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1. Febrile urinary-tract infection due to extended-spectrum beta-lactamase-producing enterobacteriaceae in children: a french prospective multicenter study

Author: Fouad Madhi, Camille Jung, Sandra Timsit, Corinne Levy, Sandra Biscardi, Mathie Lorrot, Emmanuel Grimprel, Laure Hees, Irina Craiu, Aurelien Galerne, François Dubos, Emmanuel Cixous, Véronique Hentgen, Stéphane Béchet, Urinary-tract Infection due to Extended-Spectrum Beta-lactamase–producing Enterobacteriaceae in Children Group, Stéphane Bonacorsi, Robert Cohen, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), AP-HP Hôpital universitaire Robert-Debré [Paris], CHU Lille, Université de Lille, METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694, Groupe de Pathologie Infectieuse Pédiatrique [Paris] [GPIP], Centre Hospitalier Intercommunal de Créteil [CHIC], Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS], and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Subjects: Male, medicine.medical_treatment, Antibiotics, Cephalosporin, Urine, Pediatrics, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prospective Studies, lcsh:Science, Child, Enterobacteriaceae Infections, 3. Good health, Ciprofloxacin, Child, Preschool, Pediatric Infectious Disease, Pediatric Infections, medicine.medical_specialty, Urinary system, 030106 microbiology, Microbial Sensitivity Tests, Microbiology, 03 medical and health sciences, Humans, Pharmacology, Bacteria, lcsh:R, Organisms, Infant, Biology and Life Sciences, bacterial infections and mycoses, Carbapenems, lcsh:Q, 0301 basic medicine, Physiology, lcsh:Medicine, Risk Factors, Medicine and Health Sciences, Prospective cohort study, Multidisciplinary, Antimicrobials, Drugs, Anti-Bacterial Agents, Body Fluids, Amikacin, Urinary Tract Infections, Female, France, Anatomy, medicine.drug, Research Article, Adolescent, Fever, medicine.drug_class, Bladder, beta-Lactamases, Enterobacteriaceae, 030225 pediatrics, Internal medicine, Microbial Control, medicine, book, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Infant, Newborn, Kidneys, Renal System, Beta-lactamase, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, book.journal, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Objectives To assess the management of febrile urinary-tract infection (FUTIs) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) in children, the Pediatric Infectious Diseases Group of the French Pediatric Society set up an active surveillance network in pediatric centers across France in 2014. Materials and methods We prospectively analysed data from 2014 to 2016 for all children < 18 years old who received antibiotic treatment for FUTI due to ESBL-E in 24 pediatric centers. Baseline demographic, clinical features, microbiological data and antimicrobials prescribed were collected. Results 301 children were enrolled in this study. The median age was 1 year (IQR 0.02–17.9) and 44.5% were male. These infections occurred in children with history of UTIs (27.3%) and urinary malformations (32.6%). Recent antibiotic use was the main associated factor for FUTIs due to ESBL-E, followed by a previous hospitalization and travel history. Before drug susceptibility testing (DST), third-generation cephalosporins (3GC) PO/IV were the most-prescribed antibiotics (75.5%). Only 13% and 24% of children received amikacine alone for empirical or definitive therapy, respectively, whereas 88.7% of children had isolates susceptible to amikacin. In all, 23.2% of children received carbapenems in empirical and/or definitive therapy. Cotrimoxazole (24.5%), ciprofloxacin (15.6%) and non-orthodox clavulanate–cefixime combination (31.3%) were the most frequently prescribed oral options after obtaining the DST. The time to apyrexia and length of hospital stay did not differ with or without effective empirical therapy. Conclusions We believe that amikacin should increasingly take on a key role in the choice of definitive therapy of FUTI due to ESBL-E in children by avoiding the use of carbapenems.
Published: 2018

2. Successful treatment of JAK1 associated inflammatory disease

Author: Fayand, Antoine, Hentgen, Véronique, Posseme, Céline, Lacout, Carole, Picard, Capucine, Moguelet, Philippe, Cescato, Margaux, Sbeih, Nabiha, Moreau, Thomas R.J., Zhu, Yixiang Yj., Charuel, Jean-Luc, Corneau, Aurélien, Deibener-Kaminsky, Joelle, Dupuy, Stéphanie, Fusaro, Mathieu, Hoareau, Benedicte, Hovnanian, Alain, Langlois, Vincent, Le Corre, Laurent, Maciel, Thiago, Miskinyte, Snaigune, Miyara, Makoto, Moulinet, Thomas, Perret, Magali, Schuhmacher, Marie Hélène, Rignault-Bricard, Rachel, Viel, Sébastien, Vinit, Angélique, Soria, Angèle, Duffy, Darragh, Launay, Jean-Marie, Callebert, Jacques, Herbeuval, Jean Philippe, Rodero, Mathieu P, Georgin-Lavialle, Sophie, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Chimie et de Biochimie Pharmacologiques et Toxicologiques (LCBPT - UMR 8601), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre Hospitalier de Versailles André Mignot (CHV), Immunologie Translationnelle - Translational Immunology lab, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), CHU Trousseau [APHP], Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Cytométrie Pitié-Salpêtrière (PASS-CYPS), Unité Mixte de Service Production et Analyse de données en Sciences de la vie et en Santé (PASS), 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)-Sorbonne Université (SU), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Biomedtech Facilities (UMS 2009 / US36), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) (GHH), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Emile Durkheim [Epinal] (CH Epinal / CHED), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, and Hôpital Lariboisière-Fernand-Widal [APHP]
Subjects: JAK 1, JAK inhibitors, atopic dermatitis, inborn errors of immunity, [SDV]Life Sciences [q-bio], allergy
Abstract: International audience; Background: Gain of function (GOF) variants of JAK1 drive a rare immune dysregulation syndrome associated with atopic dermatitis, allergy and eosinophilia.Objectives: To describe the clinical and immunological characteristics associated with a new GOF variant of JAK1 and report the therapeutic efficacy of JAK inhibition.Methods: We identified a family affected by JAK1 associated autoinflammatory disease and performed clinical assessment and immunological monitoring on 9 patients. JAK1 signalling was studied by flow and mass cytometry in patients' cells at basal state, or after immune stimulation. A molecular disease signature in the blood was studied at the transcriptomic level. Patients were treated with one of two JAK inhibitors; either baricitinib or upadacitinib. Clinical, cellular, and molecular response were evaluated over a 2-year period.Results: Affected individuals displayed a syndromic disease with prominent allergy including atopic dermatitis, ichthyosis, arthralgia, chronic diarrhoea, disseminated calcifying fibrous tumours and elevated whole blood histamine levels. A variant of JAK1 localized in the pseudokinase domain was identified in all 9 affected tested patients. Hyper-phosphorylation of STAT3 was found in 5 out of 6 patients tested. Treatment of patients' cells with baricitinib controlled most of the atypical hyper-phosphorylation of STAT3. Administration of baricitinib to patients led to rapid improvement of the disease in all adults and was associated with reduction of systemic inflammation.Conclusions: Patients with this new JAK1 GOF pathogenic variant displayed very high levels of blood histamine and showed a variable combination of atopy with articular and gastrointestinal manifestations as well as calcifying fibrous tumours. The disease, that appears to be linked to STAT3 hyper-activation, was well controlled under treatment by JAK inhibitors in adult patients.
Published: 2023

3. 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

4. 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

5. 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

6. Why should the meningococcal B vaccine be recommended, and therefore reimbursed, for infants in France?

Author: Véronique Dufour, Etienne Javouhey, Fabienne Kochert, Jean-Paul Stahl, Christèle Gras-Le Guen, Nicolas Vignier, Odile Launay, Pierre Tattevin, Robert Cohen, Elise Launay, Joël Gaudelus, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Association Française de Pédiatrie Ambulatoire (AFPA), Hospices Civils de Lyon (HCL), Infovac-France, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)-Groupe hospitalier Broca-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), 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)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHI Créteil, Pfizer, Sanofi, Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: 0303 health sciences, Pediatrics, medicine.medical_specialty, 030306 microbiology, business.industry, [SDV]Life Sciences [q-bio], MEDLINE, Infant, Meningococcal Vaccines, Neisseria meningitidis, Serogroup B, 3. Good health, Meningococcal Infections, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, MENINGOCOCCAL B, Humans, Medicine, France, 030212 general & internal medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2021

7. 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

8. 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

9. 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

10. Different Clinical Presentations and Outcomes of Disseminated Varicella in Children With Primary and Acquired Immunodeficiencies

Author: Paul Bastard, Aurélien Galerne, Alain Lefevre-Utile, Coralie Briand, André Baruchel, Philippe Durand, Judith Landman-Parker, Elodie Gouache, Nathalie Boddaert, Despina Moshous, Joel Gaudelus, Robert Cohen, Georges Deschenes, Alain Fischer, Stéphane Blanche, Loïc de Pontual, Bénédicte Neven, Human genetics of infectious diseases : Mendelian predisposition (Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), 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), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Louis Mourier - AP-HP [Colombes], Hôpital Robert Debré, Institut de Chimie des Substances Naturelles (ICSN), Institut de Chimie du CNRS (INC)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Intercommunal de Créteil (CHIC), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gestionnaire, HAL Sorbonne Université 5, 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), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: Male, 0301 basic medicine, lcsh:Immunologic diseases. Allergy, Pediatrics, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Adolescent, medicine.medical_treatment, Fulminant, Immunology, Disease, Antiviral Agents, 03 medical and health sciences, Fatal Outcome, 0302 clinical medicine, varicella, medicine, Humans, Immunology and Allergy, Child, innate immunity, Immunodeficiency, Original Research, Lung, Chickenpox, business.industry, Immunologic Deficiency Syndromes, Infant, Immunosuppression, primary immumunodeficiencies, medicine.disease, Rash, 3. Good health, 030104 developmental biology, medicine.anatomical_structure, Child, Preschool, Varicella Zoster Virus Infection, disseminated varicella, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, business, lcsh:RC581-607, Nephrotic syndrome, 030215 immunology, steroids
Abstract: International audience; Primary infection with varicella-zoster virus (VZV) causes chickenpox, a benign and self-limited disease in healthy children. In patients with primary or acquired immunodeficiencies, primary infection can be life-threatening, due to rapid dissemination of the virus to various organs [lung, gastrointestinal tract, liver, eye, central nervous system (CNS)]. We retrospectively described and compared the clinical presentations and outcomes of disseminated varicella infection (DV) in patients with acquired (AID) (n= 7) and primary (PID) (n= 12) immunodeficiencies. Patients with AID were on immunosuppression (mostly steroids) for nephrotic syndrome, solid organ transplantation or the treatment of hemopathies, whereas those with PID had combined immunodeficiency (CID) or severe CID (SCID). The course of the disease was severe and fulminant in patients with AID, with multiple organ failure, no rash or a delayed rash, whereas patients with CID and SICD presented typical signs of chickenpox, including a rash, with dissemination to other organs, including the lungs and CNS. In the PID group, antiviral treatment was prolonged until immune reconstitution after bone marrow transplantation, which was performed in 10/12 patients. Four patients died, and three experienced neurological sequelae. SCID patients had the worst outcome. Our findings highlight substantial differences in the clinical presentation and course of DV between children with AID and PID, suggesting differences in pathophysiology. Prevention, early diagnosis and treatment are required to improve outcome.
Published: 2020

11. Applying a Human-Centered Design to Develop a Patient Prioritization Tool for a Pediatric Emergency Department: Detailed Case Study of First Iterations

Author: Schiro, Jessica, Pelayo, Sylvia, Martinot, Alain, Dubos, François, Beuscart-Zéphir, Marie-Catherine, Marcilly, Romaric, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Service de Neuro-pédiatrie[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301 (CIC Lille), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Maison Régionale de la Recherche Clinique [Lille], and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: Original Paper, human-centered design, emergency department, triage systems, ergonomics, [SCCO.PSYC]Cognitive science/Psychology, design, Medical technology, R855-855.5, patients
Abstract: BackgroundOvercrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients’ waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians’ workflow. ObjectiveThis case study presents the development of a patient prioritization tool (PPT) and of the related patient prioritization algorithm (PPA) for a pediatric emergency department (PED), relying on a human-centered design process. MethodsWe followed a human-centered design process, wherein we (1) performed a work system analysis through observations and interviews in an academic hospital’s PED; (2) deduced design specifications; (3) designed a mock PPT and the related PPA; and (4) performed user testing to assess the intuitiveness of the icons, the effectiveness in communicating patient priority, the fit between the prioritization model implemented and the participants’ prioritization rules, and the participants’ satisfaction. ResultsThe workflow analysis identified that the PPT interface should meet the needs of physicians and nurses, represent the stages of patient care, and contain patient information such as waiting time, test status (eg, prescribed, in progress), age, and a suggestion for prioritization. The mock-up developed gives the status of patients progressing through the PED; a strip represents the patient and the patient’s characteristics, including a delay indicator that compares the patient’s waiting time to the average waiting time of patients with a comparable reason for emergency. User tests revealed issues with icon intuitiveness, information gaps, and possible refinements in the prioritization algorithm. ConclusionsThe results of the user tests have led to modifications to improve the usability and usefulness of the PPT and its PPA. We discuss the value of integrating human factors into the design process for a PPT for PED. The PPT/PPA has been developed and installed in Lille University Hospital's PED. Studies are carried out to evaluate the use and impact of this tool on clinicians’ situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients’ experience.
Published: 2020

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Incidence of paediatric pneumococcal meningitis and emergence of new serotypes: a time-series analysis of a 16-year French national survey

Author: Severine Haouisee, Sandrine Anne Martha, Elodie Blondel, Maxime Thouvenin, Fouad Madhi, Guilaine Barnaud, Sylvie Charachon, Jérémie Violette, Chrystèle Fabbro, Hubert Ythier, Marie Pierre Fos, Emmanuelle Varon, Danielle Roybet, Grégory Dubourg, Olivier Guilluy, Jean Marc Schneider, Stéphane Bonacorsi, Abdelmalek Belgaid, Anne Laure Roux, Alain Goudeau, Stéphane Dauger, Valérie Biran, Olivier Moquet, Anne Gougeon Jollivet, Alain Martinot, Bertrand Chevallier, Chantal Chaplain, Claude Bosi, Josette Jehan, Caroline Garandeau, Karen Milcent, Claire Plassart, Nicolas Kalach, Valérie Sivadon-Tardy, Pascal Bolot, Françoise Evreux, Ellia Mezgueldi, Mireille Cheron, Marie Françoise Prere, Nawal Nicola, Jacques Brouard, Ralph Epaud, Agnès Ferroni, Eric Moulene, Emmanuelle Dessioux, Sylvia Akitani, Aurélia Pitsch, Cyril Morisot, Danielle Landragin, Eterne Twizeyimana, François Angoulvant, Jean Sarlangue, Isabelle Glatz, Caroline Guyot, Anne Bertrou, Anne Chace, Stéphanie Honore Bouakline, Delphine Desbois, Philippe Labrune, Didier Moissenet, Sophie Boyer, Alain Barrans, Leila Lafendi, Françoise Cascarigny, Nathalie Bednarek, Albert Faye, Ahmed Sadik, Valérie Marcou, Daniele De Luca, Etienne Javouhey, Véronqiue Vernet-Garnier, Florence Doucet-Populaire, Josette Raymond, Leatitia Pantalone, Célestin M’Bamba, Jean Marc Chamouilli, Katherine Dieckmann, Mariane Marin, Philippe Lehours, Mathie Lorrot, Didier Pinquier, Hélène Garrec, Christian Herve, Martin Chalumeau, Naim Ouldali, François Gouraud, Marc Le Bideau, Laurence Eitenschenck, Emmanuel Grimprel, Hélène Biessy, Valérie Macchi, Véronique Duval, Ilhem Agha-Mir, Hakim Lahrach, H. Haas, Pierre Lureau, Farida Hamdad, Marie Hélène Pierre, Florent Girard, Valérie Asensio, Romain Basmaci, Marlène Amara, Maité Micaelo, Patricia Roussellier, Brigitte Zimmermann, Nathalie Hubert, Julie Toubiana, Mohamed Amine Yangui, Sylvie Ledru, Fréderic Tronc, Corinne Levy, Jean Gaschignard, Alain Goux, Catherine Glastre, Pierre Patoz, Francis Chomienne, Bernadette Cartier-Riviere, Stéphanie Eyssette-Gayraud, Robert M. Cohen, Rodrigue Dessein, Nicolas Soustelle, Anna Grando, Didier Jan, François Dubos, Huong Porcheret, Isabelle Savoy, Fanny Autret, Marie Noelle Adam, Marie Josée Dufour, Anne Charbonneau, Olivier Lemenand, Anne Dao-Dubremetz, Agnes Rey, Anne Cécile Hochart, Guillaume Arlet, Véronique Despert, Didier Eyer, Fabrice Lapeyre, Nevena Danekova, Olivier Sebag, Ali Khalfi, Emmanuel Jeannot, Joël Gaudelus, Marie Aliette Dommergues, Frédéric Wallet, Elodie Dorangeon, Christine Vervel, Marie Emmanuelle Juvin, Gery Courouble, Gael Guyon, Florence Richardin, Marion Decobert, Laurent Geniez, Nejib Lejri, Stéphane Béchet, Katia Barsotti, Christian Cattoen, Julien Baleine, Pierre Goumy, Laure Warin, Serge Gallet, Anthony Texier, Delphine Minette Brunel, Rachel Heyman Guenais, Grégoire Benoist, Béatrice Pellegrino, Muriel Halna, Vincent Laugel, André De Briel, Norbert Laisney, A. Vachée, Christophe De Champs, Patrick Daoud, Isabelle Haegy-Doehring, Jean-Philippe Lavigne, Simone Saumureau, Delphine Penel-Capelle, Véronique Blanc, Abdelaziz Oulepsir, Elise Launay, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Urgences pédiatriques, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France, parent, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR)
Subjects: Male, Serotype, Pediatrics, medicine.medical_specialty, Future studies, Adolescent, Population, Serogroup, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, 030212 general & internal medicine, Child, education, book, Prospective survey, National health, education.field_of_study, Meningitis, Pneumococcal, business.industry, Incidence, Incidence (epidemiology), Streptococcal Vaccines, Infant, Newborn, Infant, PNEUMOCOCCAL MENINGITIS, medicine.disease, Health Surveys, 3. Good health, Streptococcus pneumoniae, Infectious Diseases, Child, Preschool, Pediatric Infectious Disease, book.journal, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Meningitis, Forecasting
Abstract: Successive implementation of seven-valent then 13-valent pneumococcal conjugate vaccines (PCVs) led to a marked decrease in pneumococcal disease burden, including pneumococcal meningitis. We assessed the long-term effect of implementation of PCVs on incidence of pneumococcal meningitis in children in France over a 16-year period.We did a quasi-experimental, population-based interrupted time-series analysis with a nationwide prospective survey over 16 years in France, recruiting children aged younger than 15 years from 227 paediatric wards from January, 2001, to December, 2016. The main outcome by the time-series model was the estimated incidence of pneumococcal meningitis per 100 000 children (of a population of 12·6 million children in 2017) before and after PCV7 and PCV13 implementation. The time-series model was based on segmented regression with autoregressive error.We enrolled 1778 children with pneumococcal meningitis. PCV13 implementation led to a significant reduction in monthly incidence of pneumococcal meningitis from 0·12 per 100 000 children before PCV13 to a nadir of 0·07 in December, 2014 (-38%, 95% CI -56·1 to -20·4; p0·0001). A sharp increase occurred during 2015 and 2016, (+2·3% per month, incidence of 0·13 per 100 000 children at the end of the study period, p=0·0002), mainly related to an increase of serotype 24F, which was frequently penicillin resistant.The early effect of PCV13 implementation greatly reduced the incidence of pneumococcal meningitis in children less than 15 years old. However, a sharp rebound in incidence linked to the emergence of serotype 24F compromised the long-term PCV efficacy. If confirmed in future studies and in other countries, pneumococcal meningitis incidence rebound and 24F emergence should be considered when developing next-generation PCVs.The French Pediatric Infectious Diseases Group, Association Clinique et Thérapeutique Infantile du Val de Marne, Pfizer, and for the National Reference Centre for Pneumococci, the French National Health Agency.
Published: 2018

19. Relay oral therapy in febrile urinary tract infections caused by extended spectrum beta-lactamase–producing Enterobacteriaceae in children: A French multicenter study

Author: Vincent Gajdos, André Birgy, Isabelle Andriantahina, Didier Pinquier, Valérie Soussan-Banini, Elise Launay, Olivier Vignaud, Yves Gillet, Alexis Rybak, Emmanuel Grimprel, Loïc de Pontual, Corinne Levy, François Angoulvant, Emilie Georget, Irina Craiu, François Dubos, Gabriel Lignieres, Marie Aliette Dommergues, Robert M. Cohen, Camille Jung, Emmanuel Cixous, Fouad Madhi, Stéphane Bonacorsi, Centre Hospitalier Intercommunal de Créteil (CHIC), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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)), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier de Versailles André Mignot (CHV), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Centre Hospitalier de Saint-Camille [Bry sur Marne], Hôpital Ambroise Paré [AP-HP], and Centre Hospitalier Intercommunal Villeneuve-Saint-Georges (CHIV)
Subjects: Male, Physiology, Klebsiella pneumoniae, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Antibiotics, Administration, Oral, Urine, Geographical locations, Families, Ciprofloxacin, Recurrence, Medicine and Health Sciences, Child, Children, Routes of Administration, Multidisciplinary, biology, Antimicrobials, Drugs, Body Fluids, Europe, Phenotype, Treatment Outcome, Child, Preschool, Urinary Tract Infections, Medicine, Female, France, Anatomy, Research Article, medicine.drug, Risk, medicine.medical_specialty, Adolescent, Fever, medicine.drug_class, Science, Urinary system, Microbial Sensitivity Tests, Amoxicillin-Potassium Clavulanate Combination, Microbiology, Antibiotic Susceptibility Testing, beta-Lactamases, Enterobacteriaceae, Cefixime, Microbial Control, Intravenous Injections, Internal medicine, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, Humans, European Union, Etest, Retrospective Studies, Pharmacology, Bacteria, business.industry, Organisms, Infant, Newborn, Biology and Life Sciences, Infant, Renal System, bacterial infections and mycoses, biology.organism_classification, Pharmacologic Analysis, Age Groups, People and Places, Beta-lactamase, Population Groupings, business
Abstract: ObjectivesWe need studies assessing therapeutic options for oral relay in febrile urinary tract infection (FUTI) due to ESBL–producing Enterobacteriaceae (ESBL-E) in children. Amoxicillin-clavulanate/cefixime (AC-cefixime) combination seems to be a suitable option. We sought to describe the risk of recurrence at 1 month after the end of treatment for FUTI due to ESBL-E according to the oral relay therapy used.Materials and methodsWe retrospectively identified children ResultsWe included 199 children who received an oral relay therapy with cotrimoxazole (n = 72, 36.2%), ciprofloxacin (n = 38, 19.1%) or the AC-cefixime combination (n = 89, 44.7%). Nine (4.5%) patients had a recurrence within the first month after the end of treatment, with no difference between the 3 groups of oral relay (p = 0.8): 4 (5.6%) cotrimoxazole, 2 (5.3%) ciprofloxacin and 3 (3.4%) AC-cefixime combination. Phenotype characterization of 249 strains responsible for FUTI due to ESBL-E showed that 97.6% were susceptible to the AC-cefixime combination.ConclusionsThe AC-cefixime combination represents an interesting therapeutic option for oral relay treatment of FUTI due to ESBL-E as the recurrence rate at 1 month after the end of treatment was the same when compared to cotrimoxazole and ciprofloxacin.
Published: 2021

20. 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

21. Compliance with the current recommendations for prescribing antibiotics for paediatric community-acquired pneumonia is improving: data from a prospective study in a French network

Author: Flora Lepage, Matthieu Hanf, Corinne Levy, Christèle Gras-Le Guen, Emmanuel Grimprel, Alain Martinot, François Dubos, François Angoulvant, K. Levieux, Robert M. Cohen, B. Vrignaud, Elise Launay, Bodescot, Myriam, Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Clinique Médicale et Service d'Urgences Pédiatriques, Hôpital Mère-Enfant, Centre hospitalier universitaire de Nantes (CHU Nantes), Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC - Nantes, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Hopital Robert Debre, Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP, Hôpital Robert Debré, Pôle de Pédiatrie Aiguë et Médecine Interne, Service d'Accueil des Urgences Pédiatriques, Université Paris Diderot - Paris 7 (UPD7), and The French pneumonia network is supported by a grant from Pfizer.
Subjects: Male, Pediatrics, Inappropriate Prescribing, Antibiotic prescription, 0302 clinical medicine, Community-acquired pneumonia, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Prospective Studies, Practice Patterns, Physicians', Prospective cohort study, Child, Children, Antibiotic stewardship, Univariate analysis, Confounding, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, 3. Good health, Anti-Bacterial Agents, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Community-Acquired Infections, Child, Preschool, Practice Guidelines as Topic, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, Guideline Adherence, Emergency Service, Hospital, medicine.drug, Research Article, medicine.medical_specialty, Adolescent, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 030225 pediatrics, Lower respiratory tract infection, medicine, Humans, Pediatrics, Perinatology, and Child Health, Medical prescription, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Infant, Pneumonia, Amoxicillin, medicine.disease, Logistic Models, Pediatrics, Perinatology and Child Health, Emergency medicine, business
Abstract: Background Lower respiratory tract infection is a common cause of consultation and antibiotic prescription in paediatric practice. The misuse of antibiotics is a major cause of the emergence of multidrug-resistant bacteria. The aim of this study was to evaluate the frequency, changes over time, and determinants of non-compliance with antibiotic prescription recommendations for children admitted in paediatric emergency department (PED) with community-acquired pneumonia (CAP). Methods We conducted a prospective two-period study using data from the French pneumonia network that included all children with CAP, aged one month to 15 years old, admitted to one of the ten participating paediatric emergency departments. In the first period, data from children included in all ten centres were analysed. In the second period, we analysed children in three centers for which we collected additional data. Two experts assessed compliance with the current French recommendations. Independent determinants of non-compliance were evaluated using a logistic regression model. The frequency of non-compliance was compared between the two periods for the same centres in univariate analysis, after adjustment for confounding factors. Results A total of 3034 children were included during the first period (from May 2009 to May 2011) and 293 in the second period (from January to July 2012). Median ages were 3.0 years [1.4–5] in the first period and 3.6 years in the second period. The main reasons for non-compliance were the improper use of broad-spectrum antibiotics or combinations of antibiotics. Factors that were independently associated with non-compliance with recommendations were younger age, presence of risk factors for pneumococcal infection, and hospitalization. We also observed significant differences in compliance between the treatment centres during the first period. The frequency of non-compliance significantly decreased from 48 to 18.8 % between 2009 and 2012. The association between period and non-compliance remained statistically significant after adjustment for confounding factors. Amoxicillin was prescribed as the sole therapy significantly more frequently in the second period (71 % vs. 54.2 %, p
Published: 2016

22. 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

23. 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

24. [Impact of corticosteroids in the immediate management of invasive meningococcal disease associated with hyperinvasive strains of the ST-11 clonal complex in children]

Author: F, Madhi, C, Levy, A-E, Deghmane, S, Béchet, R, Cohen, M-K, Taha, 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), Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP), Société Française de Pédiatrie (SFP), Association Clinique et Thérapeutique du Val-de-Marne (ACTIV), 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], Groupe des pédiatres et microbiologistes de l’Observatoire national des méningites bactériennes de l’enfant Service de pédiatrie, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France, and Institut Pasteur [Paris] (IP)
Subjects: Male, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Time Factors, Genotype, Infant, Neisseria meningitidis, Meningitis, Bacterial, Adrenal Cortex Hormones, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Child, Preschool, Purpura Fulminans, Humans, Female, Prospective Studies, Child
Abstract: International audience; ObjectifsÀ partir des données de l’Observatoire national des méningites bactériennes de l’enfant du Groupe de pathologie infectieuse pédiatrique/Association clinique et thérapeutique infantile du Val-de-Marne (GPIP/ACTIV) et des données microbiologiques des souches du Centre national de référence du méningocoque (CNRM), l’impact potentiel des corticoïdes dans la prise en charge immédiate des infections invasives à méningocoque (IIM) liées aux différents génotypes, notamment aux souches hautement pro-inflammatoires du complexe clonal ST-11 (génotype ST-11) a été évalué.MéthodesDe 2001 à 2009, 259 services de pédiatrie et 168 laboratoires de microbiologie répartis dans toute la France ont inclus de façon prospective tous les sujets de moins de 18 ans, ayant une IIM (méningite ou purpura fulminans). Les souches isolées ont été envoyées au CNRM pour génotypage. La mise en relation entre les données cliniques d’ACTIV et les souches isolées du CRNM a été faite lorsque l’information sur le traitement par corticoïdes était présente.RésultatsMille neuf cent quatre-vingt-un cas d’IIM ont été identifiés en 8 ans dont 805 (712 [88,5 %] méningites bactériennes et 93 [11,5 %] purpura fulminans) disposaient d’informations sur la corticothérapie (33,8 % des patients ayant reçu des corticoïdes). L’information sur le génotype des souches était disponible pour 410 patients (24,4 % lié au génotype ST-11, soit 100 patients). Pour l’ensemble des cas, la mortalité était associée au génotype ST-11 (OR = 2,39, IC 95 % [1,29 ; 4,42], p = 0,004). La mortalité était également significativement plus élevée pour l’ensemble des IIM en cas de prise de corticoïdes (12,7 % vs 4,5 %, p < 0,001). Cependant, ce traitement avait été prescrit plus fréquemment dans les formes graves incluant choc et/ou purpura fulminans, coma ou ventilation mécanique. Pour les enfants n’ayant pas reçu de corticoïdes, le taux de mortalité était significativement plus élevé lorsqu’il s’agissait d’une souche du génotype ST-11 que d’autres génotypes (OR = 4,68 [1,91 ; 11,46], p = 0,001). En revanche, pour les enfants ayant reçu une corticothérapie, la mortalité ne différait pas en fonction du génotype de la souche.ConclusionLes données de cette étude montrent, en l’absence de corticothérapie, une surmortalité dans les infections invasives à méningocoque liées aux souches du complexe clonal ST-11. Ce résultat suggère un possible effet positif de la corticothérapie en fonction du génotype incriminé.; ObjectivesWe used data from the Groupe de pathologie infectieuse pédiatrique and Association clinique et thérapeutique infantile du Val-de-Marne (GPIP/ACTIV) National Survey of Bacterial Meningitis in children and the National Reference Center for Meningococci (CNRM) microbiological data to assess the potential impact of corticosteroids on the immediate management of invasive meningococcal disease (IMD) associated with different genotypes, including highly pro-inflammatory strains of the ST-11 clonal complex (genotype ST-11).MethodsFrom 2001 to 2009, 259 pediatric wards and 168 microbiology laboratories distributed throughout France prospectively included all under-18-year-old patients with IMD (meningitis or purpura fulminans). The strains were sent to the CNRM for genotyping. We linked the ACTIV clinical data of IMD cases, where information on corticosteroid therapy was available, to strains isolated by the CRNM.ResultsA total of 1981 IMD cases were identified during the 8-year study, 805 cases (712 [88.5%] bacterial meningitis and 93 [11.5%] purpura fulminans) had steroid treatment data (33.8% received corticosteroids). The genotype of the strains was available for 410 patients (24.4% related to genotype ST-11; 100 patients). For all cases and regardless of the corticosteroids, mortality was significantly associated with the genotype ST-11 (OR = 2.39, 95% CI [1.29; 4.42], P = 0.004). For all cases and regardless of the genotypes of the isolates, mortality was also significantly higher for children with than without corticosteroid therapy (12.7% versus 4.5%, P < 0.001). However, this treatment had been prescribed more frequently in severe cases, including shock, PF, coma and/or mechanical ventilation. For children who did not receive corticosteroids, the mortality rate was significantly higher with genotype ST-11 compared to other genotypes (OR = 4.68 [1.91, 11.46], P = 0.001). This difference disappeared in children who received corticosteroids.ConclusionThis study indicates that in the absence of corticosteroids, higher mortality in invasive meningococcal disease is associated with the ST-11 clonal complex strains. This suggests a possible positive effect of corticosteroid therapy depending on the genotype of the strain involved.
Published: 2014

25. 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

26. 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

27. 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

28. 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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28 results on '"Groupe de Pathologie Infectieuse Pédiatrique [Paris] (GPIP)"'

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7. 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?

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18. Incidence of paediatric pneumococcal meningitis and emergence of new serotypes: a time-series analysis of a 16-year French national survey

19. Relay oral therapy in febrile urinary tract infections caused by extended spectrum beta-lactamase–producing Enterobacteriaceae in children: A French multicenter study

20. Neonatal Meningococcal Meningitis In France From 2001 To 2013

21. Compliance with the current recommendations for prescribing antibiotics for paediatric community-acquired pneumonia is improving: data from a prospective study in a French network

22. Vaccine Failure After Meningococcal C Conjugate Vaccine May Be Linked to Decline of Bactericidal Titers and Absence of Herd Immunity

23. Change in French bacterial meningitis in children resulting from vaccination

24. [Impact of corticosteroids in the immediate management of invasive meningococcal disease associated with hyperinvasive strains of the ST-11 clonal complex in children]

25. Corticosteroid Therapy in Genotype ST-11 Meningococcal Infections

26. Invasive serogroup w meningococcal disease in children: a national survey from 2001 to 2008 in France

27. Méningites à méningocoques de l’enfant en France: résultats de l’observatoire ACTIV/GPIP

28. Association of Meningococcal Phenotypes and Genotypes With Clinical Characteristics and Mortality of Meningitis in Children

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