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Bahuaud O, Genestet C, Hodille E, Vallée M, Testard Q, Tataï C, Saison J, Rasigade JP, Lina G, Ader F, Dumitrescu O. Rapid resistance detection is reliable for prompt adaptation of isoniazid resistant tuberculosis management. Heliyon 2024; 10:e29932. [PMID: 38726207 PMCID: PMC11078763 DOI: 10.1016/j.heliyon.2024.e29932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
Objectives Appropriate tuberculosis (TB) management requires anti-TB drugs resistance detection. We assessed the performance of rapid resistance detection assays and their impact on treatment adaptation, focusing on isoniazid resistant (Hr) TB. Methods From 2016 to 2022, all TB cases enrolled in 3 hospitals were reviewed for phenotypic drug susceptibility testing (p-DST) and genotypic DST (g-DST) performed by rapid molecular testing, and next generation sequencing (NGS). Clinical characteristics, treatment and outcome were collected for Hr-TB patients. The concordance between g-DST and p-DST results, and delay between treatment initiation and results of g-DST and p-DST were respectively recorded to assess the contribution of DST results on Hr-TB management. Results Among 654 TB cases enrolled, 29 were Hr-TB. Concordance between g-DST by rapid molecular methods and p-DST was 76.9 %, whilst concordance between NGS-based g-DST and p-DST was 98.7 %. Rapid resistance detection significantly fastened Hr-TB treatment adaptation (median delay between g-DST results and treatment modification was 6 days). It consisted in fluoroquinolone implementation for 17/23 patients; outcome was favourable except for 2 patients who died before DST reporting. Conclusion Rapid resistance detection fastened treatment adaptation. Also, NGS-based g-DST showed almost perfect concordance with p-DST, thus providing rapid and safe culture-free DST alternative.
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Affiliation(s)
- Olivier Bahuaud
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Service des Maladies Infectieuses et Tropicales, Lyon, France
| | - Charlotte Genestet
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
| | - Elisabeth Hodille
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
| | - Maxime Vallée
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
| | - Quentin Testard
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
| | - Caroline Tataï
- Centre de Lutte Anti Tuberculeuse, Bourg-en-Bresse, France
| | - Julien Saison
- Infectious Diseases Department, Valence Hospital Center, Valence, France
- Clinical Research Unit, Valence Hospital Center, Valence, France
| | - Jean-Philippe Rasigade
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
| | - Gérard Lina
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
- Université Lyon 1, Facultés de Médecine et de Pharmacie de Lyon, Lyon, France
| | - Florence Ader
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Service des Maladies Infectieuses et Tropicales, Lyon, France
| | - Oana Dumitrescu
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
- Université Lyon 1, Facultés de Médecine et de Pharmacie de Lyon, Lyon, France
| | - Lyon TB study group
- CIRI - Centre International de Recherche en Infectiologie, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon-1, Inserm U1111, CNRS UMR5308, Lyon, France
- Hospices Civils de Lyon, Service des Maladies Infectieuses et Tropicales, Lyon, France
- Hospices Civils de Lyon, Institut des Agents Infectieux, Laboratoire de Bactériologie, Lyon, France
- Centre de Lutte Anti Tuberculeuse, Bourg-en-Bresse, France
- Infectious Diseases Department, Valence Hospital Center, Valence, France
- Clinical Research Unit, Valence Hospital Center, Valence, France
- Université Lyon 1, Facultés de Médecine et de Pharmacie de Lyon, Lyon, France
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Lacombe K, Hueso T, Porcher R, Mekinian A, Chiarabini T, Georgin-Lavialle S, Ader F, Saison J, Martin-Blondel G, De Castro N, Bonnet F, Cazanave C, Francois A, Morel P, Hermine O, Pourcher V, Michel M, Lescure X, Soussi N, Brun P, Pommeret F, Sellier P, Rousset S, Piroth L, Michot JM, Baron G, de Lamballerie X, Mariette X, Tharaux PL, Resche-Rigon M, Ravaud P, Simon T, Tiberghien P. Use of covid-19 convalescent plasma to treat patients admitted to hospital for covid-19 with or without underlying immunodeficiency: open label, randomised clinical trial. BMJ Med 2023; 2:e000427. [PMID: 37920150 PMCID: PMC10619082 DOI: 10.1136/bmjmed-2022-000427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/05/2023] [Indexed: 11/04/2023]
Abstract
Objective To evaluate the efficacy of covid-19 convalescent plasma to treat patients admitted to hospital for moderate covid-19 disease with or without underlying immunodeficiency (CORIPLASM trial). Design Open label, randomised clinical trial. Setting CORIMUNO-19 cohort (publicly supported platform of open label, randomised controlled trials of immune modulatory drugs in patients admitted to hospital with moderate or severe covid-19 disease) based on 19 university and general hospitals across France, from 16 April 2020 to 21 April 2021. Participants 120 adults (n=60 in the covid-19 convalescent plasma group, n=60 in the usual care group) admitted to hospital with a positive SARS-CoV2 test result, duration of symptoms <9 days, and World Health Organization score of 4 or 5. 49 patients (n=22, n=27) had underlying immunosuppression. Interventions Open label randomisation to usual care or four units (200-220 mL/unit, 2 units/day over two consecutive days) of covid-19 convalescent plasma with a seroneutralisation titre >40. Main outcome measures Primary outcomes were proportion of patients with a WHO Clinical Progression Scale score of ≥6 on the 10 point scale on day 4 (higher values indicate a worse outcome), and survival without assisted ventilation or additional immunomodulatory treatment by day 14. Secondary outcomes were changes in WHO Clinical Progression Scale scores, overall survival, time to discharge, and time to end of dependence on oxygen supply. Predefined subgroups analyses included immunosuppression status, duration of symptoms before randomisation, and use of steroids. Results 120 patients were recruited and assigned to covid-19 convalescent plasma (n=60) or usual care (n=60), including 22 (covid-19 convalescent plasma) and 27 (usual care) patients who were immunocompromised. 13 (22%) patients who received convalescent plasma had a WHO Clinical Progression Scale score of ≥6 at day 4 versus eight (13%) patients who received usual care (adjusted odds ratio 1.88, 95% credible interval 0.71 to 5.24). By day 14, 19 (31.6%) patients in the convalescent plasma group and 20 (33.3%) patients in the usual care group needed ventilation, additional immunomodulatory treatment, or had died. For cumulative incidence of death, three (5%) patients in the convalescent plasma group and eight (13%) in the usual care group died by day 14 (adjusted hazard ratio 0.40, 95% confidence interval 0.10 to 1.53), and seven (12%) patients in the convalescent plasma group and 12 (20%) in the usual care group by day 28 (adjusted hazard ratio 0.51, 0.20 to 1.32). In a subgroup analysis performed in patients who were immunocompromised, transfusion of covid-19 convalescent plasma was associated with mortality (hazard ratio 0.39, 95% confidence interval 0.14 to 1.10). Conclusions In this study, covid-19 convalescent plasma did not improve early outcomes in patients with moderate covid-19 disease. The efficacy of convalescent plasma in patients who are immunocompromised should be investigated further. Trial registration ClinicalTrials.gov NCT04345991.
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Affiliation(s)
- Karine Lacombe
- Sorbonne Université, Paris, France
- IPLESP, INSERM, Paris, France
- Infectious Diseases Department, St Antoine Hospital, AP-HP, Paris, France
| | - Thomas Hueso
- Hematology department, Avicenne Hospital, AP-HP, Bobigny, France
- Hôpitaux Universitaires Paris Seine Saint Denis, Bobigny, France
| | - Raphael Porcher
- Centre de Recherche Épidémiologie et Statistique, CRESS-UMR1153, Sorbonne Paris Cité, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Arsene Mekinian
- Sorbonne Université, Paris, France
- Internal Medicine Department, Saint Antoine Hospital, AP-HP, Paris, France
| | | | - Sophie Georgin-Lavialle
- Sorbonne Université, Paris, France
- Internal Medicine department, Tenon Hospital, AP-HP, Paris, France
| | - Florence Ader
- CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France
| | - Julien Saison
- Infectious Diseases Department, Centre Hospitalier de Valence, Valence, France
| | - Guillaume Martin-Blondel
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291 - CNRS UMR5051, Université Toulouse III, Toulouse, France
- Infectious Diseases department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Nathalie De Castro
- Infectious Diseases department, Saint Louis Hospital, AP-HP, Paris, France
| | - Fabrice Bonnet
- Bordeaux Population Health, INSERM U1219, Université de Bordeaux, Bordeaux, France
- Internal Medicine Department, Saint-André Hospital, Bordeaux, France
| | - Charles Cazanave
- Infectious Diseases Department, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
| | - Anne Francois
- Etablissement Francais du Sang, La Plaine Saint-Denis, France
| | - Pascal Morel
- Etablissement Francais du Sang, La Plaine Saint-Denis, France
| | - Olivier Hermine
- Université de Paris, Paris, France
- Hematology Department, Hôpital Necker - Enfants Malades, AP-HP, Paris, France
| | - Valerie Pourcher
- Sorbonne Université, Paris, France
- IPLESP, INSERM, Paris, France
- Infectious Diseases Department, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Marc Michel
- Université de Paris Est Créteil, Créteil, France
- Internal Medicine Department, Hôpital henri-Mondor, AP-HP, Créteil, France
| | - Xavier Lescure
- Université de Paris, Paris, France
- Infectious Diseases Department, Hôpital Bichat - Claude Bernard, AP-HP, Paris, France
| | - Nora Soussi
- Clinical Research Platform (URC-CRC-CRB), Saint-Antoine Hospital, AP-HP, Paris, France
| | | | - Fanny Pommeret
- Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Pierre Sellier
- Infectious Diseases Department, Lariboisière Hospital, AP-HP, Paris, France
| | - Stella Rousset
- Infectious Diseases department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Lionel Piroth
- Infectious Diseases Department, University Hospital Centre Dijon Bourgogne, Dijon, France
| | | | - Gabriel Baron
- Centre de Recherche Épidémiologie et Statistique, CRESS-UMR1153, Sorbonne Paris Cité, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents, IRD 190-Inserm 1207, Aix-Marseille University, Marseille, France
| | - Xavier Mariette
- Inserm UMR1184, Université Paris-Saclay, Le Kremin-Bicêtre, France
- Rhumatology Department, Centre Hospitalier Universitaire Bicêtre, Le Kremlin-Bicêtre, France
| | - Pierre-Louis Tharaux
- Paris Cardiovascular Centre - PARCC, Inserm, Université Paris-Cité, Paris, France
| | - Matthieu Resche-Rigon
- INSERM U153, Université Paris-Cité, Paris, France
- Service de biostatistique et information médicale, Saint-Louis Hospital, AP-HP, Paris, France
| | - Philippe Ravaud
- INSERM U153, Université Paris-Cité, Paris, France
- Service de biostatistique et information médicale, Saint-Louis Hospital, AP-HP, Paris, France
| | - Tabassome Simon
- Sorbonne Université, Paris, France
- Département de Pharmacologie clinique, Saint-Antoine Hospital, AP-HP, Paris, France
| | - Pierre Tiberghien
- Etablissement Francais du Sang, La Plaine Saint-Denis, France
- UMR1098 RIGHT, Inserm, Université de Franche-Comté, Besançon, France
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Rival G, Chalbet S, Dupont C, Brun P, Letranchant L, Reynaud C, Dureault A, Saison J, Jeannot M, Barbour S, Bacconnier M, Paulus V, Champagne H, Buiret G. Post-traumatic stress among COVID-19 survivors: A descriptive study of hospitalized first-wave survivors. Can J Respir Ther 2023; 59:20-25. [PMID: 36741307 PMCID: PMC9854389 DOI: 10.29390/cjrt-2022-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction The coronavirus Severe Acute Respiratory Syndrome Coronavirus Type 1 induces a severe respiratory disease, coronavirus disease 2019 (COVID-19). After Severe Acute Respiratory Syndrome Coronavirus Type 1 and Middle East Respiratory Syndrome infection, increased post-traumatic stress disorder (PTSD) rates were described. Methods This single-centred, prospective study aimed to evaluate the rates of PTSD in patients who were hospitalized for COVID-19. Inclusion criteria were COVID-19 patients hospitalized in the intensive care unit (ICU) or in a standard unit with at least 2 L/min oxygen. Six months post-hospitalization, subjects were assessed for PTSD using a validated screening tool, the Post-Traumatic Stress Checklist-5 (PCL-5). Results A total of 40 patients were included. No demographic differences between the ICU and non-ICU groups were found. The mean PCL-5 score for the population was 8.85±10. The mean PCL-5 score was 6.7±8 in the ICU group and 10.5±11 in the non-ICU group (P=0.27). We screened one patient with a positive PCL-5 score and one with a possible PCL-5 cluster score. Nine patients had a PCL-5 score of up to 15. Seven patients reported no symptoms. Seven patients accepted a psychological follow-up: one for PTSD, three for possible PTSD and three for other psychological problems. Discussion The PCL-5 tool can be used by lung physicians during consultations to identify patients for whom follow-up mental health assessment and treatment for PTSD are warranted. Conclusion Lung physicians should be aware of the risk of PTSD in patients hospitalized for COVID-19 and ensure appropriate screening and follow-up care.
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Affiliation(s)
- Gilles Rival
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Sophie Chalbet
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Clarisse Dupont
- Pneumology Department, Valence Hospital Center, Valence, France
| | - Philippe Brun
- Pneumology Department, Valence Hospital Center, Valence, France
| | | | - Claire Reynaud
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Aurélie Dureault
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Julien Saison
- Infectious Diseases Department, Valence Hospital Center, Valence, France,Clinical Research Unit, Valence Hospital Center, Valence, France
| | - Mathieu Jeannot
- Intensive Care Department, Valence Hospital Center, Valence, France
| | - Sophie Barbour
- Pneumology Department, Valence Hospital Center, Valence, France
| | | | - Valérie Paulus
- Pneumology Department, Valence Hospital Center, Valence, France,Clinical Research Unit, Valence Hospital Center, Valence, France
| | - Hélène Champagne
- Infectious Diseases Department, Valence Hospital Center, Valence, France
| | - Guillaume Buiret
- Clinical Research Unit, Valence Hospital Center, Valence, France,Correspondence: Guillaume Buiret, Unité de Recherche Clinique, Valence Hospital Center, 179 Boulevard Maréchal Juin, 26 953 Valence Cedex 9, France. Tel: +33475757528. Fax: +33475757110, E-mail:
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Massart N, Maxime V, Fillatre P, Razazi K, Ferré A, Moine P, Legay F, Voiriot G, Amara M, Santi F, Nseir S, Marque-Juillet S, Bounab R, Barbarot N, Bruneel F, Luyt CE, Pham T, Pavot A, Monnet X, Richard C, Demoule A, Dres M, Mayaux J, Beurton A, Daubin C, Descamps R, Joret A, Du Cheyron D, Pene F, Chiche JD, Jozwiak M, Jaubert P, Voiriot G, Fartoukh M, Teulier M, Blayau C, Bodenes L, Ferriere N, Auchabie J, Le Meur A, Pignal S, Mazzoni T, Quenot JP, Andreu P, Roudau JB, Labruyère M, Nseir S, Preau S, Poissy J, Mathieu D, Benhamida S, Paulet R, Roucaud N, Thyrault M, Daviet F, Hraiech S, Parzy G, Sylvestre A, Jochmans S, Bouilland AL, Monchi M, Déserts MDD, Mathais Q, Rager G, Pasquier P, Reignier J, Seguin A, Garret C, Canet E, Dellamonica J, Saccheri C, Lombardi R, Kouchit Y, Jacquier S, Mathonnet A, Nay MA, Runge I, Martino F, Flurin L, Rolle A, Carles M, Coudroy R, Thille AW, Frat JP, Rodriguez M, Beuret P, Tientcheu A, Vincent A, Michelin F, Tamion F, Carpentier D, Boyer D, Girault C, Gissot V, Ehrmann S, Gandonniere CS, Elaroussi D, Delbove A, Fedun Y, Huntzinger J, Lebas E, Kisoka G, Grégoire C, Marchetta S, Lambermont B, Argaud L, Baudry T, Bertrand PJ, Dargent A, Guitton C, Chudeau N, Landais M, Darreau C, Ferre A, Gros A, Lacave G, Bruneel F, Neuville M, JérômeDevaquet, Tachon G, Gallo R, Chelha R, Galbois A, Jallot A, Lemoine LC, Kuteifan K, Pointurier V, Jandeaux LM, Mootien J, Damoisel C, Sztrymf B, Schmidt M, Combes A, Chommeloux J, Luyt CE, Schortgen F, Rusel L, Jung C, Gobert F, Vimpere D, Lamhaut L, Sauneuf B, Charrrier L, Calus J, Desmeules I, Painvin B, Tadie JM, Castelain V, Michard B, Herbrecht JE, Baldacini M, Weiss N, Demeret S, Marois C, Rohaut B, Moury PH, Savida AC, Couadau E, Série M, Alexandru N, Bruel C, Fontaine C, Garrigou S, Mahler JC, Leclerc M, Ramakers M, Garçon P, Massou N, Van Vong L, Sen J, Lucas N, Chemouni F, Stoclin A, Avenel A, Faure H, Gentilhomme A, Ricome S, Abraham P, Monard C, Textoris J, Rimmele T, Montini F, Lejour G, Lazard T, Etienney I, Kerroumi Y, Dupuis C, Bereiziat M, Coupez E, Thouy F, Hoffmann C, Donat N, Chrisment A, Blot RM, Kimmoun A, Jacquot A, Mattei M, Levy B, Ravan R, Dopeux L, Liteaudon JM, Roux D, Rey B, Anghel R, Schenesse D, Gevrey V, Castanera J, Petua P, Madeux B, Hartman O, Piagnerelli M, Joosten A, Noel C, Biston P, Noel T, Bouar GLE, Boukhanza M, Demarest E, Bajolet MF, Charrier N, Quenet A, Zylberfajn C, Dufour N, Mégarbane B, Voicu S, Deye N, Malissin I, Legay F, Debarre M, Barbarot N, Fillatre P, Delord B, Laterrade T, Saghi T, Pujol W, Cungi PJ, Esnault P, Cardinale M, Ha VHT, Fleury G, Brou MA, Zafimahazo D, Tran-Van D, Avargues P, Carenco L, Robin N, Ouali A, Houdou L, Le Terrier C, Suh N, Primmaz S, Pugin J, Weiss E, Gauss T, Moyer JD, Burtz CP, La Combe B, Smonig R, Violleau J, Cailliez P, Chelly J, Marchalot A, Saladin C, Bigot C, Fayolle PM, Fatséas J, Ibrahim A, Resiere D, Hage R, Cholet C, Cantier M, Trouiler P, Montravers P, Lortat-Jacob B, Tanaka S, Dinh AT, Duranteau J, Harrois A, Dubreuil G, Werner M, Godier A, Hamada S, Zlotnik D, Nougue H, Mekontso-Dessap A, Carteaux G, Razazi K, De Prost N, Mongardon N, Lamraoui M, Alessandri C, de Roux Q, de Roquetaillade C, Chousterman BG, Mebazaa A, Gayat E, Garnier M, Pardo E, LeaSatre-Buisson, Gutton C, Yvin E, Marcault C, Azoulay E, Darmon M, Oufella HA, Hariri G, Urbina T, Mazerand S, Heming N, Santi F, Moine P, Annane D, Bouglé A, Omar E, Lancelot A, Begot E, Plantefeve G, Contou D, Mentec H, Pajot O, Faguer S, Cointault O, Lavayssiere L, Nogier MB, Jamme M, Pichereau C, Hayon J, Outin H, Dépret F, Coutrot M, Chaussard M, Guillemet L, Goffin P, Thouny R, Guntz J, Jadot L, Persichini R, Jean-Michel V, Georges H, Caulier T, Pradel G, Hausermann MH, Nguyen-Valat TMH, Boudinaud M, Vivier E, SylvèneRosseli, Bourdin G, Pommier C, Vinclair M, Poignant S, Mons S, Bougouin W, Bruna F, Maestraggi Q, Roth C, Bitker L, Dhelft F, Bonnet-Chateau J, Filippelli M, Morichau-Beauchant T, Thierry S, Le Roy C, Jouan MS, Goncalves B, Mazeraud A, Daniel M, Sharshar T, Cadoz C, RostaneGaci, Gette S, Louis G, Sacleux SC, Ordan MA, Cravoisy A, Conrad M, Courte G, Gibot S, Benzidi Y, Casella C, Serpin L, Setti JL, Besse MC, Bourreau A, Pillot J, Rivera C, Vinclair C, Robaux MA, Achino C, Delignette MC, Mazard T, Aubrun F, Bouchet B, Frérou A, Muller L, Quentin C, Degoul S, Stihle X, Sumian C, Bergero N, Lanaspre B, Quintard H, Maiziere EM, Egreteau PY, Leloup G, Berteau F, Cottrel M, Bouteloup M, Jeannot M, Blanc Q, Saison J, Geneau I, Grenot R, Ouchike A, Hazera P, Masse AL, Demiri S, Vezinet C, Baron E, Benchetrit D, Monsel A, Trebbia G, Schaack E, Lepecq R, Bobet M, Vinsonneau C, Dekeyser T, Delforge Q, Rahmani I, Vivet B, Paillot J, Hierle L, Chaignat C, Valette S, Her B, Brunet J, Page M, Boiste F, Collin A, Bavozet F, Garin A, Dlala M, KaisMhamdi, Beilouny B, Lavalard A, Perez S, Veber B, Guitard PG, Gouin P, Lamacz A, Plouvier F, Delaborde BP, Kherchache A, Chaalal A, Ricard JD, Amouretti M, Freita-Ramos S, Roux D, Constantin JM, Assefi M, Lecore M, Selves A, Prevost F, Lamer C, Shi R, Knani L, Floury SP, Vettoretti L, Levy M, Marsac L, Dauger S, Guilmin-Crépon S, Winiszewski H, Piton G, Soumagne T, Capellier G, Putegnat JB, Bayle F, Perrou M, Thao G, Géri G, Charron C, Repessé X, Vieillard-Baron A, Guilbart M, Roger PA, Hinard S, Macq PY, Chaulier K, Goutte S, Chillet P, Pitta A, Darjent B, Bruneau A, Lasocki S, Leger M, Gergaud S, Lemarie P, Terzi N, Schwebel C, Dartevel A, Galerneau LM, Diehl JL, Hauw-Berlemont C, Péron N, Guérot E, Amoli AM, Benhamou M, Deyme JP, Andremont O, Lena D, Cady J, Causeret A, De La Chapelle A, Cracco C, Rouleau S, Schnell D, Foucault C, Lory C, Chapelle T, Bruckert V, Garcia J, Sahraoui A, Abbosh N, Bornstain C, Pernet P, Poirson F, Pasem A, Karoubi P, Poupinel V, Gauthier C, Bouniol F, Feuchere P, Heron A, Carreira S, Emery M, Le Floch AS, Giovannangeli L, Herzog N, Giacardi C, Baudic T, Thill C, Lebbah S, Palmyre J, Tubach F, Hajage D, Bonnet N, Ebstein N, Gaudry S, Cohen Y, Noublanche J, Lesieur O, Sément A, Roca-Cerezo I, Pascal M, Sma N, Colin G, Lacherade JC, Bionz G, Maquigneau N, Bouzat P, Durand M, Hérault MC, Payen JF. Correction to: Characteristics and prognosis of bloodstream infection in patients with COVID‑19 admitted in the ICU: an ancillary study of the COVID‑ICU study. Ann Intensive Care 2022; 12:4. [PMID: 35015163 PMCID: PMC8748185 DOI: 10.1186/s13613-022-00979-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Navarre C, Fabre M, Esparcieux A, Issartel B, Dutertre M, Blanc-Gruyelle A, Suy F, Adelaide L, Champagne H, Saison J. Étude multicentrique des déterminants à la vaccination COVID-19 chez les travailleurs hospitaliers, en établissements publics et privés. Infect Dis Now 2021. [PMCID: PMC8327526 DOI: 10.1016/j.idnow.2021.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dupont D, Saison J, Miailhes P, Mouchel R, Wallon M, Persat F. Aspergillus endophthalmitis: Potential role for vitreous galactomannan testing? Int J Infect Dis 2020; 96:151-153. [PMID: 32339725 DOI: 10.1016/j.ijid.2020.04.037] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022] Open
Abstract
Eye damage during invasive aspergillosis is rarely described and biological diagnosis remains challenging. Here we report the case of a heart transplant recipient with ocular aspergillosis complicating disseminated aspergillosis. Although voriconazole was rapidly given, a decrease in visual acuity of the right eye was consistent with endophthalmitis, resulting in an emergency vitrectomy. The diagnosis was rapidly confirmed: laboratory results showed the presence of Aspergillus fumigatus in a vitreous sample. A series of systemic antifungal medications (liposomal amphotericin B, caspofungin, and voriconazole), several liposomal amphotericin B ocular injections, and pars plana vitrectomy resulted in a limited positive clinical outcome. Interestingly although standard mycological follow-up procedures were negative, Aspergillus antigen testing gave an index of 5.92 on vitreous humour, thus a new intraocular injection of liposomal amphotericin B was performed and voriconazole reinitiated. Ten other vitreous samples from patients without fungal infections were also tested, all showing indexes below 0.25. Although larger studies are needed, this case illustrates that galactomannan testing of vitreous humour could be useful for the diagnosis of fungal endophthalmitis if these data are confirmed in other patients, in particular, if standard mycology is negative and PCR is not available.
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Affiliation(s)
- Damien Dupont
- Hospices Civils de Lyon, Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Lyon, France, Université Claude Bernard Lyon I, Lyon, France; Université Claude Bernard Lyon 1, Integrative Physiology of the Brain Arousal Systems, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR5292, Lyon, France.
| | - Julien Saison
- Hospices Civils de Lyon, Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Lyon, France
| | - Patrick Miailhes
- Hospices Civils de Lyon, Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Lyon, France
| | - Romain Mouchel
- Hospices Civils de Lyon, Service d'Ophtalmologie, Hôpital Edouard Herriot, Lyon, France
| | - Martine Wallon
- Hospices Civils de Lyon, Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Lyon, France, Université Claude Bernard Lyon I, Lyon, France; Université Claude Bernard Lyon 1, Integrative Physiology of the Brain Arousal Systems, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR5292, Lyon, France
| | - Florence Persat
- Hospices Civils de Lyon, Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Lyon, France, Université Claude Bernard Lyon I, Lyon, France
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Neau P, Lochet K, Carre-Raidelet L, Champagne H, Letranchant L, Reynaud C, Sartre J, Saison J. Sérologie Coxiella burnetii de dépistage : analyse comparative des patients avec une fièvre Q aiguë et des patients avec un faux positif. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.377] [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: 11/26/2022]
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8
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Maarek A, Ferry T, Mouly-Bertin C, Farhat F, Saison J, Chidiac C, Valour F. Giant mycotic right coronary aneurism: A rare complication of Staphylococcus aureus native valve endocarditis. Int J Infect Dis 2018; 73:91-92. [PMID: 29964166 DOI: 10.1016/j.ijid.2018.06.017] [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: 03/29/2018] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Alizée Maarek
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Tristan Ferry
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Centre for Research in Infectiology, Claude Bernard Lyon 1 University, Lyon, France.
| | - Carine Mouly-Bertin
- Department of Cardiology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Fadi Farhat
- Thoracic and Cardiac Surgery, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Julien Saison
- Department of Infectious Diseases, Valence Hospital Centre, Valence, France.
| | - Christian Chidiac
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Centre for Research in Infectiology, Claude Bernard Lyon 1 University, Lyon, France.
| | - Florent Valour
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1111, International Centre for Research in Infectiology, Claude Bernard Lyon 1 University, Lyon, France.
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9
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Piart C, Armand N, Vincent A, Champagne H, Letranchant L, Reynaud C, Chidiac C, Saison J. Étude des pratiques de prévention de la grippe nosocomiale selon la profession hospitalière. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.327] [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] [Indexed: 10/14/2022]
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10
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Bosch A, Valour F, Dumortier J, Perpoint T, Saison J, Sénéchal A, Miailhes P, Radenne S, Chidiac C, Ader F. Étude de cohorte de la tuberculose après transplantation hépatique : un défi diagnostique et thérapeutique. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.275] [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: 10/19/2022]
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Abstract
A 40-year-old cystic fibrosis woman with a history of double-lung transplantation 2 years previously was admitted for a progressive respiratory distress. Physical examination revealed fever (39°C) and diffuse bilateral lung crackles. Laboratory findings included severe hypoxemia and inflammatory syndrome. Bronchoalveolar lavage and serological test were positive for mycoplasma pneumonia. As the patient did not improve after 3 days of antibiotics and donor-specific HLA antibodies had been detected, an acute antibody-mediated graft rejection was treated with high-dose corticosteroids, plasma exchange, intravenous immunoglobulin, and rituximab. The patient rapidly improved. Unfortunately, 6 months after this episode, she developed a bronchiolitis obliterans syndrome with a dependence to noninvasive ventilator leading to the indication of retransplantation. This case illustrates the possible relationship between infection and humoral rejection. These two diagnoses should be promptly investigated and systematically treated in lung transplant recipients.
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Affiliation(s)
- Sarah Démir
- Department of Pulmonary Diseases, Lyon University Hospital System, Louis Pradel Hospital, F-69003, Lyon, France
| | - Julien Saison
- Department of Infectious Diseases, Lyon University Hospital System, Croix Rousse Hospital, F-69004, Lyon, France; International Center for Infectiology Research, Inserm U1111, Lyon 1 University, F-69007, Lyon, France
| | - Agathe Sénéchal
- Department of Pulmonary Diseases, Lyon University Hospital System, Louis Pradel Hospital, F-69003, Lyon, France
| | - Jean-Francois Mornex
- Department of Pulmonary Diseases, Lyon University Hospital System, Louis Pradel Hospital, F-69003, Lyon, France; Viral Infections and Comparative Pathology, INRA UMR 754, Lyon 1 University, F-69007, Lyon, France
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12
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Saison J, Harbaoui B, Bouchiat C, Pozzi M, Ferry T. Unexpected severe native aortic subacute endocarditis due to Bartonella quintana in a 40-year-old woman with good socioeconomic condition. BMJ Case Rep 2016; 2016:bcr-2016-216355. [PMID: 27651404 DOI: 10.1136/bcr-2016-216355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Julien Saison
- Infectious and Tropical Disease Unit, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France Université Claude Bernard Lyon 1, Lyon, France
| | - Brahim Harbaoui
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Coralie Bouchiat
- Université Claude Bernard Lyon 1, Lyon, France Centre International de Recherche en Infectiologie, Centre CNRS U1111 (INSERM)-UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Matteo Pozzi
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Hospices Civils de Lyon, Lyon, France
| | - Tristan Ferry
- Infectious and Tropical Disease Unit, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France Université Claude Bernard Lyon 1, Lyon, France Centre International de Recherche en Infectiologie, Centre CNRS U1111 (INSERM)-UMR5308, ENS de Lyon, UCBL1, Lyon, France
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13
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Langlois ME, Ader F, Dumistrescu O, Servien E, Saison J, Ferry T, Chidiac C, Valour F. Mycobacterium bovis prosthetic joint infection. Med Mal Infect 2016; 46:445-448. [PMID: 27609594 DOI: 10.1016/j.medmal.2016.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/30/2016] [Accepted: 07/18/2016] [Indexed: 02/03/2023]
Affiliation(s)
- M E Langlois
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France
| | - F Ader
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - O Dumistrescu
- Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France; Laboratoire de bactériologie, hospices civils de Lyon, groupement hospitalier Sud, 69310 Pierre Bénite, France
| | - E Servien
- Service de chirurgie orthopédique, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Université Claude-Bernard-Lyon 1, 69008 Lyon, France
| | - J Saison
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - T Ferry
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - F Valour
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, hospices civils de Lyon, groupement hospitalier Nord, 69004 Lyon, France; Centre international de recherche en infectiologie (CIRI), Inserm U1111, université Claude-Bernard Lyon 1, 69008 Lyon, France.
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14
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Cavalli Z, Ader F, Valour F, Saison J, Boussel L, Dumitrescu O, Perpoint T, Chidiac C, May T, Ferry T. Clinical Presentation, Diagnosis, and Bacterial Epidemiology of Peritoneal Tuberculosis in Two University Hospitals in France. Infect Dis Ther 2016; 5:193-9. [PMID: 27295189 PMCID: PMC4929092 DOI: 10.1007/s40121-016-0113-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Indexed: 02/05/2023] Open
Abstract
Introduction Diagnosis of peritoneal tuberculosis (pTB) is difficult, even in developed countries, where data are lacking. The aim of the present study was to describe the clinical presentation, diagnosis, and bacterial epidemiology of pTB in France over a 10-year period. Methods A retrospective study was conducted on pTB in two university hospitals in France, between January 2004 and December 2014. Results Among the 34 patients, 76.5% were migrants from areas of endemic tuberculosis (TB), mainly Africa. The main presentation (85.3%) was a checkup of ascites or suspicion of peritoneal carcinomatosis. On abdominal computed tomography, ascites was found in 90.6% and peritoneal thickening in 75%. Surgery was required for diagnosis in 58.8% of patients. Six of the patients who did not undergo surgery had ultrasound-guided peritoneal biopsy. Bacteriology was positive for ascites in only 58.1% of cases, for peritoneal biopsy in 73.3%, while granuloma was found in 95.5%. TB polymerase chain reaction (PCR) was positive in 25% of peritoneal biopsy. Mycobacterium bovis was isolated in 23.1% of cases and Mycobacterium tuberculosis in 76.9%. Isolates were fully susceptible (except M. bovis naturally resistant to pyrazinamide). Many (38%) belonged to the lineage T (genetic analysis by spoligotyping). Cure rate was high (76.5%), after a 6–9 months of anti-tuberculous therapy. Conclusion In developed countries, early diagnosis of pTB is still a challenge. Ultrasound-guided peritoneal biopsy may facilitate diagnosis. TB PCR can be useful on peritoneal biopsy. The lineage T was the most prevalent lineage, but more data are required to directly incriminate this lineage in the pathophysiology of pTB.
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Affiliation(s)
- Zoé Cavalli
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. .,Université Claude Bernard 1, Lyon, France.
| | - Florence Ader
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France.,Centre Internationale de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Florent Valour
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France.,Centre Internationale de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Julien Saison
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France
| | - Loïc Boussel
- Université Claude Bernard 1, Lyon, France.,Service de Radiologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Oana Dumitrescu
- Université Claude Bernard 1, Lyon, France.,Laboratoire de Bactériologie, Hôpital de Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Thomas Perpoint
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France
| | - Christian Chidiac
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France.,Centre Internationale de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Thierry May
- Service de Maladies Infectieuses et Tropicales, Hôpital de Brabois, CHU de Nancy, Vandœuvre-lès-Nancy, France.,Université de Lorraine, Nancy, France
| | - Tristan Ferry
- Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard 1, Lyon, France.,Centre Internationale de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
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15
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Dupont D, Saison J, Miailhes P, Wallon M, Persat F. Atteinte oculaire chez un greffé cardiaque lors d’une aspergillose disséminée : intérêt des galactomannanes ? J Mycol Med 2016. [DOI: 10.1016/j.mycmed.2016.04.024] [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: 10/21/2022]
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16
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Fort R, Saison J, Miailhes P, Boibieux A, Perpoint T, Ferry T, Chidiac C. VIH-26 - Syndrome de cushing grave attribué à l’interaction ritonavir/corticothérapie locale ou systémique chez 6 patients infectés par le VIH : étude rétrospective. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30571-6] [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: 10/21/2022]
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17
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Dhelens C, Adelaide L, Saison J, Guerpillon B, Leloire M, Pirot F, Chidiac C, Boibieux A, Pivot C. BU-03 - Impact de la collaboration entre un pharmacien hospitalier et une équipe mobile en infectiologie. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30327-4] [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: 11/29/2022]
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18
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Boulogne S, Leroy C, Saison J, Berroir S, Fontaine D, Lanteri-Minet M, Demarquay G. Syndrome trophique trigéminal : une complication rare mais sévère de la chirurgie des névralgies faciales. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Durel CA, Saison J, Chidiac C, Ferry T. A case of interstitial pneumonia, myocarditis and severe sepsis caused by Chlamydia pneumoniae. BMJ Case Rep 2015; 2015:bcr-2015-211788. [PMID: 26338247 DOI: 10.1136/bcr-2015-211788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Cécile-Audrey Durel
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | - Julien Saison
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France Service INSERMU1111, International Center for Research in Infectiology, Université Claude Bernard Lyon 1, Lyon, France
| | - Christian Chidiac
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France Service INSERMU1111, International Center for Research in Infectiology, Université Claude Bernard Lyon 1, Lyon, France
| | - Tristan Ferry
- Service de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France Service INSERMU1111, International Center for Research in Infectiology, Université Claude Bernard Lyon 1, Lyon, France
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20
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Saison J, Maucort Boulch D, Chidiac C, Demaret J, Malcus C, Cotte L, Poitevin-Later F, Miailhes P, Venet F, Trabaud MA, Monneret G, Ferry T. Increased Regulatory T-Cell Percentage Contributes to Poor CD4(+) Lymphocytes Recovery: A 2-Year Prospective Study After Introduction of Antiretroviral Therapy. Open Forum Infect Dis 2015; 2:ofv063. [PMID: 26110165 PMCID: PMC4473110 DOI: 10.1093/ofid/ofv063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/27/2015] [Indexed: 01/06/2023] Open
Abstract
Background. The primary aim of this study was to determine the impact of regulatory T cells (Tregs) percentage on immune recovery in human immunodeficiency virus (HIV)-infected patients after antiretroviral therapy introduction. Methods. A 2-year prospective study was conducted in HIV-1 chronically infected naive patients with CD4 count <500 cells/mm3. Regulatory T cells were identified as CD4+CD25highCD127low cells among CD4+ lymphocytes. Effect of Treg percentage at inclusion on CD4 evolution overtime was analyzed using a mixed-effect Poisson regression for count data. Results. Fifty-eight patients were included (median CD4 = 293/mm3, median Treg percentage = 6.1%). Percentage of Treg at baseline and CD4 nadir were independently related to the evolution of CD4 absolute value according to time: (1) at any given nadir CD4 count, 1% increase of initial Treg was associated with a 1.9% lower CD4 absolute value at month 24; (2) at any given Treg percentage at baseline, 10 cell/mm3 increase of CD4 nadir was associated with a 2.4% increase of CD4 at month 24; and (3) both effects did not attenuate with time. The effect of Treg at baseline on CD4 evolution was as low as the CD4 nadir was high. Conclusions. Regulatory T-cell percentage at baseline is a strong independent prognostic factor of immune recovery, particularly among patients with low CD4 nadir.
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Affiliation(s)
- Julien Saison
- Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1
| | - Delphine Maucort Boulch
- Lyon-1 University ; Service de Biostatistique , Hospices Civils de Lyon ; Equipe Biostatistique Santé CNRS UMR 5558 , Villeurbanne
| | - Christian Chidiac
- Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1
| | - Julie Demaret
- Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France
| | - Christophe Malcus
- Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France
| | | | | | | | - Fabienne Venet
- Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Lyon-1 University
| | - Mary Anne Trabaud
- Virology Laboratory , Hospices Civils de Lyon, Hôpital Croix-Rousse , France
| | - Guillaume Monneret
- Immunology Laboratory , Hospices Civils de Lyon, Hôpital Edouard Herriot , France ; Lyon-1 University
| | - Tristan Ferry
- Infectious and Tropical Disease Unit ; Lyon-1 University ; Centre International de Recherche en Infectiologie , Centre CNRS U1111 (INSERM ) - UMR5308, ENS de Lyon, UCBL1
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Bouchiat C, Saison J, Boisset S, Flandrois JP, Issartel B, Dauwalder O, Benito Y, Jarraud S, Grando J, Boibieux A, Dumitrescu O, Delahaye F, Farhat F, Thivolet-Bejui F, Frieh JP, Vandenesch F. Nontuberculous Mycobacteria: An Underestimated Cause of Bioprosthetic Valve Infective Endocarditis. Open Forum Infect Dis 2015. [PMID: 26213691 PMCID: PMC4511745 DOI: 10.1093/ofid/ofv047] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
From 2010 to 2013, 5 cases of nontuberculous mycobacteria infective endocarditis (IE), exclusively from bioprosthesis, were diagnosed in three hospitals out of 370 blood culture-negative-suspected IE. The porcine origin of this underestimated etiology is questioned. Background. Atypical mycobacteria, or nontuberculous mycobacteria (NTM), have been barely reported as infective endocarditis (IE) agents. Methods. From January 2010 to December 2013, cardiac valve samples sent to our laboratory as cases of blood culture-negative suspected IE were analyzed by 16S rDNA polymerase chain reaction (PCR). When positive for NTM, hsp PCR allowed species identification. Demographic, clinical, echocardiographic, histopathological, and Ziehl-Neelsen staining data were then collected. Results. Over the study period, 6 of 370 cardiac valves (belonging to 5 patients in 3 hospitals) were positive for Mycobacterium chelonae (n = 5) and Mycobacterium lentiflavum (n = 1) exclusively on bioprosthetic material. The 5 patients presented to the hospital for heart failure without fever 7.1–18.9 months (median 13.1 months) after biological prosthetic valve implantation. Echocardiography revealed paravalvular regurgitation due to prosthesis dehiscence in all patients. Histopathological examination of the explanted material revealed inflammatory infiltrates in all specimens, 3 of which were associated with giant cells. Gram staining and conventional cultures remained negative, whereas Ziehl-Neelsen staining showed acid-fast bacilli in all patients. Allergic etiology was ruled out by antiporcine immunoglobulin E dosages. These 5 cases occurred exclusively on porcine bioprosthetic material, revealing a statistically significant association between bioprosthetic valves and NTM IE (P < .001). Conclusions. The body of evidence confirmed the diagnosis of prosthetic IE. The statistically significant association between bioprosthetic valves and NTM IE encourages systematic Ziehl-Neelsen staining of explanted bioprosthetic valves in case of early bioprosthesis dysfunction, even without an obvious sign of IE. In addition, we strongly question the cardiac bioprosthesis conditioning process after animal sacrifice.
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Affiliation(s)
- Coralie Bouchiat
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
| | | | - Sandrine Boisset
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
| | - Jean-Pierre Flandrois
- Laboratoire de Biometrie et Biologie Evolutive , Université Lyon 1-CNRS UMR 5558 , Bâtiment Mendel, Villeurbanne
| | | | - Olivier Dauwalder
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
| | - Yvonne Benito
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
| | - Sophie Jarraud
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
| | | | | | - Oana Dumitrescu
- Laboratoire de Bactériologie, Centre Hospitalier Lyon Sud , Hospices Civils de Lyon , Pierre-Bénite
| | - François Delahaye
- Service de Cardiologie, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron
| | - Fadi Farhat
- Service de Chirurgie Cardiaque, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron
| | - Françoise Thivolet-Bejui
- Service d'Anatomo-Pathologie, Centre de Biologie Est , Hôpital Louis Pradel, Hospices Civils de Lyon , Bron
| | - Jean-Philippe Frieh
- Service de Chirurgie Cardiaque , Clinique du Tonkin , Villeurbanne ; Service de Chirurgie Cardiaque , Infirmerie Protestante , Caluire-et-Cuire , France
| | - François Vandenesch
- Laboratoire de Bactériologie, Centre de Biologie Est , Hospices Civils de Lyon , Bron
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Heiblig M, Bozzoli V, Saison J, Thomas X, De Croze D, Traverse-Glehen A, Cosmidis A, Chidiac C, Ferry T, Alanio A, Bienvenu AL, Dupont D, Ducastelle-Lepretre S, Michallet M, Ader F. Combined medico-surgical strategy for invasive sino-orbito-cerebral breakthrough fungal infection withHormographiella aspergillatain an acute leukaemia patient. Mycoses 2015; 58:308-12. [DOI: 10.1111/myc.12305] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M. Heiblig
- Service d'Hématologie 1G; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - V. Bozzoli
- Service d'Hématologie 1G; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - J. Saison
- Service de Maladies Infectieuses et Tropicales; Hôpital de la Croix-Rousse; Hospices Civils de Lyon; Lyon France
| | - X. Thomas
- Service d'Hématologie 1G; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - D. De Croze
- Laboratoire d'Anatomie et de cytopathologie; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - A. Traverse-Glehen
- Laboratoire d'Anatomie et de cytopathologie; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - A. Cosmidis
- Service d'Otorhinolaryngologie; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - C. Chidiac
- Service de Maladies Infectieuses et Tropicales; Hôpital de la Croix-Rousse; Hospices Civils de Lyon; Lyon France
| | - T. Ferry
- Service de Maladies Infectieuses et Tropicales; Hôpital de la Croix-Rousse; Hospices Civils de Lyon; Lyon France
- Inserm U1111 Centre International de Recherche en Infectiologie (CIRI); Université Claude Bernard Lyon 1; Lyon France
| | - A. Alanio
- Service de Parasitologie-Mycologie; Groupe Hospitalier Lariboisière; Saint Louis Fernand Widal; Université Paris Diderot; Sorbonne Paris Cité; Paris France
- Institut Pasteur; Unité de Mycologie moléculaire; CNRS URA3012; Paris France
| | - A. L. Bienvenu
- Institut de Parasitologie et Mycologie Médicale; Hospices Civils de Lyon; Lyon France
- Malaria Research Unit; ICBMS; CNRS UMR 5246; Lyon 1 University; Lyon France
| | - D. Dupont
- Institut de Parasitologie et Mycologie Médicale; Hospices Civils de Lyon; Lyon France
| | - S. Ducastelle-Lepretre
- Service d'Hématologie 1G; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - M. Michallet
- Service d'Hématologie 1G; Centre Hospitalier Lyon Sud; Hospices Civils de Lyon; Pierre Bénite France
| | - F. Ader
- Service de Maladies Infectieuses et Tropicales; Hôpital de la Croix-Rousse; Hospices Civils de Lyon; Lyon France
- Inserm U1111 Centre International de Recherche en Infectiologie (CIRI); Université Claude Bernard Lyon 1; Lyon France
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Trabaud MA, Cotte L, Saison J, Ramière C, Ronfort C, Venet F, Tardy JC, Monneret G, André P. Persistent production of an integrase-deleted HIV-1 variant with no resistance mutation and wild-type proviral DNA in a treated patient. AIDS Res Hum Retroviruses 2015; 31:142-9. [PMID: 25333615 DOI: 10.1089/aid.2014.0129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
An HIV-infected patient presenting an unexpected viral escape under combined antiretroviral treatment is described. The virus isolated from plasma contained a large deletion in the HIV-1 integrase gene but no known resistance mutation. Nested polymerase chain reactions (PCRs) with patient virus integrase-specific primers and probes were developed and used to detect the mutant from plasma, blood, rectal biopsies, and sperm. The variant progressively emerged during a period of therapy-induced virosuppression, and persisted at a low but detectable level for at least 5 years. Surprisingly, proviral DNA from lymphocytes, rectal cells, and sperm cells was, and remained, mainly wild type. Cellular HIV RNA with the deletion was detected only once from the rectum. The origin and mechanisms underlying this so far not described production at a detectable level are largely hypothetical. This observation raised concern about the ability of defective viruses to spread.
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Affiliation(s)
- Mary-Anne Trabaud
- Laboratoire de Virologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Laurent Cotte
- Département des Maladies Infectieuses, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
- INSERM U1052, Lyon, France
| | - Julien Saison
- Département des Maladies Infectieuses, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire d'Immunologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon, Lyon, France
| | - Christophe Ramière
- Laboratoire de Virologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon, Lyon, France
| | - Corinne Ronfort
- Institut National de Recherche Agronomique (INRA), Université de Lyon, UMR754, UMS3444 BioSciences Gerland Lyon Sud, Lyon, France
| | - Fabienne Venet
- Laboratoire d'Immunologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jean-Claude Tardy
- Laboratoire de Virologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Monneret
- Laboratoire d'Immunologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Patrice André
- Laboratoire de Virologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
- CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université de Lyon, Lyon, France
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Saison J, Costedoat-Chalumeau N, Maucort-Boulch D, Iwaz J, Marignier R, Cacoub P, Vital-Durand D, Hot A, Tebib J, Aumaitre O, Schleinitz N, Sarrot-Reynauld F, Broussolle C, Sève P. Systemic lupus erythematosus-associated acute transverse myelitis: manifestations, treatments, outcomes, and prognostic factors in 20 patients. Lupus 2014; 24:74-81. [DOI: 10.1177/0961203314547795] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Transverse myelitis is a rare complication of systemic lupus erythematosus (SLE). This retrospective multicentre study identifies the prognostic factors in a relatively large patient series. Patients and methods Twenty patients fulfilled the SLE criteria of the ACR classification and the Transverse Myelitis Consortium Working Group. A severe neurological flare was defined as muscle strength grade <3/5 in more than half the muscle groups at the motor neurological level. Inability to run or another significant ambulation-unrelated disability was considered as ‘unfavourable neurological outcome’. Results Myelitis was the first SLE symptom in 12 patients; in the eight others, it occurred 8.6 years (median delay) after SLE onset. Eleven patients presented severe neurological impairments. The treatment included corticosteroids in all patients associated with intravenous cyclophosphamide in 11 and/or hydroxychloroquine in 14. Unfavourable outcomes were observed in 53% of the patients at six months and in 28% at end of follow-up (median: 5.9 years). An initial severe neurological impairment and no cyclophosphamide use were associated with unfavourable neurological outcomes at six months and at end of follow-up, respectively. Conclusion Transverse myelitis may reveal SLE or occur more than 10 years after SLE diagnosis. The initial severity of the neurological flare (with paraplegia) is the main prognostic marker. The study provides arguments for cyclophosphamide use.
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Affiliation(s)
- J Saison
- Département de Médecine Interne, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
| | - N Costedoat-Chalumeau
- Centre maladies rares, Service de médecine interne, Hôpital Cochin, Paris, France
- Université Paris Descartes, Paris, France
| | - D Maucort-Boulch
- Université de Lyon, Université Lyon 1, Lyon, France
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
- CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, France
| | - J Iwaz
- Université de Lyon, Université Lyon 1, Lyon, France
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
- CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, France
| | - R Marignier
- Département de Neurologie, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - P Cacoub
- i3 Immunologie-Immunopathologie-Immunotherapie, (UMR 7211-Université Pierre et Marie Curie/CNRS, INSERM U 959), Paris, France
| | - D Vital-Durand
- Département de Médecine Interne, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - A Hot
- Département de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - J Tebib
- Département de Rhumatologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - O Aumaitre
- Département de Médecine Interne, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - N Schleinitz
- Département de Médecine Interne, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - F Sarrot-Reynauld
- Département de Médecine Interne, Hôpital Albert Michalon, Grenoble, France
| | - C Broussolle
- Département de Médecine Interne, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
| | - P Sève
- Département de Médecine Interne, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
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Saison J, Ferry T, Demaret J, Maucort Boulch D, Venet F, Perpoint T, Ader F, Icard V, Chidiac C, Monneret G. Association between discordant immunological response to highly active anti-retroviral therapy, regulatory T cell percentage, immune cell activation and very low-level viraemia in HIV-infected patients. Clin Exp Immunol 2014; 176:401-9. [PMID: 24460818 DOI: 10.1111/cei.12278] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 01/07/2023] Open
Abstract
The mechanisms sustaining the absence of complete immune recovery in HIV-infected patients upon long-term effective highly active anti-retroviral therapy (HAART) remain elusive. Immune activation, regulatory T cells (T(regs)) or very low-level viraemia (VLLV) have been alternatively suspected, but rarely investigated simultaneously. We performed a cross-sectional study in HIV-infected aviraemic subjects (mean duration of HAART: 12 years) to concomitantly assess parameters associated independently with inadequate immunological response. Patients were classified as complete immunological responders (cIR, n = 48) and inadequate immunological responders (iIR, n = 39), depending on the CD4(+) T cell count (> or < 500/mm(3)). Clinical and virological data (including very low-level viraemia) were collected. In parallel, immunophenotyping of CD4(+) lymphocytes, including T(reg) subsets, and CD8(+) T cells was performed. Percentages of activated CD4(+) T cells, T(regs), effector T(regs) and terminal effector T(regs) were found to be significantly elevated in iIR. Neither the percentage of activated CD8(+) T cells nor VLLV were found to be associated with iIR. In the multivariate analysis, nadir of CD4(+) T cell count and percentage of T(regs) were the only two parameters associated independently with iIR [odds ratio (OR) = 2·339, P = 0·001, and OR = 0·803, P = 0·041]. We present here the largest study investigating simultaneously the immune response to long-term HAART, activation of CD4(+) and CD8(+) T cells, T(reg) percentages and very low-level viraemia. Causative interactions between T(regs) and CD4(+) T cells should now be explored prospectively in a large patients cohort.
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Affiliation(s)
- J Saison
- Immunology Laboratory, E. Herriot Hospital, Lyon, France; Infectious and Tropical Disease Unit, Croix Rousse Hospital, Lyon, France; Lyon-1 University, Lyon, France; CIRI (Centre International de Recherche en Infectiologie), Lyon, France
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Saison J, Bouchiat C, Boisset S, Issartel B, Thivolet F, Frieh JP, Vandenesch F. S-04: Endocardites infectieuses à mycobactéries atypiques sur bioprothèse porcine : une étiologie méconnue. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70329-4] [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]
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Saison J, Ferry T, Demaret J, Ader F, Icard V, Chidiac C, Monneret G. A-14: Association entre réponse immunologique discordante, Tregs, activation immune et virémie résiduelle chez les patients infectés par le VIH. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70097-6] [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]
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Trabaud MA, Cotte L, Saison J, Ramiere C, Ronfort C, Tardy JC, Andre P. Persistent production of an integrase-deleted HIV-1 variant with no resistance mutation and wild-type proviral DNA in a treated patient. BMC Infect Dis 2014. [PMCID: PMC4220856 DOI: 10.1186/1471-2334-14-s2-o12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Saison J, Berger F, Lebosse F, Audoual R, Thomas X, Michallet M. Hepatomegaly and fever at the time of neutrophil recovery revealing L-asparaginase toxicity in the treatment of acute lymphoblastic leukemia. Am J Case Rep 2014; 15:13-7. [PMID: 24454976 PMCID: PMC3894917 DOI: 10.12659/ajcr.889867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/21/2013] [Indexed: 12/20/2022]
Abstract
PATIENT Male, 52 FINAL DIAGNOSIS: L-asparaginase associated steatohepatitis and pulmonary Pneumocystis Symptoms: Cholestasis • hepatomegaly MEDICATION Corticosteroids • atovaquone • antioxidant therapy Clinical Procedure: Liver biopsy Specialty: Hematology • Infectious Disease • Hepatology. OBJECTIVE Challenging differential diagnosis. BACKGROUND L-asparaginase (L-aspa) is an important component of chemotherapy in acute lymphoblastic leukemia (ALL). Main adverse effects of L-aspa include allergic reactions, pancreatitis, thrombosis, and liver disturbances. L-aspa-associated steatohepatitis may be a life-threatening disorder but has very rarely been reported in the literature. CASE REPORT ALL was diagnosed in a 52-year-old man with a history of cardiovascular disease and obesity. Chemotherapy combining daunorubicin, vincristine, cyclophosphamide, and L-aspa was initiated. At the time of neutrophil recovery, the patient developed hepatomegaly in the context of fever and cough. On day 25, after 6 injections of L-aspa, liver function tests showed elevated alkaline phosphatase and transaminases levels. Although pulmonary Pneumocystis was concomitantly diagnosed, biological hepatic disturbances were attributed to L-aspa-associated toxicity. A liver biopsy revealed severe diffuse micro- and macrovesicular steatosis affecting more than 50% of hepatocytes. Other causes of liver dysfunction were eliminated. L-aspa and other hepatotoxic treatments were stopped, and treatment with antioxidant therapy, atovaquone, and corticosteroids was initiated. The clinical outcome was rapidly favorable. CONCLUSIONS This case illustrates the necessity of carefully monitoring liver function test results in patients receiving L-aspa. In case of major increase of hepatic enzymes, a hepatic biopsy should rapidly be performed to exclude differential diagnosis in patients with prolonged neutropenia. L-aspa should be stopped and further administration definitively avoided. In the present case, the early administration of systemic corticosteroids as treatment of the concomitant Pneumocystis with hypoxemia could have participated to the favorable clinical evolution.
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Affiliation(s)
- Julien Saison
- Department of Hematology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre Bénite, France ; Lyon-1 University, Lyon, France ; CIRI (Centre International de Recherche en Infectiologie), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Françoise Berger
- Lyon-1 University, Lyon, France ; Department of Pathology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre Bénite, France
| | - Fanny Lebosse
- Lyon-1 University, Lyon, France ; Hepatogastroenterology Unit, Hospices Civils de Lyon, Croix Rousse Hospital, Lyon, France
| | | | - Xavier Thomas
- Department of Hematology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre Bénite, France ; Lyon-1 University, Lyon, France
| | - Mauricette Michallet
- Department of Hematology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre Bénite, France ; Lyon-1 University, Lyon, France
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Saison J, Tardy JC, Scholtes C, Icard V, Trabaud MA, Perpoint T, Chidiac C, Ecochard R, André P, Ferry T. Low-level viremia is associated with non-B subtypes in patients infected with HIV with virological success following HAART introduction. J Med Virol 2013; 85:953-8. [PMID: 23588720 DOI: 10.1002/jmv.23553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 12/14/2022]
Abstract
This prospective study aimed to determine factors associated with detection of very low-level viremia in patients infected with HIV-1 with virological success following HAART introduction. Fifty-seven patients, mostly (n = 51, 89%) treated with a protease inhibitor-based regimen, were included and followed for 2 years. Viral loads were monitored by Abbott m2000 RealTime HIV-1. Patients were classified as (i) HIV-RNA-negative if viral loads remained strictly undetectable (0 copies/ml), or (ii) HIV-RNA-positive if at least one HIV-1 RNA could be detected in 1-49 copies/ml during follow-up. At month 24, 44 patients (77%) were in the HIV-RNA-positive group, whereas 13 (23%) remained without very low-level viremia. Univariate analysis, Kaplan-Meier curves and the Cox proportional hazard model revealed that B subtype was the only predictor of belonging to the HIV-RNA-negative group (HR 3.98; 95% CI 1.08-14.7). This association needs to be confirmed. Further study of the reservoir and the mechanisms of viral latency according to HIV-subtype will also be necessary to develop new therapeutic strategies and eradicate HIV infection.
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Affiliation(s)
- Julien Saison
- Virology Laboratory, Croix-Rousse Hospital, HCL, Lyon, France
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Saison J, Coestedoat-Chalumeau N, Maucaurt-Boulch D, Marignier R, Cacoub P, Durand DV, Hot A, Tebib J, Aumaitre O, Schleinitz N, Broussolle C, Seve P. Quel pronostic et traitement pour les myélites transverses au cours du lupus ? À propos d’une étude multicentrique rétrospective de 20 cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.303] [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: 11/26/2022]
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Demaret J, Saison J, Venet F, Malcus C, Poitevin-Later F, Lepape A, Ferry T, Monneret G. Assessment of a novel flow cytometry technique of one-step intracellular staining: Example of FOXP3 in clinical samples. Cytometry 2013; 84:187-93. [DOI: 10.1002/cyto.b.21070] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/30/2012] [Accepted: 12/03/2012] [Indexed: 01/03/2023]
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Saison J, Demaret J, Venet F, Chidiac C, Malcus C, Poitevin-Later F, Tardy JC, Ferry T, Monneret G. CD4+CD25+CD127- assessment as a surrogate phenotype for FOXP3+ regulatory T cells in HIV-1 infected viremic and aviremic subjects. Cytometry B Clin Cytom 2012; 84:50-4. [PMID: 23019018 DOI: 10.1002/cyto.b.21047] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 07/31/2012] [Accepted: 09/04/2012] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although likely pivotal, the role of regulatory T cells (Tregs) in HIV pathogenesis remains elusive. This can be partly explained by analytical issues regarding their phenotypic identification in clinical studies. Instead of intracellular FOXP3 staining, CD4+CD25+CD127- phenotype has been proposed as an alternative to identify Tregs in clinical samples. However, its use remains controversial in viremic patients. Therefore, the objective of the present study was to assess the correlation between frequencies of CD4+CD25+CD127- and CD4+CD25+FOXP3+ lymphocytes in viremic and matched aviremic HIV-infected patients. METHODS Peripheral blood was collected from HIV-1 infected patients. Eleven viremic patients (Viral Load > 40 copies/mL) were matched (age, sex, CD4+ cell number) with 8 aviremic patients under highly active antiretroviral therapy (HAART). Fresh whole blood was immediately stained to analyze by flow cytometry the correlation between CD4+CD25+CD127- and the reference phenotype CD4+CD25+FOXP3+ lymphocytes in the same tube (four color staining CD4/CD25/CD127/FOXP3 for concomitant analysis of cell surface and intracellular markers). RESULTS In both groups, no significant differences were observed when comparing CD4+CD25+CD127- and CD4+CD25+FOXP3+ cell frequencies. In line, a strong correlation between CD4+CD25+CD127- and CD4+CD25+FOXP3+ lymphocyte percentages was observed in the whole patient population (r: 0.948, P < 0.001) or each group separately: aviremic (r: 0.968, P < 0.001), viremic (r: 0.9, P < 0.001). Finally, we found that most CD4+FOXP3+ cells were indeed CD25+CD127-, both in viremic and aviremic groups (88.5% and 90.9%, respectively). CONCLUSIONS We observed that CD4+CD25+CD127- phenotype is a good and easy-to-perform surrogate identification strategy for FOXP3+ regulatory T cells in both viremic and aviremic HIV-1-infected subjects. Thus, it represents a useful tool for monitoring Tregs in clinical research studies based on large cohorts of patients prospectively monitored, including HIV-infected subjects.
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Affiliation(s)
- Julien Saison
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Laboratoire d'Immunologie, Lyon, F-69003, France
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Saison J, Cotte L, Chidiac C, Ferry T. Fatal cumulative toxicities of HAART in a stable, AIDS-free, HIV-infected patient. BMJ Case Rep 2012; 2012:bcr.10.2011.4905. [PMID: 22605589 DOI: 10.1136/bcr.10.2011.4905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The authors describe the case of fatal cumulative toxicities in a 58-year-old AIDS-free, HIV-infected patient, who successively developed under highly active antiretroviral therapy (HAART): severe lipodystrophy, complicated osteoporosis, complicated non-cirrhotic portal hypertension of the liver (with ascites, portal thrombosis, oesophageal varices and protein-losing enteropathy) due to nodular regenerative hyperplasia. These cumulative HAART-related toxicities led to death, despite symptomatic treatment and the switch of antiretrovirals (especially didanosine) putatively involved in the process in these drug-mediated diseases. As morbidity and mortality in HIV infection continue to improve, it appears important to recognise such rare HAART-associated toxicities. This case illustrates the absolute necessity of investigating the long-term side effects of HAART in HIV infection, particularly in patients treated with first generation molecules. The switch strategy (switching old molecules to newer ones) is crucial in case of severe suspected toxicity and has to be discussed in asymptomatic patients largely exposed to first generation molecules, in order to prevent long-term toxicity.
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Affiliation(s)
- Julien Saison
- Hospices Civils de Lyon, Service de Maladies Infectieuses et Tropicales, Lyon, France
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Saison J, Pérard L, Hot A, Roux M, Mausservey C, Monard E, Illinger J, Ninet J. Microangiopathie thrombotique au cours d’une maladie de Still. À propos d’un cas. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.257] [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: 11/24/2022]
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