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Goulenok T, Seurat J, Selle ADL, Jullien V, Leflon-Guibout V, Grall N, Lescure FX, Lepeule R, Bertrand J, Fantin B, Burdet C, Lefort A. Pharmacokinetic Interaction between Rifampicin and Clindamycin in Staphylococcal Osteoarticular Infections. Int J Antimicrob Agents 2023:106885. [PMID: 37302771 DOI: 10.1016/j.ijantimicag.2023.106885] [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: 02/05/2023] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
The oral combination of clindamycin and rifampicin is relevant for the treatment of staphylococcal osteoarticular infections (SOAI). However, rifampicin induces CYP3A4, suggesting a pharmacokinetic (PK) interaction with clindamycin with unknown PK/pharmacodynamic (PD) consequences. OBJECTIVES To quantify clindamycin PK/PD markers before and during rifampicin co-administration in OAI. METHODS Patients with SOAI were included (NCT02782078). After an initial intravenous antistaphylococcal treatment, oral therapy was started with clindamycin (600 or 750 mg tid), followed by the addition of rifampicin 36 hours after. Population PK analysis was performed using the SAEM algorithm. PKPD markers were compared with and without rifampicin co-administration, each patient being his own control. RESULTS In 19 patients, Clindamycin Median (min-max) through concentrations were 2.7 (0.3-8.9) and <0.05 (<0.05-0.3) mg/L, before and during rifampicin administration, respectively. Rifampicin co-administration increased clindamycin clearance by a factor 16 and reduced the AUC0-8h /MIC by a factor 15 (p<0.005). We simulated clindamycin plasma concentration for 1000 individuals, without and with rifampicin. Against a susceptible S. aureus strain with a clindamycin MIC of 0.0625 mg/L, more than 80% of individuals would reach all the proposed PKPD targets without co-administration of rifampicin, even with a low clindamycin dose. For the same strain, when rifampicin was co-administered, the probability to reach clindamycin PKPD targets dropped to 1% to have a %fT>MIC = 100% and to 6% to achieve an AUC0-24/MIC > 60, even with high dose of clindamycin. CONCLUSION Rifampicin co-administration with clindamycin has high impact on clindamycin exposure and PKPD targets in SOAI, which could result in clinical failures, even for a fully susceptible strain.
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Affiliation(s)
- T Goulenok
- Département de Médecine Interne, Hôpital Bichat-Claude Bernard, GHU APHP Nord, Université de Paris, France.
| | - J Seurat
- Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
| | - A de La Selle
- Département de Médecine Interne, Hôpital Beaujon, Clichy, GHU APHP Nord, Université de Paris, France
| | - V Jullien
- Université Sorbonne Paris Nord, UF de Pharmacologie, hôpital Jean Verdier, 93141 Bondy, France
| | - V Leflon-Guibout
- Service de Microbiologie, Hôpital Beaujon, Clichy, GHU APHP Nord, Université de Paris, France
| | - N Grall
- Service de Bactériologie, Hôpital Bichat-Claude Bernard GHU APHP Nord, Université de Paris, France; Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
| | - F X Lescure
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard GHU APHP Nord, Université de Paris, France; Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
| | - R Lepeule
- Unité transversale de traitement des infections, Assistance Publique des Hôpitaux de Paris (APHP), Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, Université Paris Est Créteil, 94000 Creteil, France
| | - J Bertrand
- Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
| | - B Fantin
- Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
| | - C Burdet
- Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France; Département d'Épidémiologie, Biostatistique et Recherche Clinique, Hôpital Bichat-Claude Bernard GHU APHP Nord, Université de Paris, France
| | - A Lefort
- Département de Médecine Interne, Hôpital Beaujon, Clichy, GHU APHP Nord, Université de Paris, France; Université Paris Cité, INSERM 1137, IAME, Paris F-75018, France
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Lepeule R, Leflon-Guibout V, Vanjak D, Zahar JR, Lafaurie M, Besson C, Lefort A. Clinical spectrum of urine cultures positive for ESBL-producing Escherichia coli in hospitalized patients and impact on antibiotic use. Med Mal Infect 2014; 44:530-4. [PMID: 25311839 DOI: 10.1016/j.medmal.2014.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/04/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We wanted to describe the clinical features associated with urinalysis positive for ESBL-producing Escherichia coli and their impact on antibiotic use. METHODS We performed a prospective observational study in 13 French hospitals of the Paris area for 3 consecutive months. We included all patients with urine cultures positive for ESBL-producing E. coli. RESULTS One hundred and seventeen of the 218 patients (54%) presented with asymptomatic bacteriuria, 31 (14%) with cystitis, and 70 (32%) with a parenchymal infection. Nineteen patients with asymptomatic bacteriuria (16%) received antibiotics. Forty-one with parenchymal infections (59%) received a carbapenem. A carbapenem alternative could have been used in every patient treated with a carbapenem, according to antibiotic susceptibility testing results. CONCLUSIONS Urinary tract infections accounted for 46% of E. coli ESBL positive urinalysis. Fifty percent of parenchymal infections were treated with a carbapenem.
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Affiliation(s)
- R Lepeule
- Unité transversale de traitement des infections, département de virologie, bactériologie-hygiène, parasitologie-mycologie, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France.
| | - V Leflon-Guibout
- Service de microbiologie, hôpital Beaujon, hôpitaux universitaires Paris Nord Val-de-Seine, AP-HP, Clichy, France
| | - D Vanjak
- Unité de contrôle des infections, institut Curie, Paris, France
| | - J-R Zahar
- Unité de prévention et de lutte contre les infections nosocomiales, CHU d'Angers - Université d'Angers, Angers, France
| | - M Lafaurie
- Unité d'intervention en infectiologie, hôpital Saint-Louis, AP-HP, Paris, France
| | - C Besson
- Service de microbiologie clinique, hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Lefort
- Service de médecine interne, hôpital Beaujon, hôpitaux universitaires Paris Nord Val-de-Seine, AP-HP, Clichy, France; IAME, UMR1137, université Paris-Diderot, Sorbonne Paris Cité, Paris, France; EA3964, faculté de médecine Xavier-Bichat, université Paris-Diderot, Paris, France
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Nicolas-Chanoine MH, Gruson C, Bialek-Davenet S, Bertrand X, Thomas-Jean F, Bert F, Moyat M, Meiller E, Marcon E, Danchin N, Noussair L, Moreau R, Leflon-Guibout V. 10-Fold increase (2006-11) in the rate of healthy subjects with extended-spectrum -lactamase-producing Escherichia coli faecal carriage in a Parisian check-up centre. J Antimicrob Chemother 2012; 68:562-8. [DOI: 10.1093/jac/dks429] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Froissart A, Gazaignes S, Gellen-Dautremer J, Leflon-Guibout V, Iakovlev G, Zarrouk V, Lefort A, Fantin B. [Intermittent prolonged fever triggered by efforts]. Rev Med Interne 2012; 33:519-21. [PMID: 22766160 DOI: 10.1016/j.revmed.2012.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 05/05/2012] [Accepted: 06/03/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Fever of unknown origin is a common reason for care in internal medicine. The wide variety of possible etiologies makes it difficult to standardize the diagnostic work-up that has to be primarily guided by the interview and physical examination. CASE REPORT We report a case of prolonged fever having as main characteristics to be intermittent and triggered by efforts. The diagnosis of cerebrospinal fluid shunt infection with Propionibacterium acnes was finally made. In reaching this conclusion, many tests were needed, including renal explorations with biopsy showing an aspect of shunt nephritis. CONCLUSION Prolonged fever of unknown origin in a patient having prosthetic material should raise the suspicion of prosthesis infection (especially if the fever is associated with efforts).
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Affiliation(s)
- A Froissart
- Service de médecine interne, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France
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de Montmollin E, Corcos O, Noussair L, Leflon-Guibout V, Belmatoug N, Joly F, Lefort A. Retroperitoneal abscesses due to Nocardia farcinica: report of two cases in patients with malnutrition. Infection 2011; 40:93-6. [PMID: 21861123 DOI: 10.1007/s15010-011-0176-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 08/04/2011] [Indexed: 11/30/2022]
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Lebeaux D, Zarrouk V, Larroque B, Leflon-Guibout V, Dreyer C, Bialek S, Froissart A, Hentic O, Tessier C, Fantin B. Impact clinique des complications infectieuses liées aux cathéters de longue durée en oncologie : résultats d’une étude prospective monocentrique observationnelle. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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de Montmollin E, Cabrol S, Corcos O, Noussair L, Leflon-Guibout V, Belmatoug N, Joly F, Lefort A. Nocardiose rétropéritonéale et dénutrition : à propos de deux cas. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nicolas-Chanoine MH, Blanco J, Leflon-Guibout V, Demarty R, Alonso MP, Canica MM, Park YJ, Lavigne JP, Pitout J, Johnson JR. Intercontinental emergence of Escherichia coli clone O25:H4-ST131 producing CTX-M-15. J Antimicrob Chemother 2007; 61:273-81. [DOI: 10.1093/jac/dkm464] [Citation(s) in RCA: 653] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Leflon-Guibout V, Pons JL, Heym B, Nicolas-Chanoine MH. Typing of Clostridium perfringens strains by use of Random Amplified Polymorphic DNA (RAPD) system in comparison with zymotyping. Anaerobe 2007; 3:245-50. [PMID: 16887598 DOI: 10.1006/anae.1997.0094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/1997] [Accepted: 04/03/1997] [Indexed: 11/22/2022]
Abstract
The definition of strain clonality postulates that strains showed identical phenotypic and genetic traits are likely to descend from a common ancestor even if they were isolated from different sources and locations. Regarding this definition, non-epidemiologically linked strains might be clonal strains. To overcome this ambiguity, the discriminatory capability of RAPD typing was assessed firstly on eight Clostridium perfringens strains proven to be chromosomally different with one being the mutant of another one. Thirteen primers were tested but only two were able to differentiate seven of the eight strains. With none of the used primers it was possible to differentiate the parental strain and its mutant harboring an insertion of 180 kb. The four most discriminant primers were retained to determine the RAPD fingerprints of a further 20 previously zymotyped strains from which seventeen were unrelated. To compare the two typing systems, the zymotype of the eight chromosomally different strains was determined. Thus, the discriminatory index was calculated on the basis of 25 unrelated C. perfringens strains. This was 0.97 with RAPD typing and 0.99 with zymotyping. From these results we conclude that the RAPD typing which is less fastidious than zymotyping can be used as an epidemiological marker for C. perfringens.
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Affiliation(s)
- V Leflon-Guibout
- Laboratoire de Microbiologie-Hygiène, Hôpital Ambroise-Paré, Faculté de Médecine Paris Ouest, Université Paris V, 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France
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Armand-Lefèvre L, Leflon-Guibout V, Bredin J, Barguellil F, Amor A, Pagès JM, Nicolas-Chanoine MH. Imipenem resistance in Salmonella enterica serovar Wien related to porin loss and CMY-4 beta-lactamase production. Antimicrob Agents Chemother 2003; 47:1165-8. [PMID: 12604564 PMCID: PMC149321 DOI: 10.1128/aac.47.3.1165-1168.2003] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [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: 11/20/2022] Open
Abstract
Two multidrug-resistant Salmonella enterica serovar Wien strains (SW468 and SW1107) were isolated in 2001 in Tunis. Both strains produced the beta-lactamases TEM-1, SHV-2a, and CMY-4, whereas strain SW1107 also produced the beta-lactamase CTX-M-3. The imipenem-resistant strain (SW468) was totally devoid of the OmpF-immunorelated porin. Imipenem resistance was shown as being related to porin loss and CMY-4 beta-lactamase production.
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Affiliation(s)
- L Armand-Lefèvre
- Hôpital Ambroise Paré AP-HP, Service de Microbiologie-Hygiène, Boulogne, France
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Granier SA, Nicolas-Chanoine MH, Nguyen Van JC, Leflon-Guibout V, Kitzis MD, Goldstein FW. False susceptibility of Klebsiella oxytoca to some extended-spectrum cephalosporins. J Antimicrob Chemother 2002; 50:303-4. [PMID: 12161419 DOI: 10.1093/jac/dkf123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Leflon-Guibout V, Heym B, Nicolas-Chanoine M. Updated sequence information and proposed nomenclature for bla(TEM) genes and their promoters. Antimicrob Agents Chemother 2000; 44:3232-4. [PMID: 11036062 PMCID: PMC101642 DOI: 10.1128/aac.44.11.3232-3234.2000] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [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: 11/20/2022] Open
Abstract
The nucleotide sequences of 59 bla(TEM) genes encoding inhibitor-resistant TEM enzymes showed great genetic variability and were associated with different types of promoters. These findings led us to suggest an updated bla(TEM) gene nomenclature based on the origin of the bla(TEM) gene (bla(TEM-1A), bla(TEM-1B), bla(TEM-1C), bla(TEM-1D), bla(TEM-1E), and bla(TEM-1F)) and the promoter type.
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Affiliation(s)
- V Leflon-Guibout
- Microbiology Department, Hôpital Ambroise-Paré, Université Paris V, 92100 Boulogne-Billancourt, France
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Leflon-Guibout V, Speldooren V, Heym B, Nicolas-Chanoine M. Epidemiological survey of amoxicillin-clavulanate resistance and corresponding molecular mechanisms in Escherichia coli isolates in France: new genetic features of bla(TEM) genes. Antimicrob Agents Chemother 2000; 44:2709-14. [PMID: 10991849 PMCID: PMC90140 DOI: 10.1128/aac.44.10.2709-2714.2000] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [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: 11/20/2022] Open
Abstract
Amoxicillin-clavulanate resistance (MIC >16 microg/ml) and the corresponding molecular mechanisms were prospectively studied in Escherichia coli over a 3-year period (1996 to 1998) in 14 French hospitals. The overall frequency of resistant E. coli isolates remained stable at about 5% over this period. The highest frequency of resistant isolates (10 to 15%) was observed, independently of the year, among E. coli isolated from lower respiratory tract samples, and the isolation rate of resistant strains was significantly higher in surgical wards than in medical wards in 1998 (7.8 versus 2.8%). The two most frequent mechanisms of resistance for the 3 years were the hyperproduction of the chromosomal class C beta-lactamase (48, 38.4, and 39.7%) and the production of inhibitor-resistant TEM (IRT) enzymes (30.4, 37.2, and 41.2%). By using the single-strand conformational polymorphism-PCR technique and sequencing methods, we determined that 59 IRT enzymes corresponded to previously described IRT enzymes whereas 8 were new. Three of these new enzymes derived from TEM-1 by only one amino acid substitution (Ser130Gly, Arg244Gly, and Asn276Asp), whereas three others derived by two amino acid substitutions (Met69Leu and Arg244Ser, Met69Leu and Ile127Val, and Met69Val and Arg275Gln). The two remaining new IRTs showed three amino acid substitutions (Met69Val, Trp165Arg, and Asn276Asp and Met69Ile, Trp165Cys, and Arg275Gln). New genetic features were also found in bla(TEM) genes, namely, bla(TEM-1B) with either the promoters Pa and Pb, P4, or a promoter displaying a C-->G transversion at position 3 of the -35 consensus sequence and new bla(TEM) genes, notably one encoding TEM-1 but possessing the silent mutations originally described in bla(TEM-2) and then in some bla(TEM)-encoding IRT enzymes.
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Affiliation(s)
- V Leflon-Guibout
- Microbiology Department, Hôpital Ambroise-Paré, Université Paris V, 92100 Boulogne-Billancourt, France
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