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1. Efficacy of carbapenem vs non carbapenem β-lactam therapy as empiric antimicrobial therapy in patients with extended-spectrum β-lactamase-producing Enterobacterales urinary septic shock: a propensity-weighted multicenter cohort study

Author

Erwann Cariou, Romain Griffier, Arthur Orieux, Stein Silva, Stanislas Faguer, Thierry Seguin, Saad Nseir, Emmanuel Canet, Arnaud Desclaux, Bertrand Souweine, Kada Klouche, Olivier Guisset, Jerome Pillot, Walter Picard, Tahar Saghi, Pierre Delobel, Didier Gruson, Renaud Prevel, and Alexandre Boyer

Subjects
Extended-spectrum β-lactamase-producing Enterobacterales, Non carbapenem β-lactam therapy, Antimicrobial resistance, Septic shock, Urinary tract infection, Aminoglycosides, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics. Methods In this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin–tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock. The primary outcome was Day-30 mortality. Results Among 156 patients included in this study, 69 received a carbapenem and 87 received non carbapenem antibiotics as empiric treatment. Baseline clinical characteristics were similar between the two groups. Patients who received carbapenem had similar Day-30 mortality (10/69 (15%) vs 6/87 (7%), OR = 1.99 [0.55; 5.34] p = 0.16), illness severity, resolution of septic shock, and ESBL-E infection recurrence rates than patients who received an empiric non carbapenem therapy. The rates of secondary infection with C. difficile were comparable. Conclusions In ESBL-E urinary septic shock, empiric treatment with a non carbapenem regimen, including systematically aminoglycosides, was not associated with higher mortality, compared to a carbapenem regimen.

Published
2023
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3. Covichem: A biochemical severity risk score of COVID-19 upon hospital admission.

Author

Marie-Lise Bats, Benoit Rucheton, Tara Fleur, Arthur Orieux, Clément Chemin, Sébastien Rubin, Brigitte Colombies, Arnaud Desclaux, Claire Rivoisy, Etienne Mériglier, Etienne Rivière, Alexandre Boyer, Didier Gruson, Isabelle Pellegrin, Pascale Trimoulet, Isabelle Garrigue, Rana Alkouri, Charles Dupin, François Moreau-Gaudry, Aurélie Bedel, and Sandrine Dabernat

Subjects
Medicine, Science
Abstract

Clinical and laboratory predictors of COVID-19 severity are now well described and combined to propose mortality or severity scores. However, they all necessitate saturable equipment such as scanners, or procedures difficult to implement such as blood gas measures. To provide an easy and fast COVID-19 severity risk score upon hospital admission, and keeping in mind the above limits, we sought for a scoring system needing limited invasive data such as a simple blood test and co-morbidity assessment by anamnesis. A retrospective study of 303 patients (203 from Bordeaux University hospital and an external independent cohort of 100 patients from Paris Pitié-Salpêtrière hospital) collected clinical and biochemical parameters at admission. Using stepwise model selection by Akaike Information Criterion (AIC), we built the severity score Covichem. Among 26 tested variables, 7: obesity, cardiovascular conditions, plasma sodium, albumin, ferritin, LDH and CK were the independent predictors of severity used in Covichem (accuracy 0.87, AUROC 0.91). Accuracy was 0.92 in the external validation cohort (89% sensitivity and 95% specificity). Covichem score could be useful as a rapid, costless and easy to implement severity assessment tool during acute COVID-19 pandemic waves.

Published
2021
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6. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network

Author

Kristina M Angelo, Teresa Smith, Daniel Camprubí-Ferrer, Leire Balerdi-Sarasola, Marta Díaz Menéndez, Guillermo Servera-Negre, Sapha Barkati, Alexandre Duvignaud, Kristina L B Huber, Arpita Chakravarti, Emmanuel Bottieau, Christina Greenaway, Martin P Grobusch, Diogo Mendes Pedro, Hilmir Asgeirsson, Corneliu Petru Popescu, Charlotte Martin, Carmelo Licitra, Albie de Frey, Eli Schwartz, Michael Beadsworth, Susana Lloveras, Carsten S Larsen, Sarah Anne J Guagliardo, Florence Whitehill, Ralph Huits, Davidson H Hamer, Phyllis Kozarsky, Michael Libman, Lucille Blumberg, Hélène Chaussade, Arnaud Desclaux, Eric Florence, Simin Aysel Florescu, Hedvig Glans, Marielle Glynn, Abraham Goorhuis, Marina Klein, Denis Malvy, Andrea McCollum, José Muñoz, Duc Nguyen, Laura Quilter, Camilla Rothe, Patrick Soentjens, Camille Tumiotto, Jef Vanhamel, Repositório da Universidade de Lisboa, Infectious diseases, AII - Infectious diseases, and APH - Global Health

Subjects
Infectious Diseases
Abstract

© 2022 Elsevier Ltd. All rights reserved., Background: The early epidemiology of the 2022 monkeypox epidemic in non-endemic countries differs substantially from the epidemiology previously reported from endemic countries. We aimed to describe the epidemiological and clinical characteristics among individuals with confirmed cases of monkeypox infection. Methods: We descriptively analysed data for patients with confirmed monkeypox who were included in the GeoSentinel global clinical-care-based surveillance system between May 1 and July 1 2022, across 71 clinical sites in 29 countries. Data collected included demographics, travel history including mass gathering attendance, smallpox vaccination history, social history, sexual history, monkeypox exposure history, medical history, clinical presentation, physical examination, testing results, treatment, and outcomes. We did descriptive analyses of epidemiology and subanalyses of patients with and without HIV, patients with CD4 counts of less than 500 cells per mm3 or 500 cells per mm3 and higher, patients with one sexual partner or ten or more sexual partners, and patients with or without a previous smallpox vaccination. Findings: 226 cases were reported at 18 sites in 15 countries. Of 211 men for whom data were available, 208 (99%) were gay, bisexual, or men who have sex with men (MSM) with a median age of 37 years (range 18-68; IQR 32-43). Of 209 patients for whom HIV status was known, 92 (44%) men had HIV infection with a median CD4 count of 713 cells per mm3 (range 36-1659; IQR 500-885). Of 219 patients for whom data were available, 216 (99%) reported sexual or close intimate contact in the 21 days before symptom onset; MSM reported a median of three partners (IQR 1-8). Of 195 patients for whom data were available, 78 (40%) reported close contact with someone who had confirmed monkeypox. Overall, 30 (13%) of 226 patients were admitted to hospital; 16 (53%) of whom had severe illness, defined as hospital admission for clinical care rather than infection control. No deaths were reported. Compared with patients without HIV, patients with HIV were more likely to have diarrhoea (p=0·002), perianal rash or lesions (p=0·03), and a higher rash burden (median rash burden score 9 [IQR 6-21] for patients with HIV vs median rash burden score 6 [IQR 3-14] for patients without HIV; p, US Centers for Disease Control and Prevention, International Society of Travel Medicine

Published
2022
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7. Sarilumab in patients admitted to hospital with severe or critical COVID-19: a randomised, double-blind, placebo-controlled, phase 3 trial

Author

François-Xavier Lescure, Hitoshi Honda, Robert A Fowler, Jennifer Sloane Lazar, Genming Shi, Peter Wung, Naimish Patel, Owen Hagino, Ignacio J. Bazzalo, Marcelo M. Casas, Sebastián A. Nuñez, Yael Pere, Carlos M. Ibarrola, Marco A. Solis Aramayo, Maria C. Cuesta, Andrea E. Duarte, Pablo M. Gutierrez Fernandez, Maria A. Iannantuono, Erica A. Miyazaki, Javier P. Silvio, Dario G. Scublinsky, Alessandra Bales, Daniela Catarino, Elie Fiss, Sara Mohrbacher, Victor Sato, Antonio Baylao, Adilson Cavalcante, Francini Correa, Celso A. de Andrade, Juvencio Furtado, Nelson Ribeiro Filho, Valéria Telles, Leopoldo T. Trevelin, Ricardo Vipich, Rodrigo Boldo, Paula Borges, Suzana Lobo, Graziela Luckemeyer, Luana Machado, Maysa B. Alves, Ana C. Iglessias, Marianna M. Lago, Daniel W. Santos, Hugo Chapdelaine, Emilia L. Falcone, Rahima Jamal, Me-Linh Luong, Madeleine Durand, Stephane Doucet, François-Martin Carrier, Bryan A. Coburn, Lorenzo Del Sorbo, Sharon L. Walmsley, Sara Belga, Luke Y. Chen, Allison D. Mah, Theodore Steiner, Alissa J. Wright, J. Hajek, Neill Adhikari, Robert A. Fowler, Nick Daneman, Kosar A. Khwaja, Jason Shahin, Carolina Gonzalez, Rafael Silva, Marcelo Lindh, Gabriel Maluenda, Patricia Fernandez, Maite Oyonarte, Martin Lasso, Alexandre Boyer, Didier Bronnimann, Hoang-Nam Bui, Charles Cazanave, Helene Chaussade, Arnaud Desclaux, Mailys Ducours, Alexandre Duvignaud, Denis Malvy, Lisa Martin, Didier Neau, Duc Nguyen, Thierry Pistone, Gaetane Soubrane-Wirth, Julie Leitao, Clotilde Allavena, Charlotte Biron, Sabelline Bouchez, Benjamin Gaborit, Antoine Gregoire, Paul Le Turnier, Anne-Sophie Lecompte, Raphael Lecomte, Maeva Lefebvre, Francois Raffi, David Boutoille, Pascale H. Morineau, Romain Guéry, Emmanuel Chatelus, Nathalie Dumoussaud, Renaud Felten, Florina Luca, Bernard Goichot, Francis Schneider, Marie-Caroline Taquet, Matthieu Groh, Mathilde Roumier, Mathilde Neuville, Antoine Bachelard, Valentina Isernia, F-Xavier Lescure, Bao-Chau Phung, Anne Rachline, Aurelie Sautereau, Dorothee Vallois, Yves Bleher, Delphine Boucher, Clémentine Coudon, Jean Esnault, Thomas Guimard, Sophie Leautez-Nainville, Dominique Merrien, Marine Morrier, Pauline Motte-Vincent, Romain Gabeff, Hélène Leclerc, Céline Cozic, Romain Decours, Ronan Février, Gwenhael Colin, Sophie Abgrall, Dorothee Vignes, Raluca Sterpu, Mira Kuellmar, Melanie Meersch-Dini, Raphael Weiss, Alexander Zarbock, Christiane Antony, Marc Berger, Thorsten Brenner, Christian Taube, Frank Herbstreit, Sebastian Dolff, Margarethe Konik, Karsten Schmidt, Markus Zettler, Oliver Witzke, Boris Boell, Jorge Garcia Borrega, Philipp Koehler, Thomas Zander, Fabian Dusse, Othman Al-Sawaf, Philipp Köhler, Dennis Eichenauer, Matthias Kochanek, Alexander Shimabukuro-Vornhagen, Sibylle Mellinghoff, Annika Claßen, Jan-Michel Heger, Charlotte Meyer-Schwickerath, Paul Liedgens, Katrin Heindel, Ana Belkin, Asaf Biber, Mayan Gilboa, Itzchak Levy, Vladislav Litachevsky, Galia Rahav, Anat Finesod Wiedner, Tal Zilberman-Daniels, Yonatan Oster, Jacob Strahilevitz, Sigal Sviri, Elena M. Baldissera, Corrado Campochiaro, Giulio Cavalli, Lorenzo Dagna, Giacomo De Luca, Emanuel Della Torre, Alessandro Tomelleri, Davide Bernasconi De Luca, Amedeo F. Capetti, Massimo Coen, Maria V. Cossu, Massimo Galli, Andrea Giacomelli, Guido A. Gubertini, Stefano Rusconi, Giulia J. Burastero, Margherita Digaetano, Giovanni Guaraldi, Marianna Meschiari, Cristina Mussini, Cinzia Puzzolante, Sara Volpi, Marina Aiello, Alarico Ariani, Alfredo A. Chetta, Annalisa Frizzelli, Andrea Ticinesi, Domenico Tuttolomondo, Stefano Aliberti, Francesco B. Blasi, Marta F. Di Pasquale, Sofia Misuraca, Tommaso Pilocane, Edoardo Simonetta, Alessio M. Aghelmo, Claudio Angelini, Enrico Brunetta, Giorgio W. Canonica, Michele Ciccarelli, Sara Dal Farra, Maria De Santis, Sebastian Ferri, Marco Folci, Giacomo M. Guidelli, Enrico M. Heffler, Ferdinando Loiacono, Giacomo Malipiero, Giovanni Paoletti, Rosa Pedale, Francesca A. Puggioni, Francesca Racca, Aurora Zumbo, Morihiko Satou, Tatyana Lisun, Denis Protsenko, Nikolay Rubtsov, Irina Beloglazova, Daria Fomina, Mariana Lysenko, Sofia Serdotetskova, Vitali Firstov, Ivan Gordeev, Ilia Kokorin, Ksenia Komissarova, Nina Lapochkina, Elena Luchinkina, Valentin Malimon, Sevinch Mamedguseyinova, Ksenia Polubatonova, Natalia Suvorova, Jose Arribas, Alberto M. Borobia Perez, Fernando de la Calle Prieto, Juan Carlos Figueira, Rocio Motejano Sanchez, Marta Mora-Rillo, Concepcion Prados Sanchez, Javier Queiruga Parada, Francisco Fernandez Arnalich, Maria Guerro Barrientos, Alejandro Bendala Estrada, Aranzazu Caballero Marcos, Maria E. Garcia Leoni, Rita García-Martínez, Ana María Collado, Patricia Munoz Garcia, Ana Torres do Rego, María V. Villalba García, Almudena Burrillo, Maricela Valerio Minero, Paloma Gijon Vidaurreta, Sonsoles Infante Herrero, Elena Velilla, Marina Machado, Maria Olmedo, Blanca Pinilla, Benito Almirante Gragera, Maria de la Esperanza Cañas Ruano, Sofia Contreras Medina, Alejandro Cortés Herrera, Vicenç Falcó Ferrer, Ricard Ferrer Roca, Xavier Nuvials Casals, Esteve Ribera Pascuet, Paula Suanzes Diez, Pedro Rebollo Castro, Felipe Garcia Alcaide, Alejandro Soriano, Aina Oliver Caldes, Ana González Cordón, Celia Cardozo, Lorena De la Mora Cañizo, Romina Pena López, Sandra Chamorro, Clara Crespillo-Andujar, Rosa Escudero Sanchez, Jesús Fortún-Abete, Begoña Monge-Maillo, Ana Moreno Zamora, Francesca Norman, Matilde Sanchez Conde, Sergio Serrano Villar, Pilar Vizcarra, Lescure, F. -X., Honda, H., Fowler, R. A., Lazar, J. S., Shi, G., Wung, P., Patel, N., Hagino, O., Bazzalo, I. J., Casas, M. M., Nunez, S. A., Pere, Y., Ibarrola, C. M., Solis Aramayo, M. A., Cuesta, M. C., Duarte, A. E., Gutierrez Fernandez, P. M., Iannantuono, M. A., Miyazaki, E. A., Silvio, J. P., Scublinsky, D. G., Bales, A., Catarino, D., Fiss, E., Mohrbacher, S., Sato, V., Baylao, A., Cavalcante, A., Correa, F., de Andrade, C. A., Furtado, J., Ribeiro Filho, N., Telles, V., Trevelin, L. T., Vipich, R., Boldo, R., Borges, P., Lobo, S., Luckemeyer, G., Machado, L., Alves, M. B., Iglessias, A. C., Lago, M. M., Santos, D. W., Chapdelaine, H., Falcone, E. L., Jamal, R., Luong, M. -L., Durand, M., Doucet, S., Carrier, F. -M., Coburn, B. A., Del Sorbo, L., Walmsley, S. L., Belga, S., Chen, L. Y., Mah, A. D., Steiner, T., Wright, A. J., Hajek, J., Adhikari, N., Daneman, N., Khwaja, K. A., Shahin, J., Gonzalez, C., Silva, R., Lindh, M., Maluenda, G., Fernandez, P., Oyonarte, M., Lasso, M., Boyer, A., Bronnimann, D., Bui, H. -N., Cazanave, C., Chaussade, H., Desclaux, A., Ducours, M., Duvignaud, A., Malvy, D., Martin, L., Neau, D., Nguyen, D., Pistone, T., Soubrane-Wirth, G., Leitao, J., Allavena, C., Biron, C., Bouchez, S., Gaborit, B., Gregoire, A., Le Turnier, P., Lecompte, A. -S., Lecomte, R., Lefebvre, M., Raffi, F., Boutoille, D., Morineau, P. H., Guery, R., Chatelus, E., Dumoussaud, N., Felten, R., Luca, F., Goichot, B., Schneider, F., Taquet, M. -C., Groh, M., Roumier, M., Neuville, M., Bachelard, A., Isernia, V., Phung, B. -C., Rachline, A., Sautereau, A., Vallois, D., Bleher, Y., Boucher, D., Coudon, C., Esnault, J., Guimard, T., Leautez-Nainville, S., Merrien, D., Morrier, M., Motte-Vincent, P., Gabeff, R., Leclerc, H., Cozic, C., Decours, R., Fevrier, R., Colin, G., Abgrall, S., Vignes, D., Sterpu, R., Kuellmar, M., Meersch-Dini, M., Weiss, R., Zarbock, A., Antony, C., Berger, M., Brenner, T., Taube, C., Herbstreit, F., Dolff, S., Konik, M., Schmidt, K., Zettler, M., Witzke, O., Boell, B., Garcia Borrega, J., Koehler, P., Zander, T., Dusse, F., Al-Sawaf, O., Kohler, P., Eichenauer, D., Kochanek, M., Shimabukuro-Vornhagen, A., Mellinghoff, S., Classen, A., Heger, J. -M., Meyer-Schwickerath, C., Liedgens, P., Heindel, K., Belkin, A., Biber, A., Gilboa, M., Levy, I., Litachevsky, V., Rahav, G., Finesod Wiedner, A., Zilberman-Daniels, T., Oster, Y., Strahilevitz, J., Sviri, S., Baldissera, E. M., Campochiaro, C., Cavalli, G., Dagna, L., De Luca, Giacomo., Della Torre, E., Tomelleri, A., Bernasconi De Luca, D., Capetti, A. F., Coen, M., Cossu, M. V., Galli, M., Giacomelli, A., Gubertini, G. A., Rusconi, S., Burastero, G. J., Digaetano, M., Guaraldi, G., Meschiari, M., Mussini, C., Puzzolante, C., Volpi, S., Aiello, M., Ariani, A., Chetta, A. A., Frizzelli, A., Ticinesi, A., Tuttolomondo, D., Aliberti, S., Blasi, F. B., Di Pasquale, M. F., Misuraca, S., Pilocane, T., Simonetta, E., Aghelmo, A. M., Angelini, C., Brunetta, E., Canonica, G. W., Ciccarelli, M., Dal Farra, S., De Santis, M., Ferri, S., Folci, M., Guidelli, G. M., Heffler, E. M., Loiacono, F., Malipiero, G., Paoletti, G., Pedale, R., Puggioni, F. A., Racca, F., Zumbo, A., Satou, M., Lisun, T., Protsenko, D., Rubtsov, N., Beloglazova, I., Fomina, D., Lysenko, M., Serdotetskova, S., Firstov, V., Gordeev, I., Kokorin, I., Komissarova, K., Lapochkina, N., Luchinkina, E., Malimon, V., Mamedguseyinova, S., Polubatonova, K., Suvorova, N., Arribas, J., Borobia Perez, A. M., de la Calle Prieto, F., Figueira, J. C., Motejano Sanchez, R., Mora-Rillo, M., Prados Sanchez, C., Queiruga Parada, J., Fernandez Arnalich, F., Guerro Barrientos, M., Bendala Estrada, A., Caballero Marcos, A., Garcia Leoni, M. E., Garcia-Martinez, R., Collado, A. M., Munoz Garcia, P., Torres do Rego, A., Villalba Garcia, M. V., Burrillo, A., Valerio Minero, M., Gijon Vidaurreta, P., Infante Herrero, S., Velilla, E., Machado, M., Olmedo, M., Pinilla, B., Almirante Gragera, B., Canas Ruano, M. D. L. E., Contreras Medina, S., Cortes Herrera, A., Falco Ferrer, V., Ferrer Roca, R., Nuvials Casals, X., Ribera Pascuet, E., Suanzes Diez, P., Rebollo Castro, P., Garcia Alcaide, F., Soriano, A., Oliver Caldes, A., Gonzalez Cordon, A., Cardozo, C., De la Mora Canizo, L., Pena Lopez, R., Chamorro, S., Crespillo-Andujar, C., Escudero Sanchez, R., Fortun-Abete, J., Monge-Maillo, B., Moreno Zamora, A., Norman, F., Sanchez Conde, M., Serrano Villar, S., and Vizcarra, P.

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Care, International Cooperation, Population, Antibodies, Monoclonal, Humanized, Placebo, Severity of Illness Index, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Intensive care, Severity of illness, medicine, Clinical endpoint, Humans, Immunologic Factors, 030212 general & internal medicine, Mortality, education, Respiratory Distress Syndrome, education.field_of_study, Dose-Response Relationship, Drug, SARS-CoV-2, business.industry, Hazard ratio, COVID-19, Articles, Middle Aged, Receptors, Interleukin-6, Sarilumab, Treatment Outcome, 030228 respiratory system, Female, Drug Monitoring, Cytokine Release Syndrome, business
Abstract

Summary Background Elevated proinflammatory cytokines are associated with greater COVID-19 severity. We aimed to assess safety and efficacy of sarilumab, an interleukin-6 receptor inhibitor, in patients with severe (requiring supplemental oxygen by nasal cannula or face mask) or critical (requiring greater supplemental oxygen, mechanical ventilation, or extracorporeal support) COVID-19. Methods We did a 60-day, randomised, double-blind, placebo-controlled, multinational phase 3 trial at 45 hospitals in Argentina, Brazil, Canada, Chile, France, Germany, Israel, Italy, Japan, Russia, and Spain. We included adults (≥18 years) admitted to hospital with laboratory-confirmed SARS-CoV-2 infection and pneumonia, who required oxygen supplementation or intensive care. Patients were randomly assigned (2:2:1 with permuted blocks of five) to receive intravenous sarilumab 400 mg, sarilumab 200 mg, or placebo. Patients, care providers, outcome assessors, and investigators remained masked to assigned intervention throughout the course of the study. The primary endpoint was time to clinical improvement of two or more points (seven point scale ranging from 1 [death] to 7 [discharged from hospital]) in the modified intention-to-treat population. The key secondary endpoint was proportion of patients alive at day 29. Safety outcomes included adverse events and laboratory assessments. This study is registered with ClinicalTrials.gov, NCT04327388; EudraCT, 2020-001162-12; and WHO, U1111-1249-6021. Findings Between March 28 and July 3, 2020, of 431 patients who were screened, 420 patients were randomly assigned and 416 received placebo (n=84 [20%]), sarilumab 200 mg (n=159 [38%]), or sarilumab 400 mg (n=173 [42%]). At day 29, no significant differences were seen in median time to an improvement of two or more points between placebo (12·0 days [95% CI 9·0 to 15·0]) and sarilumab 200 mg (10·0 days [9·0 to 12·0]; hazard ratio [HR] 1·03 [95% CI 0·75 to 1·40]; log-rank p=0·96) or sarilumab 400 mg (10·0 days [9·0 to 13·0]; HR 1·14 [95% CI 0·84 to 1·54]; log-rank p=0·34), or in proportions of patients alive (77 [92%] of 84 patients in the placebo group; 143 [90%] of 159 patients in the sarilumab 200 mg group; difference −1·7 [−9·3 to 5·8]; p=0·63 vs placebo; and 159 [92%] of 173 patients in the sarilumab 400 mg group; difference 0·2 [−6·9 to 7·4]; p=0·85 vs placebo). At day 29, there were numerical, non-significant survival differences between sarilumab 400 mg (88%) and placebo (79%; difference +8·9% [95% CI −7·7 to 25·5]; p=0·25) for patients who had critical disease. No unexpected safety signals were seen. The rates of treatment-emergent adverse events were 65% (55 of 84) in the placebo group, 65% (103 of 159) in the sarilumab 200 mg group, and 70% (121 of 173) in the sarilumab 400 mg group, and of those leading to death 11% (nine of 84) were in the placebo group, 11% (17 of 159) were in the sarilumab 200 mg group, and 10% (18 of 173) were in the sarilumab 400 mg group. Interpretation This trial did not show efficacy of sarilumab in patients admitted to hospital with COVID-19 and receiving supplemental oxygen. Adequately powered trials of targeted immunomodulatory therapies assessing survival as a primary endpoint are suggested in patients with critical COVID-19. Funding Sanofi and Regeneron Pharmaceuticals.

Published
2021

8. High-resolution Free-breathing late gadolinium enhancement Cardiovascular magnetic resonance to diagnose myocardial injuries following COVID-19 infection

Author

Aurélien Bustin, Matthias Stuber, Alexandre Ouattara, Didier Gruson, Hubert Cochet, Nahema Issa, Pierre Gravinay, Arnaud Desclaux, Renaud Prevel, Pierre Coste, Soumaya Sridi, Fabrice Bonnet, Edouard Gerbaud, François Laurent, Alexandre Boyer, Benoit Legghe, Fabrice Camou, Hadrien Rozé, Philippe Gosse, Michel Montaudon, Admin, Oskar, Equipements d'excellence - Plateforme multi-modale d'exploration en cardiologie - - MUSIC2011 - ANR-11-EQPX-0030 - EQPX - VALID, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Nationale de la Recherche, and ANR-11-EQPX-0030,MUSIC,Plateforme multi-modale d'exploration en cardiologie(2011)

Subjects
Male, Magnetic Resonance Spectroscopy, Heart disease, Image quality, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Contrast Media, Gadolinium, 030204 cardiovascular system & hematology, MINOCA, Myocardial infarction with non-obstructed coronary arteries, HR-LGE, High-resolution late gadolinium enhancement, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Cardiac Magnetic Resonance Imaging, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, TTE, Transthoracic echocardiography, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, medicine.diagnostic_test, ECG, Electrocardiogram, General Medicine, Magnetic Resonance Imaging, CMR, Cardiovascular magnetic resonance, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.anatomical_structure, EF, Ejection fraction, Cohort, embryonic structures, Cardiology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, High-resolution, medicine.medical_specialty, 3D, Three-dimensional, Myocarditis, Late Gadolinium Enhancement, Magnetic Resonance Imaging, Cine, BMI, Body mass index, TI, Inversion time, LV, Left ventricle, Article, RV, Right ventricular, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiac magnetic resonance imaging, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, ROI, Regions-of-interest, business.industry, SARS-CoV-2, LGE, Late gadolinium enhancement, COVID-19, Magnetic resonance imaging, medicine.disease, Troponin, Coronary arteries, LR-LGE, Low-resolution late gadolinium enhancement, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, biology.protein, PCR, Polymerase chain reaction, business
Abstract

International audience; PURPOSE: High-resolution free-breathing late gadolinium enhancement (HR-LGE) was shown valuable for the diagnosis of acute coronary syndromes with non-obstructed coronary arteries. The method may be useful to detect COVID-related myocardial injuries but is hampered by prolonged acquisition times. We aimed to introduce an accelerated HR-LGE technique for the diagnosis of COVID-related myocardial injuries. METHOD: An undersampled navigator-gated HR-LGE (acquired resolution of 1.25 mm(3)) sequence combined with advanced patch-based low-rank reconstruction was developed and validated in a phantom and in 23 patients with structural heart disease (test cohort; 15 men; 55 ± 16 years). Twenty patients with laboratory-confirmed COVID-19 infection associated with troponin rise (COVID cohort; 15 men; 46 ± 24 years) prospectively underwent cardiovascular magnetic resonance (CMR) with the proposed sequence in our center. Image sharpness, quality, signal intensity differences and diagnostic value of free-breathing HR-LGE were compared against conventional breath-held low-resolution LGE (LR-LGE, voxel size 1.8x1.4x6mm). RESULTS: Structures sharpness in the phantom showed no differences with the fully sampled image up to an undersampling factor of x3.8 (P > 0.5). In patients (N = 43), this acceleration allowed for acquisition times of 7min21s ± 1min12s at 1.25 mm(3) resolution. Compared with LR-LGE, HR-LGE showed higher image quality (P = 0.03) and comparable signal intensity differences (P > 0.5). In patients with structural heart disease, all LGE-positive segments on LR-LGE were also detected on HR-LGE (80/391) with 21 additional enhanced segments visible only on HR-LGE (101/391, P

Published
2021
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9. Short duration antibiotic therapy for native joint arthritis caused by

Author

Maïlys, Ducours, Samar, El-Hout, Arnaud, Desclaux, Hervé, Dutronc, Thylbert, Deltombe, Thomas, Fauthoux, François, Vercruysse, Marie, Kostine, and Charles, Cazanave

Subjects
Arthritis, Infectious, Time Factors, Humans, Neisseria, Anti-Bacterial Agents
Published
2020

10. Comparison of Genus Specific PCR and Culture with or without Sonication for Microbiological Diagnosis of Vascular Graft Infection

Author

Isabelle Accoceberry, Jean-Baptiste Pinaquy, Charles Cazanave, Chloé Le Roy, Arnaud Desclaux, Mathilde Puges, Cécile Bébéar, Laurent Stecken, Michel Dupon, Sabine Pereyre, Xavier Berard, Infectious and Tropical Diseases Department, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], USC IHMC - Infections humaines à mycoplasmes et à chlamydiae, Institut National de la Recherche Agronomique (INRA), and CHU Bordeaux [Bordeaux]

Subjects
Adult, Male, 0301 basic medicine, Prosthesis-Related Infections, Microbiological culture, Vascular graft infection, medicine.drug_class, [SDV]Life Sciences [q-bio], 030106 microbiology, Antibiotics, medicine.disease_cause, Sensitivity and Specificity, law.invention, Microbiology, Sonication, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Humans, 030212 general & internal medicine, Polymerase chain reaction, Bacteriological Techniques, biology, business.industry, Streptococcus, Middle Aged, Antimicrobial, biology.organism_classification, Enterobacteriaceae, Blood Vessel Prosthesis, Enterococcus, Female, Surgery, Molecular diagnosis, Cardiology and Cardiovascular Medicine, business, Staphylococcus
Abstract

Objectives: Vascular graft infections (VGIs) are severe and require prolonged adequate antimicrobial therapy. However, up to 45% of conventional cultures are negative. Sonication and genus specific PCRs for microbiological diagnosis of VGI was evaluated. Methods: Samples were prospectively obtained from explanted vascular grafts in Bordeaux University Hospital. Conventional bacterial cultures with and without prior sonication of samples were performed. A genus specific PCR assay panel, targeting the most frequent bacteria involved in VGI (Staphylococcus, Streptococcus, Enterococcus, and Enterobacteriaceae), was also applied to sonicate fluids. The performance of these three diagnostic strategies was compared. Results: Forty-five patients (118 samples) were included between July 2014 and October 2015. Six patients had no infection and 39 had a VGI. Sensitivities of graft culture, sonicate fluid culture, and genus specific PCR were 85.7%, 89.7%, and 79.5%, respectively. Specificities were 100%, 100%, and 83.3%, respectively. Sonicate fluid culture was positive for five graft samples (from four patients) with negative culture without sonication. Four VGIs were detected by PCR only (3 patients had previously received antibiotics). For 15 patients with positive graft cultures, PCR identified at least one additional bacterium compared with culture, thus 30 additional bacteria for all included patients. By combining sonicate fluid culture and PCR, a microbiological diagnosis was obtained for all patients with VGI. Conclusions: There was no statistical difference between performances of culture with and without sonication and genus specific PCR. However, combining sonicate fluid cultures and PCR may be the best strategy for microbiological diagnostic of VGI.

Published
2018
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11. Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis

Author

Arnaud Desclaux, Igor Sibon, Didier Raoult, Fatiha Haneche, Mathilde Puges, Didier Brönnimann, Jean-Christophe Lagier, Hubert Lepidi, Charles Cazanave, Didier Neau, Marc-Olivier Vareil, Université de Bordeaux (UB), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), CHU Bordeaux [Bordeaux], Service des Maladies Infectieuses et Tropicales A [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, and Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, 0301 basic medicine, Microbiology (medical), Spondylodiscitis, Pathology, medicine.medical_specialty, Biopsy, 030106 microbiology, Tropheryma, Polymerase Chain Reaction, Tropheryma whipplei, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Recurrence, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Limbic Encephalitis, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Whipple's disease, Cerebrum, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, medicine.diagnostic_test, biology, business.industry, Whipple Disease, Brain biopsy, Limbic encephalitis, nutritional and metabolic diseases, General Medicine, Middle Aged, medicine.disease, biology.organism_classification, Immunohistochemistry, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, digestive system diseases, 3. Good health, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, business, Encephalitis
Abstract

Many clinical manifestations can be related to Tropheryma whipplei infection. We report a Tropheryma whipplei limbic encephalitis developed as a relapse of classical Whipple’s disease. This case is to the best of our knowledge the first proof of the effective brain–blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.

Published
2019
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12. Renal Intravascular Large B-cell Lymphoma: A Case Report and Review of the Literature

Author

Jean-François Viallard, Estibaliz Lazaro, Jean-Baptiste Pinaquy, Mokrane Yacoub, and Arnaud Desclaux

Subjects
Pathology, medicine.medical_specialty, kidney, Lymphoma, B-Cell, Biopsy, intravascular lymphoma, PET-CT, 030232 urology & nephrology, Renal function, Case Report, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Internal Medicine, Medicine, Humans, Intravascular large B-cell lymphoma, Kidney, Proteinuria, medicine.diagnostic_test, business.industry, urogenital system, General Medicine, Middle Aged, medicine.disease, Vascular Neoplasms, Lymphoma, medicine.anatomical_structure, 030220 oncology & carcinogenesis, fever of unknown origin, Female, Bone marrow, medicine.symptom, business, Enlarged kidney
Abstract

We herein report the case of a 52-year-old woman who consulted us because of a 2-month history of a fever, anorexia and weight loss. A physical examination was unremarkable. The blood count showed mild anemia and lymphopenia, and lactate dehydrogenase was elevated. Creatinine clearance was normal and proteinuria was undetectable. CT showed enlarged kidneys. A bone marrow biopsy was normal. PET-CT showed an intense uptake of 18fluorodeoxyglucose in both kidneys. A kidney biopsy provided the diagnosis of intravascular large B-cell lymphoma (IVLBCL). Kidney-limited IVLBCL without an impairment in the renal function or proteinuria has not been described. We analyzed the 38 published cases of IVLBCL involving the kidney to describe the main features of this entity.

Published
2017

13. Efficacy of debridement, antibiotic therapy and implant retention within three months during postoperative instrumented spine infections

Author

Véronique Dubois, Frédéric-Antoine Dauchy, Hervé Dutronc, Heidi Wille, Michel Dupon, Jean-Marc Vital, Marc-Olivier Vareil, and Arnaud Desclaux

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Prosthesis-Related Infections, Adolescent, medicine.medical_treatment, Hospitals, University, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Antibiotic therapy, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, Debridement, General Immunology and Microbiology, business.industry, Retrospective cohort study, General Medicine, Middle Aged, University hospital, medicine.disease, Confidence interval, Anti-Bacterial Agents, Surgery, Treatment Outcome, Infectious Diseases, Female, France, Implant, business, Body mass index, 030217 neurology & neurosurgery, Spondylitis
Abstract

Postoperative instrumented spine infection (PISI) is a severe complication of invasive spine procedures.Retrospective study of patients treated for PISI between 1st January 2008 and 31st December 2012 in a French University Hospital. The objectives of this study were to describe the outcome of patients treated with debridement-irrigation, antibiotic therapy and implant retention (DAIR) within three months after the occurrence of PISI and to identify factors associated with relapse.Among 4290 patients who underwent spinal arthrodesis surgery during the 5-year study period, 129 had PISI treated by debridement-irrigation in the first three months (3.0%, 95% confidence interval [95%CI]: 2.5-3.5). Fifty-two (40%) were female and the median age was 57 years. Fourteen patients (10.8%) had diabetes and 73 (56.6%) had a BMI (Body Mass Index) ≥25 kg/mDAIR may be effective for PISI when performed within the first 3 months after onset of infection. Relapses are significantly associated with polymicrobial infection and negatively associated with moderate overweight. These results need to be confirmed in future prospective studies.

Published
2016
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14. Short duration antibiotic therapy for native joint arthritis caused byNeisseriainfection?

Author

Samar El-Hout, Thomas Fauthoux, Charles Cazanave, Arnaud Desclaux, François Vercruysse, Hervé Dutronc, Maïlys Ducours, Thylbert Deltombe, and Marie Kostine

Subjects
0301 basic medicine, medicine.medical_specialty, medicine.drug_class, Immunology, Antibiotics, Arthritis, Osteoarthritis, medicine.disease_cause, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, medicine, Immunology and Allergy, Blood culture, 030203 arthritis & rheumatology, medicine.diagnostic_test, biology, business.industry, Neisseria meningitidis, Retrospective cohort study, medicine.disease, biology.organism_classification, 030104 developmental biology, Neisseria gonorrhoeae, Neisseria, business
Abstract

We read with great interest the article “Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial” by Gjika et al .1 As staff members of a French Regional Referral Centre for complex bone and joint infections, we want to share our experience with short-duration antibiotic treatment for native joint arthritis caused by Neisseria gonorrhoeae (Ng) and Neisseria meningitidis (Nm). We conducted a retrospective study including all patients with arthritis caused by Gram-negative cocci treated in our institution from January 2018 to July 2020. Ten patients were included (seven men, three women; median age 34 years; table 1). Most patients had monarthritis (n=6); knees were the most frequently affected joints (n=7). Fever was inconsistent (n=5). Blood culture analyses were performed for nine patients and were positive for three patients. All but two patients (because absence of joint fluid) …

Published
2020
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15. Retrospective Study Comparing WBC scan and

Author

Mathilde, Puges, Xavier, Bérard, Jean-Baptiste, Ruiz, Frederic, Debordeaux, Arnaud, Desclaux, Laurent, Stecken, Sabine, Pereyre, Arnaud, Hocquelet, Laurence, Bordenave, Jean-Baptiste, Pinaquy, and Charles, Cazanave

Subjects
Male, Observer Variation, Prosthesis-Related Infections, Clinical Decision-Making, Reproducibility of Results, Middle Aged, Prognosis, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Leukocyte Count, Fluorodeoxyglucose F18, Predictive Value of Tests, Positron Emission Tomography Computed Tomography, Humans, Female, Radiopharmaceuticals, Aged, Retrospective Studies
Abstract

Prosthetic vascular graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro-d-glucose positron emission tomography integrated with computed tomography (A retrospective single centre study was conducted on patients undergoing WBC scan andThirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher thanThe WBC scan has a better diagnostic value than

Published
2018

16. Auteurs et collaborateurs

Author

Loïc, Sentilhes, Thomas, Schmitz, Antoine, Agman, Xavier, Ah-Kit, Olivia, Anselem, Élie, Azria, Delphine, Beghin, Alexandra, Benachi, Guillaume, Benoist, Jacques, Bernuau, Florence, Biquard, Valérie, Biran, Dominique, Bonneau, Hanane, Bouchghoul, Pierre-Emmanuel, Bouet, Arnaud, Bresset, Patrick, Brochard, Bruno, Carbonne, Julie, Carrara, Sylvain, Catros, Pierre-François, Ceccaldi, Jean-François, Chateil, Lydie, Chérier, Maxime, Chochoi, Frédéric, Coatleven, Gaël, Cordier Anne, Romain, Corroenne, Bénédicte, Coulm, Jean, Delmas, Fleur, Delva, Arnaud, Desclaux, Alexandre, Duvignaud, Élisabeth, Elefant, Maxime, Eslier, Mathilde, Fénelon, Mathieu, Fiore, Arthur, Foulon, Alice, Frerot, Jean-Christophe, Fricain, Alizée, Froeliger, Charles, Garabedian, Mélissa, Gilbert, Philippe, Gosse, Solenne, Gricourt, Mélissa, Hourbracq, Clémence, Houssin, François, Jacquemard, Chloe, James, Laure, Joseph, Diane, Korb, Marie, Lachâtre, Odile, Launay, Jacques, Lepercq, Gérard, Lorette, Dominique, Luton, Hugo, Madar, Agnès, Mailloux, Émeline, Maisonneuve, Guyguy, Manangama Duki, Olivier, Mansier, Louis, Marcellin, Jérôme, Massardier, Aurélien, Mattuizzi, Cécile, Morin, Christine, Mouton, Audrey, Payance, Caroline, Pecriaux, Violaine, Peyronnet-Chabrier, Olivier, Picone, Aurélie, Plessier, Perrine, Prier, Roland, Quentin, Teodora, Roman, Jonathan, Rosenblatt, Eleonora, Salakos, Marie, Sarrau, Fabrice, Sergent, Jeanne, Sibiude, Sophie, Skopinski, Raphaëlle, Teysseire, Morgane, Valentin, Christelle, Vauloup-Fellous, Catherine, Vauzelle, Marie, Vincienne, Alexandre, Vivanti, Hélène, Zephir, Maéva, Zysman, and Thanh Hai, Duong

Published
2022
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17. Dark urine, hypotension and blood smear examination

Author

Malek Souayed, Arnaud Desclaux, Marie Kostine, and Renaud Prevel

Subjects
medicine.medical_specialty, business.industry, Pain medicine, Babesia, Critical Care and Intensive Care Medicine, Hemolysis, Dark urine, Immunocompromised Host, Blood smear, Babesiosis, Neoplasms, Anesthesia, Anesthesiology, Humans, Medicine, Female, Hypotension, business, Aged
Published
2018
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18. Retrospective Study Comparing WBC scan and 18F-FDG PET/CT in Patients with Suspected Prosthetic Vascular Graft Infection

Author

Charles Cazanave, Laurence Bordenave, Arnaud Desclaux, Jean-Baptiste Ruiz, F. Debordeaux, Laurent Stecken, Jean-Baptiste Pinaquy, Xavier Berard, Mathilde Puges, Arnaud Hocquelet, and Sabine Pereyre

Subjects
medicine.diagnostic_test, Receiver operating characteristic, business.industry, Curve analysis, Retrospective cohort study, 030204 cardiovascular system & hematology, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Positron emission tomography, Vascular graft infection, White blood cell, medicine, Fdg pet ct, In patient, Surgery, Nuclear medicine, business, Cardiology and Cardiovascular Medicine
Abstract

Objectives Prosthetic vascular graft infections (PVGIs) are associated with high mortality rates. To improve treatment outcome, an early and definite diagnosis is critical, and current diagnostic criteria are often insufficient. The accuracy of 2-deoxy-2-[fluorine-18]-fluoro- d -glucose positron emission tomography integrated with computed tomography (18F-FDG PET/CT) and white blood cell (WBC) scan for the diagnosis of PVGI were compared. Methods A retrospective single centre study was conducted on patients undergoing WBC scan and 18F-FDG PET/CT for a suspected PVGI between April 2013 and June 2016 at the Bordeaux University Hospital, France. The diagnostic value of both imaging tests was assessed for all grafts, using receiver operating characteristic (ROC) curve analysis. Images were independently interpreted by two nuclear medicine physicians blinded to the patients’ clinical and other imaging data. Results Thirty-nine patients were included, of whom 15 had PVGI. Antibiotic treatment was started before nuclear imaging for 16 patients, including nine patients with a PVGI. The 96 grafts of these patients were analysed, and 19 were infected. The diagnostic value of the WBC scan was significantly higher than 18F-FDG PET/CT (ROC AUC = 0.902, 95% CI 0.824–0.980, and 0.759, CI 95% (0.659–0.858), respectively, p = .0071). Interobserver agreement was good for 18F-FDG PET/CT and excellent for WBC scan (kappa value of 0.76, 95% CI 0.62–0.9, and 0.97, 95% CI 0.92–1, respectively). Only one patient had a false negative 18F-FDG PET/CT result under antibiotic therapy. Conclusion The WBC scan has a better diagnostic value than 18F-FDG PET/CT for PVGI diagnosis.

Published
2019
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19. Extra-rectal lymphogranuloma venereum in France: a clinical and molecular study

Author

Arabella Touati, Didier Neau, Cécile Laurier-Nadalié, C. Cazanave, Arnaud Desclaux, Cécile Bébéar, Bertille de Barbeyrac, Service des maladies infectieuses et tropicales, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Recherche Agronomique (INRA), and USC IHMC - Infections humaines à mycoplasmes et à chlamydiae

Subjects
0301 basic medicine, Male, [SDV]Life Sciences [q-bio], Lymphadenopathy, chlamydia, Chlamydia trachomatis, HIV Infections, urologic and male genital diseases, medicine.disease_cause, genital ulcer, 0302 clinical medicine, Epidemiology, Prevalence, 030212 general & internal medicine, education.field_of_study, Chlamydia, Coinfection, Lymphogranuloma venereum, Middle Aged, female genital diseases and pregnancy complications, Anti-Bacterial Agents, Genital ulcer, Infectious Diseases, Doxycycline, France, medicine.symptom, Bacterial Outer Membrane Proteins, Adult, medicine.medical_specialty, Genotype, 030106 microbiology, Population, Sexually Transmitted Diseases, Dermatology, 03 medical and health sciences, Young Adult, medicine, Humans, Sex organ, Homosexuality, Male, education, Retrospective Studies, business.industry, Rectum, HIV, Pharyngeal Diseases, Sequence Analysis, DNA, medicine.disease, Surgery, Rectal Diseases, Lymphogranuloma Venereum, Pharynx, Syphilis, business
Abstract

ObjectivesTo describe a series of extrarectal lymphogranuloma venereum (LGV) cases diagnosed in France.MethodsConsecutive LGV cases confirmed at the French Reference Centre for chlamydiae with an extrarectal sample from January 2010 to December 2015 were included. The first part of the study consisted of a retrospective case note review and analysis. In a second part, the complete ompA gene sequence of our samples was determined.ResultsThere were 56 cases overall: 50 cases of genital LGV and six cases of pharyngeal LGV. Subjects were all men, median age 39 years, 27/53 were HIV-positive, 47/51 reported having sex with other men, 43/49 reported multiple sexual partners (a mean 25 in the last 6 months). Median time from symptom onset to diagnosis was 21 days. Subjects most commonly presented with inguinal adenopathy alone (19 of 50 genital cases) and adenopathy with genital ulcer (17 of 50). Three pharyngeal cases were symptomatic. Fever was reported in 11 cases. Inguinal abscess was reported in 22 of 42 cases presenting with lymphadenopathy. Co-infections were frequent: eight cases of syphilis, four non-LGV Chlamydia trachomatis infections, one case of gonorrhoea. Cure was always achieved with doxycycline therapy but prolonged treatment was necessary in eight cases with inguinal abscess. Genotyping according to ompA sequencing showed the co-circulation of genovars L2 (16 of 42 strains successfully typed) and L2b (24 of 42). There was no association between HIV status and disease severity or genovar distribution.ConclusionIn the span of 6 years, 56 extrarectal LGV cases were confirmed through genotyping in France. Extrarectal LGV seemed to share a common epidemiological background with rectal disease in terms of affected population and genovar distribution. HIV prevalence was lower than expected.

Published
2017
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20. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020

Author

Daniel Lévy-Bruhl, Sylvie Behillil, Clément Bassi, Alexandra Mailles, Anne Simondon, Yassoungo Silue, P. Rolland, François Xavier Lescure, Matthieu Mechain, Morgane Stempfelet, Anouk Tabaï, Clément Lazarus, Bruno Coignard, C Campese, Investigation team, Sophie Ismael, Sibylle Bernard Stoecklin, Denis Malvy, Vincent Enouf, Mathieu Nguyen, Laure Meurice, Estelle Yamani, Duc Minh Nguyen, Scarlett Georges, Santé publique France - French National Public Health Agency, Agence Régionale de Santé Ile-de-France [Paris] (ARS IDF), Agence Régionale de la Santé (ARS), Centre National de Référence des virus des infections respiratoires (dont la grippe) [Paris] (CNR), Institut Pasteur [Paris], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Bordeaux GeoSentinel Site [Bordeaux], Service des maladies infectieuses et tropicales [Bordeaux], CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Laboratoire de Biotechnologie et Microbiologie Appliquée (LBMA), Université Bordeaux Segalen - Bordeaux 2-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Direction Générale de la Santé [Paris] (DGS), Ministère des Solidarités et de la Santé [Paris, France], Santé publique France [Saint-Maurice, France] (French National Public Health Agency), parent-French National Public Health Agency, Investigation Team: Laurent Filleul, Stéphanie Vandentorren, Guillaume Spaccaferri, Hélène Prouvost, Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf, Alexis Ardoin, Marion Dreyer, Karim Tararbit, Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold, Didier Che, Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah, Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier, Pauline Mathieu., Direction des maladies infectieuses - Infectious Diseases Division [Saint-Maurice], Santé publique France - French National Public Health Agency [Saint-Maurice, France], Direction des régions [Saint-Maurice], Cellule Régionale Ile-de-France [Paris], Santé publique France - French National Public Health Agency [Saint-Maurice, France]-Santé publique France - French National Public Health Agency [Saint-Maurice, France], Agence Régionale de Santé Nouvelle-Aquitaine [Bordeaux] (ARS NA), Cellule Régionale Nouvelle-Aquitaine [Bordeaux], Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre opérationnel de réception et de régulation des urgences sanitaires et sociales [Paris], Ministère des Solidarités et de la Santé [Paris, France]-Ministère des Solidarités et de la Santé [Paris, France], Direction alerte et crise [Saint-Maurice], Investigation Team : Laurent Filleul, Stéphanie Vandentorren, Guillaume Spaccaferri, Hélène Prouvost, Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf, Alexis Ardoin, Marion Dreyer, Karim Tararbit, Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold, Didier Che, Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah, Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier, Pauline Mathieu, Bodescot, Myriam, and Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR)

Subjects
0301 basic medicine, Male, Epidemiology, MESH: Coronavirus Infections, [SDV]Life Sciences [q-bio], coronavirus, medicine.disease_cause, MESH: Risk Assessment, contact tracing, containment, MESH: Infection Control, 0302 clinical medicine, COVID-19, France, 2019-nCov, Surveillance, SARS-CoV-2, Coronavirus, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infection control, MESH: COVID-19, 030212 general & internal medicine, MESH: Travel, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Travel, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, biology, Transmission (medicine), Middle Aged, MESH: China, 3. Good health, Population Surveillance, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Betacoronavirus, Risk assessment, Coronavirus Infections, Adult, medicine.medical_specialty, China, Pneumonia, Viral, Disease cluster, Risk Assessment, MESH: Population Surveillance, MESH: Contact Tracing, 03 medical and health sciences, Betacoronavirus, Virology, medicine, Humans, MESH: SARS-CoV-2, Infection Control, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, biology.organism_classification, medicine.disease, MESH: Male, MESH: France, Pneumonia, 030104 developmental biology, MESH: Pneumonia, Viral, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Contact tracing
Abstract

Investigation Team : Santé publique France, Direction des régions, Cellule Régionale Nouvelle Aquitaine, Bordeaux, France: Laurent Filleul, Stéphanie Vandentorren.Santé publique France, Direction des régions, Cellule Régionale Auvergne-Rhône-Alpes, Lyon, France: Guillaume Spaccaferri.Santé publique France, Direction des régions, Cellule Régionale Hauts-de-France, Lille, France: Hélène Prouvost.Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France: Mélanie Albert, Marion Barbet, Angela Brisebarre, Flora Donati, Sylvie van der Werf.Agence Régionale de Santé Ile-de-France, Paris, France: Alexis Ardoin, Marion Dreyer, Karim Tararbit.Agence Régionale de Santé Nouvelle-Aquitaine, Bordeaux, France: Matthieu Amodeo, Elodie Couaillier, Pascal Fabre, Daniel Habold.Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France: Didier Che.AP-HP, Hôpital Bichat, Service des maladies infectieuses et tropicales, Paris, France: Gisèle Bendjelloul, Marine Billaudelle Lallemant, Valentine Charachon, Laurène Deconinck, Diane Descamps, Sandrine Gérard, Nadirha Houhou, Quentin Le Hingrat, Isabelle Lolom, Jean-Christophe Lucet, Annabelle Pourbaix, Simon Valayer, Yazdan Yazdanpanah.Centre Hospitalier Universitaire de Bordeaux, Bordeaux GeoSentinel Site, Bordeaux, France: Alexandre Boyer, Benjamin Clouzeau, Xavier Combes, Arnaud Desclaux, Jean-Michel Dindart, Alexandre Duvignaud, Isabelle Garrigue, Didier Gruson, Marie-Edith Lafon, Pauline Perreau, Thierry Pistone, Maxime Poteau, Eric Tentillier.Direction Générale de la Santé, Ministère des solidarités et de la santé, Centre opérationnel de réception et de régulation des urgences sanitaires et sociales, Paris, France: Pauline Mathieu; International audience; A novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) causing a cluster of respiratory infections (coronavirus disease 2019, COVID-19) in Wuhan, China, was identified on 7 January 2020. The epidemic quickly disseminated from Wuhan and as at 12 February 2020, 45,179 cases have been confirmed in 25 countries, including 1,116 deaths. Strengthened surveillance was implemented in France on 10 January 2020 in order to identify imported cases early and prevent secondary transmission. Three categories of risk exposure and follow-up procedure were defined for contacts. Three cases of COVID-19 were confirmed on 24 January, the first cases in Europe. Contact tracing was immediately initiated. Five contacts were evaluated as at low risk of exposure and 18 at moderate/high risk. As at 12 February 2020, two cases have been discharged and the third one remains symptomatic with a persistent cough, and no secondary transmission has been identified. Effective collaboration between all parties involved in the surveillance and response to emerging threats is required to detect imported cases early and to implement adequate control measures.

Published
2020
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