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Determines the characteristics of Streptococcus bovis infective endocarditis (IE). Use of penicillin G and amoxicillin as the principal antimicrobials; Mortality rate of IE; Prognostic factor of the disorder; Cardiac conditions associated with IE.

We reviewed 80 adult cases of measles seen in a Parisian hospital during the French 2010-2011 outbreak. Fifty per cent had at least one complication: pneumonia and hepatitis were the most frequent. Forty per cent of hospitalized cases did not have any complications, suggesting clinically poor tolerance of measles in adults. The outcome was always favourable. Subjects were younger, were more often French nationals and had a higher socio-economic status than the overall population. This report suggests that immunity resulting from natural disease in patients from an area where the disease is endemic is protective in the long term. [ABSTRACT FROM AUTHOR]

Objective The emergence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae has resulted in the increase of carbapenem prescriptions. The objective of our study was to determine the appropriateness of carbapenem prescriptions from initiation to reassessment of treatment, between 2009 and 2011. Patients and method A questionnaire drafted by infectious diseases specialists (IDS) and microbiologists was used to collect clinical and microbiological data concerning carbapenem prescriptions in 2009 and 2011. An IDS then compared the results to assess carbapenem prescription compliance with our hospital's local recommendations. Results Seventy-one prescriptions were included in 2009 and 32 in 2011. The carbapenem treatment had been most frequently probabilistic to treat nosocomial infections. The microbiological data revealed that the number of multidrug-resistant (MDR) infections had increased between 2009 and 2011, especially infections involving ESBL-producing Enterobacteriaceae . At treatment reassessment, in 2009 and 2011, 15 (21%) and 12 (38%) carbapenem prescriptions were appropriate and continued. Overall, when comparing the 2 periods, prescriptions complied with local guidelines from initiation to reassessment of treatment without any statistically significant difference (68% in 2009 and 75% in 2011). Conclusion Our study results showed that MDR infections had increased and especially infections due to ESBL-producing Enterobacteriaceae ; this was consistent with epidemiological data. We also proved that most carbapenem prescriptions were compliant with recommendations. The increased mobile IDS interventions in medical and surgical departments helped reach this rate of compliance. Carbapenem stewardship may be promoted even in a difficult epidemiological context, especially with IDS interventions for the duration of treatment or at treatment reassessment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We retrospectively studied daptomycin use during 2010 at the Bichat-Claude-Bernard teaching-hospital (Paris) to observe the evolution of daptomycin prescriptions. Patients and methods: Twenty-one patients were included and several parameters were documented: site of infection, bacterial species involved, reason for daptomycin use, dose and clinical outcome. Results: Ninety-five percent of daptomycin prescritions were off-label and most did not comply with local guidelines. Fifteen of the 21 patients were cured (71%), including 9 patients of the 12 with off-label and off-local recommendation prescriptions (75%). Osteitis and Enterococcus spp endocarditis were the new indications. Daptomycin was increasingly used at higher doses: 52% of our patients were given doses above 6mg/kg. Staphylococcus spp. was the most frequent pathogen responsible for infection is our patients, followed by Enterococcus spp. Conclusion: Daptomycin use is likely to evolve because of its effectiveness in the treatment of osteitis, left-sided and Enterococcus spp. infective endocarditis. It is generally used at higher doses, which are well tolerated. However, therapeutic monitoring needs to be developed. The antibiotic commission of our hospital gave new recommendations for daptomycin use in 2011. [Copyright &y& Elsevier]

Efavirenz has now become commonly used to treat HIV infection. Neuropsychiatric disorders have been reported in patients treated with efavirenz. Several factors often make it hard to determine the cause of these disorders: HIV infected patients take many different drugs, they may suffer from various organ diseases, and may also be heavily affected by problems in their everyday life. The French experts group working on neuropsychiatric side effects of efavirenz has undertaken a review of these disorders with the aim to identify: (1) semiology, (2) epidemiology in the global population, in HIV infected patients, and in patients treated with efavirenz. The expert group suggests recommendations to manage these disorders. [Copyright &y& Elsevier]

Clinical cases – We report three cases of acute renal failure during penicillin therapy for an infective endocarditis IE. The late occurrence, the decrease of creatinemia to normal after withdrawal of the drug, the presence of eosinophilia and, in one case, of eosinophiluria as well as the absence of any other cause of renal failure made the diagnosis of penicillin-induced allergic acute interstitial nephritis highly probable. This disease was first described in patients under methicillin treatment but may be observed with other beta-lactams. Only one third of patients present with the typical triad of renal failure with normal diuresis, fever, and rash. Acute interstitial nephritis should be considered as a potential cause of renal failure occurring during the treatment of infective endocarditis. [Copyright &y& Elsevier]

Whereas valacyclovir is widely used and is recommended by some authors in moderately immunocompromised HIV-infected patients, its use has not been validated by clinical studies. We report a case of herpes zoster in an HIV-infected patient for whom neurologic complication was not avoided despite valacyclovir therapy. Clinical outcome was favorable after intravenous acyclovir. This case suggests careful monitoring of valacyclovir in HIV-infected patients is necessary. [ABSTRACT FROM AUTHOR]

Introduction – objectifs Comparer les résultats des techniques d’Assistance Médicale à la Procréation (AMP) de femmes infectées par VIH-1 et de témoins séronégatives Matériels et méthodes Une étude rétrospective cas – témoins a analysé sur 3 ans (2009-2011) l’issue des techniques d’AMP chez les femmes infectées par VIH-1 suivies dans notre centre d’AMP, ayant les critères nationaux de prise en charge de stabilité de la maladie et d’accès légal à l’AMP. Les principaux items analysés ont été les taux de fécondation, d’implantation, de grossesse clinique et de naissance vivante. L’appariement a été effectué sur la date de la tentative, l’âge, la parité, la principale cause d’infertilité, la technique d’AMP et le rang de la tentative. Résultats 82 femmes infectées par VIH-1 et 82 témoins ont été incluses. Le nombre d’ovocytes et d’embryons obtenus, d’embryons transférés, et le taux de fécondation n’étaient pas différents. Le taux de grossesse clinique par transfert était significativement plus faible chez les femmes vivant avec VIH-1 que chez les témoins (15,9 % vs 36,3 %, p < 0,05), ainsi que le taux d’implantation (10,6 % vs 23 %, p < 0,02) et celui de naissance vivante (7 % vs 22,1 %, p < 0,02) Conclusion Les résultats de cette étude cas témoins, avec appariement sur 5 facteurs connus pour influencer les résultats de l’AMP, suggèrent que les femmes infectées par VIH-1, comme les spécialistes qui les suivent, doivent être informées des taux de réussite plus faibles dans les procédures d’AMP que ceux de la population générale, et par conséquent de ne pas différer, en cas de désir de grossesse, la démarche d’AMP, lorsque l’infection est stable, dans les situations d’échecs d’auto-insémination ou de toute autre cause d’infertilité. [ABSTRACT FROM AUTHOR]

Abstract: Systemic lupus erythematosus (SLE) remains of unknown origin. Herpes viridae infections seem to play a role in the pathogenesis of this disease. We report a 31-year-old man who presented an acute cytomegalovirus (CMV) infection with persistent fever and myopericarditis as the presenting manifestation of SLE. This case report emphasizes a difficult differential diagnosis between SLE and an acute CMV infection and suggests a possible role of this virus in the pathogenesis of SLE. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The characteristics of patients with a suspected SARS hospitalized in a Paris hospital were studied to analyze the hypothetic differences between epidemiologic and clinical teams in the management of an epidemic emerging disease, and to gather experience for the management of the next outbreak. Study design: All 90 patients hospitalized between March 16 and April 30, 2003, were included. Epidemiological and clinical data were shared with the French National Institute for Health. Cases were classified according to both the official definition (“possible”, “probable”, “excluded”) and a local one, adapted from the official definition but including an additional level of suspicion (“equivocal”), intermediate between “possible” and “excluded”. Results: The initial assessment was different in 39% of the cases (n=35), according to epidemiological (n=24) or clinical (n=11) elements. The final assessment diverged in 54% of the cases (n=47). All patients were officially considered as "excluded" for epidemiologists, while 47 remained as "possible" or "equivocal" cases of SARS according to the clinicians. Conclusion: The risk assessment was different in almost 40% of the cases, with no impact on epidemic diffusion or hospital-borne exposure as no probable case of SARS was diagnosed among these patients or their households. The confrontation of these different but complementary points of view will thus enrich the interdisciplinary management of eventual future outbreaks. [Copyright &y& Elsevier]

Objectives: Data on the efficacy of vancomycin catheter lock therapy (VLT) for conservative treatment of totally implantable venous access port-related infections (TIVAP-RI) due to CoNS are scarce. The aim of this study was to evaluate the effectiveness of VLT in the treatment of TIVAP-RI due to CoNS in cancer patients., Methods: This prospective, observational, multicentre study included adults with cancer treated with VLT for a TIVAP-RI due to CoNS. The primary endpoint was the success of VLT, defined as no TIVAP removal nor TIVAP-RI recurrence within 3 months after initiation of VLT. The secondary endpoint was 3 month mortality. Risk factors for VLT failure were also analysed., Results: One hundred patients were included [men 53%, median age 63 years (IQR 53-72)]. Median duration of VLT was 12 days (IQR 9-14). Systemic antibiotic therapy was administered in 87 patients. VLT was successful in 44 patients. TIVAP could be reused after VLT in 51 patients. Recurrence of infection after completion of VLT occurred in 33 patients, among which TIVAP was removed in 27. Intermittent VLT (antibiotic solution left in place in the TIVAP lumen part of the time) was identified as a risk factor for TIVAP-RI recurrence. At 3 months, 26 deaths were reported; 1 (4%) was related to TIVAP-RI., Conclusions: At 3 months, success of VLT for TIVAP-RI due to CoNS was low. However, removing TIVAP was avoided in nearly half the patients. Continuous locks should be preferred to intermittent locks. Identifying factors of success is essential to select patients who may benefit from VLT., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Over several decades, the economic situation and consideration of patient quality of life have been responsible for increased outpatient treatment. It is in this context that outpatient antimicrobial treatment (OPAT) has rapidly developed. The availability of elastomeric infusion pumps has permitted prolonged or continuous antibiotic administration by dint of a mechanical device necessitating neither gravity nor a source of electricity. In numerous situations, its utilization optimizes administration of time-dependent antibiotics while freeing the patient from the constraints associated with infusion by gravity, volumetric pump or electrical syringe pump and, more often than not, limiting the number of nurse interventions to one or two a day. That much said, the installation of these pumps, which is not systematically justified, entails markedly increased OPAT costs and is liable to expose the patient to a risk of therapeutic failure or adverse effects due to the instability of the molecules utilized in a non-controlled environment, instability that necessitates close monitoring of their use. More precisely, a prescriber must take into consideration the stability parameters of each molecule (infusion duration, concentration following dilution, nature of the diluent and pump temperature). The objective of this work is to evaluate the different means of utilization of elastomeric infusion pumps in intravenous antibiotic administration outside of hospital. Following a review of the literature, we will present a tool for optimized antibiotic prescription, in a town setting by means of an infusion device., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)