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1. Characteristics and outcomes of intensive care unit patients with respiratory syncytial virus compared to those with influenza infection: a multicentre matched cohort study

Author

Coussement, Julien, Zuber, Benjamin, Garrigues, Eve, Gros, Antoine, Vandueren, Charlotte, Epaillard, Nicolas, Voiriot, Guillaume, Tandjaoui-Lambiotte, Yacine, Lascarrou, Jean-Baptiste, Boissier, Florence, Lemiale, Virginie, Contou, Damien, Hraiech, Sami, Meert, Anne-Pascale, Sauneuf, Bertrand, Munting, Aline, Ricome, Sylvie, Messika, Jonathan, Muller, Gregoire, Njimi, Hassane, Grimaldi, David, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Pathologie infectieuse

Subjects
virus diseases, RSV, mechanical ventilation, influenza, mortality, community-acquired respiratory virus
Abstract

The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require intensive care unit (ICU) admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on critically ill patients. What are the characteristics and outcomes of adult ICU patients with RSV infection, and how do they compare to those of ICU patients with influenza infection? This retrospective, multicentre study in France and Belgium (17 sites) compared the characteristics and outcomes of adult ICU patients with RSV infection versus influenza infection between November 2011 and April 2018. Each patient with RSV infection was matched by institution and date of diagnosis with a patient with influenza infection. In-hospital mortality was compared between the two groups, with adjustment for prognostic factors in a multivariable model (sex, age, main underlying conditions, and concurrent bloodstream infection). Data from 618 patients (309 with RSV infection and 309 with influenza infection) were analysed. Patients with RSV infection were significantly more likely to have an underlying chronic respiratory condition (60.2% versus 40.1%, p

Published
2022

2. Comparison of RSV and influenza infection in ICU patients-the CAPTIF study

Author

Vandueren, Charlotte, Zuber, Benjamin, Lascarrou, Jean Baptiste, Boissier, Florence, Lemiale, Virginie, Contou, Damien, Hraiech, Sami, Meert, Anne-Pascale, Sauneuf, Bertrand, Geri, Guillaume, Messika, Jonathan, Muller, Grégoire, Coussement, Julien, and Grimaldi, David

Subjects
Soins intensifs réanimation, Pathologie maladies infectieuses
Abstract

0, info:eu-repo/semantics/published

Published
2020

3. Infections

Author

Lebeaux, David, Coussement, Julien, Poiree, Sylvain, and Lortholary, Olivier

Subjects
Viral disease, Prophylaxis, Cytomegalovirus, Preemptive therapy, Nonviral disease, Infection, Article
Abstract

Even if heart transplantation is an undisputed source of medical progress, several complications still hamper the outcome of transplanted patients. Among them, infections are associated with significant morbidity, mortality, and economic burden. Depending on clinical and radiological signs and based on the time interval after transplantation, a broad spectrum of microbial pathogens can be responsible for these infections. This microbiological diversity, associated with altered clinical signs due to immunosuppressive drugs, is a cause of delayed diagnosis and treatment. The objective of this overview is to provide a structured procedure to explore fever and specific symptoms that can be suggestive of infection in heart-transplanted patients. Furthermore, main preventive and curative strategies will be described.

Published
2016

4. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, López-Medrano, Francisco, Nagler, Evi, Aguado, José María, Abramowicz, Daniel, Adams, Brigitte, Agnelli, Caroline, Ailioaie, Oana, Akan, Hamdi, Amrouche, Lucile, Andrés, Amado, Anglicheau, Dany, Arnouts, Paul, Baas, Marije, Balgradean, Cristian, Bammens, Bert, Battaglia, Yuri, Baudoux, Thomas, Berto, Bert, Binet, Isabelle, Bistrup, Claus, Bonofiglio, Renzo, Bosmans, Jean-Louis, Bouatou, Yassine, Bouvier, Nicolas, Braconnier, Philippe, Bredewold, Edwin, Broeders, Nilufer, BRUNET, Philippe, Buchler, Matthias, Budde, Klemens, Buron, Fanny, Burtey, Stephane, Buscaroli, Andrea, Büttner, Stefan, Byrne, Catherine, Caldara, Rossana, Cassuto, Elisabeth, Catalano, Concetta, Cavaille, Guilhem, Corbel, Alice, Couzi, Lionel, Crespo, Marta, Daga, Sunil, Debellé, Frederic, Dedinska, Ivana, Devine, Paul, Dickenmann, Michael, Dratwa, Max, Drgona, Lubos, Durlik, Magdalena, Egidi, Maria Francesca, Errasti, Pedro, Etienne, Isabelle, Fariñas, María Carmen, Fehr, Thomas, Fernández-Ruiz, Mario, Founta, Paraskevi, Fourtounas, Konstantinos, Frangou, Eleni, Frimat, Luc, Furian, Luc, Garjau, Maria, Garrigue, Valérie, Gatault, Philippe, Geddes, Colin, Gerlinger, Paul, Gheuens, Eric, Ghisdal, Lidia, Gibbs, Paul, Giral, Magali, Girerd, Sophie, Golshayan, Dela, Gompou, Athina, Grossi, Paolo Antonio, Guglielmetti, Gabriele, Guirado, Luis, Hadaya, Karine, Hazzan, Marc, Helbert, Mark, Hellemans, Rachel, Heller, Katharina, Heemann, Uwe, Henckes, Manu, Hernandez, Domingo, Hertig, Alexandre, Hiesse, Christian, Hilbrands, Luuk, Hilton, Rachel, Hirzel, Cédric, Horcajada, Juan Pablo, Hougardy, Jean-Michel, Huynh-Do, Uyen, Idrizi, Alma, Ismaili, Khalid, Jiménez, Carlos, Jourde-Chiche, Noemie, Kamar, Nassim, Kaminski, Hannah, Kanter, Julia, Karras, Alexandre, Kemlin, Delphine, Kes, Petar, Kianda, Mireille, Klinger, Maria, Knight, Simon, Koneth, Irene, Krrashi, Anita, Kuypers, Dirk, Langlois, Anne, Lang, Philippe, Lauzurica, Ricardo, Le Moine, Alain, Lebeaux, David, Legendre, Christophe, Lemy, Anne, Len, Oscar, Liakopoulos, Vassilios, Lichodziejewska-Niemierko, Monika, Yague, Maria, Lopau, Kai, Madhoun, Philippe, Magott-Procelewska, Maria, Malik, Shafi, Montero, Anna Manonelles, Marchini, Marc, Marega, Alessandra, Mariat, Maria, Mark, Mark, Martin, Pierre-Yves, Martín, Leyre, Martín, Paloma Leticia, Massart, Annick, Matignon, Marie, Maurel, Stéphane, Mazuecos, Auxiliadora, Melexopoulou, Christina, Melilli, Edoardo, Merino, Esperanza, Mesic, Enisa, Messa, Piergiorgio, Michalak, Magdalena, Minetti, Enrico, Miserlis, Grigorios, Montejo, Miguel, Moriconi, Diego, Mottola, Clément, Mourad, Georges, Mueller, Thomas, Muñoz, Patricia, Nabokow, Alexander, Naesens, Maarten, Nikodimopoulou, Maria, Oberbauer, Rainer, Olmedo, María, Olsburgh, Jonathon, Oniscu, Gabriel, Øzbay, Lara Aygen, Palmisano, Alessandra, Papagianni, Aikaterini, Papasotiriou, Mario, Parodi, Angelica, Parry, Rob, Pascual, Julio, Flores, Isabel Pérez, Pérez-Sáez, María, Peruzzi, Licia, Petit-Hoang, Camille, Phelan, Paul, Pillebout, Evangeline, Piotti, Giovanni, Pipeleers, Lissa, Pleros, Christos, Popoola, Joyce, Pretagostini, Renzo, Psimenou, Erasmia, Puig, Josep, Rafat, Cédric, Bloudickova, Silvie Rajnochova, Bushljetikj, Irena Rambabova, Ratkovic, Marina, Redondo, Dolores, Reischig, Tomas, Robert, Thomas, Ferrero, Luis, Rroji, Merita, Rutkowski, Przemyslaw, Rydzewska-Rosolowska, Alicja, Sabé, Núria, Sahali, Dil, Salzberger, Bernd, San-Juan, Rafael, Sobrino, Beatriz Sánchez, Sandrini, Silvio, Santos, Lídia, Sava, Roxana, Schaub, Stefan, Schikowski, Johan, Schvartz, Betoul, Sester, Urban, Silva, Jose Tiago, Snanoudj, Renaud, Somenzi, Danio, Sørensen, Søren, Spanos, Georgios, Steiger, Jürg, Suwelack, Barbara, Theodoropoulou, Eleni, Thervet, Eric, Thorban, Stefan, Tognarelli, Giuliana, Tournay, Yasmina, Tricot, Leïla, Tulissi, Patrizia, Vacher-Coponat, Henri, Valerio, Maricela, Van Der Meijden, W, Van Hamersvelt, Henk, Van Laecke, Steven, Vandivinit, Alain, Vanholder, Raymond, Veroux, Massimiliano, Viklicky, Ondrej, Vigo, Emanuela, Viscoli, Claudio, Watschinger, W, Weekers, W, Welberry Smith, W, Martin, W, Zeneli, Nereida, Zervos, Angelos, Zibar, Lada, Zuber, Julien, Zukunft, Bianca, Nephrology, Department Infections Diseases, Université Libre de Bruxelles [Bruxelles] (ULB), Azienda Ospedaliero-Universitaria di Parma, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Réseau CENTAURE, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Centre National de la Recherche Scientifique (CNRS)-Université de Lille-Université Polytechnique Hauts-de-France (UPHF)-Ecole Centrale de Lille-Université Polytechnique Hauts-de-France (UPHF)-Institut supérieur de l'électronique et du numérique (ISEN), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Department of Nephrology, Humboldt Universität zu Berlin, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie, Hôpital Pasteur [Nice] (CHU), Hôpital de Brabois, CHU de Nancy, Vandoeuvre-lès-Nancy, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Laboratoire des interactions plantes micro-organismes (LIPM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Recherche Agronomique (INRA), CHU Rouen, Normandie Université (NU), Unit Infectious Diseases, Hospital 12 de Octubre, Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pédiatrie spécialisée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université de Lille, Department of Pulmonary Medicine, Tampere University Hospital, Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Swiss Transplantation Cohort Study, University of Basel (Unibas), Department of Nephrology and Hypertension, and Department of Clinical Research, University of Bern, Centro de Investigación en Ciencias del Mar y Limnología (CIMAR), Universidad Nacional de Costa Rica, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université de Bordeaux (UB), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Department of Medicine, Division of Hematology-Oncology, University of Pennsylvania [Philadelphia], Department of Nephrology and Renal Transplantation, University Hospitals Leuven [Leuven]-Catholic University Leuven, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Centre de Recherches Pétrographiques et Géochimiques (CRPG), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Milano, Université de Lorraine (UL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] (UCM), University Hospitals Leuven [Leuven], Department of Internal Medicine III, Medizinische Universität Wien = Medical University of Vienna, Service de rhumatologie, Kidney and Pancreas Transplantation, Department d'enginyeria quimica agraria i tecnologia agroalimentaria, Universitat de Girona (UdG), Néphrologie Transplantation, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris (AP-HP), Section of Microbiology [Copenhagen], Department of Biology [Copenhagen], Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University Hospital Basel [Basel], Service Néphrologie Transplantation Rénale, Hôpital Foch [Suresnes], Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Renal Division, Freiburg University Medical Center, Nephrology Section [Ghent], Ghent University Hospital, Dept. of Nephrology, Institute for Clinical and Experimental Medicine, Division of Infectious Diseases, University of Genoa (UNIGE)-San Martino University Hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université libre de Bruxelles (ULB), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 (IEMN), Centrale Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Humboldt University Of Berlin, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Université de Mons (UMons), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Pennsylvania, Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Universitäts Klinikum Freiburg = University Medical Center Freiburg (Uniklinik), Università degli studi di Genova = University of Genoa (UniGe)-San Martino University Hospital, ERA-EDTA, ESCMID, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Humboldt-Universität zu Berlin, Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut national des sciences de l'Univers (INSU - CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon], Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and San Martino University Hospital-University of Genoa (UNIGE)

Subjects
Nephrology, Male, Cross-sectional study, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Practice Patterns, 030230 surgery, Antimicrobial stewardship, urologic and male genital diseases, 0302 clinical medicine, Surveys and Questionnaires, Bacteriuria/diagnosis, Medicine, Practice Patterns, Physicians'/statistics & numerical data, Practice Patterns, Physicians', Asymptomatic Infections, Kidney transplantation, ComputingMilieux_MISCELLANEOUS, Asymptomatic bacteriuria, Questionnaire, Transplantation, Urinary tract infection, Adult, Anti-Bacterial Agents, Bacteriuria, Cross-Sectional Studies, Europe, Female, Humans, Kidney Transplantation, Transplant Recipients, Response rate (survey), Kidney Transplantation/adverse effects, 16. Peace & justice, 3. Good health, medicine.medical_specialty, Asymptomatic Infections/epidemiology, Europe/epidemiology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Dialysis, Physicians', business.industry, medicine.disease, Anti-Bacterial Agents/therapeutic use, Human medicine, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

Background Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods A panel of experts from the European Renal Association-European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs. Results Two hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27). Conclusions Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.

Published
2018
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5. An outpatient clinic as a potential site of transmission for an outbreak of NDM-producing Klebsiella pneumoniae ST716: a study using whole-genome sequencing

Author

Heinrichs, Amélie, Argudín, Maria Angeles, De Mendonça, Ricardo, Deplano, Ariane, Roisin, Sandrine, Dodémont, Magali, Coussement, Julien, Filippin, Lorenzo, Dombrecht, Jill, De Bruyne, Katrien, Huang, Te-Din, Supply, Philip, Byl, Baudouin, Glupczynski, Gerald, Denis, Olivier, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Laboratoire de biologie clinique

Abstract

The incidence of nosocomial infections due to carbapenem-resistant Klebsiella pneumoniae is increasing worldwide. Whole genome sequencing (WGS) can help elucidate the transmission route of nosocomial pathogens. We combined WGS and epidemiological data to analyze an outbreak of NDM-producing K. pneumoniae that occurred in two Belgian hospitals situated about 50 miles apart. We characterized 74 NDM-producing K. pneumoniae isolates [Hospital A (n=9); Hospital B (n=24) and 41 contemporary isolates from 15 other Belgian hospitals] using pulsed-field gel electrophoresis and WGS. A K. pneumoniae ST716 clone was identified as being responsible for the outbreak with 9/9 strains from Hospital A and 20/24 strains from Hospital B sharing a unique pulsotype and being clustered together on WGS (compared with 1/41 isolates from other Belgian hospitals). We identified the outpatient clinic of Hospital B as the probable bridging site between the hospitals after combining epidemiological, phylogenetic and resistome data. We also identified the patient who probably caused the transmission. In fact, all but one strain from Hospital A carried a Tn1331-like transposon, whereas none of the Hospital B isolates did. The patient from Hospital A who did not have the Tn1331-like transposon was treated at the outpatient clinic of Hospital B on the same day as the first NDM-producing K. pneumoniae positive patient from Hospital B. The results from our WGS-guided investigation highlight the importance of implementing adequate infection control measures in outpatient settings, especially when healthcare delivery moves from acute care facilities to outpatient clinics.

Published
2018

6. Outcome and Treatment of Nocardiosis After Solid Organ Transplantation: New Insights From a European Study

Author

Lebeaux, David, Freund, Romain, Delden, Christian, Guillot, Hélène, Marbus, Sierk D., Matignon, Marie, Van Wijngaerden, Eric, Douvry, Benoit, De Greef, Julien, Vuotto, Fanny, Tricot, Leïla, Fernández-Ruiz, Mario, Dantal, Jacques, Hirzel, Cédric, Jais, Jean-Philippe, Rodriguez-Nava, Veronica, Jacobs, Frédérique, Lortholary, Olivier, Coussement, Julien, Anstey, James R., Antoine, Martine, Ausselet, Nathalie, Belhaj, Asmae, Boelens, Jerina, Beenhouwer, Hans, Denis, Catherine, Ho, Erwin, Ieven, Margareta, Jonckheere, Stijn, Knoop, Christiane, Moine, Alain, Rodriguez-Villalobos, Hector, Racapé, Judith, Roisin, Sandrine, Vandercam, Bernard, Vander Zwalmen, Marie-Laure, Vanfraechem, Gaëlle, Van Laecke, Steven, Verhaegen, Jan, Barrou, Benoit, Battistella, Pascal, Bergeron, Emmanuelle, Bouvier, Nicolas, Caillard, Sophie, Caumes, Eric, Chaussade, Hélène, Chauvet, Cécile, Crochette, Romain, Epailly, Eric, Essig, Marie, Gallien, Sébastien, Guillemain, Romain, Herel, Canan, Hoen, Bruno, Kamar, Nassim, Gall, Thierry, Levi, Charlene, Lionet, Arnaud, Longuet, Hélène, Melica, Giovanna, Miel, Anaick, Morel, Hélène, Ammar, Salima Ould, Pattier, Sabine, Peraldi, Marie-Noelle, Sayegh, Johnny, Scemla, Anne, Senechal, Agathe, Tourret, Jérome, Boggian, Katia, Egli, Adrian, Garzoni, Christian, Hoffman, Matthias, Hirsch, Hans H., Khanna, Nina, Manuel, Oriol, Meylan, Pascal, Mueller, Nicolas J., Posfay-Barbe, Klara M., Vu, Diem-Lan, Weisser, Maja, Vollaard, Albert M., Wunderink, Herman F., Laboratoire d'Ecologie Microbienne - UMR 5557 (LEM), Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Vétérinaire de Lyon (ENVL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Ecole Nationale Vétérinaire de Lyon (ENVL), UCL - SSS/IREC/MBLG - Pôle de Microbiologie médicale, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (MGD) Service de chirurgie cardio-vasculaire et thoracique, UCL - (MGD) Service de médecine interne générale, UCL - (SLuc) Service de médecine interne générale, and UCL - (SLuc) Service de microbiologie

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, [SDV]Life Sciences [q-bio], 030106 microbiology, Antibiotics, Improved survival, 610 Medicine & health, Nocardia, 03 medical and health sciences, Internal medicine, medicine, In patient, opportunistic infections, ddc:617, business.industry, Nocardiosis, organ transplantation, Odds ratio, medicine.disease, mortality, Confidence interval, 3. Good health, Surgery, Infectious Diseases, Conditional logistic regression, prognosis, Solid organ transplantation, business
Abstract

Background Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with one-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics (≤120 days). Methods We analyzed data from a multicenter European case-control study that included 117 SOT recipients with nocardiosis diagnosed between 2000 and 2014. Factors associated with one-year all-cause mortality were identified using multivariable conditional logistic regression. Results One-year mortality was 10-fold higher in patients with nocardiosis (16.2%, 19/117) than in control transplant recipients (1.3%, 3/233, p

Published
2017
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7. Cytomegalovirus infection management in solid organ transplant recipients across European centers in the time of molecular diagnostics: An ESGICH survey

Author

Navarro, David, San-Juan, Rafael, Manuel, Oriol, Gimã©nez, Estela, Fernández-Ruiz, Mario, Hirsch, Hans H., Grossi, Paolo Antonio, Aguado, José María, Abram, Maja, Abramowicz, Daniel, Álamo, José-María, Alp, Sehnaz, Andres-Belmonte, Amado, Anne-Catherine, Pouleur, Antonelli, Barbara, Arnol, Miha, Arslan, Ayse Hande, Asderakis, Argiris, Baldanti, Fausto, Beneyto-Castello, Isabel, Benoit, Kabamba Mukadi, Blanes, Marino, Boggian, Katia, Bonofiglio, Renzo, Bubonja-Sonje, Marina, Caillard, Sophie, Calvo, Jorge, Capone, Alessandro, Cappelli, Gianni, Carmellini, Mario, Casafont, Fernando, Beatriz Castro-Hernandez, M., Catalan, Pilar, Celine, Bressollette-Bodin, Christoph, Berger, Cordero, Elisa, Costa, Cristina, Coussement, Julien, Cuervas-Mons, Valentin, David, Miruna, de la Torre Cisneros, Juliã¡n, Delgado, Juan F., Dello Strologo, Luca, Detry, Olivier, Dexter, Laura, Dieter, Hoffmann, Meis-Hübinger, Anna, Epailly, Eric, Ericzon, Bo-Goran, Eriksson, Britt-Marie, Fehervari, Imre, Fitzgerald, Susan, Folgueira, Lola, Fortun, Jesus, Franceschini, Erica, Francois, Proot, Friman, Vanda, Frimmel, Silvius, Garzoni, Christian, Gimeno, Adelina, Gkrania-Klotsas, Effrossyni, Greer, Mark, Griffiths, Paul, Grinyã³, Josep M., Guaraldi, Giovanni, Gupte, Girish, Hammad, Abdul, Hart, Ian, Helanterã¤, Ilkka, Hellemans, Rachel, Hernã¡ndez, Domingo, Herrero, Jose Ignacio, Hiesse, Christian, Hoppe-Lotichius, Maria, Hryniewiecka, Ewa, Jaksch, Peter, Jan, Lerut, Paul, Brion Jean, Jensen-Fangel, Soren, Joerg, Steinmann, Johan, Vanhaecke, Johannessen, Ingolfur, Johansson, Inger, Kamar, Nassim, Kizilates, Filiz, Knoop, Christiane, Laurent, Belec, Lauro, Augusto, Lautenschlager, Irmeli, Lauzurica, Ricardo, Liebert, U. G., dela Monica, Paolalilla, Llado, Laura, Lopez-Andujar, Rafael, Luciani, Filippo, Maccherini, Massimo, Maertens, Johan, Maggiore, Umberto, Manrique, Alejandro, Marcos, Maria Angeles, Marekovic, Ivana, Marques, Nuno, Martin, Nitschke, Martine, Neau, Martinez-Sapiña, Ana, Mateos Lindemann, M. Luisa, Mazuecos, Auxiliadora, Merino, Esperanza, Moreso, Francesc, Mueller, Nicolas, Muir, David, Mularoni, Alessandra, Muã±oz, Patricia, Muñoz-Sanz, Agustã­n, Nadalin, Silvio, Laura Ambra, Nicolini, Nosotti, Mario, Gorman, Joanne O., Osman, Husam, Padalko, Elizaveta, Palop-Borrás, Begoã±a, Javirparmer, Null, Pascual, Sonia, Pena López, María José, Pérez-Sáenz, José Luis, Pistello, Mauro, Francisca Portero, M., Puchhammer, Elisabeth, Racca, Sara, Rahamat-Langendoen, Janette, Ramos, Antonio, Boluda, Esther Ramos, Raza, Mohammad, Regalia, Enrico, Reina, Gabriel, Reischig, Tomas, Reuter, Stefan, Rodríguez-Ferrero, M. Luisa, Roilides, Emmanuel, Rolla, Serena, Rollag, Halvor, Rostaing, Lionel, Russo, Francesco Paolo, Sabã©, Nãºria, Saliba, Faouzi, Sánchez-Fructuoso, Ana, Scotton, Giorgio, Serra, Nuria, Sgarabotto, Dino, Stojanovic, Jelena, Tasbakan, Meltem, Telenti, Mauricio, Terhes, Gabriella, Thorban, Stefan, Tihic, Nijaz, Travi, Giovanna, Tulissi, Patrizia, Van Delden, Christian, Van Leer, Coretta, Van Loo, Inge, Varona-Bosque, María Aránzazu, Veroux, Massimiliano, Vila-Santandreu, Ana, Waugh, Sheila, Zibar, Lada, and Zschiedr, Stefan

Subjects
0301 basic medicine, cytomegalovirus, solid organ transplantation, survey, Cross-sectional study, Cytomegalovirus, Transplants, Practice Patterns, 030230 surgery, Organ transplantation, law.invention, 0302 clinical medicine, Postoperative Complications, law, 03.02. Klinikai orvostan, Viral, Practice Patterns, Physicians', Polymerase chain reaction, Viral Load, Europe, Infectious Diseases, Cytomegalovirus Infections, Practice Guidelines as Topic, Antibiotic Prophylaxis, Antiviral Agents, Cross-Sectional Studies, DNA, Viral, Guideline Adherence, Health Care Surveys, Humans, Immunocompromised Host, Immunosuppression, Organ Transplantation, Real-Time Polymerase Chain Reaction, Transplant Recipients, Transplantation, medicine.medical_specialty, 030106 microbiology, Congenital cytomegalovirus infection, 03 medical and health sciences, medicine, Intensive care medicine, Immunosuppression Therapy, Physicians', business.industry, DNA, medicine.disease, Molecular diagnostics, Cytomegalovirus infection, Solid organ transplantation, Survey, Immunology, business
Abstract

Background Scant information is available about how transplant centers are managing their use of quantitative molecular testing (QNAT) assays for active cytomegalovirus (CMV) infection monitoring in solid organ transplant (SOT) recipients. The current study was aimed at gathering information on current practices in the management of CMV infection across European centers in the era of molecular testing assays. Methods A questionnaire-based cross-sectional survey study was conducted by the European Study Group of Infections in Immunocompromised Hosts (ESGICH) of the Society of Clinical Microbiology and Infectious Diseases (ESCMID). The invitation and a weekly reminder with a personal link to an internet service provider (h t t p s://es.surveymonkey. com/) was sent to transplant physicians, transplant infectious diseases specialists, and clinical virologists working at 340 European transplant centers. Results Of the 1181 specialists surveyed, a total of 173 responded (14.8%): 73 transplant physicians, 57 transplant infectious diseases specialists, and 43 virologists from 173 institutions located at 23 different countries. The majority of centers used QNAT assays for active CMV infection monitoring. Most centers preferred commercially-available real-time polymerase chain reaction (RT-PCR) assays over laboratory-developed procedures for quantifying CMV DNA load in whole blood or plasma. Use of a wide variety of DNA extraction platforms and RT-PCR assays was reported. All programs used antiviral prophylaxis, preemptive therapy, or both, according to current guidelines. However, the centers used different criteria for starting preemptive antiviral treatment, for monitoring systemic CMV DNA load, and for requesting genotypic assays to detect emerging CMV-resistant variants. Conclusions Significant variation in CMV infection management in SOT recipients still remains across European centers in the era of molecular testing. International multicenter studies are required to achieve commutability of CMV testing and antiviral management procedures. This article is protected by copyright. All rights reserved.

Published
2017

8. Nocardia infection in solid organ transplant recipients: a multicenter European case-control study

Author

Melica, Giovanna, Jacobs, Frédérique, Dantal, Jacques, Jais, Jean-Philippe, Marbus, Sierk, Lortholary, Olivier, Hirzel, Cédric, Tricot, Leïla, Douvry, Benoit, Vuotto, Fanny, Guillot, Hélène, Van Wijngaerden, Eric, Freund, Romain, Van Laecke, Steven, Fernández-Ruiz, Mario, Coussement, Julien, Van Delden, Christian, Lebeaux, David, and Rodriguez-Nava, Veronica

Subjects
610 Medicine & health, 3. Good health
Abstract

BACKGROUND Nocardiosis is a rare, life-threatening opportunistic infection, affecting 0.04% to 3.5% of patients after solid organ transplantation (SOT). The aim of this study was to identify risk factors for Nocardia infection after SOT and to describe the presentation of nocardiosis in these patients. METHODS We performed a retrospective case-control study of adult patients diagnosed with nocardiosis after SOT between 2000 and 2014 in 36 European (France, Belgium, Switzerland, Netherlands, Spain) centers. Two control subjects per case were matched by institution, transplant date and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors for nocardiosis. RESULTS One hundred and seventeen cases of nocardiosis and 234 control patients were included. Nocardiosis occurred at a median of 17.5 [range 2-244] months after transplantation. In multivariable analysis, high calcineurin inhibitor trough levels in the month before diagnosis (OR=6.11 [2.58-14.51]), use of tacrolimus (OR=2.65 [1.17-6.00]) and corticosteroid dose (OR=1.12 [1.03-1.22]) at the time of diagnosis, patient age (OR=1.04 [1.02-1.07]) and length of stay in intensive care unit after SOT (OR=1.04 [1.00-1.09]) were independently associated with development of nocardiosis; low-dose cotrimoxazole prophylaxis was not found to prevent nocardiosis. Nocardia farcinica was more frequently associated with brain, skin and subcutaneous tissue infections than were other Nocardia species. Among the 30 cases with central nervous system nocardiosis, 13 (43.3%) had no neurological symptoms. CONCLUSIONS We identified five risk factors for nocardiosis after SOT. Low-dose cotrimoxazole was not found to prevent Nocardia infection. These findings may help improve management of transplant recipients.

9. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, López-Medrano, Francisco, Nagler, Evi V, Aguado, José María, and Abramowicz, Daniel

Subjects
3. Good health
Abstract

Background Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods A panel of experts from the European Renal Association-European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs. Results Two hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27). Conclusions Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.

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