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1. Risk factors for acquisition of OXA-48-producing Klebsiella pneumonia among contact patients: a multicentre study

Author

Caroline Neulier, Alexandra Lomont, J. Merrer, B. Grandbastien, J.C. Lucet, Jean-Ralph Zahar, Delphine Hilliquin, V. Thepot Seegers, Didier Lepelletier, R. Le Guern, Anne-Marie Rogues, C. Legeay, V. Marie, CHU Lille, Université de Lille, Centre Hospitalier Universitaire d'Angers [CHU Angers], Recherche translationnelle : relations hôte-pathogènes - EA 7366, Recherche translationelle relations hôte-pathogènes, Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO], AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU de Bordeaux Pellegrin [Bordeaux], Centre hospitalier universitaire de Nantes [CHU Nantes], Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
0301 basic medicine, Multivariate analysis, [SDV]Life Sciences [q-bio], Mesh:Adult, 0302 clinical medicine, Mesh:Risk Factors, Mesh:Case-Control Studies, 030212 general & internal medicine, Mesh:Aged, Mesh:Klebsiella pneumoniae/enzymology, OXA-48, Aged, 80 and over, Mesh:Klebsiella Infections/microbiology, Univariate analysis, Screening, Contact patients, Carbapenemases, Carbapenemase-producing, Risk factors, Enterobacteriaceae, General Medicine, Middle Aged, 3. Good health, Klebsiella pneumoniae, Infectious Diseases, Mesh:Klebsiella Infections/epidemiology, Adult, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Mesh:Young Adult, beta-Lactamases, Young Adult, 03 medical and health sciences, Mesh:Retrospective Studies, Mesh:Klebsiella pneumoniae/isolation & purification, Mesh:Middle Aged, Internal medicine, Mesh:80 and over, medicine, Humans, Aged, Retrospective Studies, business.industry, Case-control study, Retrospective cohort study, Odds ratio, medicine.disease, Confidence interval, Klebsiella Infections, Mesh:beta-Lactamases/analysis, Surgery, Mesh:Humans, Case-Control Studies, Concomitant, Klebsiella pneumonia, business
Abstract

International audience; BACKGROUND: Cohorting carbapenemase-producing Enterobacteriaceae (CPE) carriers during hospitalization limits in-hospital spreading.OBJECTIVE: To identify risk factors for CPE acquisition among contacts of an index patient in non-cohorted populations.METHODS: A multicentre retrospective matched case-control study was conducted in five hospitals. Each contact patient (case) who acquired Klebsiella pneumoniae (KP)-OXA-48 from an index patient was compared to three contact (controls) with the same index patients matched with hospitalization in the same unit and similar exposure times.RESULTS: Fifty-one secondary cases and 131 controls were included. By univariate analysis, exposure time (odds ratio: 1.06; 95% confidence interval: 1.02-1.1; P = 0.006), concomitant infection at admission (3.23; 1.42-7.35; P = 0.005), antimicrobial therapy within the last month before hospitalization (2.88; 1.34-6.2; P = 0.007), antimicrobial therapy during the exposure time (5.36; 2.28-12.6; P

Published
2018
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2. Expanding the phenotype of SCA19/22: Parkinsonism, cognitive impairment and epilepsy

Author

Jean-Christophe Cuvellier, Marie Delliaux, Kathy Dujardin, Delphine Dellacherie, Bernard Sablonnière, Isabelle Strubi-Vuillaume, David Devos, Luc Defebvre, Vincent Huin, Audrey Riquet, Marine Brion, Caroline Moreau, Jean-Marie Cuisset, HUIN, Vincent, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Neurologie et Pathologies du Mouvement [CHU Lille], Service de neuropédiatrie [CHU Lille], Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Centre National de la Recherche Scientifique (CNRS)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Biologie Pathologie et Génétique, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut d'Immunologie [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Pôle de Biologie Pathologie Génétique [CHU Lille], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille

Subjects
Male, 0301 basic medicine, Pediatrics, Parkinson's disease, [SDV]Life Sciences [q-bio], [SDV.GEN] Life Sciences [q-bio]/Genetics, Mesh:Adult, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, [SCCO]Cognitive science, Epilepsy, Mesh:Adolescent, 0302 clinical medicine, Medicine, Child, Neurogenetics, Mesh:Epilepsy/genetics, Mesh:Aged, Spinocerebellar Degenerations, Aged, 80 and over, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Parkinsonism, Mesh:Spinocerebellar Degenerations/complications, Cognition, Middle Aged, Mesh:Cognitive Dysfunction/genetics, Pedigree, 3. Good health, Phenotype, Neurology, Spinocerebellar ataxia, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, Adult, Mesh:Female, medicine.medical_specialty, Adolescent, Cognitive disorders, Mesh:Child, Mesh:Male, [SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics, 03 medical and health sciences, Parkinsonian Disorders, Mesh:Middle Aged, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Mesh:80 and over, Humans, Cognitive Dysfunction, Quantitative Biology - Genomics, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Aged, Genetic testing, Genomics (q-bio.GN), [SDV.GEN]Life Sciences [q-bio]/Genetics, Cerebellar ataxia, business.industry, Mesh:Pedigree, Mesh:Phenotype, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, [SCCO] Cognitive science, medicine.disease, Neuropsychiatric disorder, Mesh:Humans, 030104 developmental biology, KCND3 mutation, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Mesh:Parkinsonian Disorders/genetics, Parkinson''s disease, FOS: Biological sciences, Neurology (clinical), Geriatrics and Gerontology, business, Neuroscience, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

International audience; BACKGROUND: Spinocerebellar ataxia types 19 and 22 (SCA19/22) are rare conditions in which relatively isolated cerebellar involvement is frequently associated with cognitive impairment. Here, we report on new clinical features and provide details of the cognitive profile in two SCA19/22 families.METHODS: Two families displaying an autosomal-dominant form of cerebellar ataxia underwent clinical examinations and genetic testing.RESULTS: In addition to the classical clinical features of SCA, a wide spectrum of cognitive disorders (including visuospatial impairments) was observed. Eight patients had mild Parkinsonism, and five had epilepsy. Genetic testing showed that the KCND3 mutation (c.679_681delTTC, p.F227del) was present in both families.CONCLUSIONS: Our findings broaden the phenotypic spectrum of SCA19/22, and suggest that KCND3 should be included in the list of candidate genes for epilepsy, Parkinsonism and cognitive impairment.

Published
2017
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3. A Comparative Descriptive Study of Characteristics of Early- and Late-Onset Dementia Family Caregivers

Author

Francine M. Ducharme, Renée Coulombe, Marie-Jeanne Kergoat, Pascal Antoine, Lise Lachance, Florence Pasquier, Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Male, Gerontology, characteristics, [SDV]Life Sciences [q-bio], Disease, Mesh:Adult, Mesh:Employment, Mesh:Caregivers/psychology, [SCCO]Cognitive science, 0302 clinical medicine, Surveys and Questionnaires, Mesh:Alzheimer Disease/nursing, Mesh:Aged, comparative study, Aged, 80 and over, Family caregivers, General Neuroscience, Mesh:Canada, Middle Aged, Self Efficacy, Mesh:Self Efficacy, Psychiatry and Mental health, Clinical Psychology, late-onset dementia, Caregivers, Female, Late onset dementia, family caregivers, Descriptive research, Psychology, Mesh:Surveys and Questionnaires, Adult, Employment, Mesh:Female, Mesh:Spouses/psychology, Canada, Mesh:Psychological/psychology, Mesh:Male, early-onset dementia, 03 medical and health sciences, Social support, Alzheimer Disease, Mesh:Middle Aged, Mesh:80 and over, medicine, Humans, Dementia, Spouses, Aged, 030214 geriatrics, Social Support, medicine.disease, Mesh:Stress, Mesh:Social Support, Mesh:Humans, Younger adults, Mesh:Alzheimer Disease/psychology, Structured interview, Geriatrics and Gerontology, Stress, Psychological, 030217 neurology & neurosurgery
Abstract

International audience; Characteristics of early- and late-onset dementia family caregivers were described and compared. Based on a theoretical model of role transition, data were collected through structured interviews from 48 caregivers of adults with Alzheimer's disease or a related dementia older than the age of 70 and 48 caregivers of similarly diagnosed adults younger than the age of 60. A significantly higher proportion of caregivers of younger adults were spouses and gainfully employed compared with those of older adults; they had more years of schooling, took care of a person with more severe impairments, received more help, perceived themselves as better prepared to deal with future needs, and better informed about services. They did not differ from caregivers of older adults in terms of psychological distress, role confidence, self-efficacy, and social support. This study highlights differences and similarities to be considered in the development of services tailored to the specific needs of each group.

Published
2015
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4. Modeling the distress of spousal caregivers of people with dementia

Author

Florence Pasquier, Emilie Wawrziczny, Pascal Antoine, Francine Ducharme, Guillaume Berna, Marie-Jeanne Kergoat, Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Université de Montréal (UdeM), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Male, Family support, [SDV]Life Sciences [q-bio], psychological model, late onset Alzheimer disease, Disease, Mesh:Caregivers/psychology, [SCCO]Cognitive science, 0302 clinical medicine, Surveys and Questionnaires, Adaptation, Psychological, 030212 general & internal medicine, Mesh:Aged, media_common, Aged, 80 and over, Mesh:Adaptation, General Neuroscience, spouses, General Medicine, 3. Good health, Psychiatry and Mental health, Clinical Psychology, Distress, Feeling, Caregivers, Preparedness, behavior and behavior mechanisms, Female, Independent Living, Psychology, Mesh:Surveys and Questionnaires, Clinical psychology, Mesh:Female, media_common.quotation_subject, Mesh:Male, Context (language use), Mesh:Psychological, Mesh:Dementia/psychology, 03 medical and health sciences, Intervention (counseling), Mesh:80 and over, medicine, Humans, Dementia, Mesh:Logistic Models, Mesh:Dementia/nursing, Aged, 030214 geriatrics, medicine.disease, Mesh:Stress, Mesh:Psychological/psychology, Mesh:Humans, Logistic Models, Mesh:Psychological/etiology, early onset Alzheimer disease, Mesh:Independent Living, Geriatrics and Gerontology, Stress, Psychological, dementia
Abstract

International audience; The progressive mobilization of spouse caregivers who take care of a person with dementia (PWD) can lead to situations of distress.The current study sought to investigate the influence of the characteristics of the caregiving context on spousal caregiver distress.125 spousal caregivers participated in this study. The characteristics of the caregiving context were assessed using questionnaires. We examined a moderated-mediator model (Step 1) in which we hypothesized that PWD and caregiver characteristics and dyadic determinants contribute to spousal caregiver distress. This model was compared based on the age at onset of the disease and the gender of the caregiver (Step 2).The model revealed that poor self-rated health and a lack of family support accentuated spousal caregiver distress, whereas the feeling of being prepared and level of confidence decreased spousal caregiver distress. Moreover, the quality of couple adjustment affected spousal caregiver distress, and this effect was mediated by the severity of the PWD's symptoms. Regarding the age at onset of the disease, the path between Couple Adjustment and the Care recipient's impairments was more important for caregivers of person with early-onset dementia (PEOD). Female caregivers who reported poor self-rated health experienced greater distress.It would be interesting to create a support program that would incorporate these three areas of intervention regarding the progression of the disease: first, "preparedness modules"; second, "dyadic modules" (especially for caregivers of PEOD); and third, "family modules". Specific attention should be given to female caregivers who report poor self-rated health.

Published
2017
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5. Proactive Regional Pharmacovigilance System Versus National Spontaneous Reporting for Collecting Safety Data on Concerning Off-Label Prescribing Practices: An Example with Baclofen and Alcohol Dependence in France

Author

Julien Labreuche, Alain Duhamel, Sylvie Deheul, Benjamin Rolland, Régis Bordet, Olivier Cottencin, Sophie Gautier, Marine Auffret, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Mesh:Female, medicine.medical_specialty, Sedation, [SDV]Life Sciences [q-bio], MEDLINE, Mesh:Male, Mesh:Young Adult, Pharmacology, Mesh:Adult, Toxicology, Off-label use, 030226 pharmacology & pharmacy, Mesh:Baclofen/adverse effects, Mesh:Off-Label Use, 03 medical and health sciences, [SCCO]Cognitive science, 0302 clinical medicine, Mesh:Adolescent, Mesh:Middle Aged, Pharmacovigilance, Mesh:80 and over, Medicine, Pharmacology (medical), Mesh:Baclofen/administration & dosage, Young adult, Mesh:France, Mesh:Aged, Mesh:Factual, Coma, Mesh:GABA-B Receptor Agonists/administration & dosage, business.industry, Mesh:Alcoholism/drug therapy, Alcohol dependence, Mesh:GABA-B Receptor Agonists/adverse effects, Mesh:Databases, 3. Good health, Addiction medicine, Mesh:Humans, Emergency medicine, Mesh:Adverse Drug Reaction Reporting Systems/statistics & numerical data, medicine.symptom, business, 030217 neurology & neurosurgery, Mesh:Pharmacovigilance
Abstract

International audience; Off-label prescribing (OLP) may raise serious safety concerns that traditional spontaneous reporting of adverse drug reactions (ADRs) may not identify in a timely manner. In France, the 'Multidisciplinary Consultation Service for Off-Label Prescribing in Addiction Medicine' (CAMTEA) is a proactive regional system established to identify ADRs associated with the OLP of baclofen for alcohol dependence.The aim was to demonstrate, using the French pharmacovigilance database (FPVD), that CAMTEA allowed for the reporting of a substantial amount of ADRs, comparable in nature to those provided via spontaneous reporting.The 2012-2013 FPVD notifications associated with baclofen OLP were extracted. The ten most frequent types of ADRs among 'serious' and 'non-serious' reports were listed. The frequency of each type of ADR was compared between CAMTEA and spontaneous reporting, and the magnitudes of the differences were assessed using standardized differences.A total of 428 baclofen reports (1043 ADRs) were identified, among which 221 (51.64%) originated from CAMTEA. The ten most frequent ADRs in 'serious' reports were (1) confusion (17.3%), (2) seizures (11.5%), (3) drowsiness/sedation (11.5%), (4) agitation (10.9%), (5) coma (9.6%), (6) hallucinations (7.7%), (7) falls (7.1%), (8) behavioral disorders (5.8%), (9) withdrawal syndrome (5.1%), and (10) space-time disorientation (5.1%). A standardized difference of

Published
2016
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6. Outcome of patients with streptococcal prosthetic joint infections with special reference to rifampicin combinations

Author

V. Cattoir, B. Brunschweiler, E. Fiaux, Manuel Etienne, S. Nguyen, N. Frebourg, François Caron, J. P. Canarelli, J. Lora-Tamayo, Eric Senneville, F. Dujardin, Olivier Robineau, E. Beltrand, N. Blondiaux, Michel Valette, Marie Titecat, Henri Migaud, Caroline Loïez, Y. El Samad, C. Hulet, Inserm, Université de Lille, CHU Lille, Service des maladies infectieuses et tropicales [Rouen], Lille Inflammation Research International Center - U 995 [LIRIC], Centre Hospitalier Gustave Dron [Tourcoing], Hospital General Universitario 'Gregorio Marañón' [Madrid], CHU Amiens-Picardie, CHU Rouen, Université de Rouen Normandie [UNIROUEN], Université de Caen Normandie [UNICAEN], Université de Picardie Jules Verne [UPJV], Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab (ex-pmoi)], Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Microbiologie [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Rouen Normandie (UNIROUEN), Université de Caen Normandie (UNICAEN), Université de Picardie Jules Verne (UPJV), Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 (MABLab (ex-pmoi)), Université du Littoral Côte d'Opale (ULCO)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Thanks to Mr Philippe Choisy for technical assistance. J.L-T was supported by a grant from the Instituto de Salud Carlos III (Ministry of Economy and Competitiveness, Government of Spain, CD14/00176) and to Sharon Calandra for english editing., G4 bone and joint infection study group (G4BJIS)., and Université de Lille, LillOA

Subjects
Male, 0301 basic medicine, Prosthetic joint infection, Knee Joint, Levofloxacin, Medical microbiology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Mesh:Treatment Outcome, Mesh:Knee Prosthesis/adverse effects, Mesh:Humans, Mesh:Knee Joint/microbiology, Mesh:Middle Aged, Mesh:Streptococcal Infections/etiology, Mesh:Anti-Bacterial Agents/administration & dosage, Mesh:Arthritis/drug therapy, Mesh:Hip Prosthesis/microbiology, Mesh:Prosthesis-Related Infections/drug therapy, Mesh:Female, Mesh:Knee Joint/surgery, Mesh:Rifampin/administration & dosage, Mesh:Male, Mesh:Streptococcal Infections/drug therapy, Mesh:Aged, Mesh:Levofloxacin/administration & dosage, Mesh:Drug Therapy, Mesh:Combination, Mesh:Arthroplasty, Mesh:Replacement, Mesh:Knee/adverse effects, Mesh:Prosthesis-Related Infections/diagnosis, Mesh:80 and over, Mesh:Retrospective Studies, Mesh:Hip Prosthesis/adverse effects, Mesh:Knee Prosthesis/microbiology, Outcome, Rifampicin, Streptococcus spp, Risk factors, Arthroplasty, Replacement, Knee, 10. No inequality, Aged, 80 and over, Middle Aged, Anti-Bacterial Agents, 3. Good health, Treatment Outcome, Infectious Diseases, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Female, Rifampin, Knee Prosthesis, Research Article, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, Prosthesis-Related Infections, Prosthetic joint, 030106 microbiology, 03 medical and health sciences, Streptococcal Infections, medicine, Humans, Aged, Retrospective Studies, business.industry, Arthritis, Surgery, stomatognathic diseases, Tropical medicine, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Hip Prosthesis, business
Abstract

International audience; Background: Outcome of patients with streptococcal prosthetic joint infections (PJIs) is not well known.Methods: We performed a retrospective multicenter cohort study that involved patients with total hip/knee prosthetic joint (THP/TKP) infections due to Streptococcus spp. from 2001 through 2009.Results: Ninety-five streptococcal PJI episodes (50 THP and 45 TKP) in 87 patients of mean age 69.1 ± 13.7 years met the inclusion criteria. In all, 55 out of 95 cases (57.9 %) were treated with debridement and retention of the infected implants with antibiotic therapy (DAIR). Rifampicin-combinations, including with levofloxacin, were used in 52 (54.7 %) and 28 (29.5 %) cases, respectively. After a mean follow-up period of 895 days (IQR: 395–1649), the remission rate was 70.5 % (67/95). Patients with PJIs due to S. agalactiae failed in the same proportion as in the other patients (10/37 (27.1 %) versus 19/58 (32.7 %); p = .55). In the univariate analysis, antibiotic monotherapy, DAIR, antibiotic treatments other than rifampicin-combinations, and TKP were all associated with a worse outcome. The only independent variable significantly associated with the patients’ outcomes was the location of the prosthesis (i.e., hip versus knee) (OR = 0.19; 95 % CI 0.04–0.93; p value 0.04).Conclusions: The prognosis of streptococcal PJIs may not be as good as previously reported, especially for patients with an infected total knee arthroplasty. Rifampicin combinations, especially with levofloxacin, appear to be suitable antibiotic regimens for these patients.

Published
2016
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7. Putative invasive pulmonary aspergillosis in critically ill patients with chronic obstructive pulmonary disease: a matched cohort study

Author

Oana Dumitrescu, Rodrigue Dessein, Florent Wallet, Arnaud Friggeri, Marion Le Maréchal, Laurent Argaud, Thomas Rimmelé, Aurélie Cottereau, Anne-Lise Bienvenu, Claire Delsuc, Florence Ader, Emilie Fréalle, Sophie Jarraud, Saad Nseir, Pillet, Lauriane, Hôpital Edouard Herriot, Service Anesthésie Réanimation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Département Anesthésie-Réanimation, Hôpital Roger Salengro, CHRU de Lille, Hôpital Roger Salengro, CHRU de Lille, Lille, France, Laboratoire de Parasitologie et de Mycologie médicale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de parasitologie et mycologie médicale [Hôpital de la Croix Rousse, Lyon], Hôpital de la Croix-Rousse [CHU - HCL], Laboratoire de Bacteriologie [CHRU Lille], Département de Microbiologie Clinique [HCL Groupement Hospitalier Nord, Lyon], Hospices Civils de Lyon (HCL)-HCL Groupement Hospitalier Nord [Lyon], Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL], Faculté de Médecine Henri Warembourg - Université de Lille, Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Pathogenèse des légionelles- Legionella pathogenesis (LegioPath), CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Université de Lille, Recherche translationnelle : relations hôte-pathogènes - EA 7366, Lille Inflammation Research International Center (LIRIC) - U995, Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL], Centre National de Référence (CNR) des Enterovirus et Parechovirus [HCL Lyon] [CNR - laboratoire associé], Recherche translationelle relations hôte-pathogènes, Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS], Maladies chroniques, santé perçue, et processus d'adaptation [APEMAC], Lille Inflammation Research International Center - U 995 [LIRIC], Université Lille 2 - Faculté de Médecine, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, Antifungal Agents, [SDV]Life Sciences [q-bio], Mesh:Invasive Pulmonary Aspergillosis/mortality, Mesh:Prognosis, Critical Care and Intensive Care Medicine, outcomes, Cohort Studies, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Mesh:Critical Illness/therapy, Risk Factors, Mesh:Risk Factors, 030212 general & internal medicine, Mesh:Aged, fungal-infections, Aged, 80 and over, Invasive Pulmonary Aspergillosis, Mesh:Chronic Obstructive/mortality, 0303 health sciences, COPD, pseudomonas-aeruginosa, Mesh:Chronic Obstructive/microbiology, Middle Aged, Prognosis, Mesh:Intensive Care Units, 3. Good health, [SDV] Life Sciences [q-bio], Intensive Care Units, medicine.anatomical_structure, clinical-features, Female, Allergic bronchopulmonary aspergillosis, Cohort study, Mesh:Female, medicine.medical_specialty, Critical Illness, Mesh:Chronic Obstructive/complications, Pulmonary disease, Mesh:Male, 03 medical and health sciences, Mesh:Retrospective Studies, General & Internal Medicine, Mesh:Middle Aged, Mesh:80 and over, medicine, Humans, Mesh:Cohort Studies, Intensive care medicine, Aged, Retrospective Studies, Mesh:Invasive Pulmonary Aspergillosis/etiology, 030306 microbiology, business.industry, Critically ill, Research, Retrospective cohort study, Mesh:Antifungal Agents/therapeutic use, Mesh:Invasive Pulmonary Aspergillosis/diagnosis, fumigatus, Invasive pulmonary aspergillosis, medicine.disease, Mesh:Pulmonary Disease, Mesh:Humans, biofilms, business, Respiratory tract
Abstract

Introduction Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative invasive pulmonary aspergillosis (PIPA) in Aspergillus-positive respiratory tract cultures of critically ill patients. We focused on critically ill patients with COPD who met the criteria for PIPA. Methods This matched cohort study included critically ill patients with COPD from two university hospital intensive care units (ICUs). We studied the risk factors for PIPA as well as the impact of PIPA on short- and long-term outcomes. Whether PIPA was associated with a pattern of bacterial colonization and/or infection 6 months before and/or during ICU stay was assessed. In addition, antifungal strategies were reviewed. Results Fifty cases of PIPA in critically ill patients with COPD in the ICU were matched with one hundred control patients with COPD. The ICU short- and the long-term (at 1 year) mortality were significantly increased in the PIPA group (p p p = 0.004 and p Conclusions PIPA was a strong death predictor in critically ill patients with COPD. The use of corticosteroids and antibiotics before ICU admission was a risk factor for PIPA. PIPA was not associated with a specific bacterial pattern of colonization or infection. Prompting antifungal treatment in critically ill patients with COPD who have PIPA may not be the only factor involved in prognosis reversal.

Published
2015
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