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Devos S, Bonnet F, Hessamfar M, Neau D, Vareil MO, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Dabis F, Wittkop L, Barger D, Blanco P, Bouchet S, Breilh D, Desjardin S, Gaborieau V, Gimbert A, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Pellegrin I, Perrier A, Petrov-Sanchez V, Bernard N, Bronnimann D, Chaussade H, Dondia D, Faure I, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Nguyen D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Labasse-Depis M, Lacassin F, Barret A, Castan B, Koffi J, Saunier A, Zabbe JB, Dumondin G, Beraud G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Ngo Bell C, Carpentier C, Tumiotto C, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lai WH, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M. Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV). BMC Infect Dis 2023; 23:16. [PMID: 36624391 PMCID: PMC9830769 DOI: 10.1186/s12879-022-07963-6] [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: 05/30/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France. METHODS A multi-centric, cross-sectional analysis was conducted in 2018-19 in the QuAliV study-ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio. RESULTS 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] - 0.383, - 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI - 0.343, 0.012] in multivariable analysis (p = 0.068). CONCLUSIONS Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation. TRIAL REGISTRATION NUMBER NCT03296202.
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Affiliation(s)
- Sophie Devos
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Fabrice Bonnet
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Mojgan Hessamfar
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Didier Neau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Marc-Olivier Vareil
- grid.418076.c0000 0001 0226 3611Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, 13 Avenue de l’interne Jacques Loëb, BP 8, 64109 Bayonne Cedex, France
| | - Olivier Leleux
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Charles Cazanave
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Nicolas Rouanes
- Centre Hospitalier de Périgueux, Service de Médecine Polyvalente, 80 Av. Georges Pompidou, 22400 Périgueux, France
| | - Pierre Duffau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.4444.00000 0001 2112 9282Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Estibaliz Lazaro
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne, 1 Avenue de Magellan, 33600 Pessac, France
| | - François Dabis
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Linda Wittkop
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,Univ. Bordeaux, INSERM, INRIA, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.508062.90000 0004 8511 8605CHU de Bordeaux, Service d’information médicale, INSERM, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Diana Barger
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
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Blanc P, Bonnet F, Leleux O, Perrier A, Bessede E, Pereyre S, Cazanave C, Neau D, Vareil MO, Lazaro E, Duffau P, Saunier A, André K, Wittkop L, Vandenhende MA, Blanco P, Bonnet F, Bouchet S, Breilh D, Cazanave C, Desjardin S, Gaborieau V, Gimbert A, Hessamfar M, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Lazaro E, Leleux O, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Neau D, Pellegrin I, Perrier A, Petrov-Sanchez V, Vareil MO, Wittkop L, Bernard N, Bonnet F, Bronnimann D, Chaussade H, Dondia D, Duffau P, Faure I, Hessamfar M, Mercié P, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Cazanave C, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Neau D, Nguyen D, Malvy D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Lazaro E, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Vareil MO, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Gerard Y, Labasse-Depis M, Lacassin F, Barret A, Courtault C, Castan B, Koffi J, Rouanes N, Saunier A, Zabbe JB, Dumondin G, Gaborieau V, Gerard Y, Beraud G, Le Moal G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Bell CN, Pasdeloup T, Pasdeloup T, Blanco P, Pellegrin I, Carpentier C, Pellegrin I, Bellecave P, Lafon ME, Tumiotto C, Bouchet S, Breilh D, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lawson-Ayayi S, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M, Leleux O, Perrier A, Peyrouny-Mazeau A. Severe bacterial non-AIDS infections in persons with HIV: the epidemiology and evolution of antibiotic resistance over an 18-year period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-Aquitaine cohort. Clin Infect Dis 2023; 76:1814-1821. [PMID: 36610063 DOI: 10.1093/cid/ciac978] [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: 05/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Severe non-AIDS bacterial infections (SBIs) are one of the leading causes of hospital admissions among persons with HIV (PWH) in regions with high ART coverage. METHODS This large prospective cohort study of PWH examined the types of infections, bacterial documentation, and evolution of antibiotic resistance among PWH hospitalized with SBIs over an 18-year period. RESULTS Between 2000 and 2017, 459 PWH had at least one SBI with bacterial documentation. Among the 847 SBIs, there were 280 cases of bacteremia, 269 cases of pneumonia, and 240 urinary tract infections. The 1025 isolated bacteria included Enterobacteriaceae (n = 394; mainly Escherichia coli), Staphylococcus aureus (n = 153) and Streptococcus pneumoniae (n = 82). The proportion of S. pneumoniae as the causative agent in pneumonia and bacteremia decreased sharply over time, from 34% to 8% and from 21 to 3%, respectively.The overall antibiotic resistance of S. aureus and S. pneumoniae decreased progressively but it increased for Enterobacteriaceae (from 24% to 48% for amoxicillin-clavulanate, from 4 to 18% for cefotaxime, and from 5% to 27% for ciprofloxacin). Cotrimoxazole prophylaxis was associated with higher nonsusceptibility of S. pneumoniae to amoxicillin and erythromycin, higher nonsusceptibility of Enterobacteriaceae to beta-lactams and fluoroquinolones, and a higher risk of extended-spectrum β-lactamase producing Enterobacteriaceae. CONCLUSIONS The bacterial resistance pattern among PWH between 2014 and 2017 was broadly similar to that in the general population, with the exception of a higher resistance profile of Enterobacteriaceae to fluoroquinolones. The use of cotrimoxazole as prophylaxis was associated with an increased risk of antibiotic resistance.
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Affiliation(s)
- Peggy Blanc
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Olivier Leleux
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Adélaïde Perrier
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Emilie Bessede
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Sabine Pereyre
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, UMR 5234 Fundamental Microbiology and Pathogenicity, F-33000 Bordeaux, France
| | - Charles Cazanave
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Marc-Olivier Vareil
- Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, F-64109 Bayonne, France
| | - Estibaliz Lazaro
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque, F-33600 Pessac, France
| | - Pierre Duffau
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique, Hôpital Saint-André, UMR 5164, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, F-33000 Bordeaux, France
| | - Aurélie Saunier
- Centre Hospitalier de Périgueux, Service de Médecine Interne, F-24000 Périgueux, France
| | - Katell André
- Centre Hospitalier de Dax, Service de Maladies Infectieuses, F-40100 Dax, France
| | - Linda Wittkop
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, F-33000, Bordeaux, France.,INRIA SISTM Team, F-33405, Talence, France.,Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
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Ducours M, Desclaux A, Dutronc H, Dauchy FA, Abi-Chahla ML, Pointillart V, Wirth G. About three cases of Mycobacterium bovis bone and joint infections after BCG therapy. Infect Dis Now 2020; 51:211-213. [PMID: 33038440 DOI: 10.1016/j.medmal.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/03/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022]
Affiliation(s)
- M Ducours
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France.
| | - A Desclaux
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - H Dutronc
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - F A Dauchy
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - M L Abi-Chahla
- Centre Hospitalier Universitaire de Bordeaux, Service de chirurgie plastique, reconstructrice et esthétique - Brulés - Chirurgie de la main, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - V Pointillart
- Centre Hospitalier universitaire de Bordeaux, Service orthopédique et traumatologique, unité de chirurgie du rachis, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - G Wirth
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
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Ribes C, Masquefa T, Dutronc H, De Seynes C, Dupon M, Fabre T, Dauchy FA. One-stage versus two-stage prosthesis replacement for prosthetic knee infections. Med Mal Infect 2019; 49:519-526. [PMID: 30795868 DOI: 10.1016/j.medmal.2019.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/09/2018] [Revised: 03/27/2018] [Accepted: 01/28/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Periprosthetic knee infection is a severe complication. Confirmed criteria are lacking to choose between one-stage or two-stage prosthesis replacement to treat the infection. The one-stage replacement could lead to a satisfactory control of the infection and to better functional results. METHOD Retrospective study conducted between January 1, 2009 and December 31, 2014. The objectives of this study were to compare the infection outcome and functional results between the one-stage and two-stage replacement procedures. Functional results were evaluated using the IKS score, KOOS score, and SF-12 quality of life score. RESULTS Forty-one patients underwent a two-stage replacement procedure and 21 patients a one-stage replacement. The average follow-up was 22 months after surgery. The infection was cured in 78% of patients who underwent a two-stage replacement and 90% of patients who underwent a one-stage replacement (P=0.3). The flexion range of motion was significantly better in the one-stage group than in the two-stage group (P=0.04). Results of the IKS score and of the KOOS score were better in the one-stage group. No difference was observed for the SF-12 score. CONCLUSION The one-stage replacement procedure for periprosthetic knee infection was associated with a similar healing frequency as the two-stage replacement procedure, and with better knee function.
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Affiliation(s)
- C Ribes
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France.
| | - T Masquefa
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - H Dutronc
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - C De Seynes
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maison de santé protestante de Bordeaux Bagatelle, 33401 Bordeaux, France
| | - M Dupon
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - T Fabre
- Unité de chirurgie orthopédique périphérique, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
| | - F A Dauchy
- Centre de référence infections ostéoarticulaires complexes du Grand Sud-Ouest (Crioac GSO), hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France; Maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33401 Bordeaux, France
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Prendki V, Sergent P, Barrelet A, Oziol E, Beretti E, Berlioz-Thibal M, Bouchand F, Dauchy FA, Forestier E, Gavazzi G, Ronde-Oustau C, Stirnemann J, Dinh A. Efficacy of indefinite chronic oral antimicrobial suppression for prosthetic joint infection in the elderly: a comparative study. Int J Infect Dis 2017; 60:57-60. [PMID: 28526565 DOI: 10.1016/j.ijid.2017.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 03/09/2017] [Revised: 05/03/2017] [Accepted: 05/09/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND During prosthetic joint infection (PJI), surgical management is sometimes impossible and indefinite chronic oral antimicrobial suppression (ICOAS) may be the only option. The outcomes of elderly patients who benefited from ICOAS with strictly palliative intent were evaluated. METHODS A national retrospective cohort study was performed in France, involving patients aged >75 years with a PJI who were managed with planned life-long ICOAS from 2009 to 2014. Patients who experienced an event were compared to those who did not. An event was defined as a composite outcome in patients undergoing ICOAS, including local or systemic progression of the infection, death, or discontinuation of antimicrobial therapy because of an adverse drug reaction. RESULTS Twenty-one patients were included, with a median age of 85 years (interquartile range 81-88 years). Eight of the 21 patients experienced an event: one had an adverse drug reaction, three had systemic progression of sepsis, and two had local progression. Two of the 21 patients died. No death was related to ICOAS or infection. There was no significant difference between the population with an event and the population free of an event with regard to demographic, clinical, and microbiological characteristics (p>0.05). CONCLUSIONS ICOAS appeared to be an effective and safe option in this cohort.
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Affiliation(s)
- V Prendki
- Internal Medicine and Rehabilitation Unit, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - P Sergent
- Department of Orthopaedics and Traumatology, Jean Minjoz University Hospital, Besançon, France
| | - A Barrelet
- Division of Infectious Diseases Unit, Le Chesnay, France
| | - E Oziol
- Internal Medicine Unit, Béziers Hospital, Béziers, France
| | | | - M Berlioz-Thibal
- Department of Orthopaedics and Traumatology, University Hospital of Nantes, Nantes, France
| | - F Bouchand
- Pharmacy, Raymond Poincaré University Hospital, AP-HP, Garches, France
| | - F A Dauchy
- Division of Infectious Diseases, University Hospital of Bordeaux, Bordeaux, France
| | - E Forestier
- Infectious Diseases Unit, Chambéry Hospital, Chambéry, France
| | - G Gavazzi
- Division of Infectious Diseases, University Hospital of Grenoble - University Clinic of Geriatric Medicine, Grenoble, France
| | - C Ronde-Oustau
- Division of Infectious Diseases, University Hospital of Strasbourg, Strasbourg, France
| | - J Stirnemann
- Internal Medicine and Rehabilitation Unit, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - A Dinh
- Division of Infectious Diseases Unit, Raymond Poincaré University Hospital, AP-HP, Garches, France.
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Dauchy FA, Gruson D, Chêne G, Viot J, Bebear C, Maugein J, Bézian MC, Dutronc H, Dupon M. Prognostic factors in adult community-acquired bacterial meningitis: a 4-year retrospective study. Eur J Clin Microbiol Infect Dis 2007; 26:743-6. [PMID: 17694339 DOI: 10.1007/s10096-007-0381-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this 4-year, observational, single-center study was to identify prognostic factors and evaluate the need for intensive care in cases of bacterial meningitis. During the study period, 60 cases of adult bacterial meningitis were identified. Fifty-one patients were transferred to the intensive care unit at various times during their hospital stay. In the multivariate analysis, factors significantly associated with the need for mechanical ventilation and/or vasopressive drugs included comorbidity and a Glasgow coma score of less than 12 at hour 6 following presentation. The results indicate patients with a decreased level of consciousness, neurological deficit or comorbidity should be admitted to the intensive care unit at an early stage of illness. When patients lack these criteria 6 h following presentation, admission to the medical ward is reasonable.
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Affiliation(s)
- F A Dauchy
- CHU de Bordeaux, Hôpital Pellegrin, Fédération de Maladies infectieuses, Université Victor Segalen Bordeaux 2, Bordeaux, 33076, Bordeaux cedex, France.
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Abstract
UNLABELLED Fascioliasis is a parasitic infection caused by the ingestion of food contaminated with Fasciola hepatica. OBJECTIVE AND DESIGN We report an epidemic of eight cases of fascioliasis in southern France, and describe the clinical features, and the diagnostic and therapeutic tools. RESULTS Our series includes almost every clinical form described, apart from the pseudotumoral form. Early diagnosis relied mainly on serum assays. Among these, counter-electrophoresis was the first to be positive and therefore appears to be the most useful test, including cases where patients are asymptomatic or mildly ill. Patients were treated with the usual dose of triclabendazole, but six of them required a double dose to recover. CONCLUSION The use of 20 mg/kg triclabendazole is safe and efficient for patients with acute fascioliasis when a single dose has failed to cure them.
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Affiliation(s)
- F A Dauchy
- Service de médecine interne C, service du Docteur-Lifermann, centre hospitalier de Dax, boulevard Yves-Du-Manoir, 40100 Dax, France.
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Dauchy FA, Devars D, Lifermann F. [Emphysematous cystitis]. Ann Endocrinol (Paris) 2004; 65:176-8. [PMID: 15247879 DOI: 10.1016/s0003-4266(04)95667-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The prevalence of urinary tract infection is high in patients with diabetes mellitus. The presence of gas in the bladder lumen or wall constitute emphysematous cystitis. This disease is usually observed in diabetic patients. Early diagnosis and treatment are important factors for the outcome and absence of after-effects. We report the case of a 85 Year old women who was admitted to the hospital because of a gastrointestinal bleeding and subsequently developed an emphysematous cystitis. We present a comprehensive review of the literature and discuss pathogenesis, diagnosis and treatment of this condition.
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Affiliation(s)
- F A Dauchy
- Service de Médecine Interne C, Centre hospitalier de Dax, 40100 Dax, France
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