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1. Genome sequencing of strains of the most prevalent clonal group of O1:K1:H7 Escherichia coli that causes neonatal meningitis in France

Author: Guillaume, Geslain, André, Birgy, Sandrine, Adiba, Mélanie, Magnan, Céline, Courroux, Corinne, Levy, Robert, Cohen, Philippe, Bidet, Stéphane, Bonacorsi, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Centre National de Référence Associé des Escherichia coli - Service de Microbiologie, Hôpital Universitaire Robert-Debré (AP-HP), Institut de biologie de l'ENS Paris (UMR 8197/1024) (IBENS), Département de Biologie - ENS Paris, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Association Clinique et Thérapeutique Infantile du Val-de-Marne, This work was financed by the FERCM (Fonds d’Etudes et de Recherche du Corps Médical), the SFMP (Société Française de Médecine Périnatale) scholarships, the French Pediatric Infectious Diseases Group (GPIP), the Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV) and Pfizer., Institut de biologie de l'ENS Paris (IBENS), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Département de Biologie - ENS Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Bodescot, Myriam, Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), and Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV)
Subjects: Meningitis, Escherichia coli, Models, Genetic, Virulence, Whole Genome Sequencing, Infant, Newborn, lcsh:QR1-502, Infant, Newborn, Diseases, lcsh:Microbiology, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Sequencing data analysis, Escherichia coli, Amoeba model, Humans, Meningitis, France, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Genome, Bacterial, Phylogeny, Research Article, Newborns
Abstract: Background To describe the temporal dynamics, molecular characterization, clinical and ex vivo virulence of emerging O1:K1 neonatal meningitis Escherichia coli (NMEC) strains of Sequence Type complex (STc) 95 in France. The national reference center collected NMEC strains and performed whole genome sequencing (WGS) of O1:K1 STc95 NMEC strains for phylogenetic and virulence genes content analysis. Data on the clinical and biological features of patients were also collected. Ex vivo virulence was assessed using the Dictyostelium discoideum amoeba model. Results Among 250 NMEC strains collected between 1998 and 2015, 38 belonged to O1:K1 STc95. This clonal complex was the most frequently collected after 2004, representing up to 25% of NMEC strains in France. Phylogenetic analysis demonstrated that most (74%) belonged to a cluster designated D-1, characterized by the adhesin FimH30. There is no clinical data to suggest that this cluster is more pathogenic than its counterparts, although it is highly predominant and harbors a large repertoire of extraintestinal virulence factors, including a pS88-like plasmid. Ex vivo virulence model showed that this cluster was generally less virulent than STc95 reference strains of O45S88:H7 and O18:H7 serotypes. However, the model showed differences between several subclones, although they harbor the same known virulence determinants. Conclusions The emerging clonal group O1:K1 STc95 of NMEC strains is mainly composed of a cluster with many virulence factors but of only moderate virulence. Whether its emergence is due to its ability to colonize the gut thanks to FimH30 or pS88-like plasmid remains to be determined. Electronic supplementary material The online version of this article (10.1186/s12866-018-1376-4) contains supplementary material, which is available to authorized users.
Published: 2019
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2. Prevalence of Kingella kingae oropharyngeal carriage and predominance of type a and type b polysaccharide capsules among French young children

Author: Robert Cohen, Romain Basmaci, Corinne Levy, F. Corrard, F. Thollot, Stéphane Bonacorsi, Stéphane Béchet, K. Deschamps, Philippe Bidet, E. Sobral, V. Mathy, Service de Pédiatrie-Urgences, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pédiatrie générale, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-MRB-GRC, Centre Hospitalier Intercommunal de Créteil (CHIC), Centre National de Référence Associé des Escherichia coli - Service de Microbiologie, Hôpital Universitaire Robert-Debré (AP-HP), Association Française de Pédiatrie Ambulatoire (AFPA), Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV)., and Comets, Emmanuelle
Subjects: Microbiology (medical), Male, Neisseriaceae Infections, Oropharynx, Kingella kingae, Serogroup, Microbiology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Risk Factors, Prevalence, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, ComputingMilieux_MISCELLANEOUS, Bacterial Capsules, 0303 health sciences, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, biology, 030306 microbiology, business.industry, Infant, General Medicine, biology.organism_classification, 3. Good health, Infectious Diseases, Carriage, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Genes, Bacterial, Child, Preschool, Carrier State, Female, France, business
Abstract: International audience;
Published: 2018
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3. Neonatal Meningococcal Meningitis In France From 2001 To 2013

Author: Corinne Levy, Laurence Caeymaex, Xavier Durrmeyer, Muhamed-Kheir Taha, Ali Bilal, Robert M. Cohen, Service de Néonatologie [CHI Créteil], Centre Hospitalier Intercommunal de Créteil (CHIC), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], Centre de Recherche Clinique [Créteil] (CRC), 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), Association Clinique et Thérapeutique Infantile du Val-de-Marne, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Financial support was provided in part by Pfizer and the Pediatric Infectious Diseases Group (GPIP) of the French Pediatrics Society (SFP) and the Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV). The NRCM is funded by the Institut Pasteur and the Institut de Veille Sanitaire (InVS).Grants for GPIP/ACTIV from Pfizer, Novartis, Sanofi and GSK during the conduct of the study., Groupe des Pédiatres et microbiologistes de l’Observatoire National des Méningites, Members of the National Reference Center for Meningococci, Institut Pasteur [Paris] (IP), and Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV)
Subjects: Male, MESH: Meningitis, Meningococcal/microbiology, Pediatrics, MESH: Meningitis, Meningococcal/diagnosis, Cefotaxime, MESH: Anti-Bacterial Agents/pharmacology, Neisseria meningitidis, medicine.disease_cause, Infant, Newborn, Diseases, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Aminopenicillin, late-onset, MESH: Meningitis, Meningococcal/drug therapy, MESH: Anti-Bacterial Agents/therapeutic use, Prospective Studies, 030212 general & internal medicine, MESH: France/epidemiology, MESH: Infant, Newborn, MESH: Infant, Newborn, Diseases/drug therapy, meningitis, Anti-Bacterial Agents, 3. Good health, MESH: Infant, Newborn, Diseases/epidemiology, Infectious Diseases, MESH: Neisseria meningitidis/genetics, Female, France, Meningitis, medicine.drug, Microbiology (medical), medicine.medical_specialty, MESH: Infant, Newborn, Diseases/diagnosis, Late onset, MESH: Meningitis, Meningococcal/epidemiology, Meningitis, Meningococcal, 03 medical and health sciences, Disease severity, 030225 pediatrics, medicine, Humans, MESH: Humans, business.industry, Infant, Newborn, medicine.disease, mortality, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Male, MESH: Prospective Studies, MESH: Infant, Newborn, Diseases/microbiology, Penicillin, Pediatrics, Perinatology and Child Health, Meningococcal meningitis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, neonate, business, earlyonset, MESH: Female, MESH: Neisseria meningitidis/drug effects
Abstract: International audience; Among 831 cases of neonatal bacterial meningitis occurring from 2001 to 2013, Neisseria meningitidis was the third most frequent bacterial species found. All cases occurred only in term neonates and were mainly late onset. Serogroup B accounted for 78% of cases. At diagnosis, 27% of cases had at least one sign of disease severity. All strains were susceptible to cefotaxime, but 12% showed intermediate susceptibility to penicillin G and to aminopenicillin.
Published: 2016
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4. Immune debt: Recrudescence of disease and confirmation of a contested concept

Author: Cohen, Robert, Levy, Corinne, Rybak, Alexis, Angoulvant, François, Ouldali, Naim, Grimprel, Emmanuel, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Centre Hospitalier de Versailles André Mignot (CHV), CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Infectious Diseases, [SDV]Life Sciences [q-bio]
Abstract: International audience
Published: 2022
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5. Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Following Implementation of the 13-Valent Pneumococcal Conjugate Vaccine in France

Author: Zein Assad, Morgane Michel, Zaba Valtuille, Andrea Lazzati, Priscilla Boizeau, Fouad Madhi, Jean Gaschignard, Luu-Ly Pham, Marion Caseris, Robert Cohen, Florentia Kaguelidou, Emmanuelle Varon, Corinne Alberti, Albert Faye, François Angoulvant, Bérengère Koehl, Naïm Ouldali, Angoulvant, François, AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Caen Normandie (UNICAEN), Normandie Université (NU), Hôpital Hôtel-Dieu [Paris], Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre d'Investigation Clinique 1426 (CIC 1426), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHI Créteil, Groupe Hospitalier Nord Essonne [Longjumeau], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Jean Verdier [AP-HP], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-MRB-GRC, 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), Laboratoire de Microbiologie Clinique [AP-HP Hôpital européen Georges-Pompidou], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Biologie Intégrée du Globule Rouge (BIGR (UMR_S_1134 / U1134)), and Institut National de la Transfusion Sanguine [Paris] (INTS)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-Université Paris Cité (UPCité)
Subjects: Male, Vaccines, Conjugate, [SDV]Life Sciences [q-bio], Incidence, General Medicine, Anemia, Sickle Cell, [SDV] Life Sciences [q-bio], Cohort Studies, Streptococcus pneumoniae, Child, Preschool, Acute Chest Syndrome, Humans, Female, Child
Abstract: International audience; Importance: Acute chest syndrome (ACS) is one of the leading acute severe complications of sickle-cell disease (SCD). Although Streptococcus pneumoniae (S pneumoniae) is highly prevalent in children with SCD, its precise role in ACS is unclear. The efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) implementation on ACS is still unknown.Objective: To assess the association of PCV13 implementation in the general pediatric population with the incidence of ACS in children with SCD.Design, setting, and participants: This cohort study used an interrupted time-series analysis of patient records from a national hospital-based French surveillance system. All children younger than 18 years with SCD (based on the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision definition) hospitalized in France between January 2007 and December 2019 were included.Exposures: PCV13 implementation.Main outcomes and measures: Monthly incidence of ACS per 1000 children with SCD over time as analyzed by segmented linear regression with autoregressive error; monthly incidence of hospitalization for vaso-occlusive crisis, asthma crisis, and acute pyelonephritis per 1000 children with SCD over the same period as the control outcomes.Results: Among the 107 694 hospitalizations of children with SCD, 4007 episodes of ACS were included (median [IQR] age, 8 [4-12] years; 2228 [55.6%] boys). PCV13 implementation in 2010 was followed by a significant decrease in the incidence of ACS (-0.9% per month; 95% CI, -1.4% to -0.4%; P < .001), with an estimated cumulative change of -41.8% (95% CI, -70.8% to -12.7%) by 2019. Sensitivity analyses yielded the same results, including the incidence of ACS adjusted for that of vaso-occlusive crisis over time. The results were similar among different age groups. By contrast, no change was found for the 3 control outcomes over the study period.Conclusions and relevance: PCV13 implementation was associated with an important reduction in the incidence of ACS in children with SCD. This vaccine benefit provides new evidence of the key role of S pneumoniae in ACS and should be considered when estimating outcomes associated with current PCVs and the potential benefit of next-generation PCVs in children.
Published: 2022
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6. From the original SARS-CoV-2 strain to the Omicron variant: Predictors of COVID-19 in ambulatory symptomatic children

Author: R. Cohen, A. Rybak, N. Ouldali, F. Angoulvant, S. Béchet, V Gajdos, I. Hau, A. Sellam, I. El Aouane El Ghomari, F. Elmerich, C. Batard, A. Auvrignon, E. Grimprel, M. Favier, C. Jung, C. Levy, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre Hospitalier Intercommunal de Créteil (CHIC), Association Française de Pédiatrie Ambulatoire (AFPA), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre de Recherche Clinique [Créteil] (CRC), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Centre Hospitalier Universitaire de Reims (CHU Reims), AP-HP - Hôpital Antoine Béclère [Clamart], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, 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), CHU de Bordeaux Pellegrin [Bordeaux], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Centre Hospitalier de Versailles André Mignot (CHV), Angoulvant, François, École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE)
Subjects: Adult, Adolescent, SARS-CoV-2, [SDV]Life Sciences [q-bio], COVID-19, [SDV] Life Sciences [q-bio], Infectious Diseases, Cross-Sectional Studies, Diagnosis, Omicron variant, Humans, Prospective Studies, Child, Children
Abstract: International audience; Objectives: To determine the predictors of a positive SARS-CoV-2 test in a pediatric ambulatory setting.Patients and methods: We performed a cross-sectional prospective study (November 2020-February 2022) of 93 ambulatory settings in France. We included symptomatic children < 15 years old tested for SARS-CoV-2. For each period corresponding to the spread of the original strain and its variants (period 1: original strain; period 2: Alpha, period 3: Delta; period 4: Omicron), we used a multivariate analysis to estimate adjusted odds ratios (aORs) associated with COVID-19 among age, signs, symptoms or contact, and 95 % confidence intervals (95CIs).Results: Of 5,336 children, 13.9 % (95CI 13.0-14.8) had a positive test. During the first three periods, the positivity rate ranged from 5.6 % (95CI 4.6-6.7) to 12.6 % (95CI 10.8-14.6). The main factors associated with a positive test were contact with an infected adult at home or outside the home (aOR 11.5 [95CI 4.9-26.9] to 38.9 [95CI 19.3-78.7]) or an infected household child (aOR 15.0 [95CI 4.8-47.1] to 28.4 [95CI 8.7-92.6]). By contrast, during period 4, aORs for these predictors were substantially lower (2.3 [95CI 1.1-4.5] to 5.5 [95CI 3.2-7.7]), but the positivity rate was 45.7 % (95CI 42.3-49.2).Conclusions: In pediatric ambulatory settings, before the Omicron period, the main predictor of a positive test was contact with an infected person. During the Omicron period, the odds of these predictors were substantially lower while the positivity rate was higher. An accurate diagnostic strategy should only rely on testing and not on age, signs, symptoms or contact.
Published: 2022
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7. Association between the COVID-19 pandemic and pertussis derived from multiple nationwide data sources, France, 2013 to 2020

Author: Soraya Matczak, Corinne Levy, Camille Fortas, Jérémie F Cohen, Stéphane Béchet, Fatima Aït El Belghiti, Sophie Guillot, Sabine Trombert-Paolantoni, Véronique Jacomo, Yann Savitch, Juliette Paireau, Sylvain Brisse, Nicole Guiso, Daniel Lévy-Bruhl, Robert Cohen, Julie Toubiana, Biodiversité et Epidémiologie des Bactéries pathogènes - Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre de Recherche Clinique [Créteil] (CRC), Centre Hospitalier Intercommunal de Créteil (CHIC), Association Française de Pédiatrie Ambulatoire (AFPA), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre national de Référence de la Coqueluche et autres Bordetelloses - National Reference Center for Whooping Cough and other Bordetella infections (CNR), Institut Pasteur [Paris] (IP), Laboratoire CERBA [Saint Ouen l'Aumône], Eurofins Biomnis, Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)
Subjects: Epidemiology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Whooping Cough, Virology, Communicable Disease Control, Public Health, Environmental and Occupational Health, COVID-19, Humans, Information Storage and Retrieval, France, Child, Pandemics
Abstract: Background Interventions to mitigate the COVID-19 pandemic may impact other respiratory diseases. Aims We aimed to study the course of pertussis in France over an 8-year period including the beginning of the COVID-19 pandemic and its association with COVID-19 mitigation strategies, using multiple nationwide data sources and regression models. Methods We analysed the number of French pertussis cases between 2013 and 2020, using PCR test results from nationwide outpatient laboratories (Source 1) and a network of the paediatric wards from 41 hospitals (Source 2). We also used reports of a national primary care paediatric network (Source 3). We conducted a quasi-experimental interrupted time series analysis, relying on negative binomial regression models. The models accounted for seasonality, long-term cycles and secular trend, and included a binary variable for the first national lockdown (start 16 March 2020). Results We identified 19,039 pertussis cases from these data sources. Pertussis cases decreased significantly following the implementation of mitigation measures, with adjusted incidence rate ratios of 0.10 (95% CI: 0.04–0.26) and 0.22 (95% CI: 0.07–0.66) for Source 1 and Source 2, respectively. The association was confirmed in Source 3 with a median of, respectively, one (IQR: 0–2) and 0 cases (IQR: 0–0) per month before and after lockdown (p = 0.0048). Conclusions The strong reduction in outpatient and hospitalised pertussis cases suggests an impact of COVID-19 mitigation measures on pertussis epidemiology. Pertussis vaccination recommendations should be followed carefully, and disease monitoring should be continued to detect any resurgence after relaxation of mitigation measures.
Published: 2022
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8. Hyper inflammatory syndrome following COVID-19 mRNA vaccine in children: A national post-authorization pharmacovigilance study

Author: Naïm Ouldali, Haleh Bagheri, Francesco Salvo, Denise Antona, Antoine Pariente, Claire Leblanc, Martine Tebacher, Joëlle Micallef, Corinne Levy, Robert Cohen, Etienne Javouhey, Brigitte Bader-Meunier, Caroline Ovaert, Sylvain Renolleau, Veronique Hentgen, Isabelle Kone-Paut, Nina Deschamps, Loïc De Pontual, Xavier Iriart, Christelle Gras-Le Guen, François Angoulvant, Alexandre Belot, Aurelie Donzeau, Layal El Aridi, Sophie Lety, Bertrand Leboucher, Agnes Baur, Lucas Jeusset, Maelle Selegny, Cristian Fedorczuk, Marion Lajus, Philippe Bensaid, Yacine Laoudi, Charlotte Pons, Anne-Cécile Robert, Camille Beaucourt, Muriel Richard, Etienne Goisque, Olivier Brissaud, Pierre Segretin, Julie Molimard, Marie-Clothilde Orecel, Gregoire Benoit, Lucille Bongiovanni, Margaux Guerder, Robin Pouyau, Jean-Marie De Guillebon De Resnes, Ellia Mezgueldi, Fleur Cour-Andlauer, Come Horvat, Pierre Poinsot, Cecile Frachette, Antoine Ouziel, Yves Gillet, Catherine Barrey, Jacques Brouard, Florence Villedieu, Vathanaksambath Ro, Narcisse Elanga, Vincent Gajdos, Romain Basmaci, Hadile Mutar, Sébastien Rouget, Elodie Nattes, Isabelle Hau, Sandra Biscardi, Houmam El Jurdi, Camille Jung, Denis Semama, Frederic Huet, Anne-Marie Zoccarato, Mayssa Sarakbi, Guillaume Mortamet, Cécile Bost-Bru, Joachim Bassil, Caroline Vinit, Véronique Hentgen, Pascal Leroux, Valérie Bertrand, Caroline Parrod, Irina Craiu, Philippe Durand, Pierre Tissiere, Caroline Claude, Guillaume Morelle, Tamazoust Guiddir, Charlotte Borocco, Frédérique Delion, Camille Guillot, Stéphane Leteurtre, François Dubos, Mylene Jouancastay, Alain Martinot, Valentine Voeusler, Jeanne Languepin, Nathalie Garrec, Arnaud Chalvon Demersay, Aurélie Morand, Emmanuelle Bosdure, Noémie Vanel, Fabrice Ughetto, Fabrice Michel, Marie Caujolle, Renaud Blonde, Jacqueline Nguyen, Olivier Vignaud, Caroline Masserot-Lureau, François Gouraud, Carine Araujo, Tara Ingrao, Sanaa Naji, Mohammed Sehaba, Christine Roche, Aurelia Carbasse, Christophe Milesi, Mustapha Mazeghrane, Sandrine Haupt, Cyril Schweitzer, Benedicte Romefort, Elise Launay, Christèle Gras-Le Guen, Ahmed Ali, Nathalie Blot, Antoine Tran, Anne Rancurel, Mickael Afanetti, Sophie Odorico, Deborah Talmud, Anais Chosidow, Anne-Sophie Romain, Emmanuel Grimprel, Marie Pouletty, Jean Gaschignard, Olivier Corseri, Albert Faye, Isabelle Melki, Camille Ducrocq, Cherine Benzoïd, Johanna Lokmer, Stéphane Dauger, Maryline Chomton, Anna Deho, Fleur Lebourgeois, Fabrice Lesage, Florence Moulin, Laurent Dupic, Yael Pinhas, Agathe Debray, Martin Chalumeau, Véronique Abadie, Pierre Frange, Jeremie F Cohen, Slimane Allali, William Curtis, Zahra Belhadjer, Johanne Auriau, Mathilde Méot, Lucile Houyel, Damien Bonnet, Christophe Delacourt, Brigitte Bader Meunier, Pierre Quartier, Youssef Shaim, Laurence Baril, Samuel Crommelynck, Baptiste Jacquot, Philippe Blanc, Natacha Maledon, Blandine Robert, Camille Loeile, Clémence Cazau, Gauthier Loron, Simona Gaga, Cécile Vittot, Loubna El Nabhani, François Buisson, Muriel Prudent, Hugues Flodrops, Fadhila Mokraoui, Simon Escoda, Laurent Bonnemains, Sarah-Louisa Mahi, Clara Mertes, Joelle Terzic, Julie Helms, Charlotte Idier, Soraya Chenichene, Nicoleta Magdolena Ursulescu, Gladys Beaujour, Abdelhak Hakim, Alice Miquel, Agnès Rey, Arnaud Wiedermann, Anne Charbonneau, Agnès Veauvy-Juven, Alexandrine Ferry, Alexis Mandelcwajg, Alix Rousseau, Amandine Prenant, Anne-Laure Bourneuf, Anne Filleron, Audrey Robine, Arthur Félix, Aude Parizel, Aurélie Labarre, Aymeric Cantais, Barbara Ros, Basile Coulon, Blandine Biot, Bérengère Dalichoux, Benjamin Fournier, Benoit Cagnard, Blandine Vanel, David Brossier, Bruno Ménager, Bruno Ozanne, Carole Marie-Jeanne, Camille Bergerot, Camille Chavy, Camille Guidon, Candice Fabre, Caroline Galeotti, Catherine Baker, Claire Ballot-Schmit, Céline Belleau, Céline Charasse, Caroline Favel, Chadia Toumi, Charlène Ferrandiz, Charlotte Couturier, Charlotte Pouchoux, Maryline Chomton-Cailliez, Charlotte Kevorkian-Verguet, Clément Brunet, Céline Manteau, Clémence Mougey, Coline Santy, Coralie Fitament, Charlotte Petriat, Charlotte Rebelle, Cyril Charron, Maxime Dartus, David Toulorge, Cécile Guillou-Debuisson, Dorann Bartebin, Valérie Klein, E Broustal, E Desselas, Elodie Marteau, Emmanuelle Bouvrot, Elise Delacroix, Edeline Coinde, Loubna Elnabhani, Elsa Amouyal, Emilie Chaillou, Emeline Gabilly-Bernard, Emilie Ruiz, Emilie Thibault, Emilie Robin, Etienne Darrieux, Eva Blondel, Floriane Socchi, François Cazassus, Fanny Bajolle, Fatma Lacin, Fouad Madhi, Franck Zekre, François Guerin, Gerald Boussicault, Henri Ginies, Gnansounou Magloire, Guilhem Arnold, Ines Coulognon, Iona Sicard-Cras, Jean-Emmanuel Kahn, Jeanne Bordet, Jeanne-Lise Fausser, Jean-François Baleine, Josephine Brice, Julie Gendras, Kaan Pekin, Karine Norbert, Clément Karsenty, Léa Savary, Laurence Martinat, Léa Lesniewski, Lorelei Charbonnier, Louise Alexandre, Lucas Percheron, Marie Vincenti, Manon Lanzini, Margot Grisval, Marianne Mercy, Marie-Emilie Lampin, Marie Desgranges, Marie Duperril, Marie-Clothilde Orcel, Marion Audier, Marion Favier, Mathieu Carpentier, Mathilde Balcean, Mathilde Bonnet, Maurine Jouret, Marie Delattre, Michael Levy, Michael Valensi, Mickael Shum, Morgane Dumortier, Morgane Gelin, Morgane Nemmouchi, Morgane Williaume, M Sebaha, Nicoleta Genetay-Stanescu, Nathan Giroux, Nicolas Crassard, Neil Derridj, Noemie Lachaume, Oscar Werner, Olivier Guilluy, Olivier Richer, Olivier Tirel, Aurianne Pauvert, Paul Casha, Noémie Perez, Pauline Gras, Pierre-Louis Leger, Marion Pinchou, Pierre Mornand, Prisca Largo, Ramona-Christina Ibanez, Charlotte Roulland, Salam Hadah Albarazi, Said Bichali, Sarah Faton, Amandine Schott, Sébastien Walser, Severine Guillaume, Solene Vincent, Sophie Galene-Gromez, Stanislas Kozisek, Thierry Maugard, Thierry Blanc, Thierry Navarro, Thomas Lauvray, Tamas Kovacs, Valérie Launay, Véronique Despert, Victoria Lhostis, Virginie Gall, Xavier Micaelli, Yasmine Benadjaoud, Zied Matoussi, Hélène Géniaux, Anthony Facile, Tessa Pietri, Pascale Palassin, Sylvine Pinel, Laurent Chouchana, Delphine Callot, Charlène Boulay, Hôpital Robert Debré, CHU Sainte Justine [Montréal], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), 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), CHU Bordeaux [Bordeaux], Santé publique France - French National Public Health Agency [Saint-Maurice, France], Les Hôptaux universitaires de Strasbourg (HUS), CHU Strasbourg, CHU Marseille, Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Créteil, 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), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [CHU Necker] (RAISE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital de la Timone [CHU - APHM] (TIMONE), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Evaluation thérapeutique et pharmacologie périnatale et pédiatrique (EA_7323), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier de Versailles André Mignot (CHV), Centre de Référence des Maladies Auto-Inflammatoires et des Amyloses [CH Versailles] (CeRéMAIA - Hôpital André Mignot), Hôpital Bicêtre, Université Paris-Saclay, CH de Saint-Malo [Broussais], Hôpital Jean Verdier [AP-HP], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), 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), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant / National Referee Centre for Rheumatic and AutoImmune and Systemic Diseases in Children [Lyon] (RAISE), European Society for Paediatric Infectious Diseases, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPC), CHU Toulouse [Toulouse], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [Paris] (Institut IMAGINE/RAISE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Imagine [Paris Necker] (2I), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE)
Subjects: Oncology, [SDV]Life Sciences [q-bio], Health Policy, Multisystem inflammatory syndrome in children, Internal Medicine, COVID-19 mRNA vaccine, BNT162b2, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, SARS-COV-2, Hyper-inflammatory syndrome, Child
Abstract: International audience; BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is the most severe clinical entity associated with pediatric SARS-CoV-2 infection with a putative role of the spike protein into the immune system activation. Whether COVID-19 mRNA vaccine can induce this complication in children is unknown. We aimed to assess the risk of hyper-inflammatory syndrome following COVID-19 mRNA vaccine in children. METHODS: We conducted a post-authorization national population-based surveillance using the French enhanced pharmacovigilance surveillance system for COVID-19 vaccines. All cases of suspected hyper-inflammatory syndrome following COVID-19 mRNA vaccine in 12-17-year-old children between June 15(th), 2021 and January 1(st), 2022, were reported. Cases were reviewed according to WHO criteria for MIS-C. The reporting rate of this syndrome was compared to the MIS-C rate per 1,000,000 12-17-year-old children infected by SARS-CoV-2. FINDINGS: Up to January 2022, 8,113,058 COVID-19 mRNA vaccine doses were administered to 4,079,234 12-17-year-old children. Among them, 12 presented a hyper-inflammatory syndrome with multisystemic involvement. Main clinical features included male predominance (10/12, 83%), cardiac involvement (10/12, 83%), digestive symptoms (10/12, 83%), coagulopathy (7/12, 58%), cytolytic hepatitis (6/12, 50%), and shock (5/12, 42%). 4/12 (33%) required intensive care unit transfer, and 3/12 (25%) hemodynamic support. All cases recovered. In eight cases, no evidence of previous SARS-CoV-2 infection was found. The reporting rate was 1.5 (95%CI [0.8; 2.6]) per 1,000,000 doses injected, i.e. 2.9 (95%CI [1.5; 5.1]) per 1,000,000 12-17-year-old vaccinated children. As a comparison, 113 MIS-C (95%CI [95; 135]) occurred per 1,000,000 12-17-year-old children infected by SARS-CoV-2. INTERPRETATION: Very few cases of hyper-inflammatory syndrome with multi-organ involvement occurred following COVID-19 mRNA vaccine in 12-17-year-old children. The low reporting rate of this syndrome, compared to the rate of post-SARS-CoV-2 MIS-C in the same age-group, largely supports the vaccination in a context of an important circulation of SARS-CoV-2. FUNDING: ESPID Fellowship Award; Grandir-Fonds de Solidarité Pour L'enfance.
Published: 2022
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9. Association of Nonpharmaceutical Interventions During the COVID-19 Pandemic With Invasive Pneumococcal Disease, Pneumococcal Carriage, and Respiratory Viral Infections Among Children in France

Author: Alexis Rybak, Corinne Levy, François Angoulvant, Anne Auvrignon, Piotr Gembara, Kostas Danis, Sophie Vaux, Daniel Levy-Bruhl, Sylvie van der Werf, Stéphane Béchet, Stéphane Bonacorsi, Zein Assad, Andréa Lazzati, Morgane Michel, Florentia Kaguelidou, Albert Faye, Robert Cohen, Emmanuelle Varon, Naïm Ouldali, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Association Française de Pédiatrie Ambulatoire (AFPA), Santé publique France - French National Public Health Agency [Saint-Maurice, France], 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), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre Hospitalier Intercommunal de Créteil (CHIC), 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), Centre Hospitalier Universitaire Sainte-Justine and Pediatrics, Université de Montréal (UdeM), and This work was supported by funding from Pfizer (via ACTIV) for the pneumococcal carriage study, funding from the French Institute for Public Health Surveillance (via the National Reference Center for Pneumococci) for the invasive pneumococcal disease study, and a 2021-2023 fellowship award from the European Society of Pediatric Infectious Diseases (Dr Ouldali).
Subjects: Male, MESH: Humans, MESH: Influenza, Human, [SDV]Life Sciences [q-bio], COVID-19, Infant, General Medicine, MESH: Infant, Pneumococcal Infections, MESH: Male, Cohort Studies, MESH: Viruses, MESH: Influenza Vaccines, Streptococcus pneumoniae, Influenza Vaccines, MESH: Child, Influenza, Human, Viruses, Humans, MESH: COVID-19, MESH: Pneumococcal Infections, Child, Pandemics, MESH: Cohort Studies, MESH: Streptococcus pneumoniae
Abstract: International audience; Key PointsQuestion Was the implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic associated with changes in the incidence of invasive pneumococcal disease (IPD) and associated pneumococcal carriage and respiratory viral infections (RSVs) in children in France?Findings In this cohort study using interrupted time series analysis of data from multiple national surveillance systems involving 11 944 children, the incidence of pediatric IPD decreased after implementation of NPIs during the COVID-19 pandemic. This decrease was associated with decreases in influenza and RSV cases, but the pneumococcal carriage rate remained stable.Meaning These results suggest that the established association between pneumococcal carriage and IPD was modified after viral epidemiological changes associated with NPIs, suggesting that interventions targeting respiratory viruses may help prevent a large proportion of pediatric IPD cases.AbstractImportance An association between pneumococcal nasopharyngeal carriage and invasive pneumococcal disease (IPD) has been previously established. However, it is unclear whether the decrease in IPD incidence observed after implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic was associated with concomitant changes in pneumococcal carriage and respiratory viral infections.Objective To assess changes in IPD incidence after the implementation of NPIs during the COVID-19 pandemic and examine their temporal association with changes in pneumococcal carriage rate and respiratory viral infections (specifically respiratory syncytial virus [RSV] and influenza cases) among children in France.Design, Setting, and Participants This cohort study used interrupted time series analysis of data from ambulatory and hospital-based national continuous surveillance systems of pneumococcal carriage, RSV and influenza-related diseases, and IPD between January 1, 2007, and March 31, 2021. Participants included 11 944 children younger than 15 years in France.Exposures Implementation of NPIs during the COVID-19 pandemic.Main Outcomes and Measures The estimated fraction of IPD change after implementation of NPIs and the association of this change with concomitant changes in pneumococcal carriage rate and RSV and influenza cases among children younger than 15 years. The estimated fraction of change was analyzed using a quasi-Poisson regression model.Results During the study period, 5113 children (median [IQR] age, 1.0 [0.6-4.0] years; 2959 boys [57.9%]) had IPD, and 6831 healthy children (median [IQR] age, 1.5 [0.9-3.9] years; 3534 boys [51.7%]) received a swab test. Data on race and ethnicity were not collected. After NPI implementation, IPD incidence decreased by 63% (95% CI, −82% to −43%; P
Published: 2022
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10. Coxsackievirus A6 Recombinant Subclades D3/A and D3/H Were Predominant in Hand-Foot-And-Mouth Disease Outbreaks in the Paediatric Population, France, 2010–2018

Author: Stéphanie Tomba Ngangas, Maxime Bisseux, Gwendoline Jugie, Céline Lambert, Robert Cohen, Andreas Werner, Christine Archimbaud, Cécile Henquell, Audrey Mirand, Jean-Luc Bailly, Université Clermont Auvergne, CNRS, LMGE, 63000 Clermont–Ferrand, France, Service de Virologie Médicale et Moléculaire [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Association Française de P ediatrie Ambulatoire (AFPA), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-CH de Troyes
Subjects: Male, Sequence Analysis, DNA, atypical hand-foot-and-mouth disease, enterovirus surveillance, clinical epidemiology, molecular typing, third-generation sequencing, whole-genome sequencing, recombination, Disease Outbreaks, Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Foot-and-Mouth Disease, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Animals, Humans, Female, Hand, Foot and Mouth Disease, Enterovirus
Abstract: International audience; Coxsackievirus A6 (CVA6) emerged as the most common enterovirus of seasonal outbreaks of hand-foot-and-mouth disease (HFMD). We investigated CVA6 genetic diversity among the clinical phenotypes reported in the paediatric population during sentinel surveillance in France between 2010 and 2018. CVA6 infection was confirmed in 981 children (mean age 1.52 years [IQR 1.17–2.72]) of whom 564 (58%) were males. Atypical HFMD was reported in 705 (72%) children, followed by typical HFMD in 214 (22%) and herpangina in 57 (6%) children. Throat specimens of 245 children were processed with a target-enrichment new-generation sequencing approach, which generated 213 complete CVA6 genomes. The genomes grouped within the D1 and D3 clades (phylogeny inferred with the P1 genomic region). In total, 201 genomes were classified among the recombinant forms (RFs) A, B, F, G, H, and N, and 12 genomes were assigned to 5 previously unreported RFs (R–V). The most frequent RFs were A (58%), H (19%), G (6.1%), and F (5.2%). The yearly number of RFs ranged between 1 (in 2012 and 2013) and 6 (2018). The worldwide CVA6 epidemic transmission began between 2005 and 2007, which coincided with the global spread of the recombinant subclade D3/RF-A.
Published: 2022
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11. Vaccins conjugués contre le pneumocoque chez l’enfant

Author: Emmanuelle Varon, Robert M. Cohen, Corinne Levy, N. Ouldali, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Française de Pédiatrie Ambulatoire (AFPA), 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), CHI Créteil, and CCSD, Accord Elsevier
Subjects: 0301 basic medicine, [SCCO]Cognitive science, 03 medical and health sciences, 0302 clinical medicine, 030106 microbiology, Pediatrics, Perinatology and Child Health, [SCCO] Cognitive science, 030212 general & internal medicine, 3. Good health
Abstract: Pneumococci (more than 90 different serotypes have been identified) are the leading cause of bacterial infections in humans and a major cause of mortality and morbidity worldwide. The risk of pneumococcal infection is particularly high in children in the first 2 years of life, in subjects over 65 years of age, and at any age in patients with risk factors. The introduction of pneumococcal vaccines has led to a significant reduction in pneumococcal infections significantly reducing mortality and morbidity, but infections will not disappear: the selection pressure exerted by vaccines that have led to serotypic replacement. These vaccines are now included in the vaccination schedules of more than 180 countries around the world., Les pneumocoques (plus de 90 sérotypes différents ont été identifiés) représentent la première cause d’infections bactériennes chez l’homme et une cause majeure de mortalité et de morbidité dans le monde. Le risque d’infection à pneumocoque est particulièrement élevé chez les enfants dans les 2 premières années de vie, chez les sujets âgés de plus de plus de 65 ans, et à tout âge chez des patients présentant des facteurs de risque. L’introduction des vaccins contre le pneumocoque a permis une diminution franche des infections pneumococciques réduisant significativement la mortalité et la morbidité, mais les infections ne vont pas disparaître : la pression de sélection exercée par les vaccins ayant conduit à un remplacement sérotypique. Ces vaccins sont aujourd’hui inclus dans les calendriers vaccinaux de plus de 180 pays dans le monde.
Published: 2020
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12. Respective roles of non-pharmaceutical interventions in bronchiolitis outbreaks: an interrupted time-series analysis based on a multinational surveillance system

Author: Lea, Lenglart, Naim, Ouldali, Kate, Honeyford, Zsolt, Bognar, Silvia, Bressan, Danilo, Buonsenso, Liviana, Da Dalt, Tisham, De, Ruth, Farrugia, Ian K, Maconochie, Henriette A, Moll, Rianne, Oostenbrink, Niccolo, Parri, Damian, Roland, Katy, Rose, Esra, Akyüz Özkan, François, Angoulvant, Camille, Aupiais, Clarissa, Barber, Michael, Barrett, Romain, Basmaci, Susana, Castanhinha, Antonio, Chiaretti, Sheena, Durnin, Patrick, Fitzpatrick, Laszlo, Fodor, Borja, Gomez, Susanne, Greber-Platzer, Romain, Guedj, Florian, Hey, Lina, Jankauskaite, Daniela, Kohlfuerst, Ines, Mascarenhas, Anna Maria, Musolino, Zanda, Pučuka, Sofia, Reis, Alexis, Rybak, Petra, Salamon, Matthias, Schaffert, Keren, Shahar-Nissan, Maria Chiara, Supino, Ozlem, Teksam, Caner, Turan, Roberto, Velasco, Ruud G, Nijman, Luigi, Titomanlio, Vanda, Anacleto, Orkun, Aydin, Elena, Bellelli, Ron, Berant, Thibault, De Groc, Sara, Geitoeira, Florian, Hoffmann, Franziska, Leeb, Fiona, Leonard, Mark, Lyttle, Lia, Mano, Vytenis, Masillonis, Rosa, Morello, Francisa, Saraiva, Gabor, Simon, Ines Silva, Costa, Joao Sous, Marques, Jonas, Thüminger, Corinne, Vasilico, Anna Chiara, Vittucci, Christoph, Zurl, Pediatrics, Business Economics, Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Sainte Justine [Montréal], Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), The institute of cancer research [London], Pál Heim Children's Hospital = Heim Pál Gyermekkórház [Budapest], Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Imperial College London, Mater Dei Hospital [Malta], St Mary's Hospital [London], Hammersmith Hospital NHS Imperial College Healthcare, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Azienda Ospedaliero Universitaria A. Meyer [Firenze, Italy], University of Leicester, University Hospitals Leicester, Ondokuz Mayis University (OMU), Université Paris Cité (UPCité), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jean Verdier [AP-HP], North Bristol NHS Trust [Bristol, UK], Children's Health Ireland [Crumlin, Dublin, Ireland] (CHI), University College Dublin [Dublin] (UCD), Hôpital Louis Mourier - AP-HP [Colombes], Centro Hospitalar de Lisboa Central E.P.E, CHI at Tallaght Children's Outpatient and Emergency Care Unit [Tallaght, Ireland] (COECU), CHI at Temple Street [Temple Street, Ireland] (TS), Fejér County Szent György University Teaching Hospital [Szekesfehervar, Hungary] (FCSGUTH), Hospital Universitario Cruces = Cruces University Hospital, Medizinische Universität Wien = Medical University of Vienna, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Dr von Hauner Children's Hospital [Munich, Germany], Ludwig-Maximilians-Universität München (LMU), Ludwig-Maximilians University [Munich] (LMU), Hospital of Lithuanian University of Health Sciences Kauno Klinikos [Kaunas, Lithuania], Medical University of Graz, Hospital Prof Doutor Fernando Fonseca [Amadora, Portugal], Bambino Gesù Children’s Hospital [Rome, Italy], Children's Clinical University Hospital [Riga, Latvia] (CCUH), Centro Hospitalar Tondela-Viseu [Viseu, Portugal] (CHTV), Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Schneider Children’s Medical Center [Petah Tikva, Israel] (SCMC), Hacettepe University = Hacettepe Üniversitesi, Mersin University, Rio Hortega University Hospital (Hospital Universitario Río Hortega) [Valladolid, Spain] (RHUH), Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), EPISODES Study Group., and Angoulvant, François
Subjects: [SDV] Life Sciences [q-bio], Pulmonary and Respiratory Medicine, SDG 3 - Good Health and Well-being, [SDV]Life Sciences [q-bio]
Abstract: BackgroundBronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries.MethodsWe conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling.ResultsIn total, 42 916 children were included. We observed an overall cumulative 78% (95% CI −100– −54%; pConclusionsSeveral NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis.
Published: 2022
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13. Fall of Community-Acquired Pneumonia in Children following COVID-19 Non-Pharmaceutical Interventions: A Time Series Analysis

Author: Corinne Levy, Julie Tort, Robert Cohen, David D. Yang, Vincent Gajdos, François Angoulvant, David Skurnik, Cécile Schrimpf, Naim Ouldali, Romain Guedj, Alexis Rybak, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Necker - Enfants Malades [AP-HP], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Antoine Béclère [Clamart], Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital Robert Debré Paris, Hôpital Robert Debré, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHI Créteil, 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), Épidémiologie des radiations, épidémiologie clinique des cancers et survie (U1018 (Équipe 3) ), Institut Gustave Roussy (IGR)-Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Harvard Medical School [Boston] (HMS), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, and Gestionnaire, HAL Sorbonne Université 5
Subjects: Microbiology (medical), Pediatric emergency, medicine.medical_specialty, community-acquired pneumonia, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], Psychological intervention, mitigation measures, Article, Interrupted Time Series Analysis, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 0302 clinical medicine, Community-acquired pneumonia, children, 030225 pediatrics, Immunology and Allergy, Medicine, 030212 general & internal medicine, Molecular Biology, non-pharmaceutical interventions, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, General Immunology and Microbiology, business.industry, COVID-19, medicine.disease, 3. Good health, Pneumonia, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, time series analysis, Hospital admission, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of coronavirus disease 2019 (COVID-19). A first national lockdown was decided in France on the 17 March 2020. These measures had an impact on other viral and non-viral infectious diseases. We aimed to assess this impact on community-acquired pneumonia (CAP) in children. We performed a quasi-experimental interrupted time series analysis. We used data from a French prospective surveillance system of six pediatric emergency departments (PEDs). All visits from 1 January 2017 to 31 December 2020 were included. Pre-intervention period was before 17 March 2020 and post-intervention period was after 18 March 2020. We estimated the impact on the weekly number of visits for CAP and CAP admission using quasi-Poisson regression modeling. A total of 981,782 PEDs visits were analyzed, among them, 8318 visits were associated with CAP, and 1774 of these were followed by a hospital admission. A major decrease was observed for CAP visits (−79.7% 95% CI [−84.3, −73.8], p &lt, 0.0001), and CAP admission (−71.3% 95 CI [−78.8, −61.1], 0.0001). We observed a dramatic decrease of CAP in children following NPIs implementation. Further studies are required to assess the long-term impact of these measures.
Published: 2021
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14. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap?

Author: Alexis Rybak, Nicole Guiso, Muhamed-Kheir Taha, Marion Ashman, Corinne Levy, Robert Cohen, Naim Ouldali, Emmanuel Grimprel, François Angoulvant, Emmanuelle Varon, Centre Hospitalier Intercommunal de Créteil (CHIC), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 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), Association Française de Pédiatrie Ambulatoire (AFPA), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), AP-HP Hôpital universitaire Robert-Debré [Paris], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), No funding, Institut Pasteur [Paris] (IP), HAL-SU, Gestionnaire, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), and École Pratique des Hautes Études (EPHE)
Subjects: medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Vaccination schedule, Bordetella, Population, Covid-19 pandemic, Infections, Measles, VZV, Article, Herd immunity, Immune System Phenomena, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Immunity, 030225 pediatrics, Pandemic, medicine, Neisseria meningitides, Humans, 030212 general & internal medicine, Child, Intensive care medicine, education, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Vaccines, education.field_of_study, business.industry, Transmission (medicine), COVID-19, medicine.disease, vaccination, 3. Good health, Vaccination, Infectious Diseases, Streptococcus pneumoniae, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.IMM]Life Sciences [q-bio]/Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Since the beginning of the COVID-19 pandemic, reduced incidence of many viral and bacterial infections has been reported in children: bronchiolitis, varicella, measles, pertussis, pneumococcal and meningococcal invasive diseases. The purpose of this opinion paper is to discuss various situations that could lead to larger epidemics when the non-pharmaceutical interventions (NPI) imposed by the SARS-CoV-2 epidemic will no longer be necessary.While NPIs limited the transmission of SARS-CoV-2, they also reduced the spread of other pathogens during and after lockdown periods, despite the re-opening of schools since June 2020 in France. This positive collateral effect in the short term is welcome as it prevents additional overload of the healthcare system. The lack of immune stimulation due to the reduced circulation of microbial agents and to the related reduced vaccine uptake induced an "immunity debt" which could have negative consequences when the pandemic is under control and NPIs are lifted. The longer these periods of "viral or bacterial low-exposure" are, the greater the likelihood of future epidemics. This is due to a growing proportion of "susceptible" people and a declined herd immunity in the population. The observed delay in vaccination program without effective catch-up and the decrease in viral and bacterial exposures lead to a rebound risk of vaccine-preventable diseases.With a vaccination schedule that does not include vaccines against rotavirus, varicella, and serogroup B and ACYW Neisseria meningitidis, France could become more vulnerable to some of these rebound effects.
Published: 2021
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15. SARS-CoV-2 transmission among children and staff in daycare centres during a nationwide lockdown in France: a cross-sectional, multicentre, seroprevalence study

Author: Didier Pinquier, Romain Basmaci, Robert M. Cohen, E. Lachassinne, Vincent Gajdos, Anne-Sophie Romain, Aurélie Naud, Ségolène Brichler, Xavier Vuillaume, Oscar Lescano, Loïc de Pontual, Coralie Bloch-Queyrat, Camille Aupiais, Carole Guilluy, Gaelle Pinto Cardoso, Elisabeth Hausherr, Bahia Rabehi, Véronique Hentgen, François Vié le Sage, M.-A. Dommergues, Mathie Lorrot, Lorelei Charbonnier, Camille Jung, Anais Chosidow, Nathalie Mestre, Jean-Ralph Zahar, Roselyne Masson, Evelyne Wannepain, Marion Caseris, Pierre-Yves Boëlle, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pédiatrie, Hopital Robert Debré (APHP), Université Paris Diderot - Paris 7 (UPD7), Hôpital Armand Trousseau [AP-HP] (AP-HP), Service de Pédiatrie-Urgences [Hopital Louis Mourier - APHP, Colombes], Hopital Louis Mourier - AP-HP [Colombes], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Centre Hospitalier de Versailles André Mignot (CHV), CHU Rouen, Normandie Université (NU), Protection maternelle et infantile [Seine-Saint-Denis, Bobigny], Santé de la femme enceinte et de l'enfant [Paris] (PMI), Ville de Paris, Centre de Ressource Biologique [CHI Créteil] (Centre de Recherche Clinique), Centre Hospitalier Intercommunal de Créteil (CHIC), AP-HP - Hôpital Antoine Béclère [Clamart], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Service de Microbiologie Clinique [Hôpital Avicenne - APHP], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratory of molecular mechanisms of hematologic disorders and therapeutic implications (ERL 8254 - Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), COVIDOCRECHE collaborators: Lorelei Charbonnier, Anais Chosidow, Véronique Hentgen, Oscar Lescano, Nathalie Mestre, Gaelle Pinto Cardoso, Roselyne Masson, Bahia Rabehi, Anne-Sophie Romain, François Vié le Sage, Xavier Vuillaume, Comets, Emmanuelle, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Louis Mourier - AP-HP [Colombes], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)
Subjects: Adult, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cross-sectional study, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Antibodies, Viral, Serology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Seroepidemiologic Studies, law, 030225 pediatrics, Epidemiology, Developmental and Educational Psychology, Humans, Medicine, Seroprevalence, Pediatrics, Perinatology, and Child Health, 030212 general & internal medicine, Immunoassay, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], SARS-CoV-2, business.industry, COVID-19, Infant, Child Day Care Centers, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], 3. Good health, Cross-Sectional Studies, Transmission (mechanics), Immunoglobulin M, Child, Preschool, Immunoglobulin G, Relative risk, Pediatrics, Perinatology and Child Health, France, business, Demography
Abstract: Summary Background The extent to which very young children contribute to the transmission of SARS-CoV-2 is unclear. We aimed to estimate the seroprevalence of antibodies against SARS-CoV-2 in daycare centres that remained open for key workers' children during a nationwide lockdown in France. Methods Children and staff who attended one of 22 daycare centres during a nationwide lockdown in France (between March 15 and May 9, 2020) were included in this cross-sectional, multicentre, seroprevalence study. Hospital staff not occupationally exposed to patients with COVID-19, or to children, were enrolled in a comparator group. The primary outcome was SARS-CoV-2 seroprevalence in children, daycare centre staff, and the comparator group. The presence of antibodies against SARS-CoV-2 in capillary whole blood was measured with a rapid chromatographic immunoassay. We computed raw prevalence as the percentage of individuals with a positive IgG or IgM test, and used Bayesian smoothing to account for imperfect sensitivity and specificity of the assay. This study is registered with ClinicalTrials.gov, NCT04413968. Findings Between June 4 and July 3, 2020, we enrolled 327 children (mean age 1·9 [SD 0·9] years; range 5 months to 4·4 years), 197 daycare centre staff (mean age 40 [12] years), and 164 adults in the comparator group (42 [12] years). Positive serological tests were observed for 14 children (raw seroprevalence 4·3%; 95% CI 2·6–7·1) and 14 daycare centre staff (7·7%; 4·2–11·6). After accounting for imperfect sensitivity and specificity of the assay, we estimated that 3·7% (95% credible interval [95% CrI] 1·3–6·8) of the children and 6·8% (3·2–11·5) of daycare centre staff had SARS-CoV-2 infection. The comparator group fared similarly to the daycare centre staff; nine participants had a positive serological test (raw seroprevalence 5·5%; 95% CI 2·9–10·1), leading to a seroprevalence of 5·0% (95% CrI 1·6–9·8) after accounting for assay characteristics. An exploratory analysis suggested that seropositive children were more likely than seronegative children to have been exposed to an adult household member with laboratory-confirmed COVID-19 (six [43%] of 14 vs 19 [6%] of 307; relative risk 7·1 [95% CI 2·2–22·4]). Interpretation According to serological test results, the proportion of young children in our sample with SARS-CoV-2 infection was low. Intrafamily transmission seemed more plausible than transmission within daycare centres. Further epidemiological studies are needed to confirm this exploratory hypothesis. Funding Assistance Publique—Hopitaux de Paris; Mairie de Paris, Conseil Departemental de Seine Saint Denis. Translations For the French translation of the abstract see Supplementary Materials section.
Published: 2021
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16. Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children

Author: Fanny Bajolle, Mathie Lorrot, Arnaud Wiedemann, Marion Grimaud, Slimane Allali, Fouad Madhi, Mehdi Oualha, Ulrich Meinzer, Noémie Lachaume, Corinne Levy, Jeanne Bordet, Pierre-Louis Leger, Alexandre Belot, Caroline Ovaert, Etienne Javouhey, Julie Toubiana, Marie-Laure Girardin, Alexis Mandelcwajg, Robert Cohen, Blandine Biot, François Angoulvant, Denise Antona, Caroline Galeotti, David D. Yang, Ana-Maria Paulet, Naim Ouldali, Jean-Emmanuel Kahn, Michael Levy, Caroline Claude, Morgane Dumortier, Lucas Percheron, Constance Beyler, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Biodiversité et Epidémiologie des Bactéries pathogènes - Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur [Paris] (IP), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Hospices Civils de Lyon (HCL), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Universitaire de Nancy (CHU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Assistance Publique - Hôpitaux de Marseille (APHM), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre hospitalier de Valence, CHU Strasbourg, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hôpital Nord Franche-Comté [Hôpital de Trévenans] (HNFC), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Institut Pasteur [Paris], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Hôpital des Enfants, CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)
Subjects: Male, medicine.medical_specialty, Adolescent, Fever, [SDV]Life Sciences [q-bio], Lower risk, Intensive Care Units, Pediatric, Methylprednisolone, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Interquartile range, Recurrence, 030225 pediatrics, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Child, Propensity Score, Glucocorticoids, Retrospective Studies, Original Investigation, Pediatric intensive care unit, business.industry, Absolute risk reduction, COVID-19, Immunoglobulins, Intravenous, Correction, Retrospective cohort study, Odds ratio, General Medicine, Length of Stay, Combined Modality Therapy, Systemic Inflammatory Response Syndrome, 3. Good health, COVID-19 Drug Treatment, Treatment Outcome, Child, Preschool, Female, France, business, medicine.drug
Abstract: International audience; Importance: Multisystem inflammatory syndrome in children (MIS-C) is the most severe pediatric disease associated with severe acute respiratory syndrome coronavirus 2 infection, potentially life-threatening, but the optimal therapeutic strategy remains unknown. Objective: To compare intravenous immunoglobulins (IVIG) plus methylprednisolone vs IVIG alone as initial therapy in MIS-C. Design, Setting, and Participants: Retrospective cohort study drawn from a national surveillance system with propensity score-matched analysis. All cases with suspected MIS-C were reported to the French National Public Health Agency. Confirmed MIS-C cases fulfilling the World Health Organization definition were included. The study started on April 1, 2020, and follow-up ended on January 6, 2021. Exposures: IVIG and methylprednisolone vs IVIG alone. Main Outcomes and Measures: The primary outcome was persistence of fever 2 days after the introduction of initial therapy or recrudescence of fever within 7 days, which defined treatment failure. Secondary outcomes included a second-line therapy, hemodynamic support, acute left ventricular dysfunction after first-line therapy, and length of stay in the pediatric intensive care unit. The primary analysis involved propensity score matching with a minimum caliper of 0.1. Results: Among 181 children with suspected MIS-C, 111 fulfilled the World Health Organization definition (58 females [52%]; median age, 8.6 years [interquartile range, 4.7 to 12.1]). Five children did not receive either treatment. Overall, 3 of 34 children (9%) in the IVIG and methylprednisolone group and 37 of 72 (51%) in the IVIG alone group did not respond to treatment. Treatment with IVIG and methylprednisolone vs IVIG alone was associated with lower risk of treatment failure (absolute risk difference, -0.28 [95% CI, -0.48 to -0.08]; odds ratio [OR], 0.25 [95% CI, 0.09 to 0.70]; P =.008). IVIG and methylprednisolone therapy vs IVIG alone was also significantly associated with lower risk of use of second-line therapy (absolute risk difference, -0.22 [95% CI, -0.40 to -0.04]; OR, 0.19 [95% CI, 0.06 to 0.61]; P =.004), hemodynamic support (absolute risk difference, -0.17 [95% CI, -0.34 to -0.004]; OR, 0.21 [95% CI, 0.06 to 0.76]), acute left ventricular dysfunction occurring after initial therapy (absolute risk difference, -0.18 [95% CI, -0.35 to -0.01]; OR, 0.20 [95% CI, 0.06 to 0.66]), and duration of stay in the pediatric intensive care unit (median, 4 vs 6 days; difference in days, -2.4 [95% CI, -4.0 to -0.7]). Conclusions and Relevance: Among children with MIS-C, treatment with IVIG and methylprednisolone vs IVIG alone was associated with a more favorable fever course. Study interpretation is limited by the observational design..
Published: 2021
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17. Young children formula consumption and iron deficiency at 24 months in the general population: A national-level study

Author: Mariane de Montalembert, Serge Hercberg, Catherine Vincelet, Martin Chalumeau, Massimiliano Rallo, Anne-Sylvia Sacri, Béatrice Blondel, Laurent Gouya, Alain Bocquet, Amandine Ganon, Piotr Gembara, Franck Thollot, Corinne Levy, Pascale Hebel, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire d'Excellence : Biogenèse et pathologies du globule rouge (Labex Gr-Ex), Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association Française de Pédiatrie Ambulatoire (AFPA), Société Française de Pédiatrie (SFP), Hôpital Avicenne [AP-HP], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Laboratoire CERBA [Saint Ouen l'Aumône], Centre de recherche pour l'étude et l'observation des conditions de vie (CREDOC), Centre Régional de Coordination du Dépistage des Cancers [Paris] (CRCDC-IDF), 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), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), and CCSD, Accord Elsevier
Subjects: Male, 0301 basic medicine, Pediatrics, Micronutrient deficiency, [SDV]Life Sciences [q-bio], Effectiveness, Critical Care and Intensive Care Medicine, Eating, 0302 clinical medicine, Odds Ratio, Prevalence, Infant Nutritional Physiological Phenomena, 2. Zero hunger, education.field_of_study, Nutrition and Dietetics, Primary prevention, Iron Deficiencies, Iron deficiency, Infant Formula, 3. Good health, [SDV] Life Sciences [q-bio], Child, Preschool, Regression Analysis, Female, France, medicine.medical_specialty, Population, Nutritional Status, 030209 endocrinology & metabolism, Diet Surveys, 03 medical and health sciences, medicine, Humans, Weaning, education, 030109 nutrition & dietetics, business.industry, Socio-economic factors, Infant, Odds ratio, medicine.disease, Confidence interval, Diet, Nationwide cohort study, Cross-Sectional Studies, Social Class, Young-child formula, Ferritins, business, Blood sampling
Abstract: International audience; Background & aims: Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status.Methods: In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron.Results: Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if
Published: 2021
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18. Invasive pneumococcal disease incidence in children and adults in France during the pneumococcal conjugate vaccine era: an interrupted time-series analysis of data from a 17-year national prospective surveillance study

Author: Robert M. Cohen, Kostas Danis, François Angoulvant, Daniel Levy Bruhl, Emmanuelle Varon, Julie Cremniter, Corinne Levy, Marie Kempf, Marie-Cécile Ploy, Naim Ouldali, Scarlett Georges, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Hôpital Robert Debré, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre de Référence du Pneumocoque, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre national de référence pour les pneumocoques [CHI Créteil], Centre Hospitalier Intercommunal de Créteil (CHIC), Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-MRB-GRC, Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), CHU Limoges, Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), ATOMycA (CRCINA-ÉQUIPE 6), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Bernardo, Elizabeth, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges, 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)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)
Subjects: 0301 basic medicine, Serotype, Adult, Male, Pediatrics, medicine.medical_specialty, Pneumococcal disease, Time Factors, Adolescent, 030106 microbiology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Pneumococcal conjugate vaccine, Pneumococcal Infections, Interrupted Time Series Analysis, Pneumococcal Vaccines, 03 medical and health sciences, Young Adult, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, Humans, 030212 general & internal medicine, Young adult, Child, Aged, Retrospective Studies, Aged, 80 and over, Vaccines, Conjugate, business.industry, Immunization Programs, Incidence (epidemiology), Incidence, Age Factors, Infant, Newborn, Infant, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, Infectious Diseases, Child, Preschool, Female, France, business, Meningitis, Sentinel Surveillance, medicine.drug, Forecasting
Abstract: International audience; Background: The long-term benefits of pneumococcal conjugate vaccines (PCVs) remain unknown because of serotype replacement. We aimed to estimate the effect of PCV implementation on invasive pneumococcal disease incidence in France.Methods: We did a quasi-experimental interrupted time-series analysis using data from a French national prospective surveillance system. We included all invasive pneumococcal disease cases in children and adults from more than 250 participating hospitals between Jan 1, 2001, and Dec 31, 2017. The primary outcome was incidence of invasive pneumococcal disease (meningitis and non-meningitis) over time, analysed by segmented regression with autoregressive error. Isolates were serotyped by latex agglutination with antiserum samples.Findings: We included 75 903 patients with invasive pneumococcal disease, including 4302 (5·7%) children younger than 2 years and 37 534 (49·4%) adults aged 65 years or older. Before PCV7 implementation, the estimated monthly incidence of invasive pneumococcal disease was 0·78 cases per 100 000 inhabitants, which did not change significantly up to May, 2010. PCV13 implementation in 2010 was followed by a significant decrease in the incidence of invasive pneumococcal disease (-1·5% per month, 95% CI -2·2 to -0·8), reaching an estimated monthly incidence of 0·52 cases per 100 000 inhabitants in December, 2014. From January, 2015, the incidence rebounded (1·8% per month, 95% CI 1·0 to 2·6), reaching an estimated monthly incidence of 0·73 cases per 100 000 inhabitants in December, 2017. The estimated monthly incidence increased from 0·93 cases per 100 000 in December, 2014, to 1·73 cases per 100 000 in December, 2017, for children younger than 2 years, and from 1·54 cases per 100 000 in December, 2014, to 2·08 cases per 100 000 in December, 2017, for adults aged 65 years or older. The main non-PCV13 serotypes involved in the increase were 24F in young children and 12F, 22F, 9N, and 8 in adults aged 65 years or older.Interpretation: PCV13 implementation led to a major reduction in the incidence of invasive pneumococcal disease. However, a rebound in cases among children and adults since 2015, driven by several emerging non-PCV13 serotypes, jeopardises the long-term PCV benefits. These findings, if confirmed in the coming years, should be considered in the development of next-generation PCVs and might guide policy makers in the selection of future pneumococcal vaccines.Funding: Foundation for Medical Research; Pfizer, BioMérieux, Sanofi for the Regional Observatory of Pneumococci.
Published: 2021
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19. Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System

Author: Celia Guenver, Mehdi Oualha, Corinne Levy, Denise Antona, Fouad Madhi, Julie Toubiana, Noémie Lachaume, Etienne Javouhey, Mathie Lorrot, David Dawei Yang, Michael Levy, Marion Caseris, Caroline Galeotti, Caroline Ovaert, Arnaud Wiedemann, Marie-Laure Girardin, Alexis Rybak, Robert Cohen, Alexandre Belot, AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 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), Centre Hospitalier Intercommunal de Créteil (CHIC), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Biodiversité et Epidémiologie des Bactéries pathogènes - Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur [Paris] (IP), Hôpital Louis Mourier - AP-HP [Colombes], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Hospices Civils de Lyon (HCL), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital de Hautepierre [Strasbourg], Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), This study received an unrestricted grant from Pfizer, the French Covid-19 Paediatric Inflammation Consortium received an unrestricted grant from the Square Foundation (Grandir–Fonds de Solidarité Pour L'enfance), Hôpital Robert Debré, Institut Pasteur [Paris], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Strasbourg, École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), the French Covid-19 Paediatric Inflammation Consortium received an unrestricted grant from the Square Foundation (Grandir–Fonds de Solidarité Pour L'enfance)., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: School, medicine.medical_specialty, Household contact, Population level, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030204 cardiovascular system & hematology, Educational setting, Pediatrics, RJ1-570, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Environmental health, medicine, 030212 general & internal medicine, Closure (psychology), Pediatrics-children, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Transmission (medicine), SARS-CoV-2, Public health, Multisystem inflammatory syndrome in children (MIS-C), Brief Research Report, 3. Good health, Pediatrics, Perinatology and Child Health, Who criteria, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, School attendance
Abstract: Background:Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C.Methods:We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening.Results:We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38).Conclusion:Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.
Published: 2021
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20. Factors associated with death in children with purpura fulminans: a French national prospective cohort study

Author: Madhi, Fouad, Ouldali, Naim, Levy, Corinne, Taha, Muhamed-Kheir, Cohen, Robert, van de Perre, Philippe, Centre Hospitalier Intercommunal de Créteil (CHIC), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), 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), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Infections Bactériennes Invasives - Invasive Bacterial Infections, Institut Pasteur [Paris] (IP), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Salvy-Córdoba, Nathalie, and Institut Pasteur [Paris]
Subjects: Male, Pediatrics, medicine.medical_specialty, MEDLINE, Critical Care and Intensive Care Medicine, MESH: Purpura Fulminans, MESH: Multivariate Analysis, Cohort Studies, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Risk Factors, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, medicine, Research Letter, Humans, Prospective Studies, Prospective cohort study, Child, MESH: Cohort Studies, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, MESH: Humans, business.industry, RC86-88.9, MESH: Child, Preschool, Medical emergencies. Critical care. Intensive care. First aid, medicine.disease, MESH: Prospective Studies, MESH: Male, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Preschool, Purpura Fulminans, Multivariate Analysis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, MESH: Female, Purpura fulminans
Abstract: International audience
Published: 2021
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21. Systematic Severe Acute Respiratory Syndrome Coronavirus 2 Screening at Hospital Admission in Children: A French Prospective Multicenter Study

Author: Fouad Madhi, Noémie Lachaume, Patricia Mariani, Stéphane Bonacorsi, Marion Caseris, Julie Poline, Mounira Smati-Lafarge, Elsa Foucaud, Albert Faye, Jean Gaschignard, Naim Ouldali, Romain Basmaci, Claire Leblanc, Elodie Nattes, Emmanuelle Varon, Hôpital Robert Debré, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), 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, Université de Paris - UFR Médecine [Santé] (UP Médecine), Université de Paris (UP), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Intercommunal de Créteil (CHIC), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Centre National de Référence des Pneumocoques (CNRP), Assistance Publique - Hôpitaux de Paris, Service de Pédiatrie-Urgences [Hopital Louis Mourier - APHP, Colombes], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Comets, Emmanuelle, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université Paris Cité - UFR Médecine [Santé] (UPCité UFR Médecine), Université Paris Cité (UPCité), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité)
Subjects: Microbiology (medical), Pediatrics, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), viruses, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, intra-hospital transmission, children, medicine, 030212 general & internal medicine, 0101 mathematics, skin and connective tissue diseases, Prospective cohort study, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], business.industry, SARS-CoV-2 infection, fungi, 010102 general mathematics, COVID-19, virus diseases, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], 3. Good health, body regions, systematic screening, Infectious Diseases, Multicenter study, Hospital admission, business
Abstract: To assess the relevance of systematic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening of all children admitted to hospital, we conducted a prospective multicenter study including 438 consecutive hospitalized children. A symptom-based SARS-CoV-2 testing strategy failed to identify 45% (95% confidence interval, 24%–68%) of hospitalized children infected by SARS-CoV-2. To limit intrahospital transmission, a systematic screening of children admitted to hospital should be considered.
Published: 2020
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22. Calendrier vaccinal InfoVac

Author: Isabelle Hau, Robert M. Cohen, F. Vie Le Sage, O. Romain, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Française de Pédiatrie Ambulatoire (AFPA), 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), and CCSD, Accord Elsevier
Subjects: 0301 basic medicine, 03 medical and health sciences, [SCCO]Cognitive science, 0302 clinical medicine, 030106 microbiology, Pediatrics, Perinatology and Child Health, 030212 general & internal medicine, [SCCO] Cognitive science, 3. Good health
Abstract: Resume Les calendriers vaccinaux, malgre des similitudes dans les niveaux socioeconomiques et epidemiologiques pour les maladies a prevention vaccinales comparables, varient d’un pays a l’autre tant en ce qui concerne le nombre de maladies prevenues que le nombre d’injections. Contrairement a une idee repandue en France, de tous les pays europeens, les enfants francais font partie de ceux qui sont les moins bien proteges etcontre le moins de maladies et qui recoivent le moins d’injections. D’autres vaccins utiles sont preconises dans la majorite des pays entourant la France : rotavirus, infections invasives a meningocoque du groupe B, varicelle, infections invasives a meningocoque des groupes A, C, YW, papillomavirus pour les garcons. L’hesitation vaccinale, particulierement marquee en France, a conduit les autorites de sante a rendre l’ensemble des vaccins recommandes pour les nourrissons, obligatoires, induisant ainsi une augmentation des couvertures vaccinales. Cependant, l’obligation vaccinale risque de compliquer l’introduction de nouveaux vaccins.
Published: 2020
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23. Vaccin contre rougeole, oreillons et rubéole

Author: H. Haas, G. Thiebault, P. Bakhache, Robert M. Cohen, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Française de Pédiatrie Ambulatoire (AFPA), 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), CCSD, Accord Elsevier, and CHI Créteil
Subjects: 0301 basic medicine, 03 medical and health sciences, [SCCO]Cognitive science, 030104 developmental biology, 0302 clinical medicine, Pediatrics, Perinatology and Child Health, [SCCO] Cognitive science, 030212 general & internal medicine, 3. Good health
Abstract: Resume La rougeole, les oreillons et la rubeole sont des maladies virales tres contagieuses, considerees comme des « maladies inevitables » avant l’ere de la vaccination et contre lesquelles il n’existe aucun traitement efficace. Si elles evoluent le plus souvent favorablement en quelques jours, des complications severes peuvent survenir et provoquer des sequelles physiques ou neurologiques permanentes et, dans de rares cas, la mort. La vaccination ROR presente une tres bonne efficacite : apres deux doses elle est estimee a plus de 97 % pour la rougeole, 100 % pour la rubeole et environ 90 % pour les oreillons. La vaccination est le seul moyen efficace de prevenir ces maladies. La rougeole est la plus grave des trois de ces trois maladies et l’Organisation mondiale de la sante (OMS) a pour objectif son elimination en Europe.
Published: 2020
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24. Les vaccins hexavalents

Author: P. Bakhache, G. Thiebault, Robert M. Cohen, H. Haas, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Française de Pédiatrie Ambulatoire (AFPA), Institut Mondor de Recherche Biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Subjects: 03 medical and health sciences, [SCCO]Cognitive science, 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, 030212 general & internal medicine, 3. Good health
Abstract: Resume Les vaccins hexavalents (Hexyon®, Infanrix Hexa® et Vaxelis®) sont la pierre angulaire des programmes de vaccination dans la majorite des pays du monde. Ils protegent contre 6 maladies : la diphterie, le tetanos, la coqueluche, la poliomyelite, l’hepatite B et les infections a Haemophilus influenzae de type B. Ces infections qui peuvent avoir des complications graves, voire mortelles, touchent aujourd’hui essentiellement ceux qui ne sont pas vaccines. L’efficacite sur le terrain est estimee a environ 85 % pour la coqueluche et plus de 95 % pour les autres maladies. Cette vaccination, obligatoire chez l’enfant en France, doit etre administree des l’âge de 2 mois et revet a la fois un objectif de protection individuelle et collective (effet de groupe).
Published: 2020
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25. Les vaccins contre la varicelle

Author: Didier Pinquier, H. Haas, R. Cohen, Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Française de Pédiatrie Ambulatoire (AFPA), 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), Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CCSD, Accord Elsevier, CHI Créteil, Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), and Hôpital Charles Nicolle [Rouen]-CHU Rouen
Subjects: 03 medical and health sciences, [SCCO]Cognitive science, 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, 030212 general & internal medicine, [SCCO] Cognitive science, 3. Good health
Abstract: Resume La varicelle est une maladie infantile tres contagieuse, provoquee par un virus egalement responsable du zona. Le plus souvent benigne, l’infection peut cependant entrainer des complications graves voire des deces, notamment chez les personnes immunodeprimees, chez la femme enceinte non immunisee et l’enfant qu’elle porte, ou lorsqu’elle survient apres l’âge de dix ans meme chez des sujets dont l’immunite est normale. Sante publique France recense une vingtaine de deces par an (70 % sont des patients de plus de 10 ans) et 3000 hospitalisations pour 700 000 cas de varicelle annuels. Il existe cependant des vaccins tres efficaces et bien toleres contre la varicelle qui, s’ils ne sont ni obligatoires, ni recommandes en population generale, peuvent etre utilises dans differentes circonstances.
Published: 2020
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26. Vaccine-preventable meningitis in French children with incorrect vaccination status from 2011 to 2013

Author: Corinne Levy, H.P.K. Nguyen, Albert Faye, J. Truong, Mathie Lorrot, Emmanuel Grimprel, Robert Cohen, S. Prot-Labarthe, Service de pédiatrie générale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Cité (UPCité), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-MRB-GRC, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Pharmacie à Usage Intérieur [Robert-Debré, Paris], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de néphrologie et pédiatrie générale [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Néonatologie [CHI Créteil], Centre Hospitalier Intercommunal de Créteil (CHIC), Financial support was provided in part by Pfizer and the Pediatric Infectious Diseases Group (GPIP) of the French Pediatric Society (SFP) and the Association Clinique et Therapeutique Infantile du Val de Marne (ACTIN). We thank all pediatricians and microbiologists of the 'Observatoire National des Méningites' who participated in this study.., CCSD, Accord Elsevier, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, Pediatrics, medicine.medical_specialty, Adolescent, Haemophilus influenzae type, [SDV]Life Sciences [q-bio], Bacterial meningitis, Neisseria meningitidis, medicine.disease_cause, Meningitis, Bacterial, 03 medical and health sciences, 0302 clinical medicine, Vaccination status, Vaccine-Preventable Diseases, 030225 pediatrics, Streptococcus pneumoniae, medicine, Humans, Prospective Studies, Child, Children, Immunization Schedule, Haemophilus Vaccines, business.industry, Vaccination, Haemophilus influenzae type b, Infant, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Immunization, Child, Preschool, Purpura Fulminans, Bacterial Vaccines, Pediatrics, Perinatology and Child Health, Female, France, business, Meningitis, Vaccine, Purpura fulminans
Abstract: International audience; The objective of this study was to determine the number of cases of pediatric meningitis or purpura fulminans associated with an incorrect vaccination status from 2011 to 2013 in France. A total of 48 children with vaccine-preventable meningitis or purpura fulminans, including three deaths, had an incorrect vaccination status: 26 cases were due to Neisseria meningitidis group C (54.2%), 19 to Streptococcus pneumoniae (39.6%), and three to Haemophilus influenzae type b (6.3%). The majority of patients (n = 35, 72.9%) had received no injection of the vaccine concerned. Over a 3-year period, 48 cases of bacterial meningitis or purpura fulminans in children could have been avoided if the French immunization schedule had been followed.
Published: 2020
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27. CHANGES IN REVERSE TRANSCRIPTION POLYMERASE CHAIN REACTION–POSITIVE SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 RATES IN ADULTS AND CHILDREN ACCORDING TO THE EPIDEMIC STAGES

Author: H. Haas, Nicoleta Ursulescu, Corinne Levy, Stéphane Béchet, François Vié le Sage, Philippe Bensaid, Cecile Bost bru, Cecile Fournial, Anne Sophie Romain, Muriel Lalande, Josette Raymond, Robert M. Cohen, Emmanuelle Dessioux, Véronique Hentgen, Jean Gashignard, Edeline Coinde, Alain Martinot, Charlotte Pons, Julie Toubiana, Romain Basmaci, Frédéric Huet, Comets, Emmanuelle, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles (GEMINI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-MRB-GRC, Centre de Recherche Clinique [Créteil] (CRC), Centre Hospitalier Intercommunal de Créteil (CHIC), Service de Pédiatrie-Urgences [Hopital Louis Mourier - APHP, Colombes], Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Victor Dupouy, Centre Hospitalier Général Néonatologie Ajaccio, Hôpitaux du Pays du Mont-Blanc, Centre hospitalier universitaire de Nantes (CHU Nantes), Service de pédiatrie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Département Pédiatrie [CHRU Montpellier], Pôle Femme Mère Enfant [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Neuro-pédiatrie[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Henri Duffaut (Avignon), Hôpital Nord Franche-Comté [Hôpital de Trévenans] (HNFC), and Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV)
Subjects: Adult, Microbiology (medical), 2019-20 coronavirus outbreak, Pediatrics, medicine.medical_specialty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, reverse transcription polymerase chain reaction, Betacoronavirus, 03 medical and health sciences, COVID-19 Testing, 0302 clinical medicine, children, 030225 pediatrics, adults, Humans, Medicine, 030212 general & internal medicine, Pediatrics, Perinatology, and Child Health, Child, Pandemics, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], biology, Clinical Laboratory Techniques, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, business.industry, Age Factors, COVID-19, biology.organism_classification, medicine.disease, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Confidence interval, 3. Good health, Reverse transcription polymerase chain reaction, Pneumonia, Real-time polymerase chain reaction, Infectious Diseases, Relative risk, Pediatrics, Perinatology and Child Health, France, Coronavirus Infections, business, severe acute respiratory syndrome coronavirus 2
Abstract: International audience; From March 2, 2020, to April 26, 2020, 52,588 reverse transcription polymerase chain reaction (RT-PCR) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were performed in France, 6490 in children and 46,098 in adults. The rate of RT-PCR-positive SARS-CoV-2 tests for children (5.9%) was always less than that for adults (20.3%) but vary according to the epidemic stage. The risk ratio of RT-PCR-positive SARS-CoV-2 tests for adults compared with children was 3.5 (95% confidence interval: 3.2-3.9) for the whole study period.
Published: 2020
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28. Timeliness of routine immunization in non-preterm children less than 2 years old using electronic data capture in an ambulatory setting in France in the context of vaccine hesitancy

Author: Corinne Levy, Alexis Rybak, E. Caulin, Andreas Werner, P. Bakhache, F. Vie Le Sage, G. Thiebault, Robert Cohen, Stéphane Béchet, B. Virey, Association Française de Pédiatrie Ambulatoire (AFPA), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Institut Mondor de Recherche Biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Subjects: Male, Pediatrics, medicine.medical_specialty, Time Factors, Vaccination Coverage, [SDV]Life Sciences [q-bio], Context (language use), 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Ambulatory Care, Medicine, Humans, Immunization Schedule, business.industry, Medical record, Data Collection, Infant, Odds ratio, Patient Acceptance of Health Care, Confidence interval, 3. Good health, Vaccination, Pneumococcal vaccine, Immunization, Child, Preschool, Pediatrics, Perinatology and Child Health, Ambulatory, Female, France, business
Abstract: Objectives The vaccine schedule was changed in 2013 in France, which resulted in fewer vaccinations. However, to maintain disease protection, both vaccine timeliness and high coverage should be respected. In the context of growing vaccine hesitancy, we aimed to describe compliance with the immunization program according to the age recommended for each dose for non-preterm children less than 2 years old. Methods Between May 2013 and April 2016, we used automated electronic data capture of electronic medical records for non-preterm children less than 2 years old. Children were followed up by 92 randomly selected pediatricians from the French ambulatory pediatricians group. Delayed immunization was defined as more than 15 days after the recommended age for the primary series of diphtheria-tetanus-pertussis-polio-Haemophilus influenzae b-hepatitis B (DTaP-IPV-Hib±HB) and 13-valent pneumococcal vaccine (PCV13), 2 months for boosters, 1 month for measles-mumps-rubella (MMR)/meningococcal C conjugate (Men-C), and 6 months for the second dose of MMR. An association between delayed first dose and other doses delayed were described with odds ratios (ORs) and their 95% confidence intervals (CIs). Results Data for 22,097 children in France with 124,702 vaccinations were analyzed: 21.8%, 20.4%, and 30.7% of children had one or more delayed doses of DTaP-IPV-Hib±HB, PCV13, and MMR vaccines, respectively. For 47.6% of children, the single-dose Men-C vaccination was delayed. A delayed first dose of DTaP-IPV-Hib±HB, PCV13, and MMR was associated with a delayed second dose of the same vaccine (OR 7.5 [95% CI 6.6–8.6], 39.0 [34.1–44.8], and 23.5 [19.1–29.0], respectively) and with a third dose of DTaP-IPV-Hib±HB and PCV13 (14.7 [13.3–17.7] and 3.7 [3.1–4.5]). Conclusion This large study shows that the proportion of children with delayed vaccination in France was globally high and substantial for Men-C and the first MMR vaccination. Risk of a delayed second and third dose was increased with a delayed first dose, which may reflect vaccine hesitancy.
Published: 2019
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29. Effect of Atropine With Propofol vs Atropine With Atracurium and Sufentanil on Oxygen Desaturation in Neonates Requiring Nonemergency Intubation

Author: Durrmeyer, Xavier, Breinig, Sophie, Claris, Olivier, Tourneux, Pierre, Alexandre, Ceneric, Saliba, Elie, Beuchee, Alain, Jung, Camille, Levy, Corinne, Marchand-Martin, Laetitia, Marcoux, Marie-Odile, Dechartres, Agnes, Danan, Claude, Grp, Prettineo Res, Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Toulouse [Toulouse], Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL), Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Ressource Biologique [CHI Créteil] (Centre de Recherche Clinique), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de soins intensifs néonatals [Hôpital des Enfants, Toulouse], CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de réanimation néonatale, CHI Créteil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Réanimation néonatale et pédiatrique spécialisée [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Atropine, Sufentanil, [SDV]Life Sciences [q-bio], Sedation, Birth weight, medicine.medical_treatment, Blood Pressure, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, Heart Rate, law, Intensive Care Units, Neonatal, 030225 pediatrics, Intubation, Intratracheal, medicine, Humans, Intubation, 030212 general & internal medicine, Propofol, Original Investigation, Analgesics, business.industry, Infant, Newborn, Gestational age, General Medicine, Oxygen, Anesthesia, Atracurium, Drug Therapy, Combination, Premedication, medicine.symptom, business, Adjuvants, Anesthesia, medicine.drug
Abstract: IMPORTANCE: Propofol or a combination of a synthetic opioid and muscle relaxant are both recommended for premedication before neonatal intubation but have yet to be compared. OBJECTIVE: To compare prolonged desaturation during neonatal nasotracheal intubation after premedication with atropine-propofol vs atropine-atracurium-sufentanil treatment. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, double-blind, randomized clinical trial (2012-2016) in 6 NICUs in France that included 173 neonates requiring nonemergency intubation. The study was interrupted due to expired study kits and lack of funding. INTERVENTIONS: Eighty-nine participants were randomly assigned to the atropine-propofol group and 82 to the atropine-atracurium-sufentanil group before nasotracheal intubation. MAIN OUTCOMES AND MEASURES: The primary outcome was prolonged desaturation (Spo(2 60 seconds), using intention-to-treat analysis using mixed models. Secondary outcomes assessed the characteristics of the procedure and its tolerance. RESULTS: Of 173 neonates randomized (mean gestational age, 30.6 weeks; mean birth weight, 1502 g; 71 girls), 171 (99%) completed the trial. Of 89 infants, 53 (59.6%) in the atropine-propofol group vs 54 of 82 (65.9%) in the atropine-atracurium-sufentanil group achieved the primary outcome (adjusted RD, −6.4; 95% CI, −21.0 to 8.1; P = .38). The atropine-propofol group had a longer mean procedure duration than did the atropine-atracurium-sufentanil group (adjusted RD, 1.7 minutes; 95% CI, 0.1-3.3 minutes; P = .04); a less frequent excellent quality of sedation rate, 51.7% (45 of 87) vs 92.6% (75 of 81; P
Published: 2018
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30. Vaccine Failure After Meningococcal C Conjugate Vaccine May Be Linked to Decline of Bactericidal Titers and Absence of Herd Immunity

Author: Eva Hong, Robert M. Cohen, Fouad Madhi, Marcel Guillot, Rania Matar, Muhamed-Kheir Taha, Corinne Levy, Service de pédiatrie générale [CHIC], Centre Hospitalier Intercommunal de Créteil (CHIC), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre de Recherche Clinique [Créteil] (CRC), Service de pédiatrie générale [CH Lisieux], Centre Hospitalier Robert Bisson (CH Robert Bisson), Service de Néonatologie [CHI Créteil], Service de Pédiatrie [Créteil], CHI Créteil, and Institut Pasteur [Paris] (IP)
Subjects: Microbiology (medical), Male, Meningococcal Vaccines, Meningococcal vaccine, Meningitis, Meningococcal, Neisseria meningitidis, medicine.disease_cause, MESH: Neisseria meningitidis, Herd immunity, MESH: Meningococcal Vaccines, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030225 pediatrics, MESH: Antibodies, Bacterial, Meningococcal C conjugate vaccine, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, MESH: Humans, business.industry, MESH: Meningitis, Meningococcal, Virology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Antibodies, Bacterial, MESH: Male, 3. Good health, Titer, Infectious Diseases, Pediatrics, Perinatology and Child Health, Female, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, Vaccine failure, MESH: Female
Abstract: International audience
Published: 2015
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31. Change in French bacterial meningitis in children resulting from vaccination

Author: Lévy, C., Varon, E., Taha, Muhamed-Kheir, Bechet, S., Bonacorsi, S., Cohen, R., Bingen, E., Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre de Recherche Clinique [Créteil] (CRC), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre National de Référence des Pneumocoques (CNRP), Assistance Publique - Hôpitaux de Paris, Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Service de Néonatologie [CHI Créteil], Financement de l’Observatoire national des méningites bactériennes : GPIP, Groupe de pathologie infectieuse pédiatrique et ACTIV, Association clinique et thérapeutique infantile du Val-de-Marne., and Institut Pasteur [Paris] (IP)
Subjects: MESH: Adolescent, MESH: France, MESH: Meningitis, Bacterial, MESH: Humans, MESH: Anti-Bacterial Agents, MESH: Child, MESH: Child, Preschool, MESH: Drug Resistance, Bacterial, MESH: Infant, Newborn, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Infant, MESH: Bacterial Vaccines
Abstract: International audience; BackgroundFor the past 20 years, three vaccines against the three main bacterial species implicated in meningitis in children have been included in the French vaccine calendar: Haemophilus influenzae b in 1993, 7-valent pneumococcal conjugate vaccine (PCV7) in 2003 (replaced by 13-valent in 2010) and Neisseria meningitidis C in 2009. The French active surveillance network from the GPIP/ACTIV monitors the change in the epidemiological, clinical, and biological features of bacterial meningitis due to vaccine use.MethodsOver a 12-year period, 233 pediatric wards working with 168 microbiology departments throughout France were asked to report all cases of bacterial meningitis.ResultsFrom January 2001 to December 2012, 4808 bacterial meningitis cases were reported. Between 2001 and 2012, the number of pneumococcal meningitis (PM) cases decreased by 23.4%, and by 32.2% for children less than 2 years old. During this period, the proportion of cases attributable to PCV7 and six additional PCV13 types decreased from 63.3% to 8.1% and 83.7% to 32.4%, respectively. In 2012, the main vaccine types (accounting for 25.8% of cases) were 7F (12.2%), 19A (6.8%), and 19F (6.8%), and the most frequent non-vaccine types were 12F (14.9%), 24F (14.9%), 15B/C (6.8%), 22F (6.8%), and 10A (5.4%). In 2012, the rate of strains with decreased susceptibility to cefotaxime/ceftriaxone (MIC > 0.5 μg/mL) represented less than 3% of cases, with no identified resistant strain since 2010 (MIC > 2 μg/mL). Between 2001 (n = 67) and 2012 (n = 9), the number of NmC meningitis cases decreased by 87%.ConclusionWith more than 4800 bacterial meningitis cases reported in 12 years, this nationwide survey provides essential information on the microbiological and clinical characteristics of bacterial meningitis (epidemiology or resistance data). These results could lead to changing antibiotic treatment of pneumococcal meningitis before the results of antibiotic susceptibility tests.; ObjectifsDepuis 20 ans, 3 vaccins dirigés contre les 3 principales espèces bactériennes impliquées dans les méningites font parties du calendrier vaccinal recommandé en France : Haemophilus influenzae sérotype b en 1993, pneumocoque conjugué heptavalent (PCV7) en 2003 (remplacé par le PCV13 en 2010) et méningocoque C en 2009. L’observatoire national des méningites bactériennes de l’enfant du Groupe de pathologie infectieuse pédiatrique et de l’Association clinique et thérapeutique infantile du Val-de-Marne (GPIP/ACTIV) a pour objectif de suivre les changements induits par les vaccinations en colligeant l’épidémiologie bactérienne et les données anamnestiques, cliniques, biologiques et évolutives des méningites bactériennes de l’enfant.MéthodesDeux cent trente-trois services de pédiatrie et 168 services de microbiologie ont inclus depuis 12 ans tous les patients de moins de 18 ans ayant eu une méningite bactérienne documentée.RésultatsDe 2001 à 2012, 4808 méningites ont été documentées. Le nombre de méningites à pneumocoque (MP) a diminué de 23,4 % et chez les enfants de moins de 2 ans de 32,2 %. La proportion des sérotypes (ST) du PCV7 a diminué de 63,3 % en 2001 à 8,1 % en 2012 (p < 0,0001) et les ST du PCV13 ont diminué de 83,7 à 32,4 % sur la même période (p < 0,0001). En 2012, les ST vaccinaux les plus fréquents étaient 7F (12,2 %), 19A (6,8 %) et 19F (6,8 %) ; ils représentaient 25,8 % des cas de MP. Les sérotypes non vaccinaux les plus fréquents étaient 12F (14,9 %), 24F (14,9 %), 15B/C (6,8 %), 22F (6,8 %) et 10A (5,4 %). En 2012, les souches intermédiaires aux céphalosporines de 3e génération représentaient moins de 3 % des cas. Aucune souche résistante aux céphalosporines de 3e génération (C3G) n’a été isolée depuis 2010. Entre 2001 (n = 67) et 2012 (n = 9), le nombre de méningite à méningocoque C a diminué de 87 %.ConclusionAvec plus de 4800 méningites bactériennes recueillies en 12 ans, l’observatoire est un outil indispensable de surveillance des modifications épidémiologiques et de la résistance aux antibiotiques des bactéries impliquées dans les méningites de l’enfant. Les données actuelles sont en faveur d’une modification de la stratégie de prise en charge des méningites suspectées à pneumocoque.
Published: 2014
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32. Invasive serogroup w meningococcal disease in children: a national survey from 2001 to 2008 in France

Author: Albert Faye, Robert M. Cohen, Muhamed-Kheir Taha, Edouard Bingen, François Dubos, Mathias Muszlak, Jean Gaschignard, Ala-Eddine Deghmane, Corinne Levy, AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier de Mayotte, and Institut Pasteur [Paris] (IP)
Subjects: Microbiology (medical), Male, Adolescent, Genotype, Meningitis, Meningococcal, Neisseria meningitidis, Meningococcal disease, 03 medical and health sciences, 0302 clinical medicine, Prevalence, Medicine, Humans, 030212 general & internal medicine, Serotyping, Child, Tropism, Sequence (medicine), 0303 health sciences, Molecular Epidemiology, 030306 microbiology, business.industry, Infant, Newborn, Infant, medicine.disease, Virology, 3. Good health, Molecular Typing, Infectious Diseases, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Meningitis
Abstract: International audience; From 2001 to 2008, 119 pediatric cases of meningococcal disease caused by serogroup W were reported in France. They cases represented 4% of all meningococcal disease cases in children and were mostly in infants (54%). Meningitis occurred in 78 (66%) patients but differed by isolate. Isolates of the clonal complex sequence type-22 were associated with nonmeningeal presentation. Further investigations of clinical tropism of meningococcal W isolates are warranted.
Published: 2013
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33. Corticosteroid Therapy in Genotype ST-11 Meningococcal Infections

Author: Corinne Levy, Fouad Madhi, Ala Eddine Deghmane, Robert M. Cohen, Stéphane Béchet, Muhamed-Kheir Taha, Service de Pédiatrie [Créteil], CHI Créteil, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre de Recherche Clinique [Créteil] (CRC), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], This work was supported by ACTIV/GPIP, the Institut Pasteur and the Institut de Veille Sanitaire., The authors thank all pediatricians and microbiologists of 'Observatoire National des Méningites' who participated in this study. Groupe des pédiatres et microbiologistes de l’Observatoire National des Méningites and Members of the National Reference Center for Meningococci., and Institut Pasteur [Paris] (IP)
Subjects: Male, Anti-Inflammatory Agents, Neisseria meningitidis, MESH: Meningococcal Infections, MESH: Genotype, 0302 clinical medicine, Adrenal Cortex Hormones, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Genotype, 030212 general & internal medicine, Child, 0303 health sciences, MESH: Infant, Newborn, MESH: Infant, 3. Good health, Infectious Diseases, Corticosteroid therapy, Child, Preschool, MESH: Survival Analysis, Female, Risk of death, Microbiology (medical), medicine.medical_specialty, Adolescent, education, Corticosteroid treatment, Meningococcal Infections, Meningococcal disease, MESH: Neisseria meningitidis, MESH: Adrenal Cortex Hormones, 03 medical and health sciences, Internal medicine, medicine, Humans, 030304 developmental biology, MESH: Adolescent, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, Newborn, Infant, Odds ratio, medicine.disease, Survival Analysis, Confidence interval, MESH: Male, MESH: Anti-Inflammatory Agents, Pediatrics, Perinatology and Child Health, Immunology, business, MESH: Female
Abstract: International audience; Corticosteroid treatment for meningococcal disease is debated. We report a high risk of death (odds ratio 4.68, 95% confidence interval: 1.91-11.46; P = 0.001) without corticosteroid treatment when meningococcal disease is provoked by isolates belonging to the hyperinvasive genotype ST-11. Genotypes of meningococcal isolates should be considered with corticosteroids therapy for meningococcal disease.
Published: 2013
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34. Méningites à méningocoques de l’enfant en France: résultats de l’observatoire ACTIV/GPIP

Author: Levy, C., Taha, Muhamed-Kheir, Bingen, E., Cohen, R., Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris] (IP), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Intercommunal de Créteil (CHIC), Matériaux, ingénierie et science [Villeurbanne] (MATEIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), C. Levy, M.- K. Taha, E. Bingen, R. Cohen : versements substantiels au budget d’une institution (GSK, Pfizer). Financement de l’Observatoire National des méningites Bactériennes : GPIP, Groupe de Pathologie Infectieuse Pédiatrique et ACTIV, Association Clinique et thérapeutique Infantile du Val de Marne., Groupe des Pédiatres et Microbiologistes de l’Observatoire National des Meningites Bactériennes de l’Enfant., Institut Pasteur [Paris], Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)
Subjects: Male, Adolescent, Meningococcal Vaccines, Neisseria meningitidis, Serogroup C, Meningitis, Meningococcal, Neisseria meningitidis, Neisseria meningitidis, Serogroup B, Spinal Puncture, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Serotyping, Child, Societies, Medical, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Vaccines, Conjugate, Incidence, Vaccination, Infant, Newborn, Infant, Anti-Bacterial Agents, Survival Rate, Treatment Outcome, Child, Preschool, Female, France
Abstract: International audience; BackgroundThe GPIP/ACTIV (Groupe de Pathologie Infectieuse Pédiatrique and Association Clinique et Thérapeutique Infantile du Val de Marne) set up an active surveillance network to analyze the epidemiological, clinical and biological features of meningococcal meningitis.MethodsFrench pediatric wards working with 166 microbiology laboratories enrolled all children (0–18 years old) with bacterial meningitis. Risk factors, signs and symptoms, vaccination status, cerebrospinal fluid analysis, treatments and case fatality rate were recorded.ResultsSince 2001, 1661 meningococcal meningitis were reported among 3769 (44.1%) bacterial meningitis. Mean age was 4.4- year- old (±4.8, median 2.5) and 2/3 cases occurred in children under 5- year- old (68.8%). Serogroup B (61.3%) is preponderant following by serogroup C (27.0%). 27.5% of children had received an antibiotic treatment 24 hours before lumbar puncture. A shock is reported in 31.0% of cases. No cases of meningococcal meningitis C has been reported in children vaccinated with a conjugate vaccine. Two children vaccinated with MenBvac® vaccine had a meningitis B14:P1.7,16. Global case fatality rate was 6.5% but was higher (9.2%) for serogroup C than for serogroup B (5.9%) (p = 0.02).ConclusionThis is among the largest series of microbiologically documented meningococcal meningitis to date (1661 cases). In France, meningococal is responsible for approximately 50 % of meningitis. Effective meningococcal serogroup B vaccine and serogroup C vaccination recommendation could control the burden of meningococal meningitis.; ObjectifsÀ partir des données de l’Observatoire National des Méningites Bactériennes de l’enfant du GPIP/ACTIV (Groupe de Pathologie Infectieuse Pédiatrique et Association Clinique et Thérapeutique Infantile du Val de Marne), l’objectif de ce travail est de décrire les caractéristiques cliniques et épidémiologiques des méningites à méningocoque en France.Méthodes252 services de pédiatrie, répartis dans toute la France et 166 services de microbiologie incluent, depuis 9 ans, tous les patients de moins de 18 ans, ayant une méningite bactérienne documentée. Les facteurs de risque, les signes et les symptômes, le statut vaccinal, l’analyse du LCR, les traitements et la mortalité sont recueillis.RésultatsDe 2001 à 2009, 1661 méningites à méningocoque ont été enregistrées sur 3769 (44,1%) méningites bactériennes de l’observatoire. L’âge moyen est de 4,4 ans (± 4,8, médiane à 2,5 ans) et près des deux tiers des cas surviennent chez des enfants de moins de 5 ans (68,8%). Le sérogroupe B est le plus fréquent (61,3%) suivi du C (27,0%). Dans 27,5% des cas, 24 heures avant la ponction lombaire une antibiothérapie a été donnée. Dans 31,0% des cas, les patients sont en état de choc. Aucun cas de méningite à méningocoque C n’a été enregistré chez des enfants vaccinés par un vaccin conjugué. Deux enfants ont déclaré une méningite à méningocoque B14:P1.7,16 alors qu’ils étaient vaccinés par MenBvac®. Le taux de létalité des méningites à méningocoque est de 6,5%. Ce taux varie selon le sérogroupe, 9,2% pour le sérogroupe C versus 5,9% pour le sérogroupe B (p = 0,02).ConclusionChez l’enfant en France, un peu moins de la moitié des cas de méningites sont dus au méningocoque. Cette série de 1661 cas est l’une des plus importantes en pédiatrie. La commercialisation d’un vaccin ciblant le méningocoque B, ainsi que l’application des recommandations de la vaccination anti- méningocoque C chez l’enfant permettraient de contrôler les méningites à méningocoque dues à ces sérogroupes.
Published: 2012
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35. Association of Meningococcal Phenotypes and Genotypes With Clinical Characteristics and Mortality of Meningitis in Children

Author: Muhamed-Kheir Taha, Edouard Bingen, Yannick Aujard, A. Lécuyer, Jean Michel Alonso, Catherine Weil Olivier, Corinne Levy, Beatrice Quinet, Robert M. Cohen, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris] (IP), Groupe des pédiatres et microbiologistes de l'Observatoire National des Méningites, and Institut Pasteur [Paris]
Subjects: Male, Neisseria meningitidis, medicine.disease_cause, MESH: Genotype, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Genotype, Epidemiology, Case fatality rate, MESH: DNA Fingerprinting, Cluster Analysis, 030212 general & internal medicine, Child, Molecular Epidemiology, 0303 health sciences, MESH: Infant, Newborn, phenotypes, MESH: Meningitis, Meningococcal, MESH: Infant, Bacterial Typing Techniques, 3. Good health, Infectious Diseases, Child, Preschool, Female, epidemiology, France, Meningitis, Microbiology (medical), medicine.medical_specialty, Adolescent, Meningitis, Meningococcal, Meningococcal disease, MESH: Bacterial Typing Techniques, MESH: Neisseria meningitidis, 03 medical and health sciences, children, genotypes, Internal medicine, medicine, Humans, MESH: Molecular Epidemiology, Typing, Serotyping, MESH: Adolescent, MESH: Humans, 030306 microbiology, business.industry, MESH: Child, Preschool, Infant, Newborn, Infant, MESH: Serotyping, medicine.disease, DNA Fingerprinting, MESH: Cluster Analysis, MESH: Male, MESH: France, El Niño, Pediatrics, Perinatology and Child Health, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, meningococcal meningitis
Abstract: International audience; Background: Neisseria meningitidis meningitis represents approximately one-half of the meningococcal cases in French children. To explore the contribution of bacterial typing in improving the management of cases, we aimed to describe clinical characteristics and mortality of meningococcal meningitis in children reported to the multicenter survey system, GPIP/ACTIV, in association with phenotypes/genotypes of bacterial isolates.Methods: From 2001 to 2005, 259 pediatric wards and 168 microbiology laboratories enrolled all children with bacterial meningitis. Risk factors, vaccination status, signs and symptoms, cerebrospinal fluid analysis, treatments and case fatality rate were recorded.Results: A total of 962 cases of Neisseria meningitidis meningitis among a total of 2131 bacterial meningitis (45%) were recorded (mean age, 4.5 ± 4.7 years). Serogroup distribution of the isolates was 62.3%, 33.7%, 2.9%, 0.6%, and 0.6% for serogroups B, C, W135, A and Y, respectively. The major clonal complexes were ST-41/44 (32.2%), ST-11 (21.9%), ST-32 (20.8%), ST-8 (8.2%), and ST-269 (4.9%). Despite global heterogeneity of the isolates, 2 phenotypes/genotypes were of interest. Isolates of the phenotype/genotype B:14:P1.7,16/ST-32 (56% clustered in the region of Haute Normandie) were observed in older children (8.6 years) and were associated with a higher case fatality rate (12%) than were other phenotypes of serogroup B. The phenotype/genotype C:2a:P1.5/ST-11 was found in 26.3% of serogroup C cases and was possibly associated with a higher mortality among serogroup C (9.9% for C and 5.9% for B, P = 0.04).Conclusions: This large survey provides data that could be important for implementation of future vaccines. Typing of meningococcal isolates could contribute to an understanding of prognosis in meningococcal meningitis.
Published: 2010
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36. Impact of C-reactive protein point-of-care testing on antibiotic prescriptions for children and adults with suspected respiratory tract infections in primary care: a French patient-level randomized controlled superiority trial.

Author: Jung C, Levy C, Béchet S, Aegerter P, Cohen R, and Touitou R
Subjects: Humans, Male, France, Female, Adult, Child, Preschool, Middle Aged, Drug Prescriptions statistics & numerical data, Child, General Practitioners, Adolescent, Aged, Practice Patterns, Physicians' statistics & numerical data, Young Adult, C-Reactive Protein analysis, Anti-Bacterial Agents therapeutic use, Respiratory Tract Infections drug therapy, Respiratory Tract Infections diagnosis, Point-of-Care Testing, Primary Health Care
Abstract: Objectives: The value of C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescriptions in adults has previously been emphasized. The aim of this study was to assess the impact of CRP POCT on antibiotic prescriptions by general practitioners (GPs) for suspected lower respiratory tract infections in children ≥3 years old and in adults., Methods: This was an open-label randomized trial (NCT03540706) conducted in 26 GPs in France between October 2019 and March 2023. Of the 404 participating patients, 207 (51.2%) were randomized to the CRP POCT group and 197 (48.8%) to the control group (i.e. no CRP POCT). During consultations, GPs measured CRP levels in patients randomized to the CRP POCT group. The primary endpoint was the proportion of patients in each group who were prescribed antibiotics by their GP during the consultation. Z-tests were used for comparisons., Results: The overall proportion of patients treated with antibiotics was similar in the CRP POCT (n = 89/207, 43% CI: 36.2, 50.0) and in the control group (n = 94/197, 47.7% CI: 40.6, 54.9), difference: -4.7 CI: -14.4, 5.0; p 0.3. Overall, 75% of the GPs followed CRP-based antibiotic prescription recommendations in the CRP POCT group., Discussion: CRP POCT did not reduce antibiotic prescriptions in this trial., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2024
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37. Pneumococcal conjugate vaccine schedule: 3+1, 2+1, or 1+1?

Author: Levy C and Cohen R
Abstract: Competing Interests: The institution of CL and RC (ACTIV) has received research grant support from GSK, MSD, Pfizer, and Sanofi. CL reports personal fees from MSD and Pfizer outside of the submitted work. RC reports personal fees from GSK, MSD, Pfizer, and Sanofi outside of the submitted work.
Published: 2024
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38. Effectiveness of nirsevimab against RSV-bronchiolitis in paediatric ambulatory care: a test-negative case-control study.

Author: Lassoued Y, Levy C, Werner A, Assad Z, Bechet S, Frandji B, Batard C, Sellam A, Cahn-Sellem F, Fafi I, Lenglart L, Aupiais C, Basmaci R, Cohen R, and Ouldali N
Abstract: Background: Respiratory syncytial virus (RSV) is the leading cause of lower-respiratory-tract infection in children. Nirsevimab, a monoclonal antibody against RSV, was implemented in a few countries in September 2023. However, its post-license effectiveness in ambulatory care settings is unknown. We aimed to assess the effectiveness of nirsevimab against RSV-bronchiolitis in outpatients aged <12 months., Methods: We conducted a test-negative case-control study based on a national ambulatory surveillance system. We included all infants aged <12 months who had bronchiolitis and results of an RSV rapid antigen test performed, visiting a network of 107 ambulatory paediatricians from September 15, 2023, to February 1, 2024. Case patients were infants with bronchiolitis and a rapid antigen test positive for RSV. Control patients were infants with bronchiolitis and a rapid antigen test negative for RSV. Effectiveness was assessed by a logistic regression model adjusted for potential confounders. A range of sensitivity analyses were conducted to assess the robustness of the findings., Findings: We included 883 outpatients who had bronchiolitis and results of an RSV rapid antigen test (453 were case patients, and 430 were control patients). Overall, 62/453 (13.7%) case patients and 177/430 (41.2%) control patients had been previously immunised for nirsevimab. The adjusted effectiveness of nirsevimab against RSV-bronchiolitis was 79.7% (95% CI 67.7-87.3). Sensitivity analyses gave similar results., Interpretation: This post-license study indicates that nirsevimab was effective in preventing RSV-bronchiolitis in ambulatory care settings., Funding: The study was supported by Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), French Pediatrician Ambulatory Association (AFPA) and unrestricted grants from GSK, MSD, Pfizer and Sanofi., Competing Interests: YL has no conflicts of interest to disclose. RB declares receiving fees from Sanofi and MSD for medical conferences or scientific meetings. CL declares receiving travel grants from MSD, Pfizer and fees from MSD and Pfizer for scientific meetings and expert board participation. AW declares receiving fees from Sanofi, GSK and MSD for medical conferences or scientific meetings. FCS declares receiving fees from Sanofi for expert board participation. CB declares receiving fees from Sanofi, GSK and MSD for medical conferences or scientific meetings. RC reports personal fees and non-financial support from Pfizer and personal fees from GSK, Merck, Pfizer, Sanofi, Viatris outside the submitted work. NO declares receiving travel grants from MSD, Pfizer, Sanofi, and GSK., (© 2024 The Authors.)
Published: 2024
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39. Age-Specific Resurgence in Invasive Pneumococcal Disease Incidence in the COVID-19 Pandemic Era and Its Association With Respiratory Virus and Pneumococcal Carriage Dynamics: A Time-Series Analysis.

Author: Rybak A, Assad Z, Levy C, Bonarcorsi S, Béchet S, Werner A, Wollner A, Valtuille Z, Kaguelidou F, Angoulvant F, Cohen R, Varon E, and Ouldali N
Subjects: Humans, Infant, Incidence, Pandemics, Streptococcus pneumoniae, Age Factors, Pneumococcal Vaccines, COVID-19 epidemiology, Pneumococcal Infections epidemiology, Pneumococcal Infections prevention & control, Respiratory Syncytial Virus, Human
Abstract: Using multiple national surveillance systems, we found an increase in the incidence of invasive pneumococcal disease during after the relaxation of non-pharmaceutical interventions against COVID-19, which strongly varied by age. Age groups with higher incidence of respiratory syncytial virus and influenza also experienced higher increase in invasive pneumococcal disease incidence, with no change in pneumococcal carriage., Competing Interests: Potential conflicts of interest . A. R. reports nonfinancial support from Pfizer and AstraZeneca; consulting fees from Sanofi (board paid by Sanofi); and payment or honoraria for presentations paid by MSD. C. L. reports grants from Pfizer during the conduct of the study; personal fees from Pfizer and MSD; nonfinancial support from Pfizer; grants or contracts from GlaxoSmithKline (GSK), MSD, Pfizer, and Sanofi (payment to ACTIV); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from MSD; participation on a data safety monitoring board or advisory board for MSD and support for attending meetings and/or travel from Pfizer, outside the submitted work. S. Béchet reports grants or contracts from GSK, MSD, Pfizer, and Sanofi paid to ACTIV, outside the submitted work. A. Werner reports all of the following from Sanofi, MSD, GSK, and Pfizer: consulting fees, paid to the author and institution; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events, to the author and institution; payment for expert testimony, to the author and institution; support for attending meetings and/or travel, to the author; and participation on a data safety monitoring board or advisory board. F. A. reports receiving personal fees from MSD, Sanofi, and AstraZeneca and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, paid to the institution Centre hospitalier universitaire vaudois (CHUV), and from MSD and Pfizer, paid to the author, outside the submitted work. R. C. reports receiving personal fees from Sanofi, Pfizer, MSD, Viatris and GSK; travel grants from Pfizer and MSD; grants from Sanofi, Pfizer, MSD, and GSK; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, paid to the author; participation on a data safety monitoring board or advisory board for Pfizer, Sanofi, MSD, and GSK; and payment for expert testimony from Pfizer and MSD, outside the submitted work. E. V. reports grants from the French public health agency, paid to the institution; grants from Pfizer and from MSD; payment for expert testimony from Pfizer and MSD, paid to the institution; and support for attending meetings and/or travel from Pfizer, outside the submitted work. N. O. reports receiving grants from Pfizer to his institution during the conduct of the study and travel grants from Pfizer, Sanofi, and GSK, outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Published: 2024
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40. Exploring factors shaping antibiotic resistance patterns in Streptococcus pneumoniae during the 2020 COVID-19 pandemic.

Author: Kovacevic A, Smith DRM, Rahbé E, Novelli S, Henriot P, Varon E, Cohen R, Levy C, Temime L, and Opatowski L
Subjects: Humans, Streptococcus pneumoniae, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, SARS-CoV-2, Pandemics, Communicable Disease Control, COVID-19 epidemiology
Abstract: Non-pharmaceutical interventions implemented to block SARS-CoV-2 transmission in early 2020 led to global reductions in the incidence of invasive pneumococcal disease (IPD). By contrast, most European countries reported an increase in antibiotic resistance among invasive Streptococcus pneumoniae isolates from 2019 to 2020, while an increasing number of studies reported stable pneumococcal carriage prevalence over the same period. To disentangle the impacts of the COVID-19 pandemic on pneumococcal epidemiology in the community setting, we propose a mathematical model formalizing simultaneous transmission of SARS-CoV-2 and antibiotic-sensitive and -resistant strains of S. pneumoniae . To test hypotheses underlying these trends five mechanisms were built into the model and examined: (1) a population-wide reduction of antibiotic prescriptions in the community, (2) lockdown effect on pneumococcal transmission, (3) a reduced risk of developing an IPD due to the absence of common respiratory viruses, (4) community azithromycin use in COVID-19 infected individuals, (5) and a longer carriage duration of antibiotic-resistant pneumococcal strains. Among 31 possible pandemic scenarios involving mechanisms individually or in combination, model simulations surprisingly identified only two scenarios that reproduced the reported trends in the general population. They included factors (1), (3), and (4). These scenarios replicated a nearly 50% reduction in annual IPD, and an increase in antibiotic resistance from 20% to 22%, all while maintaining a relatively stable pneumococcal carriage. Exploring further, higher SARS-CoV-2 R 0 values and synergistic within-host virus-bacteria interaction mechanisms could have additionally contributed to the observed antibiotic resistance increase. Our work demonstrates the utility of the mathematical modeling approach in unraveling the complex effects of the COVID-19 pandemic responses on AMR dynamics., Competing Interests: AK, DS, ER, SN, PH, EV, LT No competing interests declared, RC received consulting fees from Pfizer, Sanofi, MSD, and GSK, including travel grants from Pfizer and payments from Symposium Pfizer, MSD, GSK, and Sanofi, and participated in advisory/data safety monitoring board at Pfizer, Sanofi, MSD, and GSK, CL received travel grants from Pfizer and payments from Symposium Pfizer and MSD, LO received a research grant from Pfizer and Sanofi Pasteur on unrelated topics through her institution, (© 2024, Kovacevic et al.)
Published: 2024
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41. Unique Changes in the Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Unravel the Role of Respiratory Pathogens: A Time Series Analysis.

Author: Assad Z, Valtuille Z, Rybak A, Kaguelidou F, Lazzati A, Varon E, Pham LL, Lenglart L, Faye A, Caseris M, Cohen R, Levy C, Vabret A, Gravey F, Angoulvant F, Koehl B, and Ouldali N
Subjects: Child, Humans, Child, Preschool, Adolescent, Incidence, Time Factors, Acute Chest Syndrome etiology, Acute Chest Syndrome complications, Influenza, Human complications, Anemia, Sickle Cell complications, Anemia, Sickle Cell epidemiology
Abstract: Background: Acute chest syndrome (ACS) is a life-threatening complication of sickle cell disease (SCD). Although respiratory pathogens are frequently detected in children with ACS, their respective role in triggering the disease is still unclear. We hypothesized that the incidence of ACS followed the unprecedented population-level changes in respiratory pathogen dynamics after COVID-19-related nonpharmaceutical interventions (NPIs)., Research Question: What is the respective role of respiratory pathogens in ACS epidemiology?, Study Design and Methods: This study was an interrupted time series analysis of patient records from a national hospital-based surveillance system. All children aged < 18 years with SCD hospitalized for ACS in France between January 2015 and May 2022 were included. The monthly incidence of ACS per 1,000 children with SCD over time was analyzed by using a quasi-Poisson regression model. The circulation of 12 respiratory pathogens in the general pediatric population over the same period was included in the model to assess the fraction of ACS potentially attributable to each respiratory pathogen., Results: Among the 55,941 hospitalizations of children with SCD, 2,306 episodes of ACS were included (median [interquartile range] age, 9 [5-13] years). A significant decrease was observed in ACS incidence after NPI implementation in March 2020 (-29.5%; 95% CI, -46.8 to -12.2; P = .001) and a significant increase after lifting of the NPIs in April 2021 (24.4%; 95% CI, 7.2 to 41.6; P = .007). Using population-level incidence of several respiratory pathogens, Streptococcus pneumoniae accounted for 30.9% (95% CI, 4.9 to 56.9; P = .02) of ACS incidence over the study period and influenza 6.8% (95% CI, 2.3 to 11.3; P = .004); other respiratory pathogens had only a minor role., Interpretation: NPIs were associated with significant changes in ACS incidence concomitantly with major changes in the circulation of several respiratory pathogens in the general population. This unique epidemiologic situation allowed determination of the contribution of these respiratory pathogens, in particular S pneumoniae and influenza, to the burden of childhood ACS, highlighting the potential benefit of vaccine prevention in this vulnerable population., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: N. O. reports travel grants from GlaxoSmithKline, Pfizer, and Sanofi. A. R. reports travel grants from Pfizer and AstraZeneca and personal fees from MSD outside the submitted work. A. V. reports personal fees from Sanofi, Moderna, GlaxoSmithKline, and MSD. R. C. reports speaking and lecture fees from Pfizer, Sanofi, GlaxoSmithKline, and MSD; and funding and travel grants from Pfizer. E. V. reports grants from Santé Publique France, Pfizer, and MSD. F. A. reports honoraria from Pfizer, GlaxoSmithKline, MSD, and Sanofi outside the submitted work. None declared (Z. A., Z. V., F. K., A. L., L.-L. P., L. L., A. F., M. C., C. L., F. G., B. K.)., (Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Published: 2024
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42. Antibiotic Resistance of Haemophilus influenzae in Nasopharyngeal Carriage of Children with Acute Otitis Media and in Middle Ear Fluid from Otorrhea.

Author: Assad Z, Cohen R, Varon E, Levy C, Bechet S, Corrard F, Werner A, Ouldali N, Bonacorsi S, and Rybak A
Abstract: Haemophilus influenzae (Hi) is one of the leading bacteria implicated in childhood acute otitis media (AOM). Recent concerns have been raised about the emergence of Hi-resistant strains. We aimed to analyze the evolution of β-lactam resistance to Hi among strains isolated from nasopharyngeal carriage in children with AOM and in mild ear fluid (MEF) after the spontaneous perforation of the tympanic membrane (SPTM) in France. In this national ambulatory-based cohort study over 16 years, we analyzed the rate of Hi nasopharyngeal carriage and the proportion of β-lactam-resistant Hi strains over time using a segmented linear regression model. Among the 13,865 children (median [IQR] age, 12.7 [9.3-17.3] months; 7400 [53.4%] male) with AOM included from November 2006 to July 2022, Hi was isolated in 7311 (52.7%) children by nasopharyngeal sampling. The proportion of β-lactamase-producing and β-lactamase-negative, ampicillin-resistant (BLNAR) Hi strains in nasopharyngeal carriage remained stable during the study period. Among the 783 children (median [IQR] age, 20 [12.3-37.8] months; 409 [52.2%] male) with SPTM included from October 2015 to July 2022, Hi was isolated in 177 (22.6%) cases by MEF sampling. The proportions of β-lactamase-producing and BLNAR Hi strains did not significantly differ between nasopharyngeal (17.6% and 8.8%, respectively) and MEF (12.6% and 7.4%) samples. Accordingly, amoxicillin remains a valid recommendation as the first-line drug for AOM in France.
Published: 2023
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43. Antimicrobial treatment of lower respiratory tract infections in children.

Author: Madhi F, Panetta L, De Pontual L, Biscardi S, Remus N, Gillet Y, Gajdos V, Ros B, Angoulvant F, Dutron S, and Cohen R
Subjects: Child, Humans, Anti-Bacterial Agents therapeutic use, Amoxicillin therapeutic use, Streptococcus pneumoniae, Respiratory Tract Infections diagnosis, Respiratory Tract Infections drug therapy, Anti-Infective Agents therapeutic use, Pneumonia drug therapy
Abstract: Lower respiratory tract infections (LRTI) encompass a wide range of clinical syndromes, prominently including bronchiolitis, bronchitis and pneumonia. LRTIs are the second leading cause of antibiotic prescriptions. The vast majority of these infections are due to (or triggered by) viruses and are self-limited diseases. Pneumonia in children is responsible for significant morbidity and mortality worldwide. For clinicians, one of the main difficulties consists in diagnosing pneumonia in febrile children with (or without) cough. The diagnosis is given on the basis of anamnesis, clinical examination and (if necessary) complementary examinations, with chest X-ray or thoracic ultrasound; biological markers are particularly important. Over recent years, since the implementation of PCV13, the bacterial epidemiology of pneumonia and empyema has evolved; involvement in these diseases of pneumococcus has been reduced, and resistance to penicillin has lessened - and remained extremely low. In 2021, according to the National Pneumococcal Reference Center, only 6% of the strains isolated from blood cultures in children are resistant to amoxicillin. The therapeutic choices proposed in this article are in full compliance with the previously published official French recommendations., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Published: 2023
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44. Antimicrobial treatment of urinary tract infections in children.

Author: Madhi F, Rybak A, Basmaci R, Romain AS, Werner A, Biscardi S, Dubos F, Faye A, Grimprel E, Raymond J, Ros B, and Cohen R
Subjects: Humans, Child, Infant, Newborn, Amikacin therapeutic use, Anti-Bacterial Agents therapeutic use, Escherichia coli, Urinary Tract Infections drug therapy, Anti-Infective Agents, Bacterial Infections drug therapy
Abstract: Urinary tract infections are the most frequently proven bacterial infections in pediatrics. The treatment options proposed in this guide are based on recommendations published by the Groupe de Pathologie Infectieuse de Pédiatrique (GPIP-SFP). Except in rare situations (newborns, neutropenia, sepsis), a positive urine dipstick for leukocytes and/or nitrites should precede a urine culture examination and any antibiotic therapy. After rising steadily between 2000 and 2012, the proportion of Escherichia coli strains resistant to extended-spectrum ß-lactamases (E-ESBL) has remained stable over the last ten years (between 7% and 10% in pediatrics). However, in many cases no oral antibiotic is active on E-ESBL leading either to prolonged parenteral treatment, or to use of a non-orthodox combination such as cefixime + clavulanate. With the aim of avoiding penem antibiotics and encouraging outpatient management, this guide favors initial treatment of febrile urinary tract infections (suspected or actual E-ESBL infection), with amikacin. Amikacin remains active against the majority of E-ESBL strains. It could be prescribed as monotherapy for patients in pediatric emergency departments or otherwise hospitalized patients., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Published: 2023
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45. Anti-infective treatment of gastro-intestinal tract infections in children.

Author: Cohen R, Minodier P, Hau I, Filleron A, Werner A, Haas H, Raymond J, Thollot F, and Bellaïche M
Subjects: Humans, Child, Child, Preschool, Anti-Bacterial Agents therapeutic use, Bacteria, Gastroenteritis drug therapy, Gastroenteritis microbiology, Salmonella Infections drug therapy, Campylobacter Infections drug therapy, Communicable Diseases drug therapy, Campylobacter
Abstract: Gastroenteritis is most often viral in origin and Rotavirus and Norovirus most frequently implicated in young children. Stool-based multiplex Polymerase Chain Reaction (PCR) can detect bacteria, viruses or parasites that may or may not be responsible for gastroenteritis (colonization). While the etiological profile of these digestive infections has greatly benefited from PCR, in the absence of underlying pathologies the presence of potential pathogens does not justify anti-infectious treatment. Indeed, very few bacterial causes require antibiotic treatment, apart from shigellosis, severe forms of salmonellosis and a few Campylobacter sp. infections. The development of antibiotic resistance in Salmonella sp., Shigella sp. and Campylobacter sp. is a cause for concern worldwide, limiting therapeutic options. The antibiotics proposed in this guide are in line with the joint recommendations of the European Society of Pediatric Infectious Diseases and the European Society of Pediatric Gastroenterology and Nutrition. Azithromycin is preferentially used to treat infections with Shigella sp. or Campylobacter sp. Ceftriaxone and ciprofloxacin are recommended for salmonellosis requiring antibiotic therapy. Empirical treatments without bacterial identification are not indicated except in cases of severe sepsis or in subjects at risk (e.g., sickle-cell disease). Metronidazole should be prescribed only for acute intestinal amebiasis after microbiological confirmation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Masson SAS.)
Published: 2023
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46. Surveillance of noninvasive group A Streptococcus infections in French ambulatory pediatrics before and during the COVID-19 pandemic: a prospective multicenter study from 2018-2022.

Author: Cohen JF, Rybak A, Werner A, Kochert F, Cahn-Sellem F, Gelbert N, Vié Le Sage F, Batard C, Béchet S, Corbaux H, Frandji B, Levy C, and Cohen R
Subjects: Child, Humans, Adolescent, Streptococcus pyogenes, Prospective Studies, Pandemics, Communicable Disease Control, COVID-19 diagnosis, COVID-19 epidemiology, Streptococcal Infections diagnosis, Streptococcal Infections epidemiology, Pediatrics
Abstract: Objectives: We evaluated the burden of noninvasive group A Streptococcus (GAS) infections in ambulatory pediatrics before and during the COVID-19 pandemic in France., Methods: We analyzed data from a national network of ambulatory pediatricians between 2018 and 2022. Clinicians evaluating children ≤15 years old for tonsillopharyngitis, perianal infections, paronychia/blistering dactylitis, and scarlet fever were invited to perform a rapid antigen detection test (RADT) for GAS. Monthly incidence of noninvasive GAS infections per 10,000 visits was modeled using time series analysis, considering two breakpoints: March 2020 (first national lockdown) and March 2022 (end of mandatory mask-wearing in schools)., Results: Over the study period, 125 pediatricians recorded 271,084 infectious episodes. GAS-related illnesses represented 4.3% of all infections. In March 2020, the incidence of GAS diseases decreased by 84.5% (P <0.001), with no significant trend until March 2022. After March 2022, the incidence significantly increased (+23.8% per month, P <0.001), with similar patterns across all monitored GAS-related diseases., Conclusion: By using routine clinical data and RADTs, we have monitored changes in the incidence of noninvasive GAS infections in ambulatory pediatrics. COVID-19 mitigation measures have had a major impact on the epidemiology of noninvasive GAS infections, but their relaxation was followed by a surge above baseline levels., Competing Interests: Declarations of competing interest The authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Published: 2023
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47. Diagnostic accuracy of a rapid nucleic acid test for group A streptococcal pharyngitis using saliva samples: protocol for a prospective multicenter study in primary care.

Author: Touitou R, Bidet P, Dubois C, Partouche H, Bonacorsi S, Jung C, Cohen R, Levy C, and Cohen JF
Abstract: Background: Group A streptococcus is found in 20-40% of cases of childhood pharyngitis; the remaining cases are viral. Streptococcal pharyngitis ("strep throat") is usually treated with antibiotics, while these are not indicated in viral cases. Most guidelines recommend relying on a diagnostic test confirming the presence of group A streptococcus before prescribing antibiotics. Conventional first-line tests are rapid antigen detection tests based on throat swabs. Recently, rapid nucleic acid tests were developed; they allow the detection of elements of the genome of group A streptococcus. We hypothesize that these rapid nucleic acid tests are sensitive enough to be performed on saliva samples instead of throat swabs, which could be more convenient in practice., Methods: This is a multicenter, prospective diagnostic accuracy study evaluating the performance of a rapid nucleic acid test for group A streptococcus (Abbott ID NOW STREP A2) in saliva, compared with a conventional pharyngeal rapid antigen detection test (EXACTO PRO STREPTATEST, lateral flow assay, comparator test), with a composite reference standard of throat culture and group A streptococcus PCR in children with pharyngitis in primary care (i.e., 27 primary care pediatricians or general practitioners). To ensure group A streptococcus is not missed, the salivary rapid nucleic acid test requires a minimally acceptable value of sensitivity (primary outcome) set at 80%. Assuming 35% of participants will have group A streptococcus, we will recruit 800 consecutive children with pharyngitis. Secondary outcomes will include difference in sensitivity between the pharyngeal rapid antigen detection test and the salivary rapid nucleic acid test; variability in sensitivity and specificity of the salivary rapid nucleic acid test with the level of McIsaac score; time to obtain the result of the salivary rapid nucleic acid test; patient, physician, and parents satisfaction; and barriers and facilitators to using rapid tests for group A streptococcus in primary care., Ethics and Dissemination: Approved by the Institutional Review Board "Comité de protection des personnes Ile de France I" (no. 2022-A00085-38). Results will be presented at international meetings and disseminated in peer-reviewed journals., Trial Registration Number: ClinicalTrials.gov: NCT05521568., (© 2023. The Author(s).)
Published: 2023
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48. The Shortage of Amoxicillin: An Escalating Public Health Crisis in Pediatrics Faced by Several Western Countries.

Author: Cohen R, Pettoello-Mantovani M, Giardino I, Carrasco-Sanz A, Somekh E, and Levy C
Subjects: Humans, Child, Public Health, Amoxicillin, Pediatrics
Published: 2023
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49. Meningitis caused by extended-spectrum β-lactamase-producing Escherichia coli in infants in France: a case series.

Author: Lignieres G, Rybak A, Levy C, Birgy A, Bechet S, Bonacorsi S, Cohen R, and Madhi F
Abstract: Objectives: We report the first case series focusing on clinical and biological characteristics of meningitis caused by ESBL-producing Escherichia coli in infants., Methods: Between 2001 and 2020, data on all cases of E. coli meningitis were prospectively collected from a network of 259 paediatric wards and 168 microbiology laboratories in France. We analysed the clinical and biological characteristics, short-term complications and long-term sequelae of ESBL-producing E. coli meningitis cases in patients <6 months old., Results: In total, 548 cases of E. coli paediatric meningitis were reported. ESBL-producing E. coli represented 12 (2.2%) cases. We included 10 patients aged <6 months old. Eight (80%) patients presented at least one sign of clinical severity: six needed mechanical ventilation, three presented signs of shock and one was in a coma. The overall short-term prognosis was good, with only one meningitis-attributed death in the first hours of care. All surviving children received carbapenems for a median of 21 days (range 9-28). Two relapses occurred, including one in a patient who received only 14 days of imipenem. We reported no long-term sequelae at a median follow-up of 20 months., Conclusions: Meropenem seems to be the treatment of choice for ESBL-producing E. coli meningitis in children and needs to be given as early as possible (<48 h) and for at least 21 days. Maternal colonization or infection with ESBL-producing Enterobacteriaceae needs to be reported to the neonatal or paediatric ICU team, in order to adapt the empirical antibiotic therapy., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Published: 2023
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50. Diagnostic accuracy of SARS-CoV-2 rapid antigen test from self-collected anterior nasal swabs in children compared to rapid antigen test and RT-PCR from nasopharyngeal swabs collected by healthcare workers: A multicentric prospective study.

Author: Cohen R, Aupiais C, Filleron A, Cahn-Sellem F, Romain O, Béchet S, Auvrignon A, Batard C, Virey B, Jung C, Rybak A, and Levy C
Abstract: Testing for SARS-CoV-2 is central to COVID-19 management. Rapid antigen test from self-collected anterior nasal swabs (SCANS-RAT) are often used in children but their performance have not been assessed in real-life. We aimed to compare this testing method to the two methods usually used: reverse transcription polymerase chain reaction from nasopharyngeal swabs collected by healthcare workers (HCW-PCR) and rapid antigen test from nasopharyngeal swabs collected by healthcare workers (HCW-RAT), estimating the accuracy and acceptance, in a pediatric real-life study. From September 2021 to January 2022, we performed a manufacturer-independent cross-sectional, prospective, multicenter study involving 74 pediatric ambulatory centers and 5 emergency units throughout France. Children ≥6 months to 15 years old with suggestive symptoms of COVID-19 or children in contact with a COVID-19-positive patient were prospectively enrolled. We included 836 children (median 4 years), 774 (92.6%) were symptomatic. The comparators were HCW-PCR for 267 children, and HCW-RAT for 593 children. The sensitivity of the SCANS-RAT test compared to HCW-RAT was 91.3% (95%CI 82.8; 96.4). Sensitivity was 70.4% (95%CI 59.2; 80.0) compared to all HCW-PCR and 84.6% (95%CI 71.9; 93.1) when considering cycle threshold <33. The specificity was always >97%. Among children aged ≥6 years, 90.9% of SCANS-RAT were self-collected without adult intervention. On appreciation rating (from 1, very pleasant, to 10, very unpleasant), 77.9% of children chose a score ≤3. SCANS-RAT have good sensitivity and specificity and are well accepted by children. A repeated screening strategy using these tests can play a major role in controlling the pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cohen, Aupiais, Filleron, Cahn-Sellem, Romain, Béchet, Auvrignon, Batard, Virey, Jung, Rybak and Levy.)
Published: 2022
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