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Lemmet T, Bourne-Watrin M, Gerber V, Danion F, Ursenbach A, Hoellinger B, Lefebvre N, Mazzucotelli J, Zeyons F, Hansmann Y, Ruch Y. Suppressive antibiotic therapy for infectious endocarditis. Infect Dis Now 2024; 54:104867. [PMID: 38369059 DOI: 10.1016/j.idnow.2024.104867] [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: 11/17/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Suppressive antibiotic therapy (SAT) is a long-term antibiotic strategy at times applied when an indicated surgical management of infective endocarditis (IE) is not possible. Our aim was to describe the characteristics and outcomes of patients having received SAT for IE. METHODS We conducted a retrospective, observational study at Strasbourg University Hospital, France between January 2020 and May 2023. We reviewed all medical files taken into consideration at weekly meetings of the local Multidisciplinary Endocarditis Team (MET) during the study period. We included patients having received SAT following the MET evaluation. The primary endpoint was all-cause mortality at most recent follow-up. Secondary endpoints included all-cause mortality at 3 and 6 months, infection relapse, and tolerance issues attributed to SAT. RESULTS The MET considered 251 patients during the study time, among whom 22 (9 %) had received SAT. Mean age was 77.2 ± 12.3 years. Patients were highly comorbid with a mean Charlson index score of 6.6 ± 2.5. Main indication for SAT was surgery indicated but not performed or an infected device not removed (20/22). Fourteen patients had prosthetic valve IE, including 9 TAVIs. Six patients had IE affecting cardiac implantable electronic devices. Staphylococcus aureus and enterococci were the main bacteria involved (6/22 each). Median follow-up time was 249 days (IQR 95-457 days). Mortality at most recent follow-up was 23 % (5/22). Three patients (14 %) presented tolerance issues attributed to SAT, and two patients suffered late infectious relapse. CONCLUSION Mortality at most recent follow-up was low and tolerance issues were rare for patients under SAT, which might be a palliative approach to consider when optimal surgery or device removal is not possible.
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Affiliation(s)
- T Lemmet
- Infectious Disease Unit, Strasbourg University Hospital, France.
| | - M Bourne-Watrin
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - V Gerber
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - F Danion
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - A Ursenbach
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - B Hoellinger
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - N Lefebvre
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - J Mazzucotelli
- Department of Cardiovascular Surgery, Strasbourg University Hospital, France
| | - F Zeyons
- Department of Cardiology, Strasbourg University Hospital, France
| | - Y Hansmann
- Infectious Disease Unit, Strasbourg University Hospital, France
| | - Y Ruch
- Infectious Disease Unit, Strasbourg University Hospital, France
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Baclet N, Forestier E, Gavazzi G, Roubaud-Baudron C, Hiernard V, Hequette-Ruz R, Alfandari S, Aumaître H, Botelho-Nevers E, Caraux-Paz P, Charmillon A, Diamantis S, Fraisse T, Gazeau P, Hentzien M, Lanoix JP, Paccalin M, Putot A, Ruch Y, Senneville E, Beuscart JB. One Hundred Explicit Definitions of Potentially Inappropriate Prescriptions of Antibiotics in Hospitalized Older Patients: The Results of an Expert Consensus Study. Antibiotics (Basel) 2024; 13:283. [PMID: 38534718 DOI: 10.3390/antibiotics13030283] [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: 02/14/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND In geriatrics, explicit criteria for potentially inappropriate prescriptions (PIPs) are useful for optimizing drug use. OBJECTIVE To produce an expert consensus on explicit definitions of antibiotic-PIPs for hospitalized older patients. METHODS We conducted a Delphi survey involving French experts on antibiotic stewardship in hospital settings. During the survey's rounds, the experts gave their opinion on each explicit definition, and could suggest new definitions. Definitions with a 1-to-9 Likert score of between 7 and 9 from at least 75% of the participants were adopted. The results were discussed during consensus meetings after each round. RESULTS Of the 155 invited experts, 128 (82.6%) participated in the whole survey: 59 (46%) infectious diseases specialists, 45 (35%) geriatricians, and 24 (19%) other specialists. In Round 1, 65 explicit definitions were adopted and 21 new definitions were suggested. In Round 2, 35 other explicit definitions were adopted. The results were validated during consensus meetings (with 44 participants after Round 1, and 54 after Round 2). CONCLUSIONS The present study is the first to have provided a list of explicit definitions of potentially inappropriate antibiotic prescriptions for hospitalized older patients. It might help to disseminate key messages to prescribers and reduce inappropriate prescriptions of antibiotics.
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Affiliation(s)
- Nicolas Baclet
- CHU Lille, University of Lille, F-59000 Lille, France
- Groupe Hospitalier de l'Institut Catholique (GHICL), Service de Maladies Infectieuses, Université Catholique de Lille, F-59160 Lille, France
| | - Emmanuel Forestier
- Service de Maladies Infectieuses, Centre Hospitalier Métropole Savoie, F-73000 Chambéry, France
| | - Gaëtan Gavazzi
- Clinique Universitaire de Médecine Gériatrique, Centre Hospitalier Universitaire de Grenoble-Alpes, GREPI EA7408 Université Grenoble-Alpes, F-38000 Grenoble, France
| | - Claire Roubaud-Baudron
- CHU Bordeaux, Pôle de Gérontologie Clinique, University of Bordeaux, INSERM 1312 BRIC, F-33000 Bordeaux, France
| | | | | | - Serge Alfandari
- Service Universitaire de Maladies Infectieuses et Tropicales, Hôpital Gustave Dron, F-59200 Tourcoing, France
| | - Hugues Aumaître
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Perpignan, F-66000 Perpignan, France
| | - Elisabeth Botelho-Nevers
- Infectious Diseases Department, University Hospital of Saint-Etienne, GIMAP (EA 3064), F-42055 Cedex 02 Saint-Etienne, France
- Faculty of Medicine of Saint-Etienne, University of Saint-Etienne, F-42023 Cedex 02 Saint-Etienne, France
- Faculty of Medicine, University of Lyon, F-69000 Lyon, France
| | - Pauline Caraux-Paz
- Service de Maladies Infectieuses et Tropicales, Hôpital Intercommunal de Villeneuve-Saint-Georges, F-94190 Villeneuve-Saint-Georges, France
| | - Alexandre Charmillon
- CHRU-Nancy, Infectious Diseases Department, F-54000 Nancy, France
- Grand Est Antibiotic Stewardship Network Coordinator, AntibioEst, F-54000 Nancy, France
| | - Sylvain Diamantis
- Service de Maladies Infectieuses et Tropicales, Hôpital de Melun, F-77000 Melun, France
- Unité de Recherche DYNAMIC, Université Paris-Est Créteil, F-94000 Créteil, France
| | - Thibaut Fraisse
- Court Séjour Gériatrique Aigu, Centre Hospitalier Alès-Cévennes, F-30100 Alès, France
| | - Pierre Gazeau
- Service des Maladies Infectieuses et Tropicales, CHRU de Brest, F-29609 Brest Cedex, France
| | - Maxime Hentzien
- Department of Internal Medicine, Infectious Diseases and Clinical Immunology, University Hospital of Reims, F-51100 Reims, France
- EA3797-Viellissement Fragilité, Reims Champagne Ardennes University, F-51100 Reims, France
| | - Jean-Philippe Lanoix
- AGIR UR 4294, University Picardie Jules Verne, F-80000 Amiens, France
- Department of Infectious Diseases, Amiens University Hospital, F-80000 Amiens, France
| | - Marc Paccalin
- Pôle de Gériatrie, CHU Poitiers, Université Poitiers, F-86000 Poitiers, France
- Centre d'Investigation Clinique CIC 1402, INSERM CHU Poitiers, Université Poitiers, F-86000 Poitiers, France
| | - Alain Putot
- Médecine Interne et Maladies Infectieuses, Hôpitaux du Pays du Mont Blanc, F-74700 Sallanches, France
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires, Université de Bourgogne, F-21000 Dijon, France
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, F-67000 Strasbourg, France
| | - Eric Senneville
- Service Universitaire de Maladies Infectieuses et Tropicales, Hôpital Gustave Dron, F-59200 Tourcoing, France
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Faua C, Ursenbach A, Fuchs A, Caspar S, Jegou F, Ruch Y, Hoellinger B, Laugel E, Velay A, Rey D, Fafi-Kremer S, Gantner P. HIV Productively Infects Highly Differentiated and Exhausted CD4+ T Cells During AIDS. Pathog Immun 2024; 8:92-114. [PMID: 38420260 PMCID: PMC10901154 DOI: 10.20411/pai.v8i2.638] [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: 10/20/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Background Throughout HIV infection, productively infected cells generate billions of viral particles and are thus responsible for body-wide HIV dissemination, but their phenotype during AIDS is unknown. As AIDS is associated with immunological changes, analyzing the phenotype of productively infected cells can help understand HIV production during this terminal stage. Methods Blood samples from 15 untreated viremic participants (recent infection, n=5; long-term infection, n=5; active opportunistic AIDS-defining disease, n=5) and 5 participants virologically controlled on antiretroviral therapy (ART) enrolled in the Analysis of the Persistence, Reservoir and HIV Latency (APRIL) study (NCT05752318) were analyzed. Cells expressing the capsid protein p24 (p24+ cells) after 18 hours of resting or 24 hours of stimulation (HIV-Flow) revealed productively infected cells from viremic participants or translation-competent reservoir cells from treated participants, respectively. Results The frequency of productively infected cells tended to be higher during AIDS in comparison with recent and long-term infections (median, 340, 72, and 32/million CD4+ T cells, respectively) and correlated with the plasma viral load at all stages of infection. Altogether, these cells were more frequently CD4low, HLA-ABClow, CD45RA-, Ki67+, PD-1+, with a non-negligible contribution from pTfh (CXCR5+PD-1+) cells, and were not significantly enriched in HIV coreceptors CCR5 nor CXCR4 expression. The comparison markers expression between stages showed that productively infected cells during AIDS were enriched in memory and exhausted cells. In contrast, the frequencies of infected pTfh were lower during AIDS compared to non-AIDS stages. A UMAP analysis revealed that total CD4+ T cells were grouped in 7 clusters and that productive p24+ cells were skewed to given clusters throughout the course of infection. Overall, the preferential targets of HIV during the latest stages seemed to be more frequently highly differentiated (memory, TTD-like) and exhausted cells and less frequently pTfh-like cells. In contrast, translation-competent reservoir cells were less frequent (5/million CD4+ T cells) and expressed more frequently HLA-ABC and less frequently PD-1. Conclusions In long-term infection and AIDS, productively infected cells were differentiated and exhausted. This could indicate that cells with these given features are responsible for HIV production and dissemination in an immune dysfunction environment occurring during the last stages of infection.
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Affiliation(s)
- Clayton Faua
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
| | - Axel Ursenbach
- Le Trait d'Union, HIV-Infection Care Center, Strasbourg University Hospital, Strasbourg, France
| | - Anne Fuchs
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Stéphanie Caspar
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Frédérick Jegou
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Yvon Ruch
- Infectious Diseases Department, Strasbourg University Hospital, Strasbourg, France
| | - Baptiste Hoellinger
- Infectious Diseases Department, Strasbourg University Hospital, Strasbourg, France
| | - Elodie Laugel
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Aurélie Velay
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - David Rey
- Le Trait d'Union, HIV-Infection Care Center, Strasbourg University Hospital, Strasbourg, France
| | - Samira Fafi-Kremer
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Pierre Gantner
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
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Ursenbach A, Ruch Y, Hoellinger B, Fuchs A, Caspar S, Jegou F, Rey D, Fafi-Kremer S, Mesplede T, Gantner P. Two cases of viral re-suppression after M184V + R263 K selection on DTG/3TC without treatment modification. Clin Infect Dis 2024:ciae006. [PMID: 38193816 DOI: 10.1093/cid/ciae006] [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: 11/17/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024] Open
Abstract
DTG/3TC has a high genetic barrier against the development of HIV drug resistance. We report two cases of R263K + M184 V mutations during DTG/3TC failure followed by viral suppression after adherence intervention without treatment change that we attribute to residual drug activity, reduced viral fitness, and robust immune competence.
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Affiliation(s)
- Axel Ursenbach
- Le Trait d'Union, HIV-Infection Care Center, Strasbourg University Hospital, Strasbourg, France
| | - Yvon Ruch
- Infectious Diseases department, Strasbourg University Hospital, Strasbourg, France
| | - Baptiste Hoellinger
- Infectious Diseases department, Strasbourg University Hospital, Strasbourg, France
| | - Anne Fuchs
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Stéphanie Caspar
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - Frédérick Jegou
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
| | - David Rey
- Le Trait d'Union, HIV-Infection Care Center, Strasbourg University Hospital, Strasbourg, France
| | - Samira Fafi-Kremer
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
| | - Thibault Mesplede
- Viroscience Department, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Pierre Gantner
- Clinical Virology Laboratory, Strasbourg University Hospital, Strasbourg, France
- INSERM UMR_S1109, Strasbourg University, Strasbourg, France
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5
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Hoellinger B, Magnus L, Ruch Y, Ohana M, Hansmann Y, Letscher-Bru V, Lejay A, Chakfé N, Danion F. Case Report and Literature Review of Prosthetic Cardiovascular Mucormycosis. Emerg Infect Dis 2023; 29:2388-2390. [PMID: 37877713 PMCID: PMC10617327 DOI: 10.3201/eid2911.230837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
We report a rare case of aorto-bi-iliac prosthetic allograft mucormycosis in a 57-year-old immunocompetent patient in France. Outcome was favorable after surgery and dual antifungal therapy with liposomal amphotericin B and isavuconazole. In a literature review, we identified 12 other cases of prosthetic vascular or heart valve mucormycosis; mortality rate was 38%.
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Hoellinger B, Kaeuffer C, Boyer P, Lefebvre N, Hansmann Y, Robert A, Severac F, Gravet A, Danion F, Ruch Y, Ursenbach A. Cefepime vs carbapenems for treating third-generation cephalosporin-resistant AmpC β-lactamase-hyperproducing Enterobacterales bloodstream infections: a multicenter retrospective study. Int J Infect Dis 2023; 134:273-279. [PMID: 37453486 DOI: 10.1016/j.ijid.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES AmpC β-lactamase-hyperproducing Enterobacterales (ABLHE) bloodstream infections (BSI) are emerging and leading to therapeutic challenges worldwide. Prescriptions of carbapenems may lead to the emergence of resistance. This study aimed to compare cefepime with carbapenems for the treatment of third-generation cephalosporin-resistant ABLHE BSI. METHODS This retrospective multicenter study included patients with ABLHE BSI from two tertiary hospitals in France, between July 2017 and July 2022. Non-AmpC-producing Enterobacterales, extended-spectrum β-lactamase, and carbapenemase-producing Enterobacterales were excluded. Cefepime was prescribed only in case of minimal inhibitory concentration ≤1 mg/l. The primary outcome was 30-day in-hospital mortality from the date of index blood culture. Secondary outcomes were infection recurrence and treatment toxicity. An inverse probability of treatment weighting approach was used to balance the baseline characteristics between the two groups. RESULTS We analyzed 164 BSI, which included 77 in the cefepime group and 87 in the carbapenem group. In the weighted cohort, the 30-day mortality rates were similar between the cefepime group (23.3%) and the carbapenem group (19.6%) with a relative risk of 1.19 (95% confidence interval, 0.61-2.33 P = 0.614). No significant difference in recurrence or toxicity was found between the two groups. CONCLUSION This study adds evidence in favor of the use of cefepime for treating third-generation cephalosporin-resistant ABLHE BSI in case of minimal inhibitory concentration ≤ 1 mg/l, which could spare carbapenems.
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Affiliation(s)
- Baptiste Hoellinger
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France; Hôpital Emile Muller, service de Médecine Interne, Mulhouse, France
| | | | - Pierre Boyer
- CHU de Strasbourg, service de Bactériologie, Strasbourg, France
| | - Nicolas Lefebvre
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France
| | - Yves Hansmann
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France
| | - Amandine Robert
- CHU de Strasbourg, service de Réanimation Médicale Hautepierre, Strasbourg, France
| | - François Severac
- CHU de Strasbourg, Groupe Méthodes en Recherche Clinique (GMRC), Strasbourg, France
| | - Alain Gravet
- Hôpital Emile Muller, laboratoire de microbiologie, Mulhouse, France
| | - François Danion
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France; Inserm UMR_S 1109, Laboratoire d'ImmunoRhumatologie Moléculaire, Strasbourg, France
| | - Yvon Ruch
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France
| | - Axel Ursenbach
- CHU de Strasbourg, service des Maladies Infectieuses et Tropicales, Strasbourg, France.
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Kepka S, Heimann C, Severac F, Hoffbeck L, Le Borgne P, Bayle E, Ruch Y, Muller J, Roy C, Sauleau EA, Andres E, Ohana M, Bilbault P. Organizational Benefits of Ultra-Low-Dose Chest CT Compared to Chest Radiography in the Emergency Department for the Diagnostic Workup of Community-Acquired Pneumonia: A Real-Life Retrospective Analysis. Medicina (Kaunas) 2023; 59:1508. [PMID: 37763627 PMCID: PMC10532772 DOI: 10.3390/medicina59091508] [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] [Received: 05/26/2023] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Chest radiography remains the most frequently used examination in emergency departments (ED) for the diagnosis of community-acquired pneumonia (CAP), despite its poor diagnostic accuracy compared with ultra-low-dose (ULD) chest computed tomography (CT). However, although ULD CT appears to be an attractive alternative to radiography, its organizational impact in ED remains unknown. Our objective was to compare the relevant timepoints in ED management of CT and chest radiography. Materials and Methods: We conducted a retrospective study in two ED of a University Hospital including consecutive patients consulting for a CAP between 1 March 2019 and 29 February 2020 to assess the organizational benefits of ULD chest CT and chest radiography (length of stay (LOS) in the ED, time of clinical decision after imaging). Overlap weights (OW) were used to reduce covariate imbalance between groups. Results: Chest radiography was performed for 1476 patients (mean age: 76 years [63; 86]; 55% men) and ULD chest CT for 133 patients (mean age: 71 [57; 83]; 53% men). In the weighted population with OW, ULD chest CT did not significantly alter the ED LOS compared with chest radiography (11.7 to 12.2; MR 0.96 [0.85; 1.09]), although it did significantly reduce clinical decision time (6.9 and 9.5 h; MR 0.73 [0.59; 0.89]). Conclusion: There is real-life evidence that a strategy with ULD chest CT can be considered to be a relevant approach to replace chest radiography as part of the diagnostic workup for CAP in the ED without increasing ED LOS.
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Affiliation(s)
- Sabrina Kepka
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France; (L.H.); (P.L.B.); (E.B.); (P.B.)
- ICUBE, UMR 7357, CNRS, 300 Bd Sébastien Brant, 67400 Illkirch-Graffenstaden, France; (F.S.); (E.A.S.)
| | - Charlène Heimann
- Emergency Department, Hôpital Emile Muller, 20 rue du Dr Laennec, 68100 Mulhouse, France;
| | - François Severac
- ICUBE, UMR 7357, CNRS, 300 Bd Sébastien Brant, 67400 Illkirch-Graffenstaden, France; (F.S.); (E.A.S.)
- Méthodes en Recherche Clinique (GMRC), Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Louise Hoffbeck
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France; (L.H.); (P.L.B.); (E.B.); (P.B.)
| | - Pierrick Le Borgne
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France; (L.H.); (P.L.B.); (E.B.); (P.B.)
- UMR 1260, INSERM/Université de Strasbourg CRBS, 1 Rue Eugene Boeckel, 67000 Strasbourg, France
| | - Eric Bayle
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France; (L.H.); (P.L.B.); (E.B.); (P.B.)
| | - Yvon Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France;
| | - Joris Muller
- Public Health Units, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France;
| | - Catherine Roy
- Radiology Department, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (C.R.); (M.O.)
| | - Erik André Sauleau
- ICUBE, UMR 7357, CNRS, 300 Bd Sébastien Brant, 67400 Illkirch-Graffenstaden, France; (F.S.); (E.A.S.)
- Méthodes en Recherche Clinique (GMRC), Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Emmanuel Andres
- Department of Internal Medicine, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France;
| | - Mickaël Ohana
- Radiology Department, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (C.R.); (M.O.)
| | - Pascal Bilbault
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, CHRU of Strasbourg, 67091 Strasbourg, France; (L.H.); (P.L.B.); (E.B.); (P.B.)
- UMR 1260, INSERM/Université de Strasbourg CRBS, 1 Rue Eugene Boeckel, 67000 Strasbourg, France
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Tanoglu A, Erdem H, Friedland JS, Ankaralı H, Garcia-Goez JF, Albayrak A, El-Kholy A, Ceviker SA, Amer F, Erol S, Darazam IA, Rabiei MM, Sarwar MZ, Zeb M, Nawaz H, Ceylan MR, Cernat R, Tasbakan M, Ayoade F, Ruch Y, Tigen ET, Angioni G, Rajani DP, Akhtar N, Surme S, Sengoz G, Karlıdag GE, Marino A, Ripon RK, Çağ Y, Aydın Ö, Akkoyunlu Y, Seyman D, Angamuthu K, Cascio A, Popescu CP, Sirmatel F, Eren E, Dar RE, Munu FU, Tanoglu EG, Echeverry E, Velez JD, Artuk C, Balin SO, Pandya N, Erdem A, Demiray EKD, Aypak A. Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study. Eur J Clin Microbiol Infect Dis 2023:10.1007/s10096-023-04630-9. [PMID: 37318601 DOI: 10.1007/s10096-023-04630-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023]
Abstract
Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 ± 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.
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Affiliation(s)
- Alpaslan Tanoglu
- Department of Internal Medicine and Gastroenterology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, University of Health Sciences, 34785, Istanbul, Turkey.
| | - Hakan Erdem
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
- MKCC Cardiac Centre, Awali, Bahrain
| | | | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Jose Fernando Garcia-Goez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Ayse Albayrak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sevil Alkan Ceviker
- Department of Infectious Diseases, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Zagazig Faculty of Medicine, Zagazig, Egypt
| | - Serpil Erol
- Department of Infectious Diseases, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | | | | | - Misbah Zeb
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | - Hassan Nawaz
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | | | - Roxana Cernat
- Department of Infectious Diseases, Clinical Hospital for Infectious Diseases, Constanta, Romania
| | - Meltem Tasbakan
- Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Folusakin Ayoade
- Department of Infectious Diseases, University of Miami, Miami, FL, USA
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University, Strasbourg, France
| | - Elif Tükenmez Tigen
- Department of Infectious Diseases, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Goffredo Angioni
- Department of Infectious Diseases, Hospital SS Trinità, Borgomanero, Italy
| | - Dhanji P Rajani
- Microcare Laboratory & Tuberculosis Research Centre, Surat, Gujarat, India
| | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Serkan Surme
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gonul Sengoz
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gulden Eser Karlıdag
- Department of Infectious Diseases, Elazig Fethi Sekin City Hospital, University of Health Sciences, Elazig, Turkey
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar Union, Bangladesh
| | - Yasemin Çağ
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Özlem Aydın
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Akkoyunlu
- Department of Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Derya Seyman
- Department of Infectious Diseases, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Kumar Angamuthu
- Department of Infectious Diseases, Almana General Hospitals, Dammam, Saudi Arabia
| | - Antonio Cascio
- Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | - Corneliu Petru Popescu
- Department of Infectious Diseases, Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Fatma Sirmatel
- Department of Infectious Diseases, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Esma Eren
- Department of Infectious Diseases, Kayseri City Hospital, Kayseri, Turkey
| | - Razi Even Dar
- Department of Infectious Diseases, Caemal, Haifa, Israel
| | - Foday Usman Munu
- Department of Infectious Diseases, Lakka Government Hospital, Freetown, Sierra Leone
| | - Esra Guzel Tanoglu
- Department of Molecular Biology and Genetics, University of Health Sciences, Istanbul, Turkey
| | - Esteban Echeverry
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Juan Diego Velez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Cumhur Artuk
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Safak Ozer Balin
- Department of Infectious Diseases, Fırat University Medical Faculty, Elazig, Turkey
| | - Nirav Pandya
- Department of Infectious Diseases, Bhailal Amin General Hospital, Vadodara, India
| | - Aysegul Erdem
- Department of Pathology, Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | | | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Training and Research Hospital, Ankara, Turkey
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Hoellinger B, Danion F, Hansmann Y, Schramm F, Ruch Y. 'Real world clinical outcome of cefiderocol for treatment of multidrug resistant non-fermenting gram-negative bacilli infections' - Author's reply. Clin Microbiol Infect 2023:S1198-743X(23)00089-7. [PMID: 36871827 DOI: 10.1016/j.cmi.2023.02.019] [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: 02/08/2023] [Revised: 02/17/2023] [Accepted: 02/25/2023] [Indexed: 03/07/2023]
Affiliation(s)
- B Hoellinger
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
| | - F Danion
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Y Hansmann
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - F Schramm
- Department of Bacteriology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Y Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
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Danion F, Margue M, Ruch Y, Séverac F, Hansmann Y. Seasonal variation in azithromycin prescription. Lancet Infect Dis 2023; 23:277-278. [PMID: 36736337 DOI: 10.1016/s1473-3099(23)00009-9] [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] [Received: 12/23/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 02/04/2023]
Affiliation(s)
- François Danion
- Department of Infectious Diseases, CHU de Strasbourg, University of Strasbourg, 67 000 Strasbourg, France; Laboratoire d'ImmunoRhumatologie Moléculaire, Inserm UMR_S 1109, Strasbourg, France.
| | - Magali Margue
- Department of Infectious Diseases, CHU de Strasbourg, University of Strasbourg, 67 000 Strasbourg, France
| | - Yvon Ruch
- Department of Infectious Diseases, CHU de Strasbourg, University of Strasbourg, 67 000 Strasbourg, France
| | - François Séverac
- Groupe Méthodes en Recherche Clinique (GMRC), CHU de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Diseases, CHU de Strasbourg, University of Strasbourg, 67 000 Strasbourg, France
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Hoellinger B, Simand C, Jeannot K, Garijo C, Cristinar M, Reisz F, Danion F, Ursenbach A, Lefebvre N, Boyer P, Hansmann Y, Studer A, Schramm F, Ruch Y. Real-world clinical outcome of cefiderocol for treatment of multidrug-resistant non-fermenting, gram negative bacilli infections: a case series. Clin Microbiol Infect 2023; 29:393-395. [PMID: 36410645 DOI: 10.1016/j.cmi.2022.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Baptiste Hoellinger
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | - Célestine Simand
- Department of Hematology, Institute for Cancer Strasbourg-Europe, Strasbourg University, Strasbourg, France
| | - Katy Jeannot
- Centre National de Référence de la Résistance aux Antibiotiques, Laboratoire Associé, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Carlos Garijo
- Service de Réanimation Médicale de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mircea Cristinar
- Service de Réanimation Chirurgicale du Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Fanny Reisz
- Department of Pharmacy, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - François Danion
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Axel Ursenbach
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nicolas Lefebvre
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pierre Boyer
- Department of Bacteriology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Antoine Studer
- Service de Médecine Intensive Réanimation du Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Frédéric Schramm
- Department of Bacteriology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yvon Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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12
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Hoellinger B, Deboscker S, Danion F, Lavigne T, Severac F, Ruch Y, Ursenbach A, Lefebvre N, Boyer P, Hansmann Y. Incidence and Time-to-Onset of Carbapenemase-Producing Enterobacterales (CPE) Infections in CPE Carriers: a Retrospective Cohort Study. Microbiol Spectr 2022; 10:e0186822. [PMID: 36321906 PMCID: PMC9769894 DOI: 10.1128/spectrum.01868-22] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/02/2022] [Indexed: 12/24/2022] Open
Abstract
This study aimed to assess the proportion of carbapenemase-producing Enterobacterales (CPE) infections among all infectious episodes in CPE carriers, compare the time-to-onset of CPE infections with that of other infections, assess the mortality of patients with CPE infections, and identify risk factors for CPE infections in CPE carriers. A retrospective cohort study was performed over a 10-year period in our University Hospital, and 274 CPE carriers were identified. All infectious episodes within the first 6 months following the diagnosis of CPE rectal carriage were considered. Risk factor analysis for CPE infections in CPE carriers was performed by univariate and multivariate analyses. This study revealed an incidence of 24.1% (66/274) of CPE infection within 6 months of CPE carriage diagnosis. The 28-day all-cause mortality due to CPE infections was 25.7%. CPE infections represented 52.6% (70/133) of all infectious episodes in CPE carriers in the first 6 months following CPE carriage detection, and these significantly occurred earlier than non-CPE infections, with a median time of 15 versus 51 days, respectively (P < 0.01). Based on the multivariate analysis, prior neurological disease was the only risk factor associated with CPE infections in CPE carriers. CPE infections have an early onset, accounting for a large proportion of infections in CPE carriers, and are associated with high mortality. IMPORTANCE Carbapenemase-producing Enterobacterales (CPE) infections are emerging infections and may represent a therapeutic challenge, while effective antibiotic therapy is likely to be delayed. We aimed to assess the proportion of CPE infections in CPE carriers and to identify risk factors of CPE infections among this population that could guide empirical antibiotic therapy. We showed that CPE infections are frequent in CPE carriers, have an early onset after CPE carriage diagnosis, and represent a significant proportion of all infectious episodes in CPE carriers. No significant risk factors for CPE infections could be identified. Overall, this study suggests that empirical antibiotic treatment covering CPE might be initiated in CPE carriers at least in the first month after its diagnosis and in severe infections due to the high frequency and early occurrence of CPE infections in these patients.
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Affiliation(s)
- B. Hoellinger
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - S. Deboscker
- Service d’Hygiène Hospitalière, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F. Danion
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - T. Lavigne
- Service d’Hygiène Hospitalière, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Service de Réanimation Médicale de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F. Severac
- Groupe Méthodes en Recherche Clinique (GMRC), Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Y. Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A. Ursenbach
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N. Lefebvre
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - P. Boyer
- Department of Bacteriology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Y. Hansmann
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Ruch Y, Ursenbach A, Danion F, Reisz F, Nai T, Hoellinger B, Hansmann Y, Lefebvre N, Martzloff J. High Incidence of Acute Kidney Injury in Patients Treated with High-Dose Amoxicillin and Cloxacillin Combination Therapy. Antibiotics (Basel) 2022; 11:antibiotics11060770. [PMID: 35740176 PMCID: PMC9220067 DOI: 10.3390/antibiotics11060770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
High-dose amoxicillin and cloxacillin combination therapy is recommended for the empiric treatment of selected patients with infective endocarditis despite a low level of evidence. The main objective of this study was to evaluate the renal tolerance of high-dose intravenous amoxicillin and cloxacillin combination. We studied 27 patients treated with amoxicillin and cloxacillin (≥100 mg/kg daily) for at least 48 h. The primary endpoint was the occurrence of acute kidney injury (AKI). The median patient age was 68 ± 8 years, and 16 (59%) were male. The indication for this combination therapy was suspected or confirmed endocarditis with no bacterial identification in 22 (81%) patients. The primary endpoint occurred in 16 (59%) patients after initiating this combination therapy within an average of 4.4 ± 3.6 days. Among them, seven (26%) patients developed severe AKI, including four (15%) patients who required hemodialysis. Other risk factors for AKI were identified in all patients, including injection of iodinated contrast media in 21 (78%), acute heart failure in 18 (67%), cardiac surgery in 11 (41%), and aminoglycoside use in 9 (33%) patients. This study reports an incidence of 59% of AKI after initiating amoxicillin and cloxacillin combination therapy in a population at high renal risk.
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Affiliation(s)
- Yvon Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
- Correspondence:
| | - Axel Ursenbach
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
| | - François Danion
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
| | - Fanny Reisz
- Department of Pharmacy, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.R.); (T.N.)
| | - Thierry Nai
- Department of Pharmacy, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.R.); (T.N.)
| | - Baptiste Hoellinger
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
| | - Yves Hansmann
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
| | - Nicolas Lefebvre
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (A.U.); (F.D.); (B.H.); (Y.H.); (N.L.)
| | - Jonas Martzloff
- Department of Nephrology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
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Askarian M, Semenov A, Llopis F, Rubulotta F, Dragovac G, Pshenichnaya N, Assadian O, Ruch Y, Shayan Z, Padilla Fortunatti C, Lucey D, Almohaizeie A, Kamal AHM, Ogunshe A, Konkayev A, Beg A, Primerano E, Amer F, Kumari Pilli HP, Hung I, Ayoade F, Lefrant JY, Zajkowska J, Rello J, Kazi M, Taghrir MH, Blot S, Leib S, Hosseinpour P, Hosseinpour H, Erfani A, Borazjani R, Akbarialiabad H, Najafi M, Askarian A, Erdem H. The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 Countries: A multicenter cross-sectional study. EXCLI J 2022; 21:93-103. [PMID: 35221837 PMCID: PMC8859647 DOI: 10.17179/excli2021-4439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/15/2021] [Indexed: 12/23/2022]
Abstract
The aim of this study was to investigate the COVID-19 vaccination acceptance rate and its determinants among healthcare workers in a multicenter study. This was a cross-sectional multi-center survey conducted from February 5 to April 29, 2021. The questionnaire consisted of 26 items in 6 subscales. The English version of the questionnaire was translated into seven languages and distributed through Google Forms using snowball sampling; a colleague in each country was responsible for the forward and backward translation, and also the distribution of the questionnaire. A forward stepwise logistic regression was utilized to explore the variables and questionnaire factors tied to the intention to COVID-19 vaccination. 4630 participants from 91 countries completed the questionnaire. According to the United Nations Development Program 2020, 43.6 % of participants were from low Human Development Index (HDI) regions, 48.3 % high and very high, and 8.1 % from medium. The overall vaccination hesitancy rate was 37 %. Three out of six factors of the questionnaire were significantly related to intention to the vaccination. While 'Perceived benefits of the COVID-19 vaccination' (OR: 3.82, p-value<0.001) and 'Prosocial norms' (OR: 5.18, p-value<0.001) were associated with vaccination acceptance, 'The vaccine safety/cost concerns' with OR: 3.52, p-value<0.001 was tied to vaccination hesitancy. Medical doctors and pharmacists were more willing to take the vaccine in comparison to others. Importantly, HDI with OR: 12.28, 95 % CI: 6.10-24.72 was a strong positive determinant of COVID-19 vaccination acceptance. This study highlighted the vaccination hesitancy rate of 37 % in our sample among HCWs. Increasing awareness regarding vaccination benefits, confronting the misinformation, and strengthening the prosocial norms would be the primary domains for maximizing the vaccination coverage. The study also showed that the HDI is strongly associated with the vaccination acceptance/hesitancy, in a way that those living in low HDI contexts are more hesitant to receive the vaccine.
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Affiliation(s)
- Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz
| | - Aleksandr Semenov
- Ekaterinburg Research Institute of Viral Infections SRC VB Vector, Ekaterinburg, Russia
| | - Ferran Llopis
- Emergency Department. Bellvitge University Hospital, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Francesca Rubulotta
- Department of Intensive Care Medicine, Charing Cross Hospital, Imperial College, NHS Trust London, UK
| | - Gorana Dragovac
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Serbia; Center of Disease Prevention and Control, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Natalia Pshenichnaya
- Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Moscow, Russia
| | - Ojan Assadian
- Regional Hospital Wiener Neustadt, Austria; Institute of Skin Integrity and Infection Prevention, University of Huddersfield, UK
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Zahra Shayan
- Trauma Research Center, Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Daniel Lucey
- Department of Infectious Diseases, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Abdullah Almohaizeie
- King Faisal Specialist Hospital and Research Center, Riyadh, Alfaisal University Riyadh, Saudi Arabia
| | - Abu Hena Mostafa Kamal
- Department of Anaesthesiology & ICU, Rajshahi Medical College Hospital, Rajshahi, Bangladesh
| | - Adenike Ogunshe
- Applied Microbiology and Infectious Diseases, Department of Microbiology, Faculty of Science, University of Ibadan, Oyo State, Nigeria
| | - Aidos Konkayev
- Department of Anesthesiology and Intensive Care, Astana Medical University, Nur-Sultan, Kazakhstan; National Centre of Traumatology and Orthopedia named by Batpenov, Nur-Sultan, Kazakhstan
| | - Asim Beg
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Enzo Primerano
- Department of Anesthesia and Intensive Care, Polyclinic of Monza, Monza, Italy
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, School of Medicine, Zagazig University, Zagazig, Egypt
| | - Hema Prakash Kumari Pilli
- Department of Microbiology, GITAM Institute of Medical Sciences and Research, GITAM , Deemed to be University, Visakhapatnam, India
| | - Ivan Hung
- Department of Infectious Diseases; Gastroenterology & Hepatology, The University of Hong Kong
| | - Folusakin Ayoade
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Jean Yves Lefrant
- Department of Anaesthesia, Critical Care Emergency and Pain Medicine, University Hospital of Nimes, Montpellier University, Nimes, France
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University in Biaøystok, Poland
| | - Jordi Rello
- CRIPS, Vall Hebron Institute of Research (VHIR) & CHRU Nimes, Nimes, France
| | - Momin Kazi
- Research Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Mohammad Hossein Taghrir
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Stijn Blot
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Stephen Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Parisa Hosseinpour
- School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran
| | - Hamidreza Hosseinpour
- Department of Surgery, Shiraz Laparoscopic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roham Borazjani
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Masoud Najafi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ardalan Askarian
- Student, College of Arts & Science, University of Saskatchewan, Saskatoon, Canada
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15
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Kaeuffer C, Baldacini M, Ruge T, Ruch Y, Zhu YJ, De Cian M, Philouze G, Bachellier P, Denis J, Lefebvre N, Schneider F, Hansmann Y, Letscher-Bru V, Herbrecht R, Sabou M, Danion F. Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007-2020. Emerg Infect Dis 2022; 28:29-34. [PMID: 34932452 PMCID: PMC8714217 DOI: 10.3201/eid2801.211543] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/02/2022] Open
Abstract
Rare fungal pathogens are emerging as agents of invasive fungal infections. We analyzed 13 cases of fungal infections caused by Kazachstania (Arxiozyma) spp. in Strasbourg University Hospital, Strasbourg, France. Among the cases, 4 patients had proven fungal disease (3 cases of invasive fungal disease and 1 mucocutaneous infection) and 9 were colonized by Kazachstania (Arxiozyma) spp. Candida albicans was also isolated from 11 of the 13 patients. None of the patients with proven invasive fungal disease met host criteria, but most had underlying diseases. All strains were identified as K. telluris by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and 3 were confirmed as K. bovina by internal transcribed spacer sequencing. For all tested strains, the MICs for fluconazole were >2 μg/mL. Emergence of this rare fungal infection might be explained by the increasing number of patients with immunocompromised conditions and gastroesophageal diseases.
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Mariette X, Hermine O, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P, Bureau S, Dougados M, Tibi A, Azoulay E, Cadranel J, Emmerich J, Fartoukh M, Guidet B, Humbert M, Lacombe K, Mahevas M, Pene F, Pourchet-Martinez V, Schlemmer F, Yazdanpanah Y, Baron G, Perrodeau E, Vanhoye D, Kedzia C, Demerville L, Gysembergh-Houal A, Bourgoin A, Dalibey S, Raked N, Mameri L, Alary S, Hamiria S, Bariz T, Semri H, Hai DM, Benafla M, Belloul M, Vauboin P, Flamand S, Pacheco C, Walter-Petrich A, Stan E, Benarab S, Nyanou C, Montlahuc C, Biard L, Charreteur R, Dupré C, Cardet K, Lehmann B, Baghli K, Madelaine C, D'Ortenzio E, Puéchal O, Semaille C, Savale L, Harrois A, Figueiredo S, Duranteau J, Anguel N, Pavot A, Monnet X, Richard C, Teboul JL, Durand P, Tissieres P, Jevnikar M, Montani D, Bulifon S, Jaïs X, Sitbon O, Pavy S, Noel N, Lambotte O, Escaut L, Jauréguiberry S, Baudry E, Verny C, Noaillon M, Lefèvre E, Zaidan M, Le Tiec CLT, Verstuyft C, Roques AM, Grimaldi L, Molinari D, Leprun G, Fourreau A, Cylly L, Virlouvet M, Meftali R, Fabre S, Licois M, Mamoune A, Boudali Y, Georgin-Lavialle S, Senet P, Pialoux G, Soria A, Parrot A, François H, Rozensztajn N, Blin E, Choinier P, Camuset J, Rech JS, Canellas A, Rolland-Debord C, Lemarié N, Belaube N, Nadal M, Siguier M, Petit-Hoang C, Chas J, Drouet E, Lemoine M, Phibel A, Aunay L, Bertrand E, Ravato S, Vayssettes M, Adda A, Wilpotte C, Thibaut P, Fillon J, Debrix I, Fellahi S, Bastard JP, Lefèvre G, Fallet V, Gottenberg JE, Hansmann Y, Andres E, Bayer S, Becker G, Blanc F, Brin S, Castelain V, Chatelus E, Chatron E, Collange O, Danion F, De Blay F, Demonsant E, Diemunsch P, Diemunsch S, Felten R, Goichot B, Greigert V, Guffroy A, Heger B, Hutt A, Kaeuffer C, Kassegne L, Korganow AS, Le Borgne P, Lefebvre N, Martin T, Mertes PM, Metzger C, Meyer N, Nisand G, Noll E, Oberlin M, Ohlmann-Caillard S, Poindron V, Pottecher J, Ruch Y, Sublon C, Tayebi H, Weill F, Mekinian A, Abisror N, Jachiet V, Chopin D, Fain O, Garnier M, Krause le Garrec J, Morgand M, Pacanowski J, Urbina T, McAvoy C, Pereira M, Aratus G, Berard L, Simon T, Daguenel-Nguyen A, Antignac M, Leplay C, Arlet JB, Diehl JL, Bellenfant F, Blanchard A, Buffet A, Cholley B, Fayol A, Flamarion E, Godier A, Gorget T, Hamada SR, Hauw-Berlemont C, Hulot JS, Lebeaux D, Livrozet M, Michon A, Neuschwander A, Penet MA, Planquette B, Ranque B, Sanchez O, Volle G, Briois S, Cornic M, Elisee V, Jesuthasan D, Djadi-Prat J, Jouany P, Junquera R, Henriques M, Kebir A, Lehir I, Meunier J, Patin F, Paquet V, Tréhan A, Vigna V, Sabatier B, Bergerot D, Jouve C, Knosp C, Lenoir O, Mahtal N, Resmini L, Lescure FX, Ghosn J, BACHELARD A, BIRONNE T, BORIE R, BOUNHIOL A, BOUSSARD C, CHAUFFiER J, CHALAL S, CHALAL L, CHANSOMBAT M, CRESPIN P, CRESTANI B, DACONCEICAO O, DECONINCK L, DIEUDE P, DOSSIER A, DUBERT M, DUCROCQ G, FUENTES A, GERVAIS A, GILBERT M, ISERNIA V, ISMAEL S, JOLY V, JULIA Z, LARIVEN S, LE GAC S, LE PLUART D, LOUNI F, NDIAYE A, PAPO T, PARISEY M, PHUNG B, POURBAIX A, RACHLINE A, RIOUX C, SAUTEREAU A, STEG G, TARHINI H, VALAYER S, VALLOIS D, VERMES P, VOLPE T, Nguyen Y, Honsel V, Weiss E, Codorniu A, Zarrouk V, De Lastours V, Uzzan M, Olivier O, Rossi G, Gamany N, Rahli R, Louis Z, Boutboul D, Galicier L, Amara Y, Archer G, Benattia A, Bergeron A, Bondeelle L, De Castro N, Clément M, Darmont M, Denis B, Dupin C, Feredj E, Feyeux D, Joseph A, Lengliné E, Le Guen P, Liégeon G, Lorillon G, Mabrouki A, Mariotte E, Martin de Frémont G, Mirouse A, Molina JM, Peffault de Latour R, Oksenhendler E, Saussereau J, Tazi A, Tudesq JJ, Zafrani L, Brindele I, Bugnet E, Celli Lebras K, Chabert J, Djaghout L, Fauvaux C, Jegu AL, Kozaliewicz E, Meunier M, Tremorin MT, Davoine C, Madeleine I, Caillat-Zucman S, Delaugerre C, Morin F, SENE D, BURLACU R, CHOUSTERMAN B, MEGARBANE B, RICHETTE P, RIVELINE JP, FRAZIER A, VICAUT E, BERTON L, HADJAM T, VASQUEZ-IBARRA MA, JOURDAINE C, JACOB A, SMATI J, RENAUD S, MANIVET P, PERNIN C, SUAREZ L, Semerano L, ABAD S, Benainous R, Bloch Queyrat C, Bonnet N, Brahmi S, Cailhol J, Cohen Y, Comparon C, Cordel H, Dhote R, Dournon N, Duchemann B, Ebstein N, Giroux-Leprieur B, Goupil de Bouille J, Jacolot A, Nunes H, Oziel J, Rathouin V, Rigal M, Roulot D, Tantet C, Uzunhan Y, COSTEDOAT-CHALUMEAU N, Ait Hamou Z, Benghanem S, BLANCHE P, CANOUI E, CARLIER N, CHAIGNE B, CONTEJEAN A, DUNOGUE B, DUPLAND P, DUREL - MAURISSE A, GAUZIT R, JAUBERT P, Joumaa H, Jozwiak M, KERNEIS S, LACHATRE M, Lafoeste H, LEGENDRE P, LUONG NGUYEN LB, MAREY J, MORBIEU C, MOUTHON L, NGUYEN L, Palmieri LJ, REGENT A, SZWEBEL TA, TERRIER B, GUERIN C, ZERBIT J, CHEREF K, CHITOUR K, CISSE MS, CLARKE A, CLAVERE G, DUSANTER I, GAUDEFROY C, JALLOULI M, KOLTA S, LE BOURLOUT C, MARIN N, MENAGE N, MOORES A, PEIGNEY I, PIERRON C, SALEH-MGHIR S, VALLET M, MICHEL M, MELICA G, LELIEVRE JD, FOIS E, LIM P, MATIGNON M, GUILLAUD C, THIEMELE A, SCHMITZ D, BOUHRIS M, BELAZOUZ S, LANGUILLE L, MEKONTSO-DESSAPS A, SADAOUI T, Mayaux J, Cacoub P, Corvol JC, Louapre C, Sambin S, Mariani LL, Karachi C, Tubach F, Estellat C, Gimeno L, Martin K, Bah A, Keo V, Ouamri S, Messaoudi Y, Yelles N, Faye P, Cavelot S, Larcheveque C, Annonay L, Benhida J, Zahrate-Ghoul A, Hammal S, Belilita R, Lecronier M, Beurton A, Haudebourg L, Deleris R, Le Marec J, Virolle S, Nemlaghi S, Bureau C, Mora P, De Sarcus M, Clovet O, Duceau B, Grisot PH, Pari MH, Arzoine J, Clarac U, Faure M, Delemazure J, Decavele M, Morawiec E, Demoule A, Dres M, Vautier M, Allenbach Y, Benveniste O, Leroux G, Rigolet A, Guillaume-Jugnot P, Domont F, Desbois AC, Comarmond C, Champtiaux N, Toquet S, Ghembaza A, Vieira M, Maalouf G, Boleto G, Ferfar Y, Charbonnier F, AGUILAR C, ALBY-LAURENT F, ALYANAKIAN MA, BAKOUBOULA P, BROISSAND C, BURGER C, CAMPOS-VEGA C, CHAVAROT N, CHOUPEAUX L, FOURNIER B, GRANVILLE S, ISSORAT E, ROUZAUD C, VIMPERE D, Geri G, Derridj N, Sguiouar N, Meddah H, Djadel M, Chambrin-Lauvray H, Duclos-Vallée JC, Saliba F, Sacleux SC, Koumis I, Michot JM, Stoclin A, Colomba E, Pommeret F, Willekens C, Sakkal M, Da Silva R, Dejean V, Mekid Y, Ben-Mabrouk I, Pradon C, Drouard L, Camara-Clayette V, Morel A, Garcia G, Mohebbi A, Berbour F, Dehais M, Pouliquen AL, Klasen A, Soyez-Herkert L, London J, Keroumi Y, Guillot E, Grailles G, El Amine Y, Defrancq F, Fodil H, Bouras C, Dautel D, Gambier N, Dieye T, Razurel A, Bienvenu B, Lancon V, Lecomte L, Beziriganyan K, Asselate B, Allanic L, Kiouris E, Legros MH, Lemagner C, Martel P, Provitolo V, Ackermann F, Le Marchand M, Clan Hew Wai A, Fremont D, Coupez E, Adda M, Duée F, Bernard L, Gros A, Henry E, Courtin C, Pattyn A, Guinot PG, Bardou M, Maurer A, Jambon J, Cransac A, Pernot C, Mourvillier B, Servettaz A, Deslée G, Wynckel A, Benoit P, Marquis E, Roux D, Gernez C, Yelnik C, Poissy J, Nizard M, Denies F, Gros H, Mourad JJ, Sacco E, Renet S. Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial. The Lancet Rheumatology 2022; 4:e24-e32. [PMID: 34812424 PMCID: PMC8598187 DOI: 10.1016/s2665-9913(21)00315-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia. Methods We did a multicentric, open-label, Bayesian randomised, adaptive, phase 2/3 clinical trial, nested within the CORIMUNO-19 cohort, to test a superiority hypothesis. Patients 18 years or older hospitalised with COVID-19 in six French centres, requiring at least 3L/min of oxygen but without ventilation assistance and a WHO Clinical Progression Scale [CPS] score of 5 were enrolled. Patients were randomly assigned (1:1) via a web-based system, according to a randomisation list stratified on centre and with blocks randomly selected among 2 and 4, to receive usual care plus 400 mg of sarilumab intravenously on day 1 and on day 3 if clinically indicated (sarilumab group) or usual care alone (usual care group). Primary outcomes were the proportion of patients with WHO-CPS scores greater than 5 on the 10-point scale on day 4 and survival without invasive or non-invasive ventilation at day 14. This completed trial is closed to new participants and is registered with ClinicalTrials.gov, NCT04324073. Findings 165 patients were recruited from March 27 to April 6, 2020, and 148 patients were randomised (68 patients to the sarilumab group and 80 to the usual care group) and followed up for 90 days. Median age was 61·7 years [IQR 53·0–71·1] in the sarilumab group and 62·8 years [56·0–71·7] in the usual care group. In the sarilumab group 49 (72%) of 68 were men and in the usual care group 59 (78%) of 76 were men. Four patients in the usual care group withdrew consent and were not analysed. 18 (26%) of 68 patients in the sarilumab group had a WHO-CPS score greater than 5 at day 4 versus 20 (26%) of 76 in the usual care group (median posterior absolute risk difference 0·2%; 90% credible interval [CrI] −11·7 to 12·2), with a posterior probability of absolute risk difference greater than 0 of 48·9%. At day 14, 25 (37%) patients in the sarilumab and 26 (34%) patients in the usual care group needed ventilation or died, (median posterior hazard ratio [HR] 1·10; 90% CrI 0·69–1·74) with a posterior probability HR greater than 1 of 37·4%. Serious adverse events occurred in 27 (40%) patients in the sarilumab group and 28 (37%) patients in the usual care group (p=0·73). Interpretation Sarilumab treatment did not improve early outcomes in patients with moderate-to-severe COVID-19 pneumonia. Further studies are warranted to evaluate the effect of sarilumab on long-term survival. Funding Assistance publique—Hôpitaux de Paris
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Carapito R, Li R, Helms J, Carapito C, Gujja S, Rolli V, Guimaraes R, Malagon-Lopez J, Spinnhirny P, Lederle A, Mohseninia R, Hirschler A, Muller L, Bastard P, Gervais A, Zhang Q, Danion F, Ruch Y, Schenck M, Collange O, Chamaraux-Tran TN, Molitor A, Pichot A, Bernard A, Tahar O, Bibi-Triki S, Wu H, Paul N, Mayeur S, Larnicol A, Laumond G, Frappier J, Schmidt S, Hanauer A, Macquin C, Stemmelen T, Simons M, Mariette X, Hermine O, Fafi-Kremer S, Goichot B, Drenou B, Kuteifan K, Pottecher J, Mertes PM, Kailasan S, Aman MJ, Pin E, Nilsson P, Thomas A, Viari A, Sanlaville D, Schneider F, Sibilia J, Tharaux PL, Casanova JL, Hansmann Y, Lidar D, Radosavljevic M, Gulcher JR, Meziani F, Moog C, Chittenden TW, Bahram S. Identification of driver genes for critical forms of COVID-19 in a deeply phenotyped young patient cohort. Sci Transl Med 2021; 14:eabj7521. [PMID: 34698500 DOI: 10.1126/scitranslmed.abj7521] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Raphael Carapito
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Richard Li
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Julie Helms
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Christine Carapito
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Sharvari Gujja
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Véronique Rolli
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Raony Guimaraes
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | | | - Perrine Spinnhirny
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Alexandre Lederle
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Razieh Mohseninia
- Center for Quantum Information Science and Technology, University of Southern California; Los Angeles, 90089-0484 CA, USA
| | - Aurélie Hirschler
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Leslie Muller
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Paul Bastard
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - Adrian Gervais
- Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - Qian Zhang
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - François Danion
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Yvon Ruch
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Maleka Schenck
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; Avenue Molière, 67200 Strasbourg, France
| | - Olivier Collange
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67000 Strasbourg, France
| | - Thiên-Nga Chamaraux-Tran
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg Cedex, France
| | - Anne Molitor
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Angélique Pichot
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Alice Bernard
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Ouria Tahar
- Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sabrina Bibi-Triki
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Haiguo Wu
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Nicodème Paul
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sylvain Mayeur
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Annabel Larnicol
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Géraldine Laumond
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Julia Frappier
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sylvie Schmidt
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Antoine Hanauer
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Cécile Macquin
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Tristan Stemmelen
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Michael Simons
- Yale Cardiovascular Research Center, Departments of Medicine and Cell Biology, Yale University School of Medicine; New Haven, CT 06511, USA
| | - Xavier Mariette
- Department of Rheumatology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris; 94270 Paris, France.,Université Paris-Saclay, INSERM UMR_S 1184; 94270 Le Kremlin Bicêtre, France
| | - Olivier Hermine
- University of Paris, Imagine Institute; 75015 Paris, France.,Department of Hematology, INSERM UMR_S 1153, Imagine Institute, Necker Hospital, University of Paris, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Samira Fafi-Kremer
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Virology, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Bernard Goichot
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Interne, Endocrinologie et Nutrition, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg, France
| | - Bernard Drenou
- Département d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace; 68100 Mulhouse, France
| | - Khaldoun Kuteifan
- Service de Réanimation Médicale, Groupe Hospitalier de la région Mulhouse Sud Alsace; 68100 Mulhouse, France
| | - Julien Pottecher
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg Cedex, France
| | - Paul-Michel Mertes
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67000 Strasbourg, France
| | | | - M Javad Aman
- Integrated BioTherapeutics, Inc.; Rockville, MD 20850, USA
| | - Elisa Pin
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab; Stockholm, SE-171 21, Sweden
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab; Stockholm, SE-171 21, Sweden
| | | | | | | | - Francis Schneider
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; Avenue Molière, 67200 Strasbourg, France
| | - Jean Sibilia
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Rhumatologie, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg, France
| | - Pierre-Louis Tharaux
- INSERM (Institut de la Santé et de la Recherche Médicale), Université de Paris, Paris Cardiovascular Center-PARCC; 75015 Paris, France
| | - Jean-Laurent Casanova
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France.,Howard Hughes Medical Institute; New York, NY 10065, USA
| | - Yves Hansmann
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Daniel Lidar
- Center for Quantum Information Science and Technology, University of Southern California; Los Angeles, 90089-0484 CA, USA.,Department of Electrical and Computer Engineering, Department of Chemistry, Department of Physics and Astronomy, University of Southern California; Los Angeles, CA 90089, USA
| | - Mirjana Radosavljevic
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Jeffrey R Gulcher
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Ferhat Meziani
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Christiane Moog
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Thomas W Chittenden
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA.,Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School; Boston, MA 02115, USA
| | - Seiamak Bahram
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
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18
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Saydam FN, Erdem H, Ankarali H, El-Arab Ramadan ME, El-Sayed NM, Civljak R, Pshenichnaya N, Moroti RV, Mahmuodabad FM, Maduka AV, Mahboob A, Prakash Kumari PH, Stebel R, Cernat R, Fasanekova L, Uysal S, Tasbakan M, Arapović J, Magdalena DI, Angamuthu K, Ghanem-Zoubi N, Meric-Koc M, Ruch Y, Marino A, Sadykova A, Batirel A, Khan EA, Kulzhanova S, Al-Moghazi S, Yegemberdiyeva R, Nicastri E, Pandak N, Akhtar N, Ozer-Balin S, Cascio A, Dimzova M, Evren H, Puca E, Tokayeva A, Vecchi M, Bozkurt I, Dogan M, Dirani N, Duisenova A, Khan MA, Kotsev S, Obradovic Z, Del Vecchio RF, Almajid F, Barac A, Dragovac G, Pishmisheva-Peleva M, Rahman MT, Rahman T, Le Marechal M, Cag Y, Ikram A, Rodriguez-Morales AJ. Vector-borne and zoonotic infections and their relationships with regional and socioeconomic statuses: An ID-IRI survey in 24 countries of Europe, Africa and Asia. Travel Med Infect Dis 2021; 44:102174. [PMID: 34699956 DOI: 10.1016/j.tmaid.2021.102174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. METHOD VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. RESULTS 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. CONCLUSIONS Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.
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Affiliation(s)
- Fatma Nurhayat Saydam
- Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas University, Faculty of Medicine, Batikent Medical Park Hospital, Ankara, Turkey
| | - Hakan Erdem
- ID-IRI Lead Coordinator, Ankara, Turkey; Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, 24343, Bahrain.
| | - Handan Ankarali
- Istanbul Medeniyet University, School of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | | | | | - Rok Civljak
- "Dr. Fran Mihaljevic" University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ruxandra Valentina Moroti
- National Institute for Infectious Diseases 'Matei Bals', and 'Carol Davila' University of Medicine and Pharmacy', Bucharest, Romania
| | | | | | - Amjad Mahboob
- Gajju Khan Medical College/Bacha Khan Medical Complex, Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Roman Stebel
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Roxana Cernat
- Clinical Infectious Disease Hospital Constanta, Ovidius University of Constanta, Romania
| | - Lenka Fasanekova
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Firat University Faculty of Medicine, Elazig, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, Izmir, Turkey
| | - Jurica Arapović
- Department of Infectious Diseases, Mostar University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | | | | | | | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Hospital of Medical Faculty, Istanbul, Turkey
| | - Yvon Ruch
- Strasbourg University Hospital (Nouvel Hôpital Civil - Centre Hospitalo-Universitaire de Strasbourg), Strasbourg, France
| | - Andrea Marino
- Department of Infectious Diseases, Garibaldi Nesima Hospital, Italy
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa Tameer-E-Millat University, Shifa International Hospital, Islamabad, Pakistan
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Samir Al-Moghazi
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | - Ravilya Yegemberdiyeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Emanuele Nicastri
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, G-8/3, Islamabad, Pakistan
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Firat University, Faculty of Medicine, Elazıg, Turkey
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Italy
| | - Marija Dimzova
- Clinic for Infectious Diseases and Febrile Conditions, Medical University, Skopje, Macedonia
| | - Hakan Evren
- Department of Infectious Diseases and Clinical Microbiology, University of Kyrenia, Kyrenia, Cyprus
| | | | - Alma Tokayeva
- Department of Infectious Diseases, Semey Medical University, Semey, Kazakhstan
| | | | - Ilkay Bozkurt
- Department of Infectious Diseases, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
| | - Mustafa Dogan
- Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
| | - Natalia Dirani
- Department of Infectious Diseases, Dar Al Amal University Hospital, Douris, Baalbak, Lebanon
| | - Amangul Duisenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Stanislav Kotsev
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Zarema Obradovic
- Faculty for Health Studies University of Sarajevo, Bosnia and Herzegovina
| | | | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Gorana Dragovac
- Centre of Disease Prevention and Control, Institute of Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Maria Pishmisheva-Peleva
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | | | - Marion Le Marechal
- Grenoble Alpes University, CHUGA, Infectious Diseases Department, 38043, Grenoble, France
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Perú
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19
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Kepka S, Ohana M, Séverac F, Muller J, Bayle E, Ruch Y, Laugel E, Oberlin M, Solis M, Hansmann Y, Bilbault P, Fafi Kremer S. Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department. J Clin Med 2021; 10:3455. [PMID: 34441750 PMCID: PMC8397078 DOI: 10.3390/jcm10163455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/24/2021] [Accepted: 07/29/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Correct and timely identification of SARS-CoV-2-positive patients is critical in the emergency department (ED) prior to admission to medical wards. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis of COVID-19 but have lower sensitivity. METHODS We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly. The combined strategy performed in the ED for patients with COVID-19 symptoms was assessed and compared with RT-PCR. RESULTS Compared with RT-PCR, the negative predictive value was 96.7% for Ag-RDT alone, 98.5% for Ag-RDT/CT combined, and increased to 100% for patients with low viral load. CONCLUSION A strategy combining Ag-RDT and chest CT is effective in ruling out COVID-19 in ED patients with high precision.
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Affiliation(s)
- Sabrina Kepka
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (E.B.); (M.O.); (P.B.)
- URCEco, Hôtel Dieu, AP-HP, 1 Place du Parvis Notre Dame, 75004 Paris, France
| | - Mickaël Ohana
- Radiology Department, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France;
| | - François Séverac
- Groupe Méthodes en Recherche Clinique (GMRC), Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France;
| | - Joris Muller
- Public Health Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France;
| | - Eric Bayle
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (E.B.); (M.O.); (P.B.)
| | - Yvon Ruch
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (Y.R.); (Y.H.)
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (E.L.); (M.S.); (S.F.K.)
| | - Elodie Laugel
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (E.L.); (M.S.); (S.F.K.)
- Department of Virology, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Mathieu Oberlin
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (E.B.); (M.O.); (P.B.)
- Department of Internal Medicine, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Morgane Solis
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (E.L.); (M.S.); (S.F.K.)
- Department of Virology, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Yves Hansmann
- Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (Y.R.); (Y.H.)
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (E.L.); (M.S.); (S.F.K.)
| | - Pascal Bilbault
- Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France; (E.B.); (M.O.); (P.B.)
- UMR 1260, INSERM/Université de Strasbourg CRBS, 1 rue Eugene Boeckel, 67000 Strasbourg, France
| | - Samira Fafi Kremer
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (E.L.); (M.S.); (S.F.K.)
- Department of Virology, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
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Kaeuffer C, Baldacini M, Ruch Y, Lefebvre N, Hansmann Y, Letscher-Bru V, Herbrecht R, Sabou M, Danion F. Infections fongiques à Kazachstania spp. : une levure émergente ? Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Gerber V, Ruch Y, Chamaraux-Tran TN, Oulehri W, Schneider F, Lindner V, Greigert V, Denis J, Brunet J, Danion F. Detection of Pneumocystis jirovecii in Patients with Severe COVID-19: Diagnostic and Therapeutic Challenges. J Fungi (Basel) 2021; 7:jof7080585. [PMID: 34436124 PMCID: PMC8397120 DOI: 10.3390/jof7080585] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/25/2022] Open
Abstract
Cases of Pneumocystis jirovecii pneumonia (PCP) in patients suffering from COVID-19 were described in patients with various comorbidities and outcomes. The diagnosis of PCP in these patients is difficult due to clinical and radiological similarities. We carried out this study in order to better describe potentially at-risk patients and their outcomes. We retrospectively analyzed all patients with a P. jirovecii PCR performed in bronchoalveolar lavage fluid, tracheal aspirate, or sputum within a month after the COVID-19 diagnosis. Fifty-seven patients with COVID-19 infection were tested for P. jirovecii. Among 57 patients with COVID-19, four patients had a concomitant positive P. jirovecii PCR. These four patients were elderly with a mean age of 78. Two patients were immunocompromised, and the two others presented only diabetes mellitus. Three patients presented an ARDS requiring transfer to the ICU and mechanical ventilation. All patients presented lymphocytopenia. Three patients had probable PCP, and one had proven PCP. All patients died within two months after hospital admission. These co-infections are rare but severe, therefore, PCP should be considered in case of worsening of the condition of patients with severe COVID-19.
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Affiliation(s)
- Victor Gerber
- CHU de Strasbourg, Service de Maladies Infectieuses et Tropicales, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (V.G.); (Y.R.)
| | - Yvon Ruch
- CHU de Strasbourg, Service de Maladies Infectieuses et Tropicales, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (V.G.); (Y.R.)
| | - Thiên-Nga Chamaraux-Tran
- Service d’Anesthésie-Réanimation Chirurgicale, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, CEDEX, 67098 Strasbourg, France;
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), CNRS UMR7104, INSERM U1258, Université de Strasbourg, 67400 Illkirch, France
| | - Walid Oulehri
- Service d’Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Francis Schneider
- Service de Médecine Intensive Réanimation, Hautepierre, Hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Veronique Lindner
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, CEDEX, 67098 Strasbourg, France;
| | - Valentin Greigert
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63130, USA;
| | - Julie Denis
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (J.D.); (J.B.)
| | - Julie Brunet
- Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (J.D.); (J.B.)
| | - François Danion
- CHU de Strasbourg, Service de Maladies Infectieuses et Tropicales, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France; (V.G.); (Y.R.)
- Correspondence:
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22
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Pretet V, Blondet C, Ruch Y, Martinez M, El Ghannudi S, Morel O, Hansmann Y, Schindler TH, Imperiale A. Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis. Diagnostics (Basel) 2021; 11:diagnostics11040720. [PMID: 33919643 PMCID: PMC8073326 DOI: 10.3390/diagnostics11040720] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as "possible" or "rejected" IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the 'imaging specialist'. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.
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Affiliation(s)
- Valentin Pretet
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France; (V.P.); (C.B.); (M.M.); (S.E.G.)
| | - Cyrille Blondet
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France; (V.P.); (C.B.); (M.M.); (S.E.G.)
- Faculty of Medicine, FMTS, University of Strasbourg, 67000 Strasbourg, France; (Y.R.); (Y.H.)
| | - Yvon Ruch
- Faculty of Medicine, FMTS, University of Strasbourg, 67000 Strasbourg, France; (Y.R.); (Y.H.)
- Infectious Diseases, University Hospitals of Strasbourg, 67000 Strasbourg, France
| | - Matias Martinez
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France; (V.P.); (C.B.); (M.M.); (S.E.G.)
- Nuclear Medicine and Molecular Imaging, Oulton Institute, 5000 Cordoba, Argentina
- Nuclear Medicine, Hospital Privado Universitario, 5000 Cordoba, Argentina
| | - Soraya El Ghannudi
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France; (V.P.); (C.B.); (M.M.); (S.E.G.)
- Radiology, University Hospitals of Strasbourg, 67000 Strasbourg, France
| | - Olivier Morel
- Cardiology, University Hospitals of Strasbourg, 67000 Strasbourg, France;
| | - Yves Hansmann
- Faculty of Medicine, FMTS, University of Strasbourg, 67000 Strasbourg, France; (Y.R.); (Y.H.)
- Infectious Diseases, University Hospitals of Strasbourg, 67000 Strasbourg, France
| | - Thomas H. Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University, St Louis, MO 63110, USA;
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, rue Albert Calmette, 67093 Strasbourg, France; (V.P.); (C.B.); (M.M.); (S.E.G.)
- Faculty of Medicine, FMTS, University of Strasbourg, 67000 Strasbourg, France; (Y.R.); (Y.H.)
- Molecular Imaging–DRHIM, IPHC, UMR 7178, CNRS, 67037 Strasbourg, France
- Correspondence: ; Tel.: +33-368-767-448; Fax: +33-368-767-256
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Kaeuffer C, Ruge T, Diancourt L, Romain B, Ruch Y, Jaulhac B, Boyer PH. First Case of Bacteraemia Due to Carbapenem-Resistant Bacteroides faecis. Antibiotics (Basel) 2021; 10:antibiotics10030319. [PMID: 33808699 PMCID: PMC8003481 DOI: 10.3390/antibiotics10030319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
Abstract
Multidrug resistant (MDR) bacteria are increasingly observed in nosocomial and community-acquired settings. Anaerobes are no exception to this rule, but there are fewer reports of MDR in the scientific literature on anaerobes than there are for other bacteria. In this short case report, we describe the first case of bacteraemia caused by a multidrug-resistant Bacteroides faecis, which produces a carbapenemase encoded by the blaCfiA gene. This bacteraemia followed a digestive surgery operation. Surprisingly, these findings did not lead to a change in antibiotic therapy, probably because the patient’s clinical state had improved. Nevertheless this report calls for better knowledge of anaerobic bacteria and for a systematic antimicrobial stewardship procedure following bacteraemia.
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Affiliation(s)
- Charlotte Kaeuffer
- Department of Infectious Disease, Strasbourg University Hospital, 67000 Strasbourg, France; (C.K.); (Y.R.)
| | - Tiffany Ruge
- Laboratory of Bacteriology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (T.R.); (B.J.)
| | - Laure Diancourt
- National Reference Center for Anaerobic Bacteria and Botulism, Institut Pasteur, 25-28 Rue du Docteur Roux, 75724 Paris, France;
| | - Benoît Romain
- Department of Digestive Surgery, Strasbourg University Hospital, 67000 Strasbourg, France;
| | - Yvon Ruch
- Department of Infectious Disease, Strasbourg University Hospital, 67000 Strasbourg, France; (C.K.); (Y.R.)
| | - Benoît Jaulhac
- Laboratory of Bacteriology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (T.R.); (B.J.)
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67000 Strasbourg, France
- CHRU Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, 67000 Strasbourg, France
| | - Pierre H. Boyer
- Laboratory of Bacteriology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (T.R.); (B.J.)
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, 67000 Strasbourg, France
- CHRU Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, 67000 Strasbourg, France
- Correspondence:
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24
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Ursenbach A, Schramm F, Séverac F, Hansmann Y, Lefebvre N, Ruch Y, Argemi X. Correction to: Impact of 16S rDNA sequencing on clinical treatment decisions: a single center retrospective study. BMC Infect Dis 2021; 21:276. [PMID: 33736594 PMCID: PMC7977158 DOI: 10.1186/s12879-021-05938-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Axel Ursenbach
- Laboratoire de bactériologie, Faculté de Médecine, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Frédéric Schramm
- Laboratoire de bactériologie, Faculté de Médecine, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France
| | - François Séverac
- Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nicolas Lefebvre
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yvon Ruch
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Xavier Argemi
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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25
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Erdem H, Hargreaves S, Ankarali H, Caskurlu H, Ceviker SA, Bahar-Kacmaz A, Meric-Koc M, Altindis M, Yildiz-Kirazaldi Y, Kizilates F, Alsalman J, Cag Y, Kamal AHM, Dokmetas I, Dindar-Demiray EK, Shehata GA, Hasman H, Sadykova A, Llopis F, Ramosaco E, Logar M, Alay H, Kesmez-Can F, Ruch Y, Bulut D, Makek MJ, Marino A, Mahboob A, El-Kholy A, Abdallah D, Sefa-Sayar M, Karaali R, Aslan S, Dar RE, Abdalla E, Monzón-Camps H, Baljić R, Mgdalena DI, Naghili B, Abbas Dafalla ME, Alwashmi ASS, Carmen CR, Ramirez-Estrada S, Wojewodzka-Zelezniakowicz M, Akyildiz O, Zajkowska J, El-Sokkary R, Pandya N, Amer F, Alavi-Darazam I, Grgić S, Wegdan AA, El-Kholy J, Bulut-Avsar C, Kulzhanova S, Tasbakan M, Kumari HP, Dirani N, Koganti K, Konkayev AK, Petrov MM, Cascio A, Liskova A, Del Vecchio RF, Lambertenghi L, Mladenov N, Oncu S, Rello J. Managing adult patients with infectious diseases in emergency departments: international ID-IRI study. J Chemother 2021; 33:302-318. [PMID: 33734040 DOI: 10.1080/1120009x.2020.1863696] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.
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Affiliation(s)
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hulya Caskurlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Sevil Alkan Ceviker
- Department of Infectious Diseases and Clinical Microbiology, Kutahya Evliya Celebi Research and Education Hospital, Kutahya, Turkey
| | - Asiye Bahar-Kacmaz
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Mustafa Altindis
- Department of Medical Microbiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | | | - Filiz Kizilates
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
| | | | - Yasemin Cag
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | | | | | - Hakan Hasman
- Emergency Department, Ankara Medicalpark Hospital, Ankara, Turkey
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, City Clinical Infectious Hospital, Kazakh National Medical University, Almaty, Kazakhstan
| | - Ferran Llopis
- Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Ergys Ramosaco
- Infectious Diseases Clinic, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Mateja Logar
- Department of Infectious Diseases, UMC Ljubljana, Ljubljana, Slovenia
| | - Handan Alay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Fatma Kesmez-Can
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Dilek Bulut
- Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
| | | | - Andrea Marino
- Department of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Amjad Mahboob
- Bacha Khan Medical Complex Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Dirar Abdallah
- Department of Intensive Care, Prime Hospital, Dubai, United Arab Emirates
| | - Merve Sefa-Sayar
- Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
| | - Ridvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, İstanbul Üniversitesi, Istanbul, Turkey
| | - Selda Aslan
- Department of Infectious Diseases and Clinical Microbiology, Cengiz Gokcek Maternity and Children's Hospital, Gaziantep, Turkey
| | - Razi Even Dar
- Department of Internal Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Esam Abdalla
- Department of Anesthesia & ICU, Assiut University Hospital, Assiut, Egypt
| | - Helena Monzón-Camps
- Emergency Department and Infectious Diseases, Hospital Universitary Mútua Terrassa, Terrassa, Spain
| | - Rusmir Baljić
- Clinic for Infectious Diseases, Sarajevo, Bosnia and Herzegovina
| | - Dumitru Irina Mgdalena
- Clinical Infectious Diseases Hospital, Ovidius University of Constanta, Constanta, Romania
| | - Behrouz Naghili
- Department of Infectious Diseases, Imam Reza Hospital, Tabriz, Iran
| | | | - Ameen S S Alwashmi
- Medical Laboratories Department, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Cernat Roxana Carmen
- Clinical Hospital for Infectious Diseases, Ovidius University Constanta, Constanta, Romania
| | | | | | - Ozay Akyildiz
- Department of Infectious Diseases and Clinical Microbiology, Adana Acibadem Hospital, Adana, Turkey
| | | | - Rehab El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ilad Alavi-Darazam
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Svjetlana Grgić
- Clinic for Infectious Disease, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | | | | | - Cansu Bulut-Avsar
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ege University, Izmir, Turkey
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ege University, Izmir, Turkey
| | | | | | | | - Aidos K Konkayev
- Institution of Trauma and Orthopaedics, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Michael M Petrov
- Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University, Plovdiv, Bulgaria
| | - Antonio Cascio
- Infectious and Tropical Diseases Section, Department PROMISE, University of Palermo, Palermo, Italy
| | | | | | | | | | - Serkan Oncu
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Jordi Rello
- Critical Care Department, Hospital Vall d'Hebron, Barcelona, Spain.,CIBERES, Madrid, Spain.,Universitat Autonma de Barcelona, Barcelona, Spain
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26
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Gerber V, Velay A, Boehn L, Solis M, Kaeuffer C, Rougier E, Ursenbach A, Hansmann Y, Lefebvre N, Danion F, Ruch Y. Protracted SARS-CoV-2 pneumonia with rituximab treatment: About two cases. J Med Virol 2021; 93:4141-4144. [PMID: 33666242 PMCID: PMC8013359 DOI: 10.1002/jmv.26921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Victor Gerber
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Aurélie Velay
- Laboratoire de virologie, CHU de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Louis Boehn
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Morgane Solis
- Laboratoire de virologie, CHU de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Charlotte Kaeuffer
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Estelle Rougier
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Axel Ursenbach
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Nicolas Lefebvre
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - François Danion
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
| | - Yvon Ruch
- Service de Maladies Infectieuses et Tropicales, CHU de Strasbourg, Strasbourg, France
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27
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Caillard S, Chavarot N, Francois H, Matignon M, Greze C, Kamar N, Gatault P, Thaunat O, Legris T, Frimat L, Westeel PF, Goutaudier V, Jdidou M, Snanoudj R, Colosio C, Sicard A, Bertrand D, Mousson C, Bamoulid J, Masset C, Thierry A, Couzi L, Chemouny JM, Duveau A, Moal V, Blancho G, Grimbert P, Durrbach A, Moulin B, Anglicheau D, Ruch Y, Kaeuffer C, Benotmane I, Solis M, LeMeur Y, Hazzan M, Danion F. Is COVID-19 infection more severe in kidney transplant recipients? Am J Transplant 2021; 21:1295-1303. [PMID: 33259686 PMCID: PMC7753418 DOI: 10.1111/ajt.16424] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [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: 08/28/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/25/2023]
Abstract
There are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients.
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Affiliation(s)
- Sophie Caillard
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Nathalie Chavarot
- Department of Nephrology and TransplantationHôpital Universitaire NeckerAPHP CenterUniversité de Paris INEM INSERM U 1151CNRS UMR 8253ParisFrance
| | - Hélène Francois
- AP‐HP (Assistance Publique‐Hôpitaux de Paris)Department of Nephrology and TransplantationHopital TenonParisFrance
| | - Marie Matignon
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Clarisse Greze
- Department of Nephrology and TransplantationHôpital BichatParisFrance
| | - Nassim Kamar
- Department of Nephrology and TransplantationUniversity of ToulouseToulouseFrance
| | - Philippe Gatault
- Department of Nephrology and TransplantationUniversity of ToursToursFrance
| | - Olivier Thaunat
- Department of Transplantation, Nephrology and Clinical ImmunologyHôpital Edouard HerriotHospices Civils de LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - Tristan Legris
- Aix Marseille UniversitéHôpitaux Universitaires de MarseilleHôpital ConceptionCentre de Néphrologie et Transplantation RénaleMarseilleFrance
| | - Luc Frimat
- Department of NephrologyUniversity of LorraineCHRU‐NancyVandoeuvreFrance,INSERM CIC‐EC CIE6NancyFrance
| | - Pierre F. Westeel
- Department of Nephrology and TransplantationUniversity of AmiensAmiensFrance
| | - Valentin Goutaudier
- Department of Nephrology and TransplantationUniversity of MontpellierMontpellierFrance
| | - Mariam Jdidou
- Department of Nephrology and TransplantationHôpital BicêtreLe Kremlin‐BicêtreFrance
| | - Renaud Snanoudj
- Department of Nephrology and TransplantationHôpital BicêtreLe Kremlin‐BicêtreFrance
| | - Charlotte Colosio
- Department of Nephrology and TransplantationUniversity of ReimsReimsFrance
| | - Antoine Sicard
- Department of Nephrology, Dialysis, and TransplantationHopital Pasteur 2C.H.U. de NiceUnité de Recherche Clinique Côte d’Azur (UR2CA)Université Côte d’AzurNiceFrance
| | - Dominique Bertrand
- Department of Nephrology and TransplantationUniversity of RouenRouenFrance
| | - Christiane Mousson
- Department of Nephrology and TransplantationUniversity of DijonDijonFrance
| | - Jamal Bamoulid
- Department of NephrologyUniversity of BesançonBesançonFrance
| | - Christophe Masset
- Department of Nephrology and TransplantationCenter Hospitalier Universitaire de NantesNantesFrance
| | - Antoine Thierry
- Department of NephrologyUniversity of PoitiersPoitiersFrance
| | - Lionel Couzi
- Department of Nephrology‐Transplantation‐Dialysis‐ApheresisHôpital PellegrinCHU de Bordeaux PellegrinUnité Mixte de Recherche “ImmunoConcEpT” 5164 − Université de BordeauxBordeauxFrance
| | - Jonathan M. Chemouny
- University of RennesCHU RennesInsermEHESP, Irset (Institut de recherche en santéenvironnement et travail) UMR_S 1085, CIC – P 1414RennesFrance
| | - Agnes Duveau
- Department of Nephrology and TransplantationUniversity of AngersAngersFrance
| | - Valerie Moal
- Aix Marseille UniversitéHôpitaux Universitaires de MarseilleHôpital ConceptionCentre de Néphrologie et Transplantation RénaleMarseilleFrance
| | - Gilles Blancho
- Department of Nephrology and TransplantationCenter Hospitalier Universitaire de NantesNantesFrance
| | - Philippe Grimbert
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Antoine Durrbach
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Bruno Moulin
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Dany Anglicheau
- Department of Nephrology and TransplantationHôpital Universitaire NeckerAPHP CenterUniversité de Paris INEM INSERM U 1151CNRS UMR 8253ParisFrance
| | - Yvon Ruch
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
| | - Charlotte Kaeuffer
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
| | - Ilies Benotmane
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Morgane Solis
- Department of VirologyStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Yannick LeMeur
- Department of NephrologyCHU de BrestUMR1227Lymphocytes B et AutoimmunitéUniversité de BrestInsermLabex IGOBrestFrance
| | - Marc Hazzan
- Department of Nephrology and TransplantationUniversity of LilleLilleFrance
| | - Francois Danion
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
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Le Borgne P, Solis M, Severac F, Merdji H, Ruch Y, Alamé Intern K, Bayle E, Hansmann Y, Bilbault P, Fafi‐Kremer S, Meziani F. SARS-CoV-2 viral load in nasopharyngeal swabs in the emergency department does not predict COVID-19 severity and mortality. Acad Emerg Med 2021; 28:306-313. [PMID: 33481307 PMCID: PMC8014851 DOI: 10.1111/acem.14217] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 09/18/2020] [Revised: 12/08/2020] [Accepted: 01/15/2021] [Indexed: 12/25/2022]
Abstract
Introduction The ongoing COVID‐19 pandemic has led to devastating repercussions on health care systems worldwide. This viral infection has a broad clinical spectrum (ranging from influenza‐like disease, viral pneumonia, and hypoxemia to acute respiratory distress syndrome requiring prolonged intensive care unit stays). The prognostic impact of measuring viral load on nasopharyngeal swab specimens (by reverse transcriptase polymerase chain reaction [RT‐PCR]) is yet to be elucidated. Methods Between March 3 and April 5, 2020, we conducted a retrospective study on a cohort of COVID‐19 patients (mild or severe disease) who were hospitalized after presenting to the emergency department (ED) and had at least one positive nasopharyngeal swab during their hospital stay. We led our study at the University Hospitals of Strasbourg in the Greater East region of France, one of the pandemic's epicenters in Europe. Results We have collected samples from a cohort of 287 patients with a confirmed diagnosis of COVID‐19 who were included in our study. Nearly half of them (50.5%) presented a mild form of the disease, while the other half (49.5%) presented a severe form, requiring mechanical ventilation. Median (interquartile range) viral load on the initial upper respiratory swab at admission was 4.76 (3.29–6.06) log10 copies/reaction. When comparing survivors and nonsurvivors, this viral load measurement did not differ according to subgroups (p = 0.332). Additionally, we have found that respiratory viral load measurement was predictive of neither in‐hospital mortality (adjusted odds ratio [AOR] = 1.05, 95% confidence interval [CI] = 0.85 to 1.31, p = 0.637) nor disease severity (AOR = 0.88, 95% CI = 0.73 to 1.06, p = 0.167). Conclusion Respiratory viral load measurement on the first nasopharyngeal swab (by RT‐PCR) during initial ED management is neither a predictor of severity nor a predictor of mortality in SARS‐CoV‐2 infection. Host response to this viral infection along with the extent of preexisting comorbidities might be more foretelling of disease severity than the virus itself.
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Affiliation(s)
- Pierrick Le Borgne
- Emergency Department Hôpitaux Universitaires de Strasbourg Strasbourg France
- INSERM (French National Institute of Health and Medical ResearchUMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS)University of Strasbourg Strasbourg France
| | - Morgane Solis
- Laboratoire de virologie CHU de Strasbourg Strasbourg France
- Université de StrasbourgINSERMIRM UMR_S 1109 Strasbourg France
| | - François Severac
- Department of Public Health University Hospital of Strasbourg Strasbourg France
| | - Hamid Merdji
- INSERM (French National Institute of Health and Medical ResearchUMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS)University of Strasbourg Strasbourg France
- Faculté de Médecine Université de Strasbourg (UNISTRA)Hôpitaux Universitaires de StrasbourgNouvel Hôpital CivilService de Médecine Intensive‐Réanimation Strasbourg France
| | - Yvon Ruch
- Department of Infectious Disease Strasbourg University Hospital Strasbourg France
| | - Karine Alamé Intern
- Emergency Department Hôpitaux Universitaires de Strasbourg Strasbourg France
| | - Eric Bayle
- Emergency Department Hôpitaux Universitaires de Strasbourg Strasbourg France
| | - Yves Hansmann
- Department of Infectious Disease Strasbourg University Hospital Strasbourg France
| | - Pascal Bilbault
- Emergency Department Hôpitaux Universitaires de Strasbourg Strasbourg France
- INSERM (French National Institute of Health and Medical ResearchUMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS)University of Strasbourg Strasbourg France
| | - Samira Fafi‐Kremer
- Laboratoire de virologie CHU de Strasbourg Strasbourg France
- Université de StrasbourgINSERMIRM UMR_S 1109 Strasbourg France
| | - Ferhat Meziani
- INSERM (French National Institute of Health and Medical ResearchUMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS)University of Strasbourg Strasbourg France
- Faculté de Médecine Université de Strasbourg (UNISTRA)Hôpitaux Universitaires de StrasbourgNouvel Hôpital CivilService de Médecine Intensive‐Réanimation Strasbourg France
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29
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Ursenbach A, Schramm F, Séverac F, Hansmann Y, Lefebvre N, Ruch Y, Argemi X. Revised version (INFD-D-20-00242): impact of 16S rDNA sequencing on clinical treatment decisions: a single center retrospective study. BMC Infect Dis 2021; 21:190. [PMID: 33602178 PMCID: PMC7890971 DOI: 10.1186/s12879-021-05892-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background PCRs targeting 16S ribosomal DNA (16S PCR) followed by Sanger’s sequencing can identify bacteria from normally sterile sites and complement standard analyzes, but they are expensive. We conducted a retrospective study in the Strasbourg University Hospital to assess the clinical impact of 16S PCR sequencing on patients’ treatments according to different sample types. Methods From 2014 to 2018, 806 16S PCR samples were processed, and 191 of those were positive. Results Overall, the test impacted the treatment of 62 of the 191 patients (32%). The antibiotic treatment was rationalized in 31 patients (50%) and extended in 24 patients (39%), and an invasive procedure was chosen for 7 patients (11%) due to the 16S PCR sequencing results. Positive 16S PCR sequencing results on cerebrospinal fluid (CSF) had a greater impact on patients’ management than positive ones on cardiac valves (p = 0.044). The clinical impact of positive 16S PCR sequencing results were significantly higher when blood cultures were negative (p < 0.001), and this difference appeared larger when both blood and sample cultures were negative (p < 0.001). The diagnostic contribution of 16S PCR was higher in patients with previous antibiotic treatment (p < 0.001). Conclusion In all, 16S PCR analysis has a significant clinical impact on patient management, particularly for suspected CSF infections, for patients with culture-negative samples and for those with previous antibiotic treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05892-4.
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Affiliation(s)
- Axel Ursenbach
- Laboratoire de bactériologie, Faculté de Médecine, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Frédéric Schramm
- Laboratoire de bactériologie, Faculté de Médecine, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France
| | - François Séverac
- Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nicolas Lefebvre
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yvon Ruch
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Xavier Argemi
- Maladies Infectieuses et Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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30
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Kaeuffer C, Le Hyaric C, Fabacher T, Mootien J, Dervieux B, Ruch Y, Hugerot A, Zhu YJ, Pointurier V, Clere-Jehl R, Greigert V, Kassegne L, Lefebvre N, Gallais F, Meyer N, Hansmann Y, Hinschberger O, Danion F. Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 33272355 PMCID: PMC7716399 DOI: 10.2807/1560-7917.es.2020.25.48.2000895] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization. Aim Our objective was to identify risk factors predictive of severe disease and death in France. Methods In this prospective cohort study, we included patients ≥ 18 years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and patients who died, to those who did not, by day 7 after hospitalisation. Results Among 1,045 patients, 424 (41%) had severe disease, including 335 (32%) who were admitted to ICU, and 115 (11%) who died. Mean age was 66 years (range: 20–100), and 612 (59%) were men. Almost 75% of patients with body mass index (BMI) data (n = 897) had a BMI ≥ 25 kg/m2 (n = 661). Independent risk factors associated with severe disease were advanced age (odds ratio (OR): 1.1 per 10-year increase; 95% CrI (credible interval): 1.0–1.2), male sex (OR: 2.1; 95% CrI: 1.5–2.8), BMI of 25–29.9 kg/m2 (OR: 1.8; 95% CrI: 1.2–2.7) or ≥ 30 (OR: 2.2; 95% CrI: 1.5–3.3), dyspnoea (OR: 2.5; 95% CrI: 1.8–3.4) and inflammatory parameters (elevated C-reactive protein and neutrophil count, low lymphocyte count). Risk factors associated with death were advanced age (OR: 2.7 per 10-year increase; 95% CrI: 2.1–3.4), male sex (OR: 1.7; 95% CrI: 1.1–2.7), immunosuppression (OR: 3.8; 95% CrI: 1.6–7.7), diabetes (OR: 1.7; 95% CrI: 1.0–2.7), chronic kidney disease (OR: 2.3; 95% CrI: 1.3–3.9), dyspnoea (OR: 2.1; 95% CrI: 1.2–3.4) and inflammatory parameters. Conclusions Overweightedness, obesity, advanced age, male sex, comorbidities, dyspnoea and inflammation are risk factors for severe COVID-19 or death in hospitalised patients. Identifying these features among patients in routine clinical practice might improve COVID-19 management.
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Affiliation(s)
- Charlotte Kaeuffer
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Coralie Le Hyaric
- These authors contributed equally.,CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Thibaut Fabacher
- Université de Strasbourg, ICube, équipe IMAGeS, UMR7357, Strasbourg, France.,These authors contributed equally
| | - Joy Mootien
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Intensive Care Unit, Mulhouse, France
| | - Benjamin Dervieux
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Department of Internal Medicine, Mulhouse, France
| | - Yvon Ruch
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Antonin Hugerot
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves-Jean Zhu
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Valentin Pointurier
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Intensive Care Unit, Mulhouse, France
| | - Raphael Clere-Jehl
- CHU de Strasbourg, Medical Intensive Care Unit, Nouvel Hôpital Civil, Strasbourg, France
| | - Valentin Greigert
- CHU de Strasbourg, Department of Internal Medicine, Nouvel Hôpital Civil, Strasbourg, France
| | - Loic Kassegne
- CHU de Strasbourg, Department of Pneumology, Strasbourg
| | - Nicolas Lefebvre
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Floriane Gallais
- CHU de Strasbourg, Department of Virology, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
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- The members of the Covid Alsace Study Group are listed at the end of the article
| | - Nicolas Meyer
- CHU de Strasbourg, Department of Public Health, GMRC, Strasbourg, France.,Université de Strasbourg, ICube, équipe IMAGeS, UMR7357, Strasbourg, France
| | - Yves Hansmann
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Olivier Hinschberger
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Department of Internal Medicine, Mulhouse, France
| | - François Danion
- CHU de Strasbourg, Department of Infectious and Tropical Diseases; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
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Sentilhes L, De Marcillac F, Jouffrieau C, Kuhn P, Thuet V, Hansmann Y, Ruch Y, Fafi-Kremer S, Deruelle P. Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. Am J Obstet Gynecol 2020; 223:914.e1-914.e15. [PMID: 32553908 PMCID: PMC7294260 DOI: 10.1016/j.ajog.2020.06.022] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
Abstract
Background Despite the mainly reassuring outcomes for pregnant women with coronavirus disease 2019 reported by previous case series with small sample sizes, some recent reports of severe maternal morbidity requiring intubation and of maternal deaths show the need for additional data about the impact of coronavirus disease 2019 on pregnancy outcomes. Objective This study aimed to report the maternal characteristics and clinical outcomes of pregnant women with coronavirus disease 2019. Study Design This retrospective, single-center study includes all consecutive pregnant women with confirmed (laboratory-confirmed) or suspected (according to the Chinese management guideline [version 7.0]) coronavirus disease 2019, regardless of gestational age at diagnosis, admitted to the Strasbourg University Hospital (France) from March 1, 2020, to April 3, 2020. Maternal characteristics, laboratory and imaging findings, and maternal and neonatal outcomes were extracted from medical records. Results The study includes 54 pregnant women with confirmed (n=38) and suspected (n=16) coronavirus disease 2019. Of these, 32 had an ongoing pregnancy, 1 had a miscarriage, and 21 had live births: 12 vaginal and 9 cesarean deliveries. Among the women who gave birth, preterm deliveries were medically indicated for their coronavirus disease 2019–related condition for 5 of 21 women (23.8%): 3 (14.3%) before 32 weeks’ gestation and 2 (9.5%) before 28 weeks’ gestation. Oxygen support was required for 13 of 54 women (24.1%), including high-flow oxygen (n=2), noninvasive (n=1) and invasive (n=3) mechanical ventilation, and extracorporeal membrane oxygenation (n=1). Of these, 3, aged 35 years or older with positive test result for severe acute respiratory syndrome coronavirus 2 using reverse transcription polymerase chain reaction, had respiratory failure requiring indicated delivery before 29 weeks’ gestation. All 3 women were overweight or obese, and 2 had an additional comorbidity. Conclusion Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. Its association with other well-known risk factors for severe maternal morbidity in pregnant women with no infection, including maternal age above 35 years, overweight, and obesity, suggests further studies are required to determine whether these risk factors are also associated with poorer maternal outcome in these women.
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Gourieux B, Reisz F, Belmas AS, Danion F, Fourtage M, Nai T, Reiter-Schatz A, Ruch Y, Walther J, Nivoix Y, Michel B. Prescribing practices of lopinavir/ritonavir, hydroxychloroquine and azithromycin during the COVID-19 epidemic crisis and pharmaceutical interventions in a French teaching hospital. Eur J Hosp Pharm 2020; 28:242-247. [PMID: 33239282 PMCID: PMC7689541 DOI: 10.1136/ejhpharm-2020-002449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 11/04/2022] Open
Abstract
Objective The aims of this study were to describe prescribing practices of lopinavir/ritonavir, hydroxychloroquine and azithromycin during the COVID-19 epidemic crisis (primary endpoint), then to characterise pharmaceutical interventions (PIs) targeted to these medications and evaluate the impact of these PIs on prescribers’ practices (secondary end-points). Methods This retrospective observational study was carried out at the University Hospital of Strasbourg (France) from March to April 2020. The analysed population excluded patients from intensive care units but included all other adult patients with COVID-19 who received at least one dose of lopinavir/ritonavir combination, hydroxychloroquine or azithromycin, while inpatients. Analyses were performed by using data extracted from electronic medical records. Result During the study period, 278 patients were included. A rapid decrease in lopinavir/ritonavir prescriptions was observed. This was accompanied by an increase in hydroxychloroquine and azithromycin prescriptions until the end of March, followed by a decrease leading to the disappearance of these two medications in April. The pharmaceutical analysis of the prescriptions resulted in 59 PIs of which 21 were associated with lopinavir/ritonavir, 32 with hydroxychloroquine and 6 with azithromycin. Regarding the medication-related problems, the most frequent ones were incorrect treatment durations (n=32 (54.2%)), drug interactions with potential torsadogenic reactions (n=14 (23.7%)) and incorrect dosing (n=6 (10.2%)). From the 59 PIs, 48 (81.4%) were accepted and physicians adjusted the medication regimens in a timely manner. Conclusion This study demonstrated the value—even more meaningful in a crisis situation—of a strong synergy between physicians and pharmacists for patient-safety focused practices.
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Affiliation(s)
- Benedicte Gourieux
- Pharmacy, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Fanny Reisz
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Anne Sophie Belmas
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - François Danion
- Service des Maladies infectieuses et tropicales, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Marion Fourtage
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Thierry Nai
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Aurélie Reiter-Schatz
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Yvon Ruch
- Service des Maladies infectieuses et tropicales, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Julia Walther
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Yasmine Nivoix
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Bruno Michel
- Service de Pharmacie, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
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Kaeuffer C, Ruch Y, Fabacher T, Hinschberger O, Mootien J, Eyriey M, Greigert V, Meyer N, Fafi-Kremer S, Lefebvre N, Hansmann Y, Martinot M, Danion F. The BAS 2IC Score: A Useful Tool to Identify Patients at High Risk of Early Progression to Severe Coronavirus Disease 2019. Open Forum Infect Dis 2020; 7:ofaa405. [PMID: 33274248 PMCID: PMC7499730 DOI: 10.1093/ofid/ofaa405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
We developed a score, with easily accessible data (age, sex, body mass index, dyspnea, inflammatory parameters), to predict the risk of rapid progression to severe coronavirus disease 2019. Using a cutoff of >6 points, the negative predictive value was 87%.
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Affiliation(s)
- Charlotte Kaeuffer
- CHU de Strasbourg, Department of Infectious and Tropical Diseases, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yvon Ruch
- CHU de Strasbourg, Department of Infectious and Tropical Diseases, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Thibaut Fabacher
- CHU de Strasbourg, Department of Public Health, Strasbourg, France
- Université de Strasbourg, ICube, Équipe IMAGeS, UMR7357, Strasbourg, France
| | - Olivier Hinschberger
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Department of Internal Medicine, Mulhouse, France
| | - Joy Mootien
- Groupe Hospitalier Régional Mulhouse Sud Alsace, Intensive Care Unit, Mulhouse, France
| | - Magali Eyriey
- Hôpitaux Civils de Colmar, Department of Infectious Diseases, Colmar, France
| | - Valentin Greigert
- CHU de Strasbourg, Department of Internal Medicine, Nouvel Hopital Civil Strasbourg, Strasbourg, France
| | - Nicolas Meyer
- CHU de Strasbourg, Department of Public Health, Strasbourg, France
- Université de Strasbourg, ICube, Équipe IMAGeS, UMR7357, Strasbourg, France
| | - Samira Fafi-Kremer
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
- CHU de Strasbourg, Department of Virology, Strasbourg, France
| | - Nicolas Lefebvre
- CHU de Strasbourg, Department of Infectious and Tropical Diseases, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- CHU de Strasbourg, Department of Infectious and Tropical Diseases, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Martin Martinot
- Hôpitaux Civils de Colmar, Department of Infectious Diseases, Colmar, France
| | - François Danion
- CHU de Strasbourg, Department of Infectious and Tropical Diseases, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
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Ruch Y, Kaeuffer C, Ohana M, Labani A, Fabacher T, Bilbault P, Kepka S, Solis M, Greigert V, Lefebvre N, Hansmann Y, Danion F. CT lung lesions as predictors of early death or ICU admission in COVID-19 patients. Clin Microbiol Infect 2020; 26:1417.e5-1417.e8. [PMID: 32717417 PMCID: PMC7378475 DOI: 10.1016/j.cmi.2020.07.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [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] [Received: 05/15/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The main objective of this study was to investigate the prognostic value of early systematic chest computed tomography (CT) with quantification of lung lesions in coronavirus disease 2019 (COVID-19) patients. METHODS We studied 572 patients diagnosed with COVID-19 (confirmed using polymerase chain reaction) for whom a chest CT was performed at hospital admission. Visual quantification was used to classify patients as per the percentage of lung parenchyma affected by COVID-19 lesions: normal CT, 0-10%, 11-25%, 26-50%, 51-75% and >75%. The primary endpoint was severe disease, defined by death or admission to the intensive care unit in the 7 days following first admission. RESULTS The mean patient age was 66.0 ± 16.0 years, and 343/572 (60.0%) were men. The primary endpoint occurred in 206/572 patients (36.0%). The extent of lesions on initial CT was independently associated with prognosis (odds ratio = 2.35, 95% confidence interval 1.24-4.46; p < 0.01). Most patients with lung involvement >50% (66/95, 69.5%) developed severe disease compared to patients with lung involvement of 26-50% (70/171, 40.9%) and ≤25% (70/306, 22.9%) (p < 0.01 and p < 0.01, respectively). None of the patients with normal CT (0/14) had severe disease. CONCLUSION Chest CT findings at admission are associated with outcome in COVID-19 patients.
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Affiliation(s)
- Yvon Ruch
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France.
| | - Charlotte Kaeuffer
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Mickael Ohana
- Department of Radiology, Strasbourg University Hospital, Strasbourg, France
| | - Aissam Labani
- Department of Radiology, Strasbourg University Hospital, Strasbourg, France
| | - Thibaut Fabacher
- Department of Biostatistics, Strasbourg University Hospital, Strasbourg, France
| | - Pascal Bilbault
- Department of Emergency Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Sabrina Kepka
- Department of Emergency Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Morgane Solis
- Department of Virology, Strasbourg University Hospital, Strasbourg, France
| | - Valentin Greigert
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Nicolas Lefebvre
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - François Danion
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
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Ruch Y, Kaeuffer C, Guffroy A, Lefebvre N, Hansmann Y, Danion F. Rapid Radiological Worsening and Cytokine Storm Syndrome in COVID-19 Pneumonia. Eur J Case Rep Intern Med 2020; 7:001822. [PMID: 32665942 PMCID: PMC7350974 DOI: 10.12890/2020_001822] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 01/26/2023] Open
Abstract
Background In June 2020, a large randomised controlled clinical trial in the UK found that dexamethasone was effective in reducing the number of deaths in patients with severe coronavirus disease 2019 (COVID-19). Case description We describe a patient with rapid worsening of COVID-19 pneumonia and its dramatic improvement under corticosteroids. Discussion Corticosteroids could be useful in patients with an inflammatory profile, considering that acute respiratory distress syndrome may be the consequence of cytokine storm syndrome. LEARNING POINTS
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Affiliation(s)
- Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Charlotte Kaeuffer
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Aurélien Guffroy
- Department of Clinical Immunology and Internal Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Nicolas Lefebvre
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
| | - François Danion
- Department of Infectious Diseases, Strasbourg University Hospital, Strasbourg, France
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Rahal A, Ruch Y, Meyer N, Perrier S, Minh TH, Schneider C, Lavigne T, Marguerite S, Ajob G, Cristinar M, Epailly E, Mazzucotelli JP, Kindo M. Left ventricular assist device-associated infections: incidence and risk factors. J Thorac Dis 2020; 12:2654-2662. [PMID: 32642173 PMCID: PMC7330372 DOI: 10.21037/jtd.2020.03.26] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Left ventricular assist device (LVAD)-associated infections are major complications that can lead to critical outcomes. The aims of this study were to assess the incidence of and to determine the risk factors for LVAD-associated infections. Methods We included all consecutive patients undergoing LVAD implantation between January 1, 2010, and January 1, 2019, in a single institution. Infection-related data were retrospectively collected by review of patient's medical files. LVAD-associated infections were classified into three categories: percutaneous driveline infections, pocket infections and pump and/or cannula infections. Results We enrolled 72 patients. Twenty-one (29.2%) patients presented a total of 32 LVAD-associated infections. Eight (38.1%) patients had more than one infection. Five (62.5%) pocket infections and one (50.0%) pump and/or cannula infection were preceded by a driveline infection. The median delay between the operation and LVAD-associated infection was 6.5 (1.4-12.4) months. The probability of having a LVAD-associated infection at one year after receiving an implant was 26.6% (95% CI: 17.5-40.5%). Percutaneous driveline infections represented 68.7% of all LVAD-associated infections. Staphylococcus aureus and coagulase-negative staphylococci were the predominant bacteria in LVAD-associated infections (53.1% and 15.6%, respectively). Hospital length of stay (sdHR =1.22 per 10 days; P=0.001) and postoperative hemodialysis (sdHR =0.17; P=0.004) were statistically associated with infection. Colonization with multidrug-resistant bacteria was more frequent in patients with LVAD-associated infections than in others patients (42.9% vs. 15.7%; P=0.013). Conclusions LVAD-associated infections remain an important complication and are mostly represented by percutaneous driveline infections. Gram-positive cocci are the main pathogens isolated in microbiological samples. Patients with LVAD-associated infections are more frequently colonized with multidrug-resistant bacteria.
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Affiliation(s)
- Andréa Rahal
- Equipe Opérationnelle D'Hygiène, CHU de Strasbourg, 1, Place de l'Hôpital, 67091, Strasbourg, France
| | - Yvon Ruch
- Department of Infectious Diseases, University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Nicolas Meyer
- ICube, UMR7357, Université de Strasbourg, Strasbourg, France
| | - Stéphanie Perrier
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Tam Hoang Minh
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Clément Schneider
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Thierry Lavigne
- Equipe Opérationnelle D'Hygiène, CHU de Strasbourg, 1, Place de l'Hôpital, 67091, Strasbourg, France
| | - Sandrine Marguerite
- Department of Anesthesia and Intensive Care Unit, University Hospitals of Strasbourg, Strasbourg, France
| | - Gharib Ajob
- Department of Anesthesia and Intensive Care Unit, University Hospitals of Strasbourg, Strasbourg, France
| | - Mircea Cristinar
- Department of Anesthesia and Intensive Care Unit, University Hospitals of Strasbourg, Strasbourg, France
| | - Eric Epailly
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | | | - Michel Kindo
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France
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Ursenbach A, Ruch Y, Von Hunolstein JJ, Lefebvre N, Argemi X, Hansmann Y, Schramm F. First case of Robinsoniella peoriensis endocarditis. Med Mal Infect 2020; 50:533-535. [PMID: 32315704 DOI: 10.1016/j.medmal.2020.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 11/26/2022]
Affiliation(s)
- A Ursenbach
- Laboratoire de bactériologie, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Y Ruch
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, Strasbourg, France.
| | | | - N Lefebvre
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - X Argemi
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Y Hansmann
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - F Schramm
- Laboratoire de bactériologie, hôpitaux universitaires de Strasbourg, Strasbourg, France
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Rahal A, Ruch Y, Meyer N, Perrier S, Hoang Minh T, Schneider C, Lavigne T, Marguerite S, Ajob G, Cristinar M, Epailly E, Mazzucotelli JP, Kindo M. Infections associées aux assistances ventriculaires gauches : incidence et facteurs de risques. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2019.11.015] [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: 10/25/2022] Open
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Martin A, Ruch Y, Douiri N, Boyer P, Argemi X, Hansmann Y, Lefebvre N. Factors associated with treatment failure after advice from infectious disease specialists. Med Mal Infect 2019; 50:696-701. [PMID: 31812296 DOI: 10.1016/j.medmal.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/30/2019] [Accepted: 11/06/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Risk factors associated with treatment failure after the infectious disease specialist's (IDS) advice remain unknown. We aimed to identify these risk factors. METHODS We included patients hospitalized in our tertiary care center who consulted an infectious disease specialist between January 2013 and April 2015. Treatment failure was defined by a composite criterion: signs of sepsis beyond Day 3, ICU admission, or death. Treatment success was defined by the patient's sustained clinical improvement. RESULTS A total of 240 IDS recommendations were made. Diagnosis was changed for 64 patients (26.7%) and 50 patients experienced treatment failure after the IDS advice. In multivariate analysis, compliance with the IDS advice was associated with a higher rate of success (OR=0.09, 95%CI [0.01-0.67]). Variables associated with treatment failure in the multivariate analysis were Charlson comorbidity score at admission (OR=1.24, 95%CI [1.03-1.50]), a history of infection or colonization with multidrug-resistant bacteria (OR=8.27, 95%CI [1.37-49.80]), and deterioration of the patient's status three days after the IDS advice (OR=12.50, 95%CI [3.16-49.46]). CONCLUSION Reassessing IDS recommendations could be interesting for specific patients to further adapt and improve them.
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Affiliation(s)
- A Martin
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - Y Ruch
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - N Douiri
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - P Boyer
- Laboratoire de microbiologie, hôpitaux universitaires de Strasbourg, 3, rue Koeberlé, 67000 Strasbourg, France
| | - X Argemi
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - Y Hansmann
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - N Lefebvre
- Maladies infectieuses et tropicales, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Petitdemange A, Martin A, Ruch Y, Chatron E, Karol A, Hansmann Y. [Aspergillus spondylodiscitis in a patient treated with ibrutinib]. Med Mal Infect 2019; 50:296-297. [PMID: 31722863 DOI: 10.1016/j.medmal.2019.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/28/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Affiliation(s)
- A Petitdemange
- Service de maladies infectieuses et tropicales, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France.
| | - A Martin
- Service de maladies infectieuses et tropicales, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Y Ruch
- Service de maladies infectieuses et tropicales, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - E Chatron
- Service de pneumologie, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - A Karol
- Pôle d'imagerie médicale, service de radiologie 1, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - Y Hansmann
- Service de maladies infectieuses et tropicales, Nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
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Ruch Y, Hansmann Y, Riegel P, Lefebvre N, Mazzucotelli JP, Douiri N, Martin A, Argemi X. Virulence of beta-hemolytic streptococci in infective endocarditis. Infection 2019; 48:91-97. [PMID: 31520396 DOI: 10.1007/s15010-019-01358-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/06/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Streptococci involved in infective endocarditis (IE) primarily comprise alpha- or non-hemolytic streptococci (ANHS). Moreover, beta-hemolytic streptococci (BHS) can be involved, and guidelines recommend the addition of gentamicin for the first 2 weeks of treatment and the consideration of early surgery in such cases. This study compared the morbidity and mortality associated with IE depending on the microorganisms involved (BHS, ANHS, staphylococci, and enterococci). METHODS We conducted a retrospective observational study between 2012 and 2017 in a single hospital in France. The endpoints were overall in-hospital mortality, 1-year mortality and the occurrence of complications. RESULTS We analyzed 316 episodes of definite IE including 150 (38%), 96 (25%), 46 (12%), and 24 cases (6%) of staphylococcal, ANHS, enterococcal, and BHS IE, respectively. In-hospital mortality was significantly higher in the staphylococcal (n = 40; 26.7%) and BHS groups (n = 6; 25.0%) than in the ANHS (n = 9; 9.4%) and enterococcal groups (n = 5; 10.9%) (all p < 0.01). The rates of septic shock and cerebral emboli were also higher in the BHS group than in the ANHS group [n = 7 (29.2%) vs. n = 3 (3.1%), p < 0.001; n = 7 (29.2%) vs. n = 12 (12.5%); p = 0.05, respectively]. CONCLUSION This study confirmed that BHS IE has a more severe prognosis than ANHS IE. The virulence of BHS may be similar to that of staphylococci, justifying increased monitoring of these patients and more 'aggressive' treatments such as early surgery.
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Affiliation(s)
- Yvon Ruch
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France. .,Service de Maladies Infectieuses et Tropicales, Centre Hospitalo, Universitaire de Strasbourg, 1 place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France.
| | - Yves Hansmann
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Riegel
- Laboratory of Bacteriology, Strasbourg University Hospital, Strasbourg, France
| | - Nicolas Lefebvre
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | | | - Nawal Douiri
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Aurélie Martin
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Xavier Argemi
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
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Herber M, Kaeuffer C, Martin A, Averous G, Nguimpi-Tambou M, Klipfel A, Hansmann Y, Lefebvre N, Argemi X, Ruch Y, Prendki V. [Persistent diarrhea in a 77 year-old woman]. Rev Med Interne 2019; 41:134-137. [PMID: 31421900 DOI: 10.1016/j.revmed.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/04/2019] [Indexed: 11/18/2022]
Affiliation(s)
- M Herber
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Kaeuffer
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - A Martin
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - G Averous
- Service d'anatomie pathologique, CHU de Strasbourg, hôpital de Haute-Pierre, 1, avenue Molière, Strasbourg 67200, France
| | - M Nguimpi-Tambou
- Service d'hépato-gastro-entérologie, CHU de Strasbourg, Haute-Pierre, 1, avenue Molière, Strasbourg cedex 67091, France
| | - A Klipfel
- Service de chirurgie digestive, CHU de Strasbourg, Haute-Pierre, 1, avenue Molière, Strasbourg cedex 67091, France
| | - Y Hansmann
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - N Lefebvre
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - X Argemi
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - Y Ruch
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - V Prendki
- Service de médecine Interne de l'Agé, hôpitaux universitaires de Genève, faculté de médecine de Genève, Suisse
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Ruch Y, Labidi A, Martin A, Weingertner N, Hansmann Y, Lefebvre N, Andres E, Argemi X, Dieudonné Y. Le syndrome de cavitation ganglionnaire mésentérique, complication rare de la maladie cœliaque de l’adulte : à propos de quatre cas et revue de la littérature. Rev Med Interne 2019; 40:536-544. [DOI: 10.1016/j.revmed.2019.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022]
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Ruch Y, Mazzucotelli JP, Lefebvre F, Martin A, Lefebvre N, Douiri N, Riegel P, Hoang Minh T, Petit-Eisenmann H, Hansmann Y, Argemi X. Impact of Setting up an "Endocarditis Team" on the Management of Infective Endocarditis. Open Forum Infect Dis 2019; 6:ofz308. [PMID: 31660397 PMCID: PMC6735925 DOI: 10.1093/ofid/ofz308] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 05/02/2019] [Accepted: 06/25/2019] [Indexed: 02/06/2023] Open
Abstract
Background Infective endocarditis (IE) remains a severe disease with a high mortality rate. Therefore, guidelines encourage the setup of a multidisciplinary group in reference centers. The present study evaluated the impact of this "Endocarditis Team" (ET). Methods We conducted a monocentric observational study at Strasbourg University Hospital, Strasbourg, France, between 2012 and 2017. The primary end point was in-hospital mortality. Secondary end points were 6-month and 1-year mortality, surgery rate, time to surgical procedure, duration of effective antibiotic therapy, length of in-hospital stay, and sequelae. We also assessed predictors of in-hospital mortality. Results We analyzed 391 episodes of IE. In the post-ET period, there was a nonsignificant decrease in in-hospital mortality (20.3% vs 14.7%, respectively; P = .27) and sequelae, along with a significant reduction in time to surgery (16.4 vs 10.3 days, respectively; P = .049), duration of antibiotic therapy (55.2 vs 47.2 days, respectively; P < .001), and length of in-hospital stay (40.6 vs 31.9 days, respectively; P < .01). In a multivariate analysis, the post-ET period was positively associated with survival (odds ratio, 0.45; 95% confidence interval, 0.20-0.96; P = .048). Conclusions This multidisciplinary approach exerted a positive impact on the management of IE and should be considered in all hospitals managing IE.
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Affiliation(s)
- Yvon Ruch
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | | | - François Lefebvre
- Department of Biostatistics, Strasbourg University Hospital, Strasbourg, France
| | - Aurélie Martin
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Nicolas Lefebvre
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Nawal Douiri
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Riegel
- Laboratory of Bacteriology, Strasbourg University Hospital, Strasbourg, France
| | - Tam Hoang Minh
- Department of Cardiovascular Surgery, Strasbourg University Hospital, Strasbourg, France
| | | | - Yves Hansmann
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Xavier Argemi
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
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Erdem H, Puca E, Ruch Y, Santos L, Ghanem-Zoubi N, Argemi X, Hansmann Y, Guner R, Tonziello G, Mazzucotelli JP, Como N, Kose S, Batirel A, Inan A, Tulek N, Pekok AU, Khan EA, Iyisoy A, Meric-Koc M, Kaya-Kalem A, Martins PP, Hasanoglu I, Silva-Pinto A, Oztoprak N, Duro R, Almajid F, Dogan M, Dauby N, Gunst JD, Tekin R, Konopnicki D, Petrosillo N, Bozkurt I, Wadi J, Popescu C, Balkan II, Ozer-Balin S, Zupanc TL, Cascio A, Dumitru IM, Erdem A, Ersoz G, Tasbakan M, Ajamieh OA, Sirmatel F, Florescu S, Gulsun S, Ozkaya HD, Sari S, Tosun S, Avci M, Cag Y, Celebi G, Sagmak-Tartar A, Karakus S, Sener A, Dedej A, Oncu S, Del Vecchio RF, Ozturk-Engin D, Agalar C. Portraying infective endocarditis: results of multinational ID-IRI study. Eur J Clin Microbiol Infect Dis 2019; 38:1753-1763. [PMID: 31187307 DOI: 10.1007/s10096-019-03607-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 04/23/2019] [Accepted: 05/29/2019] [Indexed: 01/18/2023]
Abstract
Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042).
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Affiliation(s)
| | - Edmond Puca
- Department of Infectious Diseases, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Lurdes Santos
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Xavier Argemi
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Yves Hansmann
- Department of Infectious Diseases, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Rahmet Guner
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Gilda Tonziello
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Jean-Philippe Mazzucotelli
- Department of Cardiovascular Surgery, Strasbourg University Hospital, Nouvel Hôpital Civil, Strasbourg, France
| | - Najada Como
- Service of Infectious Disease, UHC, Tirana, Albania
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Asuman Inan
- Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Necla Tulek
- Department of Microbiology, Atilim University, School of Medicine, Ankara, Turkey
| | - Abdullah Umut Pekok
- Department of Infectious Diseases and Clinical Microbiology, Pendik Medical Park Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa International Hospital and Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Atilla Iyisoy
- Department of Cardiology, Gulhane Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakıf University School of Medicine, Istanbul, Turkey
| | - Ayse Kaya-Kalem
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - Pedro Palma Martins
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Imran Hasanoglu
- Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara, Turkey
| | - André Silva-Pinto
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Nefise Oztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Raquel Duro
- Infectious Diseases Department, Centro Hospitalar São João and Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Fahad Almajid
- Department of Medicine, Infectious Diseases Division, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Mustafa Dogan
- Department of Infectious Diseases and Clinical Microbiology, Corlu State Hospital, Tekirdag, Antalya, Turkey
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | | | - Recep Tekin
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Deborah Konopnicki
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université libre de Bruxelles (ULB), 322 rue Haute, 1000, Brussels, Belgium
| | - Nicola Petrosillo
- Clinical & Research Department for Infectious Diseases, National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS,, Via Portuense, 292, 00149, Rome, Italy
| | - Ilkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey
| | - Jamal Wadi
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | | | - Antonio Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Aysegul Erdem
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Gulden Ersoz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Oday Abu Ajamieh
- Department of Infectious Diseases, School of Medicine, The University of Jordan, Amman, Jordan
| | - Fatma Sirmatel
- Department of Infectious Disease and Clinical Microbiology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Simin Florescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Disease, Bucharest, Romania
| | - Serda Gulsun
- Department of Infectious Diseases and Clinical Microbiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey
| | - Sema Sari
- Department of Intensive Care Unit, Turkey Advanced Specialty Education and Research Hospital, Ankara, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Meltem Avci
- Department of Infectious Disease and Clinical Microbiology, Usak University School of Medicine, Usak, Turkey
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Guven Celebi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Ayse Sagmak-Tartar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sumeyra Karakus
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Arjeta Dedej
- Department of Nephrology, American Hospital, Tirana, Albania
| | - Serkan Oncu
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Rosa Fontana Del Vecchio
- Department of Clinical and Molecular Biomedicine, Section of Infectious Diseases, University of Catania, Catania, Italy
| | - Derya Ozturk-Engin
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Canan Agalar
- Department of Infectious Diseases and Clinical Microbiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Ruch Y, Weingertner N, Hansmann Y, Douiri N, Lefebvre N, Martin A, Chenard MP, D’Urso A, Argemi X, Ranque B. Ne ratez pas cette grande mode ! Rev Med Interne 2018; 39:661-664. [DOI: 10.1016/j.revmed.2018.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 02/07/2023]
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