1
|
Rolland L, Mainguy A, Boissier S, Ki Zerbo M, Tardivel A, Sébillotte M, Cailleaux M, Patrat-Delon S, Revest M, Tattevin P. A pilot project of expert nurses for the follow-up of complex intravenous antimicrobial treatment. Infect Dis Now 2023; 53:104670. [PMID: 36736828 DOI: 10.1016/j.idnow.2023.104670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To report a pilot project of expert nurses for outpatient parenteral antimicrobial treatment (OPAT) follow-up. METHODS Three nurses with specific training on antibiotics started a state-funded programme including: i) consultations for OPAT follow-up; ii) hotline for satellite hospitals; iii) peer training. Patients' data were prospectively collected. A representative sample of patients and physicians was interviewed to learn about their opinion on the project. RESULTS From December 2020 to December 2021, 118 patients (median age 66.5 years [52-75], male-to-female ratio 2.5) were enrolled, for a total of 621 consultations. Patients were mostly on OPAT for bone and joint infections (n = 76, 64 %) and cardiovascular infections (n = 16, 14 %), for a median duration of 29 days [22-57]. Eleven patients (9 %) required unplanned hospital admissions, and three experienced treatment failure. Most patients (21/22) and physicians in charge (10/10) reported a high level of satisfaction. CONCLUSIONS Nurses may be important actors for OPAT follow-up.
Collapse
Affiliation(s)
- L Rolland
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - A Mainguy
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - S Boissier
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - M Ki Zerbo
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - A Tardivel
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - M Sébillotte
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - M Cailleaux
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - S Patrat-Delon
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - M Revest
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; INSERM U1230, IFR140, Rennes 1 University, Rennes, France
| | - P Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; INSERM U1230, IFR140, Rennes 1 University, Rennes, France.
| |
Collapse
|
2
|
Hossain SI, de Goër de Herve J, Hassan MS, Martineau D, Petrosyan E, Corbin V, Beytout J, Lebert I, Durand J, Carravieri I, Brun-Jacob A, Frey-Klett P, Baux E, Cazorla C, Eldin C, Hansmann Y, Patrat-Delon S, Prazuck T, Raffetin A, Tattevin P, Vourc'h G, Lesens O, Nguifo EM. Exploring convolutional neural networks with transfer learning for diagnosing Lyme disease from skin lesion images. Comput Methods Programs Biomed 2022; 215:106624. [PMID: 35051835 DOI: 10.1016/j.cmpb.2022.106624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Lyme disease which is one of the most common infectious vector-borne diseases manifests itself in most cases with erythema migrans (EM) skin lesions. Recent studies show that convolutional neural networks (CNNs) perform well to identify skin lesions from images. Lightweight CNN based pre-scanner applications for resource-constrained mobile devices can help users with early diagnosis of Lyme disease and prevent the transition to a severe late form thanks to appropriate antibiotic therapy. Also, resource-intensive CNN based robust computer applications can assist non-expert practitioners with an accurate diagnosis. The main objective of this study is to extensively analyze the effectiveness of CNNs for diagnosing Lyme disease from images and to find out the best CNN architectures considering resource constraints. METHODS First, we created an EM dataset with the help of expert dermatologists from Clermont-Ferrand University Hospital Center of France. Second, we benchmarked this dataset for twenty-three CNN architectures customized from VGG, ResNet, DenseNet, MobileNet, Xception, NASNet, and EfficientNet architectures in terms of predictive performance, computational complexity, and statistical significance. Third, to improve the performance of the CNNs, we used custom transfer learning from ImageNet pre-trained models as well as pre-trained the CNNs with the skin lesion dataset HAM10000. Fourth, for model explainability, we utilized Gradient-weighted Class Activation Mapping to visualize the regions of input that are significant to the CNNs for making predictions. Fifth, we provided guidelines for model selection based on predictive performance and computational complexity. RESULTS Customized ResNet50 architecture gave the best classification accuracy of 84.42% ±1.36, AUC of 0.9189±0.0115, precision of 83.1%±2.49, sensitivity of 87.93%±1.47, and specificity of 80.65%±3.59. A lightweight model customized from EfficientNetB0 also performed well with an accuracy of 83.13%±1.2, AUC of 0.9094±0.0129, precision of 82.83%±1.75, sensitivity of 85.21% ±3.91, and specificity of 80.89%±2.95. All the trained models are publicly available at https://dappem.limos.fr/download.html, which can be used by others for transfer learning and building pre-scanners for Lyme disease. CONCLUSION Our study confirmed the effectiveness of even some lightweight CNNs for building Lyme disease pre-scanner mobile applications to assist people with an initial self-assessment and referring them to expert dermatologist for further diagnosis.
Collapse
Affiliation(s)
- Sk Imran Hossain
- Université Clermont Auvergne, CNRS, ENSMSE, LIMOS, F-63000 Clermont-Ferrand, France
| | - Jocelyn de Goër de Herve
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Md Shahriar Hassan
- Université Clermont Auvergne, CNRS, ENSMSE, LIMOS, F-63000 Clermont-Ferrand, France
| | - Delphine Martineau
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Evelina Petrosyan
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Violaine Corbin
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean Beytout
- CHU Clermont-Ferrand, Inserm, Neuro-Dol, CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Isabelle Lebert
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Jonas Durand
- Tous Chercheurs Laboratory, UMR 1136 'Interactions Arbres Micro-Organismes', INRAE, Centre INRAE Grand Est-Nancy, F-54280 Champenoux, France
| | | | - Annick Brun-Jacob
- Tous Chercheurs Laboratory, UMR 1136 'Interactions Arbres Micro-Organismes', INRAE, Centre INRAE Grand Est-Nancy, F-54280 Champenoux, France
| | - Pascale Frey-Klett
- INRAE, US 1371 Laboratory of Excellence ARBRE, Centre INRAE Grand Est-Nancy, Champenoux F-54280, France
| | - Elisabeth Baux
- Infectious Diseases Department, University Hospital of Nancy, Nancy, France
| | - Céline Cazorla
- Infectious Disease Department, University Hospital of Saint Etienne, Saint-Etienne, France
| | - Carole Eldin
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Yves Hansmann
- Service des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires, 67000 Strasbourg, France
| | - Solene Patrat-Delon
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Thierry Prazuck
- Department of Infectious and Tropical Diseases, CHR Orléans, Orléans, France
| | - Alice Raffetin
- Tick-Borne Diseases Reference Center, North region, Department of Infectious Diseases, Hospital of Villeneuve-Saint-Georges, 40 allée de la Source, 94190 Villeneuve-Saint-Georges; ESGBOR, European Study Group for Lyme Borreliosis
| | - Pierre Tattevin
- Department of Infectious Diseases and Intensive Care Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Gwenaël Vourc'h
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, 63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CRIOA, CHU Clermont-Ferrand, Clermont-Ferrand, France; UMR CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Université Clermont Auvergne, Clermont-Ferrand, France
| | | |
Collapse
|
3
|
Mailles A, Argemi X, Biron C, Fillatre P, De Broucker T, Buzelé R, Gagneux-Brunon A, Gueit I, Henry C, Patrat-Delon S, Makinson A, Piet E, Wille H, Vareil MO, Epaulard O, Martinot M, Tattevin P, Stahl JP. Changing profile of encephalitis: Results of a 4-year study in France. Infect Dis Now 2021; 52:1-6. [PMID: 34896660 DOI: 10.1016/j.idnow.2021.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 06/19/2021] [Revised: 11/01/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
Abstract
CONTEXT In 2007, we performed a nationwide prospective study to assess the epidemiology of encephalitis in France. We aimed to evaluate epidemiological changes 10years later. METHODS We performed a 4-year prospective cohort study in France (ENCEIF) from 2016 to 2019. Medical history, comorbidities, as well as clinical, biological, imaging, and demographic data were collected. For the comparison analysis, we selected similar data from adult patients enrolled in the 2007 study. We used Stata statistical software, version 15 (Stata Corp). Indicative variable distributions were compared using Pearson's Chi2 test, and means were compared using Student's t-test for continuous variables. RESULTS We analyzed 494 cases from 62 hospitals. A causative agent was identified in 65.7% of cases. Viruses represented 81.8% of causative agents, Herpesviridae being the most frequent (63.6%). Arboviruses accounted for 10.8%. Bacteria and parasites were responsible for respectively 14.8% and 1.2% of documented cases. Zoonotic infections represented 21% of cases. When comparing ENCEIF with the 2007 cohort (222 adults patients from 59 hospitals), a higher proportion of etiologies were obtained in 2016-2019 (66% vs. 53%). Between 2007 and 2016-2019, the proportions of Herpes simplex virus and Listeria encephalitis cases remained similar, but the proportion of tuberculosis cases decreased (P=0.0001), while tick-borne encephalitis virus (P=0.01) and VZV cases (P=0.03) increased. In the 2016-2019 study, 32 causative agents were identified, whereas only 17 were identified in the 2007 study. CONCLUSION Our results emphasize the need to regularly perform such studies to monitor the evolution of infectious encephalitis and to adapt guidelines.
Collapse
Affiliation(s)
- A Mailles
- Santé Publique France, Saint-Maurice, France; ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland.
| | - X Argemi
- Infectious diseases and internal medicine department, Axium clinic, Aix-en-Provence, France
| | - C Biron
- Infectious diseases department, CHU Hôtel-Dieu, INSERM UIC 1413, Nantes university, Nantes, France
| | - P Fillatre
- ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland; Intensive care unit, hôpital Yves-le-Foll, Saint-Brieuc, France
| | | | - R Buzelé
- Infectious diseases unit, hôpital Yves-le-Foll, Saint-Brieuc, France
| | - A Gagneux-Brunon
- Infectious diseases department, hôpital Nord, CHU Saint-Étienne, Saint-Priest-en-Jarez, France
| | - I Gueit
- Department of infectious diseases, CHU Rouen, Rouen, France
| | - C Henry
- Neurology, CH Delafontaine, Saint-Denis, France
| | - S Patrat-Delon
- Infectious diseases department, CHU Ponchaillou, Rennes, France
| | - A Makinson
- Infectious diseases and intensive care unit, Pontchaillou university hospital, Rennes, France
| | - E Piet
- Infectious diseases department, CH Annecy-Genevois, Metz Tessy, France
| | - H Wille
- Infectious diseases department, CH Côte Basque, 64109 Bayonne, France
| | - M O Vareil
- Infectious diseases department, CH Côte Basque, 64109 Bayonne, France
| | - O Epaulard
- ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland; Université Grenoble Alpes, CHUGA, infectious diseases department, Grenoble, France
| | - M Martinot
- Infectious diseases department CH Colmar, Colmar, France
| | - P Tattevin
- ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland; Infectious diseases department, CHU Ponchaillou, Rennes, France
| | - J P Stahl
- ESCMID Study Group on the infections of the Brain (ESGIB), Basel, Switzerland; Université Grenoble Alpes, CHUGA, infectious diseases department, Grenoble, France
| | | | | |
Collapse
|
4
|
Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
Collapse
Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Boissier S, Patrat-Delon S, Rolland L, Mainguy A, Rouaud C, Tattevin P, Revest M, Tardivel A. L’infirmier face à la prescription antibiotique : des difficultés à surmonter pour un meilleur usage des antibiotiques. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.450] [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: 11/30/2022]
|
6
|
Mainguy A, Bougeard E, Patrat-Delon S, Boissier S, Cosnier L, Rouaud C, Tattevin P, Revest M, Tardivel A. Le dossier médical partagé : un nouvel outil pour le suivi des infections prolongées par l’infirmier expert en thérapeutiques anti-infectieuses. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.451] [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: 11/25/2022]
|
7
|
Mailles A, Martinot M, Piet E, Biron C, Gagneux-Brunon A, Gueit I, Argemi X, Patrat-Delon S, Tattevin P, Stahl J. Encéphalites chez les patients âgés en France, 2016–2019. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.326] [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: 11/25/2022]
|
8
|
Rolland L, Benezit F, Patrat-Delon S, Boissier S, Mainguy A, Rouaud C, Tattevin P, Revest M, Tardivel A. Évaluation des besoins d’expertise infirmière pour les antibiothérapies complexes au sein d’un territoire. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Lacroix A, Revest M, Patrat-Delon S, Lemaître F, Donal E, Lorléac'h A, Arvieux C, Michelet C, Tattevin P. Outpatient parenteral antimicrobial therapy for infective endocarditis: a cost-effective strategy. Med Mal Infect 2014; 44:327-30. [PMID: 25022891 DOI: 10.1016/j.medmal.2014.05.001] [Citation(s) in RCA: 25] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 04/08/2014] [Accepted: 05/09/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We evaluated the benefit/risk ratio of outpatient parenteral antimicrobial therapy (OPAT) in infective endocarditis (IE). METHOD We performed an observational retrospective study of definite IE (Duke criteria) treated in an infectious diseases unit in 2012. We compared patients having completed the treatment in hospital (H), and those deemed sufficiently stable, and with adequate home environment, for OPAT. The costs were estimated through hospital bills, and, for OPAT, through the costs of drugs and their administration (material, staff), transportation, and outpatient visits. RESULTS Eighteen out of 39 consecutive patients presenting with IE received OPAT, with a mean hospital stay of 23.5days (vs 34.7days for H group, P=0.014). No severe adverse event related to OPAT was reported. The global saving was estimated at 267,307euros, or 14,850euros per patient. CONCLUSIONS OPAT in selected patients presenting with IE seems effective, safe, and reduces costs by approximately 15,000euros per patient.
Collapse
Affiliation(s)
- A Lacroix
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France
| | - M Revest
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France
| | - S Patrat-Delon
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France
| | - F Lemaître
- Département de pharmacologie clinique, CHU Pontchaillou, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France
| | - E Donal
- Département de cardiologie et maladies vasculaires, CHU Pontchaillou, 35033 Rennes cedex, France
| | - A Lorléac'h
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France
| | - C Arvieux
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France
| | - C Michelet
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France
| | - P Tattevin
- Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France.
| |
Collapse
|
10
|
Lefevre B, Revest M, Patrat-Delon S, Piau C, Arvieux C, Tattevin P, Michelet C. COL07-04 : Tolérance des traitements antituberculeux chez 247 patients. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70072-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Revest M, Patrat-Delon S, Devillers A, Tattevin P, Michelet C. Contribution of 18fluoro-deoxyglucose PET/CT for the diagnosis of infectious diseases. Med Mal Infect 2014; 44:251-60. [DOI: 10.1016/j.medmal.2014.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 02/03/2014] [Accepted: 04/16/2014] [Indexed: 10/25/2022]
|
12
|
Erdem H, Stahl JP, Inan A, Kilic S, Akova M, Rioux C, Pierre I, Canestri A, Haustraete E, Engin DO, Parlak E, Argemi X, Bruley D, Alp E, Greffe S, Hosoglu S, Patrat-Delon S, Heper Y, Tasbakan M, Corbin V, Hopoglu M, Balkan II, Mutlu B, Demonchy E, Yilmaz H, Fourcade C, Toko-Tchuindzie L, Kaya S, Engin A, Yalci A, Bernigaud C, Vahaboglu H, Curlier E, Akduman D, Barrelet A, Oncu S, Korten V, Usluer G, Turgut H, Sener A, Evirgen O, Elaldi N, Gorenek L. The features of infectious diseases departments and anti-infective practices in France and Turkey: a cross-sectional study. Eur J Clin Microbiol Infect Dis 2014; 33:1591-9. [PMID: 24789652 DOI: 10.1007/s10096-014-2116-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 04/08/2014] [Indexed: 11/29/2022]
Abstract
The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.
Collapse
Affiliation(s)
- H Erdem
- Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Delangle C, Bouget J, Vérin M, Bellou A, Buscail C, Perennes M, Patrat-Delon S, Tattevin P. [Bacterial meningitis: factors related to the delay before appropriate antibiotic administration in the emergency department]. Med Mal Infect 2013; 43:244-7. [PMID: 23806508 DOI: 10.1016/j.medmal.2013.05.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/25/2013] [Accepted: 05/22/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before appropriate measures were implemented. METHODS Our retrospective observational study (2009-2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports. RESULTS We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 [1h09-5h57]; admission/antimicrobials, 3h21 [1h34-5h11]. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05). CONCLUSIONS Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.
Collapse
Affiliation(s)
- C Delangle
- Urgences médico-chirurgicales adultes (UMCA), CHU Pontchaillou, 35033 Rennes cedex, France
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Duvauferrier R, Valence M, Patrat-Delon S, Brillet E, Niederberger E, Marchand A, Rescan M, Guillin R, Decaux O. Current role of CT and whole body MRI in multiple myeloma. Diagn Interv Imaging 2013; 94:169-83. [DOI: 10.1016/j.diii.2012.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
15
|
Decaux O, Patrat-Delon S, Guillin R, Lamy T, Escoffre M, Sebillot M, Grosbois B, Duvauferrier R. Comparaison de plusieurs modalités de lecture du scanner osseux corps entier dans l’exploration du myélome multiple. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.050] [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: 11/27/2022]
|
16
|
Patrat-Delon S, Drogoul AS, Le Ho H, Biziraguzenyuka J, Rabier V, Arvieux C, Michelet C, Chevrier S, Tattevin P. [Recurrent tick-borne fever: a possible diagnosis in patients returning from Senegal]. Med Mal Infect 2008; 38:396-9. [PMID: 18602236 DOI: 10.1016/j.medmal.2008.03.005] [Citation(s) in RCA: 5] [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] [Received: 11/30/2007] [Revised: 12/20/2007] [Accepted: 03/03/2008] [Indexed: 11/16/2022]
Abstract
In Senegal, tick-borne relapsing fever caused by the spirochetes Borrelia crucidurae is the most common cause of fever after malaria in rural areas. However, this is only rarely diagnosed in France, probably because: i) the diagnosis relies on investigations that are not routinely done; ii) even undiagnosed, borreliosis may be cured with empirical antibiotic treatment. We report four observations of tick-borne relapsing fever in patients returning from Senegal: In two patients, the diagnosis relied on the observation of spirochetes in blood smears; in the other two, the diagnosis relied on typical clinico-biological signs, borreliosis serology and exposure. These four cases diagnosed over a four year period in one institution suggest that relapsing fever is not rare in patients returning from West Africa. Patients who return form Senegal with unexplained fever should be investigated with careful examination of blood smears and PCR on blood samples.
Collapse
Affiliation(s)
- S Patrat-Delon
- Service de maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex, France
| | | | | | | | | | | | | | | | | |
Collapse
|