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Miendje Deyi V, Mori M, Dauby N, Clevenbergh P, Mahadeb B, Loizidou A, Maillart E, Martiny D, Debyttere A, Gerard M, Hallin M. Staggered enforcement of infection control and prevention measures following four consecutive potential laboratory exposures to imported Brucella melitensis. Infect Prev Pract 2021; 3:100128. [PMID: 34368745 PMCID: PMC8336054 DOI: 10.1016/j.infpip.2021.100128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/12/2021] [Indexed: 11/15/2022] Open
Abstract
From 2015 until 2020, Brucella melitensis was isolated four times in our microbiology laboratory. All patients had travelled in endemic-areas. Immediately after the first occurrence, all laboratory staff were risk-stratified and preventive and protective measures were applied according to CDC guidelines. Nineteen workers were exposed and needed chemoprophylaxis and follow-up. At each subsequent occurrence, risk analysis was performed, and additional measures were implemented accordingly, leading to a progressive reduction of exposed staff members to none the fourth time. We describe here the additional measures that permitted this important exposure reduction.
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Affiliation(s)
- V.Y. Miendje Deyi
- Laboratoire Hospitalier Universitaire de Bruxelles – Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
- Corresponding author. Address: LHUB-ULB, Microbiology Department, 322 Rue Haute, 1000, Bruxelles, Belgium. Tel.: +32 2 435 20 40; fax: +32 2 435 20 39.
| | - M. Mori
- National Reference Centre (NRC) for Brucella spp, Sciensano, Brussels, Belgium
| | - N. Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - P. Clevenbergh
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire (CHU) Brugmann, Brussels, Belgium
| | - B. Mahadeb
- Laboratoire Hospitalier Universitaire de Bruxelles – Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
| | - A. Loizidou
- Department of Internal Medicine and Infectious Diseases, Institut Jules Bordet, Brussels, Belgium
| | - E. Maillart
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire (CHU) Brugmann, Brussels, Belgium
| | - D. Martiny
- Laboratoire Hospitalier Universitaire de Bruxelles – Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
| | - A.L. Debyttere
- Laboratoire Hospitalier Universitaire de Bruxelles – Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
| | - M. Gerard
- Infection Control Unit, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, Belgium
| | - M. Hallin
- Laboratoire Hospitalier Universitaire de Bruxelles – Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
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Maillart E, Leemans S, Van Noten H, Vandergraesen T, Mahadeb B, Salaouatchi MT, De Bels D, Clevenbergh P. A case report of serious haemolysis in a glucose-6-phosphate dehydrogenase-deficient COVID-19 patient receiving hydroxychloroquine. Infect Dis (Lond) 2020; 52:659-661. [PMID: 32496938 PMCID: PMC7284136 DOI: 10.1080/23744235.2020.1774644] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
While the COVID-19 epidemic occurred since December 2019, as of end April 2020, no treatment has been validated or invalidated by accurate clinical trials. Use of hydroxychloroquine has been popularised on mass media and put forward as a valid treatment option without strong evidence of efficacy. Hydroxychloroquine (HCQ) has its own side effects, some of which are very serious like acute haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. Side effects may be worse than the disease itself. Belgian national treatment guidelines recommend the use of HCQ in mild to severe COVID-19 disease. As opinions, politics, media and beliefs are governing COVID-19 therapy, performance of randomised controlled blinded clinical trials became difficult. Results of sound clinical trials are eagerly awaited. We report a case of acute haemolysis leading to admission in intensive care unit and renal failure in a patient with uncovered G6PD deficiency.
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Affiliation(s)
- E Maillart
- Infectious Diseases Clinic, University Hospital Brugmann, Brussels, Belgium
| | - S Leemans
- Infectious Diseases Clinic, University Hospital Brugmann, Brussels, Belgium
| | - H Van Noten
- Infectious Diseases Clinic, University Hospital Brugmann, Brussels, Belgium
| | - T Vandergraesen
- Internal Medicine Department, University Hospital Brugmann, Brussels, Belgium
| | - B Mahadeb
- Brussels Academic Hospital Laboratory, Brussels, Belgium
| | - M T Salaouatchi
- Internal Medicine Department, University Hospital Brugmann, Brussels, Belgium
| | - D De Bels
- Intensive Care Unit, University Hospital Brugmann, Brussels, Belgium
| | - P Clevenbergh
- Infectious Diseases Clinic, University Hospital Brugmann, Brussels, Belgium
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Busson L, Bartiaux M, Brahim S, Konopnicki D, Dauby N, Gérard M, De Backer P, Van Vaerenbergh K, Mahadeb B, Mekkaoui L, De Foor M, Wautier M, Vandenberg O, Mols P, Levy J, Hallin M. Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study. Int J Infect Dis 2019; 83:32-39. [PMID: 30926539 PMCID: PMC7110685 DOI: 10.1016/j.ijid.2019.03.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 11/17/2022] Open
Abstract
AIM To evaluate the contribution of a multiplex PCR for respiratory viruses on antibiotic and antiviral prescription, ancillary test prescription, admission and length of stay of patients. METHODS Two hundred ninety-one adult and pediatric patients visiting the emergency department during the 2015-2016 influenza epidemic were prospectively included and immediately tested 24/7 using the FilmArray Respiratory Panel. The results were communicated to the practitioner in charge as soon as they became available. Clinical and biological data were gathered and analyzed. FINDINGS Results from the FilmArray Respiratory Panel do not appear to impact admission or antibiotic prescription, with the exception of a lower admission rate for children who tested positive for influenza B. Parameters that account for the clinical decisions evaluated are CRP level, white blood cell count, suspected or proven bacterial infection and, for adult patients only, signs of respiratory distress. Length of stay is also not significantly different between patients with a positive and a negative result. A rapid influenza test result permits a more appropriate prescription of oseltamivir.
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Affiliation(s)
- L Busson
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium.
| | - M Bartiaux
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - S Brahim
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - D Konopnicki
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - N Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - M Gérard
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - P De Backer
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - K Van Vaerenbergh
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - B Mahadeb
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - L Mekkaoui
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - M De Foor
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - M Wautier
- Department of Molecular Diagnostic, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - O Vandenberg
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium; Infectious Diseases Epidemiological Unit, Public Health School, Université Libre de Bruxelles, Brussels, Belgium
| | - P Mols
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - J Levy
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - M Hallin
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
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Busson L, Bartiaux M, Brahim S, Konopnicki D, Dauby N, Gérard M, De Backer P, Van Vaerenbergh K, Mahadeb B, De Foor M, Wautier M, Vandenberg O, Mols P, Levy J, Hallin M. Prospective evaluation of diagnostic tools for respiratory viruses in children and adults. J Virol Methods 2019; 266:1-6. [PMID: 30658123 PMCID: PMC7119678 DOI: 10.1016/j.jviromet.2019.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 12/30/2022]
Abstract
Molecular techniques have considerably improved sensitivity of viral diagnosis. Interpretation of results can be delicate as DNA or RNA traces can be detected. Their use is hindered by their cost and the difficulty to absorb high workloads. Their impact in management of patients still has to be demonstrated. Tertiary care hospitals should provide a testing algorithm to suit each case.
Aim To compare the performances of molecular and non-molecular tests to diagnose respiratory viral infections and to evaluate the pros and contras of each technique. Methods Two hundred ninety-nine respiratory samples were prospectively explored using multiplex molecular techniques (FilmArray Respiratory Panel, Clart Pneumovir), immunological techniques (direct fluorescent assay, lateral flow chromatography) and cell cultures. Findings Molecular techniques permitted the recovery of up to 50% more respiratory pathogens in comparison to non-molecular methods. FilmArray detected at least 30% more pathogens than Clart Pneumovir which could be explained by the differences in their technical designs. The turnaround time under 2 hours for the FilmArray permitted delivery of results when patients were still in the emergency room.
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Affiliation(s)
- L Busson
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium.
| | - M Bartiaux
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - S Brahim
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - D Konopnicki
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - N Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - M Gérard
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - P De Backer
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - K Van Vaerenbergh
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - B Mahadeb
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - M De Foor
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - M Wautier
- Department of Molecular Diagnostic, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
| | - O Vandenberg
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium; Infectious Diseases Epidemiological Unit, Public Health School, Université Libre de Bruxelles, Brussels, Belgium
| | - P Mols
- Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - J Levy
- Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - M Hallin
- Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium
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Busson L, Hallin M, De Foor M, Mahadeb B, Vandenberg O. Impact of rapid influenza diagnostic tests on the management of hospitalized patients with suspicion of flu. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.157] [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: 11/16/2022]
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