in the Test as compared to Control group, intra-subject beta-diversity distance from baseline was lower (padj = 0.02), some Enterobacteriaceae, including Escherichia-Shigella (padj = 0.0082) and Klebsiella (padj = 0.013), were less abundant, and concentrations of major SCFA (p = 0.035) and valerate (p = 0.045) were higher. Viable Lacticaseibacillus strains were detected during product consumption in feces. Results suggest that, in patients under Hp treatment, the consumption of a multi-strain fermented milk can induce a modest but significant faster recovery of the microbiota composition (beta-diversity) and of SCFA production and limit the increase of potentially pathogenic bacteria.
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Affiliation(s)
- Eric Guillemard
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
- Correspondence: ; Tel.: +33-6-29-12-63-64
| | - Marion Poirel
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
| | - Florent Schäfer
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
| | - Laurent Quinquis
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
| | - Caroline Rossoni
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
| | - Christian Keicher
- Charité Research Organisation GmbH, 10117 Berlin, Germany; (C.K.); (F.W.)
| | - Frank Wagner
- Charité Research Organisation GmbH, 10117 Berlin, Germany; (C.K.); (F.W.)
| | - Hania Szajewska
- Department of Paediatrics, Medical University of Warsaw, 02-091 Warszawa, Poland;
| | | | - Muriel Derrien
- Danone Nutricia Research, Department of Innovation Science and Nutrition, 91767 Palaiseau, France; (M.P.); (F.S.); (L.Q.); (C.R.); (M.D.)
| | - Peter Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Magdeburg Clinic, OVGU University, 39120 Magdeburg, Germany;
- Department of Internal Medicine II, LMU University Clinic, 81377 München, Germany
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27
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Jolivet S, Couturier J, Vuillemin X, Gouot C, Nesa D, Adam M, Brissot E, Mohty M, Bonnin RA, Dortet L, Barbut F. Outbreak of OXA-48-producing Enterobacterales in a haematological ward associated with an uncommon environmental reservoir, France, 2016 to 2019. ACTA ACUST UNITED AC 2021; 26. [PMID: 34047273 PMCID: PMC8161731 DOI: 10.2807/1560-7917.es.2021.26.21.2000118] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The hospital water environment, including the wastewater drainage system, is increasingly reported as a potential reservoir for carbapenemase-producing Enterobacterales (CPE). We investigated a persistent outbreak of OXA-48 CPE (primarily Citrobacter freundii) in a haematological ward of a French teaching hospital by epidemiological, microbiological and environmental methods. Between January 2016 and June 2019, we detected 37 new OXA-48 CPE-colonised and/or ‑infected patients in the haematological ward. In October 2017, a unit dedicated to CPE-colonised and/or ‑infected patients was created. Eleven additional sporadic acquisitions were identified after this date without any obvious epidemiological link between patients, except in one case. Environmental investigations of the haematological ward (June–August 2018) identified seven of 74 toilets and one of 39 drains positive for OXA-48 CPE (seven C. freundii, one Enterobacter sakazakii, one Escherichia coli). Whole genome comparisons identified a clonal dissemination of OXA-48-producing C. freundii from the hospital environment to patients. In addition to strict routine infection control measures, an intensive cleaning programme was performed (descaling and bleaching) and all toilet bowls and tanks were changed. These additional measures helped to contain the outbreak. This study highlights that toilets can be a possible source of transmission of OXA-48 CPE.
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Affiliation(s)
- Sarah Jolivet
- IAME, UMR 1137, INSERM, Université de Paris, Paris, France.,Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jeanne Couturier
- Unité INSERM S-1139, Université de Paris, Faculté de Pharmacie, Paris, France.,Laboratoire de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Vuillemin
- Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cyril Gouot
- Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Didier Nesa
- Laboratoire de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marine Adam
- Laboratoire de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eolia Brissot
- Service d'Hématologie clinique et Thérapie cellulaire, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne University, INSERM UMRs 938, Paris, France
| | - Mohamad Mohty
- Service d'Hématologie clinique et Thérapie cellulaire, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne University, INSERM UMRs 938, Paris, France
| | - Rémy A Bonnin
- Bacteriology-Hygiene unit, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.,Unité EA7361 "Structure, dynamic, function and expression of broad spectrum β-lactamases", Université Paris Sud, Université Paris Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Laurent Dortet
- Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacteriaceae, Le Kremlin-Bicêtre, France.,Bacteriology-Hygiene unit, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.,Unité EA7361 "Structure, dynamic, function and expression of broad spectrum β-lactamases", Université Paris Sud, Université Paris Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Frédéric Barbut
- Unité INSERM S-1139, Université de Paris, Faculté de Pharmacie, Paris, France.,Laboratoire de Microbiologie de l'Environnement, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.,Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
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28
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Guery B, Berger P, Gauzit R, Gourdon M, Barbut F, Dafne Study Group, Bémer P, Bessède E, Camou F, Cattoir V, Couzigou C, Descamps D, Dinh A, Laurans C, Lavigne JP, Lechiche C, Leflon-Guibout V, Le Monnier A, Levast M, Mootien JY, N'Guyen Y, Piroth L, Prazuck T, Rogeaux O, Roux AL, Vachée A, Vernet Garnier V, Wallet F. A prospective, observational study of fidaxomicin use for Clostridioides difficile infection in France. J Int Med Res 2021; 49:3000605211021278. [PMID: 34162264 PMCID: PMC8236878 DOI: 10.1177/03000605211021278] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To describe the characteristics, management and outcomes of hospitalised patients with Clostridioides difficile infection (CDI) treated with and without fidaxomicin. METHODS This prospective, multicentre, observational study (DAFNE) enrolled hospitalised patients with CDI, including 294 patients treated with fidaxomicin (outcomes recorded over a 3-month period) and 150 patients treated with other CDI therapies during three 1-month periods. The primary endpoint was baseline and CDI characteristics of fidaxomicin-treated patients. RESULTS At baseline, the fidaxomicin-treated population included immunocompromised patients (39.1%) and patients with severe (59.2%) and recurrent (36.4%) CDI. Fidaxomicin was associated with a high rate of clinical cure (92.2%) and low CDI recurrence (16.3% within 3 months). Clinical cure rates were ≥90% in patients aged ≥65 years, those receiving concomitant antibiotics and those with prior or severe CDI. There were 121/296 (40.9%) patients with adverse events (AEs), 5.4% with fidaxomicin-related AEs and 1.0% with serious fidaxomicin-related AEs. No fidaxomicin-related deaths were reported. CONCLUSIONS Fidaxomicin is an effective and well-tolerated CDI treatment in a real-world setting in France, which included patients at high risk of adverse outcomes.Trial registration: Description of the use of fidaxomicin in hospitalised patients with documented Clostridium difficile infection and the management of these patients (DAFNE), NCT02214771, www.ClinicalTrials.gov.
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Affiliation(s)
- Benoit Guery
- University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Frédéric Barbut
- National Reference Laboratory for C. difficile, Saint-Antoine Hospital, Paris, France.,INSERM S-1139, Faculty of Pharmacy, University of Paris, Paris, France
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29
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Couturier J, Ginevra C, Nesa D, Adam M, Gouot C, Descours G, Campèse C, Battipaglia G, Brissot E, Beraud L, Ranc AG, Jarraud S, Barbut F. Transmission of Legionnaires' Disease through Toilet Flushing. Emerg Infect Dis 2021; 26:1526-1528. [PMID: 32568063 PMCID: PMC7323554 DOI: 10.3201/eid2607.190941] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We describe 2 cases of healthcare-associated Legionnaires’ disease in patients in France hospitalized 5 months apart in the same room. Whole-genome sequencing analyses showed that clinical isolates from the patients and isolates from the room’s toilet clustered together. Toilet contamination by Legionella pneumophila could lead to a risk for exposure through flushing.
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30
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Khanafer N, Hemmendinger A, Guery B, Vachée A, Rogues AM, Gravet A, Boutoille D, Vanjak D, Barbut F, Vanhems P. Establishment of a French surveillance system of Clostridiodes difficile infection: Comparison of patient's characteristics with other national and European data. Anaerobe 2021; 69:102329. [PMID: 33540110 DOI: 10.1016/j.anaerobe.2021.102329] [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] [Received: 08/04/2020] [Revised: 11/17/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The magnitude and scope of Clostridioides difficile infection (CDI) has changed with an increase in incidence and severity. The epidemiology of CDI is not well known in France due to difficulties to conduct large continuous surveillance. The objectives were to compare the characteristics of patients with CDI collected through repeated point prevalence survey via DIFTEC™, a free electronic tool, with those from previous French or European studies. METHODS DIFTEC™ was developed to evaluate epidemiological burden, diagnostic strategies and management of CDI in France. National and European guidelines were used for definitions. A literature review of studies conducted in Western Europe on CDI and published between January 2008 and May 2018 was done to compare their data with those included in the DIFTEC™ database. RESULTS From January 2016, to December 2017, 455 CDI episodes from 22 French hospitals were included. Most of CDI cases were health-care associated (HCA) (78%). The comparison between included patients and French literature data showed that the rates of previous antibiotics exposure, crude mortality and recurrence were not statistically different. However HCA-CDI was significantly more frequent in the DIFTEC™ study. Gender distribution, recurrence and crude mortality rates were not statistically different compared to European data. HCA-CDI was more frequent in the DIFTEC™ study whereas previous treatment with proton pump inhibitors and antibiotics were significantly higher in European studies. DISCUSSION These results illustrated the added value of a new tool for increasing the reliable knowledge of CDI in France based on epidemiological surveillance implemented in health-care settings.
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Affiliation(s)
- Nagham Khanafer
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France; Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; European Study Group for Clostridioides difficile (ESGCD), France.
| | - Anaelle Hemmendinger
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Benoit Guery
- European Study Group for Clostridioides difficile (ESGCD), France; Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anne Vachée
- Laboratory of Microbiology, Roubaix Hospital, Roubaix, France
| | - Anne-Marie Rogues
- Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, INSERM, University of Bordeaux, F-33000, Bordeaux, France; Hygiene and Infection Control Unit, University Hospital of Bordeaux, F-33000, Bordeaux, France
| | - Alain Gravet
- Laboratory of Microbiology, Mulhouse & Sud Alsace Hospital (GHRMSA), Mulhouse, France
| | - David Boutoille
- Infectious Diseases Department, CIC UIC 1413, INSERM, University Hospital of Nantes, Nantes, France
| | | | - Frédéric Barbut
- European Study Group for Clostridioides difficile (ESGCD), France; Hygiene and Infection Control Unit, Saint Antoine Hospital, University Hospital of Paris, Paris, France; National Reference Laboratory for Clostridioides Difficile, France; Université de Paris, INSERM UMR-1139, France
| | - Philippe Vanhems
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France; Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; INSERM, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
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31
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Couturier J, Franconeri L, Janoir C, Ferraris L, Syed-Zaidi R, Youssouf A, Gateau C, Hoys S, Aires J, Barbut F. Characterization of Non-Toxigenic Clostridioides difficile Strains Isolated from Preterm Neonates and In Vivo Study of Their Protective Effect. J Clin Med 2020; 9:jcm9113650. [PMID: 33202811 PMCID: PMC7696784 DOI: 10.3390/jcm9113650] [Citation(s) in RCA: 4] [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: 10/20/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
In a previous monocentric study in preterm neonates (PN), we described a high Clostridioides difficile colonization rate (74%) with two uncommon non-toxigenic strains (NTCD) belonging to PCR-ribotype (RT) (CE)847 and (CE)032. To determine the extent of carriage of both NTCD in other spatio-temporal settings, strains isolated in PN stools from two multicenter cohorts were characterized by PCR-ribotyping, MLVA and MLST. We also evaluated the protective role of two NTCD from these RT against C. difficile infection in a hamster caecitis model. Animals were administered either each NTCD alone (n = 7), or followed by a 027 strain (n = 9). A control group received only the 027 strain (n = 8). Clinical activity and colonization by C. difficile in stools were monitored daily until death or sacrifice at D20. We isolated 18 RT(CE)032 (ST-83) strains and 2 RT(CE)847 (ST-26) strains among 247 PN from both cohorts. Within each RT, strains were genetically related. The survival rate was significantly increased when animals received a RT(CE)847 or (CE)032 strain before the 027 strain (4/9 deaths, p = 0.029; 1/9 death, p = 0.0004, respectively). We describe two predominant uncommon NTCD strains, in a PN population from different healthcare facilities. Both NTCD provide a potential protection against C. difficile infection.
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Affiliation(s)
- Jeanne Couturier
- Faculty of Pharmacy, Paris University, INSERM UMR S-1139, 4 Avenue de l’Observatoire, 75006 Paris, France; (L.F.); (J.A.); (F.B.)
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
- Correspondence:
| | - Léa Franconeri
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
| | - Claire Janoir
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 92290 Châtenay-Malabry, France; (C.J.); (S.H.)
| | - Laurent Ferraris
- Faculty of Pharmacy, Paris University, INSERM UMR S-1139, 4 Avenue de l’Observatoire, 75006 Paris, France; (L.F.); (J.A.); (F.B.)
| | - Rabab Syed-Zaidi
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
| | - Anlyata Youssouf
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
| | - Cécile Gateau
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
| | - Sandra Hoys
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 92290 Châtenay-Malabry, France; (C.J.); (S.H.)
| | - Julio Aires
- Faculty of Pharmacy, Paris University, INSERM UMR S-1139, 4 Avenue de l’Observatoire, 75006 Paris, France; (L.F.); (J.A.); (F.B.)
| | - Frédéric Barbut
- Faculty of Pharmacy, Paris University, INSERM UMR S-1139, 4 Avenue de l’Observatoire, 75006 Paris, France; (L.F.); (J.A.); (F.B.)
- National Reference Center for Clostridioides difficile, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France; (L.F.); (R.S.-Z.); (A.Y.); (C.G.)
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Djuikoue IC, Tambo E, Tazemda G, Njajou O, Makoudjou D, Sokeng V, Wandji M, Tomi C, Nanfack A, Dayomo A, Lacmago S, Tassadjo F, Sipowo RT, Kakam C, Djoko AB, Assob CN, Andremont A, Barbut F. Evaluation of inpatients Clostridium difficile prevalence and risk factors in Cameroon. Infect Dis Poverty 2020; 9:122. [PMID: 32867842 PMCID: PMC7457802 DOI: 10.1186/s40249-020-00738-8] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 08/11/2020] [Indexed: 12/18/2022] Open
Abstract
Background Clostridium difficile, rarely found in hospitals, is a bacterium responsible for post-antibiotic diarrhea and Pseudomembranous Colitis (CPM). C. difficile selective pressure represents potential public health problem due to the production of toxins A and B serious pathologies effects/consequences. A transversal and analytic study was to assess the risk factors of C. difficile infection and to determine the prevalence of C. difficile in patients received in randomly selected five hospitals in Yaoundé, Cameroon. Methods A total of 300 stool samples were collected from consented patients using a transversal and analytic study conducted from 10th July to 10th November 2018 in five hospitals in Cameroon. The detection or diagnostic kit was CerTest C. difficile Glutamate Dehydrogenase + Toxin A + Toxin B based on immuno-chromatographic assay. A univariate and multivariate analysis allowed us to highlight the associated factors. Results The results showed a prevalence of C. difficile of 27.33% (82/300 stool patients’samples taken). Of these 27.33%, the production of Toxin A and Toxin B were 37.80 and 7.31% respectively. In univariate analysis, hospitalization was a significant (P = 0.01) risk factor favoring C. difficile infection. In multivariate analysis, corticosteroids and quinolones use/administration were significantly (adjusted Odd Ratio, aOR = 14.09, 95% CI: 1.62–122.54, P = 0.02 and aOR = 3.39, 95% CI: 1.00–11.34, P = 0.05 respectively) risk factor for this infection. Conclusion The prevalence of C. difficile infections (CDI) remain high in these settings and may be related not only to permanent steroids and antibiotics. Promoting education to both medical staff and patients on the prevalence and public health impact of C. difficile can be core inimproving rationale prescription of steroids and antibiotics to patients and promote human health and exponential growth in Cameroon.
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Affiliation(s)
- Ingrid Cécile Djuikoue
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon.,Prevention and Control Foundation, Bangangte, Cameroon
| | - Ernest Tambo
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon. .,Prevention and Control Foundation, Bangangte, Cameroon.
| | - Gildas Tazemda
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Omer Njajou
- Prevention and Control Foundation, Bangangte, Cameroon
| | - Denise Makoudjou
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Vanessa Sokeng
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Morelle Wandji
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Charlène Tomi
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | | | - Audrey Dayomo
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Suzie Lacmago
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Falubert Tassadjo
- Laboratoire de Bactériologie du Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Raissa Talla Sipowo
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | | | - Aicha Bibiane Djoko
- Département de Microbiologie de la Faculté des Sciences de la Santé de l'Université des Montagnes, Bangangte, Cameroon
| | - Clement Nguedia Assob
- Faculty of Health Sciences, University of Buea, PO Box 63, Buea, SW Region, Cameroon
| | - Antoine Andremont
- Faculty of Medicine, Xavier-Bichat Campus, University of Paris VII - Denis Diderot, Paris, France
| | - Frédéric Barbut
- Faculty of Pharmacy, Paris - University of Paris Descartes, Paris, France
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Gschwind R, Fournier T, Kennedy S, Tsatsaris V, Cordier AG, Barbut F, Butel MJ, Wydau-Dematteis S. Evidence for contamination as the origin for bacteria found in human placenta rather than a microbiota. PLoS One 2020; 15:e0237232. [PMID: 32776951 PMCID: PMC7416914 DOI: 10.1371/journal.pone.0237232] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/13/2020] [Indexed: 01/12/2023] Open
Abstract
Until recently the in utero environment of pregnant women was considered sterile. Recent high-sensitivity molecular techniques and high-throughput sequencing lead to some evidence for a low-biomass microbiome associated with the healthy placenta. Other studies failed to reveal evidence for a consistent presence of bacteria using either culture or molecular based techniques. Comparing conflicting “placental microbiome” studies is complicated by the use of varied and inconsistent protocols. Given this situation, we undertook an evaluation of the in utero environment sterility using several controlled methods, in the same study, to evaluate the presence or absence of bacteria and to explain contradictions present in the literature. Healthy pregnant women (n = 38) were recruited in three maternity wards. Placenta were collected after cesarean section with or without Alexis® and vaginal delivery births. For this study we sampled fetal membranes, umbilical cord and chorionic villi. Bacterial presence was analyzed using bacterial culture and qPCR on 34 fetal membranes, umbilical cord and chorionic villi samples. Shotgun metagenomics was performed on seven chorionic villi samples. We showed that the isolation of meaningful quantities of viable bacteria or bacterial DNA was possible only outside the placenta (fetal membranes and umbilical cords) highlighting the importance of sampling methods in studying the in utero environment. Bacterial communities described by metagenomics analysis were similar in chorionic villi samples and in negative controls and were dependent on the database chosen for the analysis. We conclude that the placenta does not harbor a specific, consistent and functional microbiota.
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Affiliation(s)
- Rémi Gschwind
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
| | - Thierry Fournier
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
| | - Sean Kennedy
- Department of Computational Biology, Institut Pasteur, USR 3756 CNRS, Paris, France
| | - Vassilis Tsatsaris
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
| | - Anne-Gaël Cordier
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
| | - Frédéric Barbut
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
| | - Marie-José Butel
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
| | - Sandra Wydau-Dematteis
- Université de Paris, INSERM UMR-S 1139 (3PHM), Paris, France
- Hospital-University Department Risks in Pregnancy, Paris, France
- PremUp Foundation, Paris, France
- * E-mail:
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Sambri V, Gateau C, Zannoli S, Dirani G, Couturier J, Op den Buijs I, Roymans R, Hallet E, Arnold M, Zumoberhaus A, Steiner S, van de Bovenkamp J, Altwegg M, Berlinger L, Barbut F. Diagnosing Clostridioides difficile infections with molecular diagnostics: multicenter evaluation of revogene C. difficile assay. Eur J Clin Microbiol Infect Dis 2020; 39:1169-1175. [PMID: 32062723 PMCID: PMC7225180 DOI: 10.1007/s10096-020-03829-4] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 01/22/2020] [Indexed: 01/05/2023]
Abstract
Clostridioides difficile infections are a significant threat to our healthcare system, and rapid and accurate diagnostics are crucial to implement the necessary infection prevention and control measurements. Nucleic acid amplification tests are such reliable diagnostic tools for the detection of toxigenic Clostridioides difficile strains directly from stool specimens. In this multicenter evaluation, we determined the performance of the revogene C. difficile assay. The analysis was conducted on prospective stool specimens collected from six different sites in Europe. The performance of the revogene C. difficile assay was compared to the different routine diagnostic methods and, for a subset of the specimens, against toxigenic culture. In total, 2621 valid stool specimens were tested, and the revogene C. difficile assay displayed a sensitivity/specificity of 97.1% [93.3-99.0] and 98.9% [98.5-99.3] for identification of Clostridioides difficile infection. Discrepancy analysis using additional methods improved this performance to 98.8% [95.8-99.9] and 99.6% [99.2-99.8], respectively. In comparison to toxigenic culture, the revogene C. difficile assay displayed a sensitivity/specificity of 93.0% [86.1-97.1] and 99.5% [98.7-99.9], respectively. These results indicate that the revogene C. difficile assay is a robust and reliable aid in the diagnosis of Clostridioides difficile infections.
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Affiliation(s)
- Vittorio Sambri
- Operative unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy.
- Unit of Microbiology, The Great Romagna Hub Laboratory, Pievesestina, FC, Italy.
- DIMES, University of Bologna, Bologna, Italy.
| | - Cécile Gateau
- National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, INSERM U-1139, University Paris Descartes, Paris, France
| | - Silvia Zannoli
- Operative unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Giorgio Dirani
- Operative unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Jeanne Couturier
- National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, INSERM U-1139, University Paris Descartes, Paris, France
| | | | - René Roymans
- Laboratory of Medical Microbiology, Stichting PAMM, Veldhoven, Netherlands
| | - Emma Hallet
- Great Western Hospital, Swindon, UK
- Royal Devon and Exeter Hospital, Exeter, UK
| | | | | | | | | | | | | | - Frédéric Barbut
- National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, INSERM U-1139, University Paris Descartes, Paris, France
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Farfour E, Si Larbi AG, Couturier J, Lecuru M, Decousser JW, Renvoise A, Faibis F, Lawrence C, Nerome S, Lecointe D, Barbut F, Karnycheff F, Barbahn N, Beaujon, Costa Y, Fontaine A, Lepainteur M, Seguier JC. Asymptomatic carriage of extensively drug-resistant bacteria (eXDR), a simple way to assess spontaneous clearance. J Hosp Infect 2020; 104:503-507. [DOI: 10.1016/j.jhin.2019.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/12/2019] [Indexed: 12/29/2022]
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Le Maréchal C, Gateau C, Poezevara T, Couturier J, Rouxel S, Syed Zaidi R, Houard E, Pourcher AM, Denis M, Barbut F. Characterization of Clostridioides difficile strains isolated from manure and digestate in five agricultural biogas plants. Anaerobe 2020; 62:102180. [DOI: 10.1016/j.anaerobe.2020.102180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/20/2020] [Indexed: 02/08/2023]
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Davies K, Davis G, Barbut F, Eckert C, Petrosillo N, Pisapia R, Gärtner B, Berger FK, Reigadas E, Bouza E, Demont C, Wilcox MH. Factors affecting reported Clostridioides difficile infection rates; the more you look the more you find, but should you believe what you see? Anaerobe 2020; 62:102178. [PMID: 32092415 DOI: 10.1016/j.anaerobe.2020.102178] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 01/05/2023]
Abstract
Reported rates of C. difficile infection (CDI) have increased in many settings; however, these can be affected by factors including testing density (test-density) and diagnostic methods. We aimed to describe the impact of multiple factors on CDI rates. Hospitals (n = 182) across five countries (France, Germany, Italy, Spain, and UK) provided data on; size and type of institution, CDI testing methodology, number of tests/month and patient-bed-days (pbds)/month over one year. Incidence rates were compared between countries, different sized institutions, types of institutions and testing method. After univariate analyses, the highest CDI rates were observed in Italy (average 11.8/10,000pbds/hospital/month), acute/primary hospitals (12.3/10,000pbds/hospital/month), small hospitals (16.7/10,000pbds/hospital/month), and hospitals using methods that do not detect toxin (NO-TOXIN) (e.g. GDH/NAAT or standalone NAAT) (10.7/10,000pbds/hospital/month). After adjusting for test-density, highest incidence rates were still in Italy, acute/primary hospitals and those using NO-TOXIN. The relative rate in long-term healthcare facilities (LTHCFs) increased, but size of institution no longer influenced the CDI rate. Test-density appears to have the largest effect on reported CDI rates. NO-TOXIN testing still influences CDI rates, even after adjusting for test-density, which is consistent with tests that 'overcall' true CDI. Low test-density can mask the true burden of CDI, e.g. in LTHCFs, highlighting the importance of good quality surveillance.
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Affiliation(s)
- Kerrie Davies
- Healthcare Associated Infections Research Group, University of Leeds, Leeds, UK.
| | - Georgina Davis
- Healthcare Associated Infections Research Group, University of Leeds, Leeds, UK
| | - Frédéric Barbut
- National Reference Laboratory for Clostridium Difficile, Saint-Antoine Hospital, Paris, France
| | - Catherine Eckert
- National Reference Laboratory for Clostridium Difficile, Saint-Antoine Hospital, Paris, France; Sorbonne Université, Centre D'immunologie et des Maladies Infectieuses-Paris, Cimi-Paris, Département de Bactériologie, AP-HP, Hôpitaux Universitaires de L'Est Parisien, F-75012, Paris, France
| | - Nicola Petrosillo
- National Institute for Infectious Diseases, L. Spallanzani, IRCCS, Rome, Italy
| | - Raffaella Pisapia
- National Institute for Infectious Diseases, L. Spallanzani, IRCCS, Rome, Italy
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, National Reference Laboratory for Clostridioides (Clostridium) Difficile, Saarland University, Homburg/Saar, Germany
| | - Fabian K Berger
- Institute of Medical Microbiology and Hygiene, National Reference Laboratory for Clostridioides (Clostridium) Difficile, Saarland University, Homburg/Saar, Germany
| | - Elena Reigadas
- Hospital General Universitario Gregario Marañón, Madrid, Spain
| | - Emilio Bouza
- Hospital General Universitario Gregario Marañón, Madrid, Spain
| | | | - Mark H Wilcox
- Healthcare Associated Infections Research Group, University of Leeds, Leeds, UK
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Abstract
Conventional disinfection methods are limited by reliance on the operator to ensure appropriate selection, formulation, distribution, and contact time of the agent. Automated room disinfection (ARD) systems remove or reduce reliance on operators and so they have the potential to improve the efficacy of terminal disinfection. The most commonly used systems are hydrogen peroxide vapor (H2O2 vapor), aerosolized hydrogen peroxide (aHP), and ultraviolet (UV) light. These systems have important differences in their active agent, delivery mechanism, efficacy, process time, and ease of use. The choice of ARD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation, and cost considerations.
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Affiliation(s)
- J.A. Otter
- NIHR Health Protection Research Unit (HPRU) in HCAIs and AMR at Imperial College London, and Imperial College Healthcare NHS Trust, Infection Prevention and Control, London, United Kingdom
| | - S. Yezli
- Global Centre for Mass Gatherings Medicine, WHO Collaborating Centre for Mass Gatherings Medicine, Ministry of Health-Public Health Directorate, Riyadh, Kingdom of Saudi Arabia
| | - F. Barbut
- National Reference Laboratory for C. difficile, Infection Control Unit, Hôpital Saint Antoine, Paris, France,INSERM S-1139, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - T.M. Perl
- Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, TX, United States
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Gateau C, Deboscker S, Couturier J, Vogel T, Schmitt E, Muller J, Ménard C, Turcan B, Zaidi RS, Youssouf A, Lavigne T, Barbut F. Local outbreak of Clostridioides difficile PCR-Ribotype 018 investigated by multi locus variable number tandem repeat analysis, whole genome multi locus sequence typing and core genome single nucleotide polymorphism typing. Anaerobe 2019; 60:102087. [DOI: 10.1016/j.anaerobe.2019.102087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/06/2019] [Accepted: 08/12/2019] [Indexed: 01/05/2023]
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Le Maréchal C, Druilhe C, Repérant E, Boscher E, Rouxel S, Le Roux S, Poëzévara T, Ziebal C, Houdayer C, Nagard B, Barbut F, Pourcher AM, Denis M. Evaluation of the occurrence of sporulating and nonsporulating pathogenic bacteria in manure and in digestate of five agricultural biogas plants. Microbiologyopen 2019; 8:e872. [PMID: 31568706 PMCID: PMC6813454 DOI: 10.1002/mbo3.872] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 12/14/2018] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 11/11/2022] Open
Abstract
The number of agricultural biogas plants has been increasing in the past decades in some European countries. Digestates obtained after anaerobic digestion (AD) of manure are usually spread on agricultural land; however, their hygiene status regarding pathogens posing public health and/or animal health challenges has been poorly characterized up to now in France. In this study, three replicates of manure and digestate were collected from five farm biogas plants receiving animal manure in order to assess the occurrence and concentrations of sporulating (Clostridium botulinum, Clostridioides difficile, Clostridium perfringens) and nonsporulating (Listeria monocytogenes, thermotolerant Campylobacter spp., Salmonella, Escherichia coli, enterococci) bacteria. Concentrations of E. coli, enterococci, and C. perfringens in digestates ranged from 102 to 104, 104 to 105, and <103 to 7 × 105 CFU/g, respectively. Salmonella and C. difficile were detected in manure and digestate from the five biogas plants at concentrations ranging from <1.3 to >7 × 102 MPN/g and from 1.3 to 3 × 102 MPN/g, respectively. Thermotolerant Campylobacter, detected in all the manures, was only found in two digestates at a concentration of cells ranging from <10 to 2.6 × 102 CFU/g. Listeria monocytogenes and C. botulinum were detected in three manures and four digestates. The bacterial counts of L. monocytogenes and C. botulinum did not exceed 3 × 102 and 14 MPN/g, respectively. C. botulinum type B was detected at very low level in both the manure and digestate of farm biogas plants with no botulism history. The levels of pathogenic bacteria in both manure and digestate suggested that some bacteria can persist throughout AD.
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Affiliation(s)
- Caroline Le Maréchal
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Céline Druilhe
- OPAALE Research Unit (Optimization of Processes in Agriculture, Agri-Food and Environment), IRSTEA, Bretagne-Loire University, Rennes, France
| | - Elisabeth Repérant
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Evelyne Boscher
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Sandra Rouxel
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Sophie Le Roux
- OPAALE Research Unit (Optimization of Processes in Agriculture, Agri-Food and Environment), IRSTEA, Bretagne-Loire University, Rennes, France
| | - Typhaine Poëzévara
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Christine Ziebal
- OPAALE Research Unit (Optimization of Processes in Agriculture, Agri-Food and Environment), IRSTEA, Bretagne-Loire University, Rennes, France
| | - Catherine Houdayer
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Bérengère Nagard
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
| | - Frédéric Barbut
- National Reference Laboratory for Clostridioides difficile, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Marie Pourcher
- OPAALE Research Unit (Optimization of Processes in Agriculture, Agri-Food and Environment), IRSTEA, Bretagne-Loire University, Rennes, France
| | - Martine Denis
- ANSES, Ploufragan-Plouzané Laboratory, Hygiene and Quality of Poultry and Pig Products Unit, Bretagne-Loire University, Ploufragan, France
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Abstract
Clostridioides difficile (formerly Clostridium) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, C difficile infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of C difficile infection and the use of new therapeutic molecules. The evolution of diagnosis showed there was an important under- and misdiagnosis of C difficile infection, emphasizing the importance of algorithms recommended by European and North American infectious diseases societies to obtain a reliable diagnosis. Previously, metronidazole was considered the reference drug to treat C difficile infection, but more recently vancomycin and other newer drugs are shown to have higher cure rates. Recurrence of infection represents a key parameter in the evaluation of new drugs, and the challenge is to target the right population with the adapted therapeutic molecule. In multiple recurrences, fecal microbiota transplantation is recommended. New approaches, including antibodies, vaccines, and new molecules are already available or in the pipeline, but more data are needed to support the inclusion of these in practice guidelines. This review aims to provide a baseline for clinicians to understand and stratify their choice in the diagnosis and treatment of C difficile infection based on the most recent data available.
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Affiliation(s)
- Benoit Guery
- Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland
- French Group of Faecal Microbiota Transplantation
- European Study Group on Host and Microbiota Interactions
- European Study Group on Clostridium difficile
| | - Tatiana Galperine
- Infectious Diseases Service, Department of Medicine, University Hospital and University of Lausanne, Lausanne, Switzerland
- French Group of Faecal Microbiota Transplantation
| | - Frédéric Barbut
- National Reference Laboratory for Clostridium difficile, Paris, France
- INSERM, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
- European Study Group on Clostridium difficile
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Marvaud JC, Quevedo-Torres S, Eckert C, Janoir C, Barbut F. Virulence of new variant strains of Clostridium difficile producing only toxin A or binary toxin in the hamster model. New Microbes New Infect 2019; 32:100590. [PMID: 31516714 PMCID: PMC6734109 DOI: 10.1016/j.nmni.2019.100590] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/19/2019] [Revised: 06/26/2019] [Accepted: 08/06/2019] [Indexed: 01/05/2023] Open
Abstract
Pathogenesis of Clostridium difficile has been linked to production of toxins, including the large toxins A and B as well as the binary toxin CDT. Until recently, toxin A was only found in combination in clinical strains with the toxin B, unlike toxin B or CDT, which were found alone in toxigenic variants. New toxigenic variants of C. difficile detected in our laboratory from patients with diarrhoea or severe colitis, including a variant producing only toxin A, were tested for virulence in the hamster model, which displays the clinical features of C. difficile disease. Hamsters infected with a strain producing only toxin B induced similar clinical signs, time to death from infection and histologic damage compared to the hypervirulent strain 027. No mortality or clinical signs of infection but caecal histologic damage was found with the variant producing only toxin A. The C. difficile variant strain producing only CDT was able to kill one hamster out of seven; nevertheless, the surviving animals had few alteration of the caecum.
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Affiliation(s)
- J.-C. Marvaud
- EA 7359 ‘Unité Bactéries Pathogènes et Santé’ (UBaPS), Université Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
- Corresponding author: J.-C. Marvaud, 1EA 4043 ‘Unité Bactéries Pathogènes et Santé’ (UBaPS), Université Paris-Sud, Université 8, Paris-Saclay, 92290, Châtenay-Malabry, France.
| | - S. Quevedo-Torres
- EA 7359 ‘Unité Bactéries Pathogènes et Santé’ (UBaPS), Université Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
- AP-HP, Hôpital Saint Antoine National Reference Laboratory for C. difficile, Paris, France
| | - C. Eckert
- AP-HP, Hôpital Saint Antoine National Reference Laboratory for C. difficile, Paris, France
| | - C. Janoir
- EA 7359 ‘Unité Bactéries Pathogènes et Santé’ (UBaPS), Université Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - F. Barbut
- AP-HP, Hôpital Saint Antoine National Reference Laboratory for C. difficile, Paris, France
- Université Paris Descartes, Faculté de Pharmacie de Paris, UMR-S1139, Sorbonne Paris Cité, Paris, France
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Redway K, Barbut F, Wilcox M. ‘The method used to dry washed hands affects the number and type of transient and residential bacteria remaining on the skin’. J Hosp Infect 2019; 102:473-474. [DOI: 10.1016/j.jhin.2019.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
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Colomb-Cotinat M, Assouvie L, Durand J, Daniau C, Leon L, Maugat S, Soing-Altrach S, Gateau C, Couturier J, Arnaud I, Astagneau P, Berger-Carbonne A, Barbut F. Epidemiology of Clostridioides difficile infections, France, 2010 to 2017. Euro Surveill 2019; 24:1800638. [PMID: 31481147 PMCID: PMC6724465 DOI: 10.2807/1560-7917.es.2019.24.35.1800638] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BackgroundClostridioides difficile is a leading cause of healthcare-associated diarrhoea in middle and high-income countries. Up to 2018, there has been no systematic, annual surveillance for C. difficile infections (CDI) in France.AimsTo provide an updated overview of the epidemiology of CDI in France between 2010 and 2017 based on five different data sources.MethodsThis is a descriptive study of retrospective surveillance and alerts data. Incidence of CDI cases was estimated through the CDI incidence survey (2016) and data from the French National Uniform Hospital Discharge Database (PMSI; 2010-16). Testing frequency for CDI was estimated through the CDI incidence survey and point prevalence studies on healthcare-associated infections (HAI; 2012 and 2017). The national early warning response system for HAI (HAI-EWRS, 2012-17) and National Reference Laboratory data (2012-17) were used to follow the number of severe CDI cases and/or outbreaks.ResultsIn 2016, CDI incidence in acute care was 3.6 cases per 10,000 patient days (PD). There was a statistically significant increase in CDI incidence between 2010 and 2016 (+ 14% annually) and testing frequency was 47.4 per 10,000 PD. The number of CDI HAI-EWRS notifications decreased between 2015 and 2017 with only a few large outbreaks reported.ConclusionThe CDI incidence estimate increased from 2010, but remained below the European average of 7 per 10,000 PD in 2014; there were fewer severe cases or clusters reported in France. The consistency between PMSI and laboratory-based estimated CDI incidence could allow for more routine monitoring of CDI incidence.
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Affiliation(s)
- Mélanie Colomb-Cotinat
- Santé publique France, Saint-Maurice, France
- These authors contributed equally and share first authorship
| | - Laetitia Assouvie
- Santé publique France, Saint-Maurice, France
- These authors contributed equally and share first authorship
| | | | - Côme Daniau
- Santé publique France, Saint-Maurice, France
| | - Lucie Leon
- Santé publique France, Saint-Maurice, France
| | | | | | - Cécile Gateau
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
| | - Jeanne Couturier
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
| | - Isabelle Arnaud
- Regional center for prevention of healthcare associated infections, Paris, France
| | - Pascal Astagneau
- Regional center for prevention of healthcare associated infections, Paris, France
| | | | - Frédéric Barbut
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
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Chaves C, Gaumé M, Salauze B, Couturier J, Barbut F, Vialle R. Bacterial contamination of medical file folders in operating rooms. Clin Microbiol Infect 2019; 25:1293-1294. [PMID: 31212077 DOI: 10.1016/j.cmi.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/05/2019] [Accepted: 06/09/2019] [Indexed: 11/18/2022]
Affiliation(s)
- C Chaves
- Service de Chirurgie Orthopédique Pédiatrique, Hôpital Armand-Trousseau, Université Pierre et Marie Curie, Paris, France.
| | - M Gaumé
- Service de Chirurgie Orthopédique Pédiatrique, Hôpital Armand-Trousseau, Université Pierre et Marie Curie, Paris, France
| | - B Salauze
- Equipe Opérationnelle d'Hygiène, Hôpital Armand-Trousseau, Université Pierre et Marie Curie, Paris, France
| | - J Couturier
- Service de Microbiologie de l'Environnement, Groupe Hospitalier de l'Est Parisien, Hôpital Saint Antoine, Université Paris Descartes, Paris, France
| | - F Barbut
- Service de Microbiologie de l'Environnement, Groupe Hospitalier de l'Est Parisien, Hôpital Saint Antoine, Université Paris Descartes, Paris, France
| | - R Vialle
- Service de Chirurgie Orthopédique Pédiatrique, Hôpital Armand-Trousseau, Université Pierre et Marie Curie, Paris, France
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Ferraris L, Couturier J, Eckert C, Delannoy J, Barbut F, Butel MJ, Aires J. Carriage and colonization of C. difficile in preterm neonates: A longitudinal prospective study. PLoS One 2019; 14:e0212568. [PMID: 30785934 PMCID: PMC6382121 DOI: 10.1371/journal.pone.0212568] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/05/2019] [Indexed: 12/15/2022] Open
Abstract
Background Premature neonates (PN) present multiple risk factors for high frequencies and high levels of colonization by C. difficile, yet data is missing about this specific pediatric population. Here, we investigated PN C. difficile carriage and colonization dynamics, analyzed the impact of perinatal determinants on colonization, and characterized the isolates. Methods A one year longitudinal monocentric prospective cohort study was performed on 121 PN. C. difficile strains isolated from fecal samples on selective medium were identified and characterized by PCR (tpi housekeeping gene; tcdA and tcdB, and binary toxin genes), capillary gel-based electrophoresis PCR-ribotyping, and Multi-Locus Variable-number tandem-repeat Analysis (MLVA). Results Of the 379 samples analyzed, 199 (52%) were C. difficile culture positive with the mean levels of C. difficile colonization decreasing significantly (P = .027) over time. During hospitalization, C. difficile colonization frequency increased up to 61% with 95% of the strains belonging to both non-toxigenic PCR-ribotypes (RTs) FR082 (35%) and 032 (60%). After hospital discharge, if a higher diversity in RTs was observed, RTs FR082 and 032 remained predominant (respectively 40% and 28%). MLVA showed clonal relationship within each FR082 and 032 RTs. Ten toxigenic strains (5%) were isolated, all tcdA+/tcdB+ except for one tcdA-/tcdB+, and all being acquired after hospitalization. At 1 week, the only factors found to be linked with a higher frequency of C. difficile colonization were a higher gestational age (P = 0.006) and a higher birth weight (P = 0.016). Conclusion The dynamics of C. difficile colonization in PN followed a specific pattern. C. difficile colonization rapidly occurred after birth with a low diversity of non-toxigenic RTs. After hospitalization, non-toxigenic RTs diversity increased. Sporadic carriage of toxigenic strains was observed after hospitalization.
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Affiliation(s)
- Laurent Ferraris
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
| | - Jeanne Couturier
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
- French National Reference Laboratory for C. difficile, CHU Saint-Antoine, Paris, France
| | - Catherine Eckert
- Department of Bacteriology, AP-HP, GH Est Parisien, Paris, France
| | - Johanne Delannoy
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
| | - Frédéric Barbut
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
- French National Reference Laboratory for C. difficile, CHU Saint-Antoine, Paris, France
| | - Marie-José Butel
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
| | - Julio Aires
- EA 4065, Faculty of Pharmacy, Paris Descartes University, Hospital University Department Risks in pregnancy, Sorbonne Paris Cité, Paris, France
- * E-mail:
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Best E, Parnell P, Couturier J, Barbut F, Le Bozec A, Arnoldo L, Madia A, Brusaferro S, Wilcox MH. Corrigendum to "Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study" [J Hospital Infection 100 (2018) 469-475]. J Hosp Infect 2019; 101:487. [PMID: 30712960 DOI: 10.1016/j.jhin.2019.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E Best
- Microbiology, Leeds Teaching Hospitals, Leeds, UK
| | - P Parnell
- Microbiology, Leeds Teaching Hospitals, Leeds, UK
| | - J Couturier
- CHU Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - F Barbut
- CHU Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A Le Bozec
- CHU Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - L Arnoldo
- Department of Medicine, University of Udine, Udine, Italy
| | - A Madia
- Department of Medicine, University of Udine, Udine, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
| | - M H Wilcox
- Microbiology, Leeds Teaching Hospitals, Leeds, UK; University of Leeds, Leeds, UK.
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Barbut F, Galperine T, Vanhems P, Le Monnier A, Durand-Gasselin B, Canis F, Jeanbat V, Duburcq A, Alami S, Bensoussan C, Fagnani F. Quality of life and utility decrement associated with Clostridium difficile infection in a French hospital setting. Health Qual Life Outcomes 2019; 17:6. [PMID: 30634997 PMCID: PMC6329091 DOI: 10.1186/s12955-019-1081-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 05/07/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Clostridium difficile infection (CDI) is associated with a substantial Quality of life impact on patients that has not been so far measured with a generic validated instrument. Methods A prospective study was performed in 7 French acute-care settings in patients presenting with a bacteriologically-confirmed CDI. The EQ-5D-3 L was filled in by patients at 7 ± 2 days after CDI diagnosis to describe their state of health at that date as well as their state of health immediately before the CDI episode (baseline). Individual utility decrement was obtained by subtracting the corresponding utilities. The Quality Adjusted Life Year (QALY) loss was calculated by multiplying the days spent from baseline to the date of the interview, by the decrement of utility. A multivariate analysis of variance of the utility decrement according to CDI and patients characteristics was performed. Results Eighty patients were enrolled (mean age: 69.4 years, 55% females). The utility scores dropped from a mean 0.542 (SD: 0.391) at baseline to 0.050 (SD: 0.404) during the CDI episode with a mean adjusted utility decrement of 0.492 (SD: 0.398) point. This decrement increased significantly with CDI severity (Zar score ≥ 3) (p = 0.001), in patients with a positive baseline utility (p = 0.032), in women as compared to men (p = 0.041) and in patients aged more than 65 years (p = 0.041). No association with the Charlson index was found. The associated QALY loss not integrating the excess mortality was 0.028 (SD: 0.053). Conclusions The impact on quality of life of CDI episodes is major and translates in a substantial QALY loss despite their short duration. Electronic supplementary material The online version of this article (10.1186/s12955-019-1081-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Frédéric Barbut
- National Reference Laboratory for Clostridium difficile, Hôpital Saint-Antoine, 34 rue Crozatier, 75012, Paris, France. .,Université Paris Descartes, UMR-S1139, Sorbonne Paris Cité, Paris, France.
| | - Tatiana Galperine
- CHRU Lille, Maladies Infectieuses, French Group of Faecal Microbiota Transplantation (GFTF), Lille, France
| | - Philippe Vanhems
- Groupement Hospitalier Edouard Herriot, Unité d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, and Université Lyon 1, Lyon, France
| | - Alban Le Monnier
- Laboratoire de Microbiologie Clinique, GH Paris Saint-Joseph, Paris, France
| | - Bernard Durand-Gasselin
- Hôpital Léopold Bellan, Service de gériatrie and Fondation Hospitalière Ste Marie Service de Soins de Suite et de Réadaptation gérontologique, Paris, France
| | - Frédérique Canis
- Centre hospitalier de Valenciennes, UF de Microbiologie, Pôle de Biologie Médicale, Valenciennes, France
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Barbut F, Day N, Bouée S, Youssouf A, Grandvoinnet L, Lalande V, Couturier J, Eckert C. Toxigenic Clostridium difficile carriage in general practice: results of a laboratory-based cohort study. Clin Microbiol Infect 2019; 25:588-594. [PMID: 30616013 DOI: 10.1016/j.cmi.2018.12.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 10/14/2018] [Revised: 12/08/2018] [Accepted: 12/17/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Reported rates of community-acquired Clostridium difficile infections (CDIs) have been increasing. However, the true burden of the disease in general practice is unknown in France. Our objective was to determine the incidence of toxigenic C. difficile carriage and the percentage of stool samples prescribed by general practitioners (GPs) which contained free C. difficile toxins. METHODS During an 11-month period, all stool samples submitted for any enteric pathogen detection to 15 different private laboratories in Paris and the surrounding areas were tested for C. difficile, irrespective of the GPs' request. A clinical questionnaire was completed for each patient. Stool samples were screened using a rapid simultaneous glutamate dehydrogenase and toxins A/B detection test: any positive result (glutamate dehydrogenase or toxin) was further confirmed by the stool cytotoxicity assay (CTA) on MRC-5 cells and by toxigenic culture (TC) at a central laboratory. The C. difficile isolates were characterized by PCR ribotyping. RESULTS A total of 2541 patients (1295 female, 1246 male) were included. The incidences of patients with a positive toxigenic culture and a positive CTA were 3.27% (95% CI 2.61%-4.03%) and 1.81% (95% CI 1.33%-2.41%), respectively. GPs requested C. difficile testing in only 12.93% of the stool samples, detecting 52.30% of all TC-positive patients. The 83 toxigenic C. difficile strains belonged to 36 different PCR ribotypes. CONCLUSIONS Toxigenic C. difficile carriage is frequent in general practice but remains under-recognized. It may affect young patients without previous antimicrobial therapy or hospitalization.
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Affiliation(s)
- F Barbut
- National Reference Laboratory for Clostridium difficile, Paris, France; Department of Bacteriology, AP-HP, Saint-Antoine Hospital, Hôpitaux Universitaires de l'Est Parisien, Paris, France; INSERM 1139, Université Paris Descartes, Paris, France.
| | - N Day
- Laboratory of Chemin Vert, Paris, France
| | - S Bouée
- CEMKA-EVAL, Bourg la Reine, France
| | - A Youssouf
- National Reference Laboratory for Clostridium difficile, Paris, France; Department of Bacteriology, AP-HP, Saint-Antoine Hospital, Hôpitaux Universitaires de l'Est Parisien, Paris, France
| | | | - V Lalande
- Department of Bacteriology, AP-HP, Saint-Antoine Hospital, Hôpitaux Universitaires de l'Est Parisien, Paris, France
| | - J Couturier
- National Reference Laboratory for Clostridium difficile, Paris, France; Department of Bacteriology, AP-HP, Saint-Antoine Hospital, Hôpitaux Universitaires de l'Est Parisien, Paris, France
| | - C Eckert
- National Reference Laboratory for Clostridium difficile, Paris, France; Department of Bacteriology, AP-HP, Saint-Antoine Hospital, Hôpitaux Universitaires de l'Est Parisien, Paris, France; Sorbonne Université, Centre d'immunologie et des Maladies Infectieuses-Paris (CIMI), Paris, France.
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de Curraize C, Rousseau C, Corvec S, El-Helali N, Fihman V, Barbut F, Collignon A, Le Monnier A. Variable spectrum of disease and risk factors of peripartum Clostridium difficile infection: report of 14 cases from French hospitals and literature review. Eur J Clin Microbiol Infect Dis 2018; 37:2293-2299. [DOI: 10.1007/s10096-018-3372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/28/2018] [Indexed: 02/08/2023]
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