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Résumé: Chaque année, la National Foundation for Infectious Diseases (NFID - Fondation américaine pour les maladies infectieuses) rassemble plus de 300 personnes pour faire le point des dernières avancées scientifiques dans le domaine des vaccins et identifier les nouvelles voies de recherche les plus prometteuses. Ces conférences figurent parmi les plus importantes réunions scientifiques entièrement dédiées à la recherche sur les vaccins, que ce soit dans le secteur de la santé humaine ou dans le secteur de la santé animale. Lors de la 15e conférence, qui s’est tenue à Baltimore en mai 2012, se sont succédé conférences plénières par des experts invités de renommée internationale, sessions parallèles, présentations de posters et rencontres entre experts et jeunes chercheurs. Différents thèmes ont été abordés, allant des fondements de la vaccination, de l’exploration de la réponse immunitaire et de la conception de nouveaux vaccins et adjuvants jusqu’à l’évaluation de l’impact sur le terrain des vaccins nouvellement introduits (rotavirus, HPV) et de la sécurité des vaccins, en passant par les stratégies de vaccination, notamment dans les pays en développement. Les nouvelles techniques de la vaccinologie systémique permettant l’étude de la réponse immunitaire dans son ensemble ouvrent de nouvelles pistes pour établir des corrélats de protection, et concevoir de nouveaux vaccins, notamment contre les maladies chroniques, comme le sida ou le paludisme, pour lesquelles l’immunité naturelle est imparfaite. [ABSTRACT FROM AUTHOR]

Enteroviruses (EV) are the main etiological agents of aseptic meningitis. Diagnosis is made by detecting the genome using RT-PCR. The aim of the study was to evaluate the impact of a positive diagnosis on the management of infants, children, and adults. During 2005, 442 patients were admitted to hospital with suspected meningitis. Clinical and laboratory data and initial treatment were recorded for all patients with enteroviral meningitis. The turnaround time of tests and the length of hospital stay were analyzed. The results showed that EV-PCR detected EV in 69 patients (16%), 23% (16/69) were adults. About 18% of CSF samples had no pleocytosis. After positive PCR results, 63% of children were discharged immediately (mean 2 hr 30 min) and 95% within 24 hr. Infants and adults were discharged later (after 1.8 and 2 days, respectively). The use of antibiotics was significantly lower in children than in infants and adults. The PCR results allowed discontinuation of antibiotics in 50-60% of all patients treated. Patients received acyclovir in 16% of cases (7% children vs. 50% adults) and 23% (11% vs. 69%) underwent a CT scan. Clinical data were compared between patients whose positive EV-PCR results were available within 24 hr (n = 32) and those whose results were available > 24 hr after collection of CSF (n = 14). Duration of antibiotic treatment (difference: 2.3 days; P = 0.05) was reduced between the two groups. No statistical difference in the length of stay was observed. The EV-PCR assay should be performed daily in hospital laboratory practice and considered as part of the initial management of meningitis. J. Med. Virol. 81:42-48, 2009. © 2008 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to describe the vaccinal status of adult French patients consulting general practitioners and to identify the reasons justifying the absence and/or the delay of a booster injection from both patient and physician’s point of view.Methodology: A cross sectional epidemiological study was made on the first 3 patients consulting for vaccination against diphtheria, tetanus, and poliomyelitis.Results: Six thousand and two hundred sixty nine patients, 44 ± 15 years of age, were included in the study by 2,122 general practitioners, a representative sample 90,5%, 94,4%, and 92,6% of their patients had been vaccinated against diphtheria, tetanus, and poliomyelitis but only 58,4%, 66,1%, and 63,4% had received the required booster injection. This means that 40% of the adult French population is not properly protected. This situation appears essentially linked to negligence rather than to reluctance: only 3,6% of the patients were really reluctant. The low coverage rate was greater among underprivileged classes and the elderly.Conclusion: These results show the limits of prevention campaigns and underline the necessity of a better involvement of occupational medicine and general practitioners. [Copyright &y& Elsevier]

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis. [ABSTRACT FROM AUTHOR]

This study was conducted to identify the most rate-limiting amino acids for whole-body protein synthesis in acquired immunodeficiency syndrome (AIDS) patients. We postulated that an essential amino acid that would be rate limiting in AIDS should have a low basal plasma concentration and should remain at a low level during amino acid infusion. Seven male AIDS patients (median age 37 y, CD4 cell count: 76 mm-3) without any clinically active opportunistic infection during the month before the experiment were infused intravenously with a complete amino acid-glucose mixture for 2.5 h. Eight healthy volunteers were used as controls. Before the infusion, the concentrations of most free essential amino acids (methionine, threonine, histidine, isoleucine, leucine and tryptophan) were significantly lower (P < 0.05) in AIDS patients than in controls. Most plasma free essential amino acids increased significantly during infusion. However, the absolute increase above basal levels for threonine, valine, lysine, (P < 0.05) and methionine (P < 0.073) was smaller in AIDS patients than in control subjects. Thus, threonine and possibly methionine may be rate limiting for whole-body protein synthesis in AIDS patients, suggesting that there are selective amino acid requirements in patients with AIDS. [ABSTRACT FROM AUTHOR]