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1. Forecasting Staphylococcus aureus Infections Using Genome-Wide Association Studies, Machine Learning, and Transcriptomic Approaches

Author: Mohamed Sassi, Julie Bronsard, Gaetan Pascreau, Mathieu Emily, Pierre-Yves Donnio, Matthieu Revest, Brice Felden, Thierry Wirth, and Yoann Augagneur
Subjects: Staphylococcus aureus, genomics, GWAS, coding and noncoding regions, random forest, trancriptomics, Microbiology, QR1-502
Abstract: ABSTRACT Staphylococcus aureus is a major human and animal pathogen, colonizing diverse ecological niches within its hosts. Predicting whether an isolate will infect a specific host and its subsequent clinical fate remains unknown. In this study, we investigated the S. aureus pangenome using a curated set of 356 strains, spanning a wide range of hosts, origins, and clinical display and antibiotic resistance profiles. We used genome-wide association study (GWAS) and random forest (RF) algorithms to discriminate strains based on their origins and clinical sources. Here, we show that the presence of sak and scn can discriminate strains based on their host specificity, while other genes such as mecA are often associated with virulent outcomes. Both GWAS and RF indicated the importance of intergenic regions (IGRs) and coding DNA sequence (CDS) but not sRNAs in forecasting an outcome. Additional transcriptomic analyses performed on the most prevalent clonal complex 8 (CC8) clonal types, in media mimicking nasal colonization or bacteremia, indicated three RNAs as potential RNA markers to forecast infection, followed by 30 others that could serve as infection severity predictors. Our report shows that genetic association and transcriptomics are complementary approaches that will be combined in a single analytical framework to improve our understanding of bacterial pathogenesis and ultimately identify potential predictive molecular markers. IMPORTANCE Predicting the outcome of bacterial colonization and infections, based on extensive genomic and transcriptomic data from a given pathogen, would be of substantial help for clinicians in treating and curing patients. In this report, genome-wide association studies and random forest algorithms have defined gene combinations that differentiate human from animal strains, colonization from diseases, and nonsevere from severe diseases, while it revealed the importance of IGRs and CDS, but not small RNAs (sRNAs), in anticipating an outcome. In addition, transcriptomic analyses performed on the most prevalent clonal types, in media mimicking either nasal colonization or bacteremia, revealed significant differences and therefore potent RNA markers. Overall, the use of both genomic and transcriptomic data in a single analytical framework can enhance our understanding of bacterial pathogenesis.
Published: 2022
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2. Galleria mellonella as a Suitable Model of Bacterial Infection: Past, Present and Future

Author: Guillaume Ménard, Astrid Rouillon, Vincent Cattoir, and Pierre-Yves Donnio
Subjects: Galleria mellonella, infection model, pathogenic bacteria, antibacterial therapies, standardization, perspectives, Microbiology, QR1-502
Abstract: The increasing interest for Galleria mellonella larvae as an infection model is evidenced by the number of papers reporting its use, which increases exponentially since the early 2010s. This popularity was initially linked to limitation of conventional animal models due to financial, technical and ethical aspects. In comparison, alternative models (e.g. models using Caenorhabditis elegans, Drosophila melanogaster or G. mellonella) were cheap, simple to use and not limited by ethical regulation. Since then, similar results have been established with G. mellonella model comparatively to vertebrates, and it is more and more often used as a robust model per se, not only as an alternative to the murine model. This review attempts to summarize the current knowledge supporting the development of this model, both on immunological and microbiological aspects. For that, we focus on investigation of virulence and new therapies for the most important pathogenic bacteria. We also discuss points out directions for standardization, as well as recent advances and new perspectives for monitoring host-pathogen interactions.
Published: 2021
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3. Galleria mellonella Larvae as an Infection Model to Investigate sRNA-Mediated Pathogenesis in Staphylococcus aureus

Author: Guillaume Ménard, Astrid Rouillon, Gevorg Ghukasyan, Mathieu Emily, Brice Felden, and Pierre-Yves Donnio
Subjects: Staphylococcus aureus, sRNA, Galleria mellonella, virulence, regulation, Microbiology, QR1-502
Abstract: Small regulatory RNAs (sRNAs) are key players in bacterial regulatory networks. Monitoring their expression inside living colonized or infected organisms is essential for identifying sRNA functions, but few studies have looked at sRNA expression during host infection with bacterial pathogens. Insufficient in vivo studies monitoring sRNA expression attest to the difficulties in collecting such data, we therefore developed a non-mammalian infection model using larval Galleria mellonella to analyze the roles of Staphylococcus aureus sRNAs during larval infection and to quickly determine possible sRNA involvement in staphylococcal virulence before proceeding to more complicated animal testing. We began by using the model to test infected larvae for immunohistochemical evidence of infection as well as host inflammatory responses over time. To monitor sRNA expression during infection, total RNAs were extracted from the larvae and invading bacteria at different time points. The expression profiles of the tested sRNAs were distinct and they fluctuated over time, with expression of both sprD and sprC increased during infection and associated with mortality, while rnaIII expression remained barely detectable over time. A strong correlation was observed between sprD expression and the mortality. To confirm these results, we used sRNA-knockout mutants to investigate sRNA involvement in Staphylococcus aureus pathogenesis, finding that the decrease in death rates is delayed when either sprD or sprC was lacking. These results demonstrate the relevance of this G. mellonella model for investigating the role of sRNAs as transcriptional regulators involved in staphylococcal virulence. This insect model provides a fast and easy method for monitoring sRNA (and mRNA) participation in S. aureus pathogenesis, and can also be used for other human bacterial pathogens.
Published: 2021
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4. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections

Author: Valérie Bordeau, Anne Cady, Matthieu Revest, Octavie Rostan, Mohamed Sassi, Pierre Tattevin, Pierre-Yves Donnio, and Brice Felden
Subjects: Staphylococcus aureus, bacteria, staphylococci, regulatory RNAs, small RNAs, small pathogenicity island RNA, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: Staphylococcus aureus is a commensal bacterium and pathogen. Identifying biomarkers for the transition from colonization to disease caused by this organism would be useful. Several S. aureus small RNAs (sRNAs) regulate virulence. We investigated presence and expression of 8 sRNAs in 83 S. aureus strains from 42 patients with sepsis or septic shock and 41 asymptomatic colonized carriers. Small pathogenicity island sRNAs sprB and sprC were clade specific. Six sRNAs had variable expression not correlated with clinical status. Expression of RNAIII was lower in strains from septic shock patients than in strains from colonized patients. When RNAIII was associated with expression of sprD, colonizing strains could be discriminated from strains in patients with bloodstream infections, including patients with sepsis and septic shock. Isolates associated with colonization might have sRNAs with target expression different from those of disease isolates. Monitoring expression of RNAIII and sprD could help determine severity of bloodstream infections.
Published: 2016
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5. Infective Endocarditis in Patients on Chronic Hemodialysis

Author: Juan M. Pericàs, Jaume Llopis, Maria Jesús Jiménez-Exposito, Wissam M. Kourany, Benito Almirante, Giampiero Carosi, Emanuele Durante-Mangoni, Claudio Querido Fortes, Efthymia Giannitsioti, Stamatios Lerakis, Rodrigo Montagna-Mella, Juan Ambrosioni, Ru-San Tan, Carlos A. Mestres, Dannah Wray, Orathai Pachirat, Asuncion Moreno, Vivian H. Chu, Elisa de Lazzari, Vance G. Fowler, Jose M. Miró, Liliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, M. Cereceda, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Javier Gonzalez, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, CHU Catherine Campagnac, Thanh Doco-Lecompte, Christine Selton-Suty, Jean-Paul Casalta, Pierre-Edouard Fournier, Gilbert Habib, Didier Raoult, Franck Thuny, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Carl Neuerburg Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Maor Wanounou, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Domenico Iossa, Serena Orlando, Maria Paola Ursi, Pia Clara Pafundi, Fabiana D’Amico, Mariano Bernardo, Susanna Cuccurullo, Giovanni Dialetto, Franco Enrico Covino, Sabrina Manduca, Alessandro Della Corte, Marisa De Feo, Marie Françoise Tripodi, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif-Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O.M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Jameela Edathodu, Magid Halim, Yee-Yun Liew, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller-Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manel Almela, Manuel Azqueta, Merce Brunet, Pedro Castro, Elisa De Lazzari, Carlos Falces, David Fuster, Guillermina Fita, Cristina Garcia- de- la- Maria, Javier Garcia-Gonzalez, Jose M. Gatell, Francesc Marco, José M. Miró, José Ortiz, Salvador Ninot, J. Carlos Paré, Juan M. Pericas, Eduard Quintana, Jose Ramirez, Irene Rovira, Elena Sandoval, Marta Sitges, Adrian Tellez, José M. Tolosana, Barbara Vidal, Jordi Vila, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Emilio Bouza, Miguel Angel Garcia Fernández, Victor Gonzalez-Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez-Créixems, Jorge Solis, Nuria Fernandez-Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg-Martin, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Thomas Holland, Tahaniyat Lalani, Daniel Mudrick, Zaniab Samad, Daniel Sexton, Martin Stryjewski, Andrew Wang, Christopher W. Woods, Robert Cantey, Lisa Steed, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara-Jane Salstrom, John Baddley, Mukesh Patel, Gail Peterson, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Pericas, J. M., Llopis, J., Jimenez-Exposito, M. J., Kourany, W. M., Almirante, B., Carosi, G., Durante-Mangoni, E., Fortes, C. Q., Giannitsioti, E., Lerakis, S., Montagna-Mella, R., Ambrosioni, J., Tan, R. -S., Mestres, C. A., Wray, D., Pachirat, O., Moreno, A., Chu, V. H., de Lazzari, E., Fowler, V. G., Miro, J. M., Clara, L., Sanchez, M., Casabe, J., Cortes, C., Nacinovich, F., Oses, P. F., Ronderos, R., Sucari, A., Thierer, J., Altclas, J., Kogan, S., Spelman, D., Athan, E., Harris, O., Kennedy, K., Tan, R., Gordon, D., Papanicolas, L., Korman, T., Kotsanas, D., Dever, R., Jones, P., Konecny, P., Lawrence, R., Rees, D., Ryan, S., Feneley, M. P., Harkness, J., Post, J., Reinbott, P., Gattringer, R., Wiesbauer, F., Andrade, A. R., Passos de Brito, A. C., Guimaraes, A. C., Grinberg, M., Mansur, A. J., Siciliano, R. F., Varejao Strabelli, T. M., Campos Vieira, M. L., de Medeiros Tranchesi, R. A., Paiva, M. G., de Oliveira Ramos, A., Weksler, C., Ferraiuoli, G., Golebiovski, W., Lamas, C., Karlowsky, J. A., Keynan, Y., Morris, A. M., Rubinstein, E., Jones, S. B., Garcia, P., Cereceda, M., Fica, A., Mella, R. M., Fernandez, R., Franco, L., Gonzalez, J., Jaramillo, A. N., Barsic, B., Bukovski, S., Krajinovic, V., Pangercic, A., Rudez, I., Vincelj, J., Freiberger, T., Pol, J., Zaloudikova, B., Ashour, Z., El Kholy, A., Mishaal, M., Osama, D., Rizk, H., Aissa, N., Alauzet, C., Alla, F., Campagnac, C. C., Doco-Lecompte, T., Selton-Suty, C., Casalta, J. -P., Fournier, P. -E., Habib, G., Raoult, D., Thuny, F., Delahaye, F., Delahaye, A., Vandenesch, F., Donal, E., Donnio, P. Y., Flecher, E., Michelet, C., Revest, M., Tattevin, P., Chevalier, F., Jeu, A., Remadi, J. P., Rusinaru, D., Tribouilloy, C., Bernard, Y., Chirouze, C., Hoen, B., Leroy, J., Plesiat, P., Naber, C., Neuerburg, C., Mazaheri, B., Sophia Athanasia, C. N., Deliolanis, I., Giamarellou, H., Thomas, T., Mylona, E., Paniara, O., Papanicolaou, K., Pyros, J., Skoutelis, A., Papanikolaou, K., Sharma, G., Francis, J., Nair, L., Thomas, V., Venugopal, K., Hannan, M. M., Hurley, J. P., Wanounou, M., Gilon, D., Israel, S., Korem, M., Strahilevitz, J., Iossa, D., Orlando, S., Ursi, M. P., Pafundi, P. C., D'Amico, F., Bernardo, M., Cuccurullo, S., Dialetto, G., Covino, F. E., Manduca, S., Della Corte, A., De Feo, M., Tripodi, M. F., Cecchi, E., De Rosa, F., Forno, D., Imazio, M., Trinchero, R., Grossi, P., Lattanzio, M., Toniolo, A., Goglio, A., Raglio, A., Ravasio, V., Rizzi, M., Suter, F., Magri, S., Signorini, L., Kanafani, Z., Kanj, S. S., Sharif-Yakan, A., Abidin, I., Tamin, S. S., Martinez, E. R., Soto Nieto, G. I., van der Meer, J. T. M., Chambers, S., Holland, D., Morris, A., Raymond, N., Read, K., Murdoch, D. R., Dragulescu, S., Ionac, A., Mornos, C., Butkevich, O. M., Chipigina, N., Kirill, O., Vadim, K., Vinogradova, T., Edathodu, J., Halim, M., Liew, Y. -Y., Lejko-Zupanc, T., Logar, M., Mueller-Premru, M., Commerford, P., Commerford, A., Deetlefs, E., Hansa, C., Ntsekhe, M., Almela, M., Azqueta, M., Brunet, M., Castro, P., Falces, C., Fuster, D., Fita, G., Garcia- de- la- Maria, C., Garcia-Gonzalez, J., Gatell, J. M., Marco, F., Ortiz, J., Ninot, S., Pare, J. C., Quintana, E., Ramirez, J., Rovira, I., Sandoval, E., Sitges, M., Tellez, A., Tolosana, J. M., Vidal, B., Vila, J., Anguera, I., Font, B., Guma, J. R., Bermejo, J., Bouza, E., Garcia Fernandez, M. A., Gonzalez-Ramallo, V., Marin, M., Munoz, P., Pedromingo, M., Roda, J., Rodriguez-Creixems, M., Solis, J., Fernandez-Hidalgo, N., Tornos, P., de Alarcon, A., Parra, R., Alestig, E., Johansson, M., Olaison, L., Snygg-Martin, U., Pachirat, P., Pussadhamma, B., Senthong, V., Casey, A., Elliott, T., Lambert, P., Watkin, R., Eyton, C., Klein, J. L., Bradley, S., Kauffman, C., Bedimo, R., Corey, G. R., Crowley, A. L., Douglas, P., Drew, L., Holland, T., Lalani, T., Mudrick, D., Samad, Z., Sexton, D., Stryjewski, M., Wang, A., Woods, C. W., Cantey, R., Steed, L., Dickerman, S. A., Bonilla, H., Dipersio, J., Salstrom, S. -J., Baddley, J., Patel, M., Peterson, G., Stancoven, A., Levine, D., Riddle, J., Rybak, M., Cabell, C. H., Bristol-Myers Squibb Company, Vall d'Hebron University Hospital [Barcelona], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), 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 ), and Laboratoire Chrono-environnement (UMR 6249) (LCE)
Subjects: Male, relapses, medicine.medical_treatment, infective endocarditi, 030204 cardiovascular system & hematology, Kidney Failure, Cohort Studies, Catheters, Indwelling, 0302 clinical medicine, Surgical, Epidemiology, cardiac surgery, enterococci, hemodialysis, infective endocarditis, Staphylococcus aureus, Aged, Anti-Bacterial Agents, Arteriovenous Shunt, Surgical, Cardiac Surgical Procedures, Endocarditis, Female, Humans, Kidney Failure, Chronic, Methicillin-Resistant Staphylococcus aureus, Middle Aged, Renal Dialysis, Staphylococcal Infections, 030212 general & internal medicine, Chronic, Prospective cohort study, health care economics and organizations, relapse, Arteriovenous Shunt, 3. Good health, Cardiac surgery, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Indwelling, Infective endocarditis, Hemodialysis, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Catheters, education, 03 medical and health sciences, Internal medicine, medicine, business.industry, medicine.disease, hemodialysi, Etiology, Complication, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background - Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives - This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods - Prospective cohort study (International Collaboration on Endocarditis databases, encompassing 7,715 IE episodes from 2000 to 2006 and from 2008 to 2012). Descriptive analysis of baseline characteristics, epidemiological and etiological features, complications and outcomes, and their comparison between HD and non-HD patients was performed. Risk factors for major embolic events, cardiac surgery, relapses, and in-hospital and 6-month mortality were investigated in HD-patients using multivariable logistic regression. Results - A total of 6,691 patients were included and 553 (8.3%) received HD. North America had a higher HD-IE proportion than the other regions. The predominant microorganism was Staphylococcus aureus (47.8%), followed by enterococci (15.4%). Both in-hospital and 6-month mortality were significantly higher in HD versus non-HD-IE patients (30.4% vs. 17% and 39.8% vs. 20.7%, respectively; p
Published: 2021
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6. Time to blood culture positivity: An independent predictor of infective endocarditis and mortality in patients with Staphylococcus aureus bacteraemia

Author: V. Le Moing, Sandrine Barbas, Elodie Curlier, Hélène Jean-Pierre, Willem Vanwamel, Damien Fournier, Isabelle Patry, Eric Bellissant, Jacques Reynes, Sandrine Gohier-Treuvelot, François Alla, Catherine Chirouze, Fabienne Le Gac, Catherine Neuwirth, Philippe Géraud, François Goehringer, Christine Selton-Suty, Bruno Hoen, Virginie Sussmuth, Christine Delonca, Nathalie Keil, Catherine Sportouch, Thanh Doco-Lecompte, S. Tubiana, F. Vandenesch, Laetitia Minary, S. Desage, Catherine Leport, Hepher Malela, Cécile Descottes-Genon, Lionel Piroth, Christian Michelet, Pascale Rausch, Matthieu Revest, Bernard Iung, Jerome Etienne, Albert Sotto, Vincent Le Moing, J.-P. Lavigne, Catherine Cornu, Fernando Rivadeneira, Elise Thebault, Nathalie Bedos, Pierre-Yves Donnio, Lucie Vettoretti, Michèle Bes, S. Siméon, Jean-Christophe Eicher, Catherine Lechiche, X. Duval, François Vandenesch, Marie Célard, Pascal Chavanet, Sarah Tubiana, Raymond Ruimy, M.-L. Erpelding, Thierry May, André Pechinot, Nejla Aissa, Emila Ilic Habensus, François Delahaye, C.-A. Gustave, Lorraine Letranchant, Taissia Lelekov-Boissard, C. Chirouze, Anne Tristan, Audrey Coma, Jean-Philippe Lavigne, Xavier Duval, Pierre Tattevin, Alex van Belkum, Pierre Braquet, Marie-Line Erpelding, Pascale Longuet, Malika Hadid, Marie-Christine Greusard, Florence Galtier, Anne Verchère, P. Tattevin, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Maladies Infectieuses [CHU de Montpellier], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC1425 Bichat [AP-HP Hôpital Bichat - Claude Bernard] (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Bactériologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Virulence bactérienne et maladies infectieuses (VBMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Microbiologie [CHU Caremeau, Nîmes], Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de référence des Staphylocoques [HCL, Lyon] (Institut des Agents Infectieux), Hospices Civils de Lyon (HCL), Laboratoire de Bactériologie [HCL, Lyon] (Institut des Agents Infectieux), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), 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 ), VIRSTA/AEPEI Study Group. Chirouze C, Curlier E, Descottes-Genon C, Hoen B, Patry I, Vettoretti L, Chavanet P, Eicher JC, Gohier-Treuvelot S, Greusard MC, Neuwirth C, Péchinot A, Piroth L, Célard M, Cornu C, Delahaye F, Hadid M, Rausch P, Coma A, Galtier F, Géraud P, Jean-Pierre H, Le Moing V, Sportouch C, Reynes J, Aissa N, Doco-Lecompte T, Goehringer F, Keil N, Letranchant L, Malela H, May T, Selton-Suty C, Bedos N, Lavigne JP, Lechiche C, Sotto A, Duval X, Habensus EI, Iung B, Leport C, Longuet P, Ruimy R, Bellissant E, Donnio PY, Le Gac F, Michelet C, Revest M, Tattevin P, Thebault E, Alla F, Braquet P, Erpelding ML, Minary L, Tubiana S, Bès M, Etienne J, Lelekov-Boissard T, Tristan A, Vandenesch F, Van Belkum A, Rivadeneira F, Vanwamel W, Barbas S, Delonca C, Sussmuth V, Verchère A., Service des maladies infectieuses et réanimation médicale, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), CHU Caremeau, Nîmes, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Hôpital Jean Minjoz, Centre National de référence des Staphylocoques, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Service des Maladies Infectieuses et Tropicales [Point-à-Pitre, Guadeloupe], CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Biologie Laboratoire de Bacteriologie, Laboratoire de Microbiologie Médicale et Moléculaire, Université de Bourgogne (UB), Département d'infectiologie (CHU de Dijon), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), REseau national d'Investigation clinique en VACcinologie (REIVAC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de Gestion des Essais de Produits de Santé (CeNGEPS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Service de Bactériologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Laboratoire universitaire d'antibiologie, Université Montpellier 1 (UM1), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Bichat - Claude Bernard, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie : Risques Infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service des maladies infectieuses, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), CHU Montpellier, Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre National de Reference des Staphylocoques, Université de Lyon, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Laboratoire Chrono-environnement (UMR 6249) (LCE), 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 ), and Jonchère, Laurent
Subjects: Male, Methicillin-Resistant Staphylococcus aureus, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, bacteraemia, medicine.medical_specialty, Time Factors, Multivariate analysis, 030106 microbiology, Bacteremia, Independent predictor, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Blood culture, Prospective Studies, 030212 general & internal medicine, time to blood culture positivity, Prospective cohort study, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, medicine.diagnostic_test, infective endocarditis, business.industry, Endocarditis, Bacterial, General Medicine, Middle Aged, Staphylococcal Infections, respiratory system, medicine.disease, mortality, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Quartile, Blood Culture, Infective endocarditis, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Objectives - Time to blood culture positivity (TTP), a routinely available parameter in automated blood culture systems, may be a proxy for infectious burden in patients with bloodstream infections. We aimed to study the association between TTP and infective endocarditis (IE), or death, in patients with Staphylococcus aureus bacteraemia. Methods - VIRSTA is a multicenter prospective cohort study that included all adult patients with S. aureus bacteraemia in eight university hospitals in France (2009-2011). We analyzed data from four centers which collected data on TTP. Regression models were used to study the association between TTP and definite IE (Duke-Li criteria), and 30 day-mortality. Results - We included 587 patients with S. aureus bacteraemia: mean age was 65.3±16.3 years, 420/587 patients (71.6%) were male, 121/587 (20.6%) died, and 42/587 (7.2%) had definite IE. Median TTP of first positive blood culture was 13.7 h (interquartile range, 9.9-18). On multivariate analysis, 30-day mortality was associated with TTP≤13.7 h (74/295 (25.1%) vs 47/292 (16.1%), P=0.02), as well as old age, McCabe score, methicillin resistance, stroke, pneumonia, and C-Reactive Protein. TTP was also independently associated with IE, but with a U-shape curve: IE was more common in the first (TTP18 h, 8/146, 5.5%) quartiles of TTP, P=0.002. Conclusions - TTP provides reliable information in patients with S. aureus bacteraemia, on the risk of IE, and prognosis, with short TTP being an independent predictor of death. This data readily available at no cost may be used to identify patients who require specific attention.
Published: 2019
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7. Clonal Spread of Streptococcus pyogenes emm44 among Homeless Persons, Rennes, France

Author: Anne Cady, Céline Plainvert, Pierre-Yves Donnio, Pascaline Loury, Didier Huguenet, Alain Briand, Matthieu Revest, Samer Kayal, and Anne Bouvet
Subjects: Bacteria, France, Streptococcus pyogenes, emm typing, drug users, homeless persons, Medicine, Infectious and parasitic diseases, RC109-216
Published: 2011
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8. Clustered cases of infections due to an uncommon methicillin-resistant Staphylococcus aureus originating in a maternity ward

Author: P. Martins-Simões, Pierre-Yves Donnio, L.A. King, H. Isly, K. Le Neindre, A. Tristan, Guillaume Menard, G. Auger, A. Morin-Le Bihan, 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 ), CHU Pontchaillou [Rennes], Santé publique France - French National Public Health Agency [Saint-Maurice, France], Hospices Civils de Lyon, Departement de Neurologie (HCL), Institut des Agents Infectieux [Lyon] (IAI), Hospices Civils de Lyon (HCL), This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors., Jonchère, Laurent, 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: Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, media_common.quotation_subject, [SDV]Life Sciences [q-bio], MRSA, medicine.disease_cause, community-acquired infections, Phenotypic analysis, Hygiene, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Epidemiology, medicine, Humans, media_common, outbreak, Transmission (medicine), business.industry, Public health, Soft Tissue Infections, Infant, Newborn, Outbreak, Staphylococcal Infections, maternity, Methicillin-resistant Staphylococcus aureus, Hospitals, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Staphylococcus aureus, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Panton-Valentin leukocidin, business
Abstract: International audience; OBJECTIVE: We aimed to report a community outbreak of an uncommon methicillin-resistant Staphylococcus aureus (MRSA) originating in a maternity ward. PATIENTS AND METHODS: Cases were defined by epidemiological, clinical, and microbiological investigations. Microbiological investigations included phenotypic analysis, molecular typing, and whole genome sequencing. To control the outbreak, we applied both national recommendations to prevent in-hospital transmission and the French High Council for Public Health guidelines on the management of community-acquired MRSA infections. RESULTS: Between March and July 2016, seven patients with MRSA infections were identified: six skin and soft tissue infections and one pulmonary infection, including six microbiologically confirmed infections. Infections occurred in community settings, but a link with the same maternity ward was found for all patients. All MRSA strains had a t690 spa type, were tetracycline-resistant, and produced Panton-Valentine leukocidin. All isolates belonged to the sequence type 88 (ST88). CONCLUSION: This outbreak highlights the largely underestimated risk of healthcare-associated infections in maternity wards. Healthcare workers should be aware of the importance of standard hygiene precautions and use of alcohol-based hand sanitizers for neonates and mothers.
Published: 2021
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9. Galleria mellonella Larvae as an Infection Model to Investigate sRNA-Mediated Pathogenesis in Staphylococcus aureus

Author: Astrid Rouillon, Mathieu Emily, Gevorg Ghukasyan, Guillaume Menard, Pierre-Yves Donnio, Brice Felden, HAL UR1, Admin, ARN régulateurs bactériens et médecine (BRM), 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 ), Biosit : biologie, santé, innovation technologique (SFR UMS CNRS 3480 - INSERM 018), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut de Recherche Mathématique de Rennes (IRMAR), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École normale supérieure - Rennes (ENS Rennes)-Université de Rennes 2 (UR2)-Centre National de la Recherche Scientifique (CNRS)-INSTITUT AGRO Agrocampus Ouest, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), 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 ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), and ANR-11-LABX-0020,LEBESGUE,Centre de Mathématiques Henri Lebesgue : fondements, interactions, applications et Formation(2011)
Subjects: Microbiology (medical), Staphylococcus aureus, [SDV.IMM] Life Sciences [q-bio]/Immunology, RNAIII, Immunology, Virulence, Biology, medicine.disease_cause, Microbiology, Pathogenesis, 03 medical and health sciences, Cellular and Infection Microbiology, [STAT.AP] Statistics [stat]/Applications [stat.AP], In vivo, medicine, 030304 developmental biology, Original Research, 0303 health sciences, [STAT.AP]Statistics [stat]/Applications [stat.AP], 030306 microbiology, fungi, regulation, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, QR1-502, 3. Good health, Galleria mellonella, virulence, Infectious Diseases, SprD, [SDV.IMM]Life Sciences [q-bio]/Immunology, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, sRNA, Bacteria
Abstract: Small regulatory RNAs (sRNAs) are key players in bacterial regulatory networks. Monitoring their expression inside living colonized or infected organisms is essential for identifying sRNA functions, but few studies have looked at sRNA expression during host infection with bacterial pathogens. Insufficient in vivo studies monitoring sRNA expression attest to the difficulties in collecting such data, we therefore developed a non-mammalian infection model using larval Galleria mellonella to analyze the roles of Staphylococcus aureus sRNAs during larval infection and to quickly determine possible sRNA involvement in staphylococcal virulence before proceeding to more complicated animal testing. We began by using the model to test infected larvae for immunohistochemical evidence of infection as well as host inflammatory responses over time. To monitor sRNA expression during infection, total RNAs were extracted from the larvae and invading bacteria at different time points. The expression profiles of the tested sRNAs were distinct and they fluctuated over time, with expression of both sprD and sprC increased during infection and associated with mortality, while rnaIII expression remained barely detectable over time. A strong correlation was observed between sprD expression and the mortality. To confirm these results, we used sRNA-knockout mutants to investigate sRNA involvement in Staphylococcus aureus pathogenesis, finding that the decrease in death rates is delayed when either sprD or sprC was lacking. These results demonstrate the relevance of this G. mellonella model for investigating the role of sRNAs as transcriptional regulators involved in staphylococcal virulence. This insect model provides a fast and easy method for monitoring sRNA (and mRNA) participation in S. aureus pathogenesis, and can also be used for other human bacterial pathogens.
Published: 2021
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10. Adhesion of

Author: Guillaume, Ménard, Martine, Bonnaure-Mallet, and Pierre-Yves, Donnio
Subjects: Adult, Male, Staphylococcus aureus, Bacteria, Microbiota, Epithelial Cells, Nose, Staphylococcal Infections, Bacterial Adhesion, Nasal Mucosa, Carrier State, Humans, Female, Nasal Cavity
Published: 2020

11. Simplification of first-line antibacterial regimen for complicated appendicitis in children is associated with better adherence to guidelines and reduced use of antibiotics

Author: Nicolas Nardi, Pierre-Yves Donnio, Marion Taleb, Edouard Habonimana, Pierre Tattevin, Alexis Arnaud, Nathalie Costet, Charlotte Engrand, Eric Wodey, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Penicillanic Acid, Cefotaxime, Antimicrobial stewardship, Postoperative Complications, 0302 clinical medicine, Protocol, Pharmacology (medical), 030212 general & internal medicine, Child, Abscess, General Medicine, Anti-Bacterial Agents, 3. Good health, Piperacillin, Tazobactam Drug Combination, Infectious Diseases, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Practice Guidelines as Topic, Piperacillin/tazobactam, Drug Therapy, Combination, Female, Guideline Adherence, medicine.drug, Microbiology (medical), medicine.medical_specialty, Adolescent, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Peritonitis, Tazobactam, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Metronidazole, Piperacillin-tazobactam, 030225 pediatrics, Internal medicine, medicine, Humans, Retrospective Studies, Piperacillin, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Aminoglycoside, business.industry, Septic shock, Length of Stay, Appendicitis, medicine.disease, Regimen, Adherence, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Gentamicins, business
Abstract: International audience; Acute appendicitis in children requires early surgery and short-course antibiotics active against Enterobacteriaceae and anaerobes. Although an aminoglycoside-containing three-drug regimen has been used successfully for decades, simpler regimens with similar efficacy are increasingly used. This study evaluated the impact of a switch from the combination of cefotaxime, metronidazole and gentamicin (regimen 1) to piperacillin/tazobactam (regimen 2) as first-line regimen for complicated acute appendicitis in children. In total, 171 children were enrolled [median (IQR) age, 10 (6-13) years], treated with regimen 1 (n = 80) or regimen 2 (n = 91) following surgery for complicated acute appendicitis. The two groups were comparable except for surgical approach (through laparoscopy in 46% vs. 88% for regimens 1 and 2, respectively; P < 0.001). Post-operative complications and duration of hospital stay were similar. Deviations from antibacterial treatment protocol decreased from 36% (29/80) to 14% (13/91) (P < 0.001), with a dramatic reduction in antibacterial treatment duration from median (IQR) of 15 (12-16) days to 5 (5-8) days (P < 0.001). Post-operative intra-abdominal abscess developed in 32 children (18.7%). Female sex (OR = 2.76, 95% CI 1.18-6.48; P = 0.02) and sepsis/septic shock on admission (OR = 4.72, 95% CI 1.12-19.97; P = 0.035) were independently associated with post-operative intra-abdominal abscess, but not antibacterial regimen. This study shows that simplification of first-line antibacterial regimen for complicated appendicitis in children was associated with reduced protocol deviation, reduced duration of antibiotics, and similar outcomes (post-operative complications and duration of hospital stay).
Published: 2018
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12. Methicillin-susceptible ST398 Staphylococcus aureus responsible for bloodstream infections: an emerging human-adapted subclone?

Author: Anne-Sophie Valentin-Domelier, Myriam Girard, Xavier Bertrand, Jérémie Violette, Patrice François, Pierre-Yves Donnio, Daniel Talon, Roland Quentin, Jacques Schrenzel, Nathalie van der Mee-Marquet, and Bloodstream Infection Study Group of the Réseau des Hygiénistes du Centre (RHC)
Subjects: Medicine, Science
Abstract: In the course of an annual 3-month bloodstream infections (BSI) survey conducted during a four-year period in 31 healthcare institutions located in three noncontiguous French regions, we report 18 ST398 Staphylococcus aureus BSI. ST398 BSI incidence showed a seven-fold increase during the study period (0.002 per 1,000 patient days in 2007 vs. 0.014 in 2010). ST398 BSI isolates differed from the pig-borne multiresistant clone: 17/18 BSI isolates were methicillin susceptible and none was of t011, t034 or t108 pig-borne spa-types. ST398 BSI isolates had homogenous resistance patterns (15/18 with only Ery(r)) and prophagic content (all harboured the hlb-converting Sau3int phage). The clustering of BSI and pig-borne isolates by spa-typing and MLVA, the occurrence of Sau3int phage in BSI isolates and the lack of this phage in pig-borne isolates suggest that the emergence of BSI isolates could have arisen from horizontal transfer, at least of the Sau3int phage, in genetically diverse MSSA ST398 isolates. The acquisition of the phage likely plays a role in the increasing ability of the lysogenic ST398 isolates to colonize human. The mode of acquisition of the non pig-borne ST398 isolates by our 18 patients remains unclear. ST398 BSI were diagnosed in patients lacking livestock exposure and were significantly associated with digestive portals of entry (3/18 [16.7%] for ST398 vs. 19/767 [2.5%] for non ST398 BSI; p = .012). This raises the question of possible foodborne human infections. We suggest the need for active surveillance to study and control the spread of this human-adapted subclone increasingly isolated in the hospital setting.
Published: 2011
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13. An outbreak in intravenous drug users due to USA300 Latin-American variant community-acquired methicillin-resistant Staphylococcus aureus in France as early as 2007

Author: Mohamed Sassi, Yoann Augagneur, Matthieu Revest, Brice Felden, Pierre-Yves Donnio, Pierre Tattevin, 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 ), CHU Pontchaillou [Rennes], Region Bretagne grant SAD SARS [8254], Region Bretagne grant SAD SARS_2 [9181], 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: Methicillin-Resistant Staphylococcus aureus, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, [SDV]Life Sciences [q-bio], Clone (cell biology), Microbial Sensitivity Tests, Biology, medicine.disease_cause, DNA sequencing, Disease Outbreaks, Drug Users, 03 medical and health sciences, Medical microbiology, Arginine catabolic mobile element, medicine, Humans, Whole genome sequencing, Phylogenetic tree, Outbreak, General Medicine, Staphylococcal Infections, Virology, Methicillin-resistant Staphylococcus aureus, Anti-Bacterial Agents, 3. Good health, Surgery, Community-Acquired Infections, 030104 developmental biology, Infectious Diseases, France
Abstract: International audience; Intravenous drug users are at increased risk of Staphylococcus aureus infections. Most cases are related to clones prevalent in the community. We report an outbreak of community-acquired methicillin-resistant Staphylococcus aureus infections that occurred from 2007 to 2009 in intravenous drug users and their close contacts in Northwestern France. Clinical and molecular investigations suggested that the clones were more similar than those usually isolated in the American continent although none of the patients traveled abroad or had contact with individuals who had traveled to the Americas. Then, a retrospective whole genome sequencing and phylogenetic analyses demonstrated that the strains isolated from the first case belong to the USA300 Latin-American variant clone, based on the absence of arginine catabolic mobile element (ACME), and the presence of copper and mercury resistance mobile element (COMER), a distinctive feature of the South American variant. Our study shows genetic evidence for introduction of this clone as early as 2007 in France. This report also illustrates the importance of genome sequencing to finely characterize and monitor the emergence of unexpected S. aureus clones among high-risk populations, especially when living in promiscuity.
Published: 2017
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14. Bactériémie et ostéite à Ignatzschineria larvae sur plaie chronique infestée par des asticots

Author: O. Grasland, Patrick Jego, Pierre-Yves Donnio, Pierre Tattevin, L. Alix, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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, 03 medical and health sciences, Osteite, Infectious Diseases, Ignatzschineria larvae, Bacteriemie, 030306 microbiology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Biology, Molecular biology, 3. Good health
Abstract: National audience; Ignatzschineria larvae est un bacille à Gram négatif aérobie appartenant à la famille des Xanthomonadaceae, (dont fait également partie le genre Stenotrophomonas) et constitutif du microbiote des larves de Wohlfahrtia magnifica. W. magnifica est une espèce de mouche retrouvée dans le sud de l'Europe, en Asie centrale, au Moyen-Orient, en Afrique du Nord et en Chine. Ses larves sont responsables de myiases, essentiellement chez les moutons, les chèvres, les vaches et les chevaux et également, de manière beaucoup plus rare, chez l’Homme. Nous rapportons ici le cas d’un patient ayant présenté une bactériémie à I. larvae dans un contexte d’ostéite de l’hallux.
Published: 2020
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15. Adhesion of Staphylococcus aureus to epithelial cells: an in vitro approach to study interactions within the nasal microbiota

Author: Martine Bonnaure-Mallet, Pierre-Yves Donnio, Guillaume Menard, Jonchère, Laurent, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), ARN régulateurs bactériens et médecine (BRM), 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 ), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and 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 )-Université de Rennes 1 (UR1)
Subjects: Microbiology (medical), Staphylococcus aureus, [SDV]Life Sciences [q-bio], nasal microbiota, Biology, medicine.disease_cause, Microbiology, In vitro model, 03 medical and health sciences, Endogenous Infection, medicine, otorhinolaryngologic diseases, Nasal carriage, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Nose, 030304 developmental biology, 0303 health sciences, 030306 microbiology, General Medicine, Adhesion, interactions, biology.organism_classification, In vitro, epithelial cells, 3. Good health, [SDV] Life Sciences [q-bio], adhesion, medicine.anatomical_structure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Bacteria
Abstract: Introduction. Staphylococcus aureus is a skin and mucous commensal bacterium of warm-blooded animals. In humans, the nose is the main ecological niche of S. aureus , and nasal carriage is a risk factor for developing an endogenous infection. S. aureus nasal colonization is a multifactorial process, involving inter-species interactions among the nasal microbiota. Aims. The objectives of this study were to characterize the microbiota of carriers and non-carriers of S. aureus and to demonstrate the importance of inter-species relationships in the adhesion of S. aureus , a key step in nasal colonization. Methodology. First, we characterized the nasal microbiota from 30 S. aureus carriers and non-carriers by a culturomic approach. We then evaluated the adhesion of S. aureus , first alone and then along with other bacteria of the nasal microbiota. To do that, we used an in vitro model to measure the interactions among bacteria in the presence of epithelial cells. Results. Analysis of the nasal microbiota of the carriers and non-carriers of S. aureus made it possible to observe that each microbiota has specific features in terms of composition. However, this composition differs significantly between carriers and non-carriers mainly through two bacterial groups: coagulase-negative staphylococci and corynebacteria. In a second part, adhesion of S. aureus to epithelial cells showed competition between S. aureus and these bacteria, suggesting a limitation of nasal colonization by S. aureus . Conclusion. These findings demonstrate the existence of a negative correlation between S. aureus and other species which inhibits adhesion and could limit nasal colonization.
Published: 2020
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16. Déploiement d’une équipe mobile de prélèvement SARS-CoV-2 au sein d’une structure hospitalière multi-site

Author: L. Dejoies, Guillaume Menard, Cédric Arvieux, Pierre-Yves Donnio, M. Suriray, and L. Picard
Subjects: Gynecology, medicine.medical_specialty, 2019-20 coronavirus outbreak, Infectious Diseases, Coronavirus disease 2019 (COVID-19), Political science, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine, Article
Abstract: Introduction La pandemie d’infections a SARS-CoV-2 a conduit a une reorganisation des services de soins en « filieres COVID-19 » et « non COVID-19 » au sein de nombreux hopitaux avec pour objectifs l’orientation precoce vers une prise en charge specifique des patients COVID-19 et la limitation des risques de transmission au sein de ces etablissements. En complement de ces mesures, une surveillance active de la survenue de cas dans les filieres « non COVID-19 » a ete indispensable pour optimiser la gestion de l’epidemie au sein de notre etablissement. Le deploiement d’une equipe mobile (EM) de prelevement, basee sur une organisation pluridisciplinaire, avait pour but de realiser ces depistages dans des conditions optimales pour les patients et les soignants. Materiels et methodes Les demandes de prelevements rhinopharynges etaient systematiquement soumises aux cliniciens du service de Maladies Infectieuses pour validation des indications : prelevement de cas possibles sur la base d’arguments cliniques et d’imagerie ou prelevements a visee systematique. L’EM etait composee d’un binome d’internes, rapidement mobilisable sur les 5 sites du CHU. Au sein des services cliniques concernes, l’EM etait chargee de la realisation du prelevement ainsi que de l’accompagnement de l’equipe soignante autour des precautions d’hygiene specifiques a mettre en place dans l’attente des resultats biologiques. Le prelevement etait achemine aussitot au laboratoire de virologie pour recherche de SARS-CoV-2 par biologie moleculaire. Resultats Sur les 158 prelevements pris en charge par l’EM, 66 % l’ont ete pour des suspicions cliniques et 34 % a visee systematique. Toute indication confondue, la tranche d’âge majoritaire etait celle des plus de 80 ans (32 %), suivie par les 65–79 ans (23 %) et 50–64 ans (23 %), la population pediatrique etait minoritaire (1 %). Pour les patients symptomatiques, les signes cliniques predominants etaient la fievre (66 %), la toux (21 %), les troubles respiratoires a type de dyspnee et desaturation (21 %), la presence de criteres d’imagerie evocateurs (17 %) et les diarrhees (16 %). Le delai moyen entre l’apparition des symptomes et la suspicion clinique ayant conduit a la realisation du prelevement etait de 3 jours. Parmi les suspicions cliniques, 4 cas positifs ont ete detectes par PCR et aucun parmi les depistages systematiques. Conclusion En complement de la reorganisation des services de soins « COVID-19 », la mise en place d’une equipe mobilisable a permis une surveillance de terrain en temps reel. L’EM a ainsi contribue au diagnostic de COVID-19 pour 4 patients initialement hospitalises dans des filieres non dediees. Le faible taux de positivite constate est en accord avec l’epidemiologie locale correspondant a une zone a faible circulation virale. L’EM a egalement participe au maintien du lien avec les services et a grandement facilite la diffusion de l’information autour des bonnes pratiques d’hygiene.
Published: 2020
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17. Short-Term Decline in All-Cause Acquired Infections With the Routine Use of a Decontamination Regimen Combining Topical Polymyxin, Tobramycin, and Amphotericin B With Mupirocin and Chlorhexidine in the ICU

Author: Eric Bellissant, Arnaud Gacouin, Fabrice Uhel, Sylvain Lavoué, Loic Javaudin, Sylvain Salomon, Christophe Camus, Jean-Marc Chapplain, Pierre-Yves Donnio, Yves Le Tulzo, Claire Bouchigny, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Service de Pharmacologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation Médicale, Pontchaillou, CHU Rennes, France, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Male, medicine.medical_specialty, medicine.drug_class, Administration, Topical, [SDV]Life Sciences [q-bio], Polymyxin, Mupirocin, Critical Care and Intensive Care Medicine, medicine.disease_cause, Group B, chemistry.chemical_compound, Anti-Infective Agents, Clinical Protocols, Amphotericin B, Internal medicine, Drug Resistance, Bacterial, medicine, Tobramycin, Humans, Polymyxins, Prospective Studies, Aged, Cross Infection, Infection Control, Pseudomonas aeruginosa, business.industry, Incidence, Chlorhexidine, Antibiotic Prophylaxis, Middle Aged, 3. Good health, Surgery, Drug Combinations, Intensive Care Units, Regimen, Logistic Models, chemistry, Female, Intubation, business, medicine.drug
Abstract: International audience; In a multicenter, placebo-controlled, randomized, double-blind trial, we showed that acquired infections in intubated patients were reduced by the combination of topical polymyxin plus tobramycin and nasal mupirocin plus chlorhexidine body wash. Because intubated patients are particularly at risk for acquired infections, we reassessed the impact of this protocol as a routine procedure to control acquired infections in the ICU. Nonrandomized study comparing acquired infections in ICU patients during two 1-year periods: the last year before (group A, n = 925) and the first year after the implementation of the protocol (group B, n = 1,022). Acquired infections were prospectively recorded. Polyvalent medical ICU at a university-affiliated hospital. All patients admitted to the ICU. Administration of polymyxin/tobramycin/amphotericin B in the oropharynx and the gastric tube plus a mupirocin/chlorhexidine regimen in intubated patients and standard care in the other patients. The comparison of acquired infection rates between groups was adjusted for differences at baseline. Infection rates were lower in group B compared with group A (5.3% vs 11.0%; p < 0.001), as were the incidence rates of total acquired infections (9.4 vs 23.6 per 1,000 patient-days; p < 0.001), intubation-related pneumonia (5.1 vs 17.1 per 1,000 ventilator-days; p < 0.001), and catheter-related bloodstream infections (1.0 vs 3.5 per 1,000 catheter-days; p = 0.03). There were fewer acquired infections caused by ceftazidime-resistant Enterobacteriaceae (0.8‰ vs 3.6‰; p < 0.001), ciprofloxacin-resistant Enterobacteriaceae (0.8‰ vs 2.5‰; p = 0.02), ciprofloxacin-resistant Pseudomonas aeruginosa (0.5‰ vs 1.6‰; p = 0.05), and colistin-resistant Gram-negative bacilli (0.7‰ vs 1.9‰; p = 0.04). Fewer patients got acquired infections due to multidrug-resistant aerobic Gram-negative bacilli (p = 0.008). In intubated patients, the use of topical polymyxin/tobramycin/amphotericin B plus mupirocin/chlorhexidine was associated with the reduction of all-cause ICU-acquired infections. Long-term emergence of multidrug-resistant organisms deserves further investigation.
Published: 2014
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18. Liste des auteurs

Author: Julio, Aires, Véronique, Apaire-Marchais, Corinne, Arpin, Frédéric, Barbut, Francis, Barin, Olivier, Barraud, Isabelle, Bertrand, Nadège, Bourgeois-Nicolaos, Denys, Brand, Étienne, Brochot, Anais, Brosse, Nathalie, Caroff, Camille, Chagneau, Sabine, Chapuy-Regaud, Marius, Colin, Philippe, Colson, Héloise, Coullon, Jeanne, Couturier, Lise, Cremet, Sandrine, Dahyot, Ghislaine, Descours, Caroline, Deshayes, Anne, Dhalluin, Anne, Doleans-Jordheim, Pierre-Yves, Donnio, Florence, Doucet-Populaire, Véronique, Dubois, Gilles, Duverlie, Sophie, Edouard, Audrey, Esclatine, Matthieu, Eveillard, Virginie, Ferre, Vincent, Foulongne, Émilie, Frobert, Sophie, Gangloff, Agnès, Gautheret-Dejean, Raphaële, Germi, Anne, Goffard, François, Helle, Claire, Hennequin, Berthe-Marie, Imbert, Claire, Janoir, Anne, Jolivet-Gougeon, Frédéric, Jorand, Jérôme, Josse, Philippe, Lanotte, Floriane, Laumay, Alban, Le Monnier, Patricia, Licznar-Fajardo, Marion, Lussignol, Hélène, Marchandin, Julien, Marlet, Océane, Martin, Florence, Morfin, Christophe, Pasquier, Séverine, Pechine, Martine, Pestel-Caron, Ludovic, Pilloux, Fany, Reffuveille, Sylvie, Rogez, Jean-Marc, Rolain, Sarah, Romano-Bertrand, and Aurélie, Truffot
Published: 2024
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19. Mupirocin/chlorexidine to prevent methicillin-resistant Staphylococcus aureus infections: post hoc analysis of a placebo-controlled, randomized trial using mupirocin/chlorhexidine and polymyxin/tobramycin for the prevention of acquired infections in intubated patients

Author: Eric Bellissant, Arnaud Gacouin, P. Le Corre, A. Legras, Pierre-Yves Donnio, Dominique Perrotin, Véronique Sébille, Y. Le Tulzo, Bernard Garo, Anne Renault, Christophe Camus, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), Service de réanimation médicale, Université de Tours (UT), Service de maladies infectieuses, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Réanimation Médicale (BREST - Réa Med), Laboratoire de Pharmacie Galenique, Biopharmacie et Pharmacie Clinique [Rennes], Université de Rennes (UR), Laboratoire de Virologie [Rennes] = Virology [Rennes], Pharmacologie du Sepsis et Choc Septique, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], This study was conducted with financial support from the French Ministry of Health (Clinical Research Hospital Program, PHRC 94, Direction des Hôpitaux, Paris, France) and from a grant from GlaxoSmithKline. The grant covered the additional costs of processing and culture of colonization samples and susceptibility testing of S. aureus isolates to mupirocin. GlaxoSmithKline had no role in the design, analysis or drafting of the manuscript., Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Laboratoire de Pharmacie Galenique, Biopharmacie et Pharmacie Clinique, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Tours-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), and Cadieu, Muriel
Subjects: Male, Administration, Topical, MRSA, medicine.disease_cause, Rate ratio, Hospitals, University, Placebos, ICU-acquired infection, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Tobramycin, 030212 general & internal medicine, Aged, 80 and over, 0303 health sciences, Incidence, Incidence (epidemiology), Chlorhexidine, Selective digestive decontamination, General Medicine, Middle Aged, Staphylococcal Infections, Anti-Bacterial Agents, 3. Good health, Mupirocin, Treatment Outcome, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Female, France, medicine.drug, Adult, Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Placebo, Young Adult, 03 medical and health sciences, Double-Blind Method, Internal medicine, Intensive care, medicine, Humans, Polymyxins, Aged, 030306 microbiology, business.industry, Methicillin-resistant Staphylococcus aureus, Surgery, Regimen, chemistry, Intubation, business
Abstract: International audience; PURPOSE: The reduction in acquired infections (AI) due to methicillin-resistant Staphylococcus aureus (MRSA) with the mupirocin/chlorhexidine (M/C) decontamination regimen has not been well studied in intubated patients. We performed post hoc analysis of a prior trial to assess the impact of M/C on MRSA AI and colonization. METHODS: We conducted a multicenter, placebo-controlled, randomized, double-blind study with the primary aim to reduce all-cause AI. The two regimens used [topical polymyxin and tobramycin (P/T), nasal mupirocin with chlorhexidine body wash (M/C), or corresponding placebos for each regimen] were administered according to a 2 × 2 factorial design. Participants were intubated patients in the intensive care units of three French university hospitals. The patients enrolled in the study (n = 515) received either active P/T (n = 130), active M/C (n = 130), both active regimens (n = 129), or placebos only (n = 126) for the period of intubation and an additional 24 h. The incidence and incidence rates (per 1,000 study days) of MRSA AI were assessed. Due to the absence of a statistically significant interaction between the two regimens, analysis was performed at the margins by comparing all patient receiving M/C (n = 259) to all patients not receiving M/C (n = 256), and all patients receiving P/T (n = 259) to all patients not receiving P/T (n = 256). RESULTS: Incidence [odds ratio (OR) 0.39, 95 % confidence interval (CI) (0.16-0.96), P = 0.04] and incidence rates [incidence rate ratio (IRR) 0.41, 95 % CI 0.17-0.97, P = 0.05] of MRSA AI were significantly lower with the use of M/C. We also observed an increase in the incidence (OR 2.50, 95 % CI 1.01-6.15, P = 0.05) and the incidence rate (IRR 2.90, 95 % CI 1.20-8.03, P = 0.03) of MRSA AI with the use of P/T. CONCLUSION: Among our study cohort of intubated patients, the use of M/C significantly reduced MRSA AI.
Published: 2014
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20. Factors associated with 12 week case-fatality in Staphylococcus aureus bacteraemia: a prospective cohort study

Author: P. Braquet, F. Alla, C. Cornu, F. Goehringer, L. Piroth, C. Chirouze, M. Revest, C. Lechiche, X. Duval, V. Le Moing, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Bruno Hoen, Isabelle Patry, Lucie Vettoretti, Pascal Chavanet, Jean-Christophe Eicher, Marie-Christine Greusard, Catherine Neuwirth, André Péchinot, Lionel Piroth, Marie Célard, Catherine Cornu, François Delahaye, Malika Hadid, Pascale Rausch, Audrey Coma, Florence Galtier, Philippe Géraud, Hélène Jean-Pierre, Vincent Le Moing, Catherine Sportouch, Jacques Reynes, Nejla Aissa, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Thierry May, Christine Selton-Suty, Nathalie Bedos, Jean-Philippe Lavigne, Catherine Lechiche, Albert Sotto, Xavier Duval, Emila Ilic Habensus, Bernard Iung, Catherine Leport, Pascale Longuet, Raymond Ruimy, Eric Bellissant, Pierre-Yves Donnio, Fabienne Le Gac, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thebault, François Alla, Pierre Braquet, Marie-Line Erpelding, Laetitia Minary, Michèle Bès, Jérôme Etienne, Anne Tristan, François Vandenesch, Alex Van Belkum, Willem Vanwamel, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), CIC CHU Lyon (inserm), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Agroécologie [Dijon], Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, 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 ), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSERA CIC, Hôpital Bichat - Claude Bernard, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique - Innovation Technologique ( CIC-IT ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et réanimation médicale, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, 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 ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Centre d'Investigation Clinique - Innovation Technologique (CIC-IT), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), and Jonchère, Laurent
Subjects: 0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, Staphylococcus aureus, medicine.drug_class, 030106 microbiology, Antibiotics, Bacteremia, Penicillins, Prognostic factors, Tertiary Care Centers, 03 medical and health sciences, Interquartile range, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Vancomycin, Internal medicine, Case fatality rate, medicine, Humans, Blood culture, Prospective Studies, Prospective cohort study, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, Antistaphylococcal penicillins, Cross Infection, medicine.diagnostic_test, business.industry, Septic shock, General Medicine, Middle Aged, Staphylococcal Infections, medicine.disease, Prognosis, Survival Analysis, 3. Good health, Surgery, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Bacteraemia, Antistaphylococcal penicillin, Female, France, business, medicine.drug
Abstract: International audience; Staphylococcus aureus bacteraemia (SAB) is a frequent and deadly disease. Given the lack of a randomized trial, optimal first-line antibiotic treatment is still debated. Our aim was to identify prognostic factors in SAB patients and to analyse the impact of first-line antibiotics. The VIRSTA prospective cohort study was conducted in eight tertiary care centres in France. Consecutive incident adults in whom a blood culture drawn in participating centres grew S. aureus between April 2009 and October 2011 were prospectively followed for 12 weeks. Factors associated with 12-week case-fatality were identified by multivariate logistic regression. We enrolled 2091 patients and analysed survival in 1972 (median age 67.8 years, interquartile range 55.5–78.9; females 692/1972, 35.1%). SAB was nosocomial or healthcare-related in 1372/1972 (69.6%) of cases and the primary focus was unknown in 414/1972 (21.0%) of cases. Week 12 case-fatality rate was 671/1972 (34.0%). The main independent prognostic factors on multivariate analysis were age (adjusted OR by 10-year increment 1.56; 95% CI 1.44–1.69), septic shock (OR 5.11; 95% CI 3.84–6.80), metastatic cancer (OR 4.28; 95% CI 2.88–6.38), and unknown primary focus (OR 2.62; 95% CI 2.02–3.41). In the 1538 patients with methicillin-sensitive S. aureus (MSSA) bacteraemia, first-line empiric antistaphylococcal penicillins (OR 0.40; 95% CI 0.17–0.95) and vancomycin (OR 0.37; 95% CI 0.17–0.83), alone or combined with an aminoglycoside, were associated with better outcome compared with other antibiotics. There are few modifiable prognostic factors for SAB. Initiating empiric antibiotics with antistaphylococcal penicillins or vancomycin may be associated with better outcome in MSSA bacteraemia. © 2016 European Society of Clinical Microbiology and Infectious Diseases
Published: 2016
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21. Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections

Author: Pierre Tattevin, Pierre-Yves Donnio, Mohamed Sassi, Valérie Bordeau, Matthieu Revest, Brice Felden, Octavie Rostan, Anne Cady, Fonction, structure et inactivation d'ARN bactériens, 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 ), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Institut National de la Santé et de la Recherche Médicale (grant to B.F.)Region Bretagne (grants SAD SARS #8254 and SAD SARS_2 #9181)., 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 ), and Lefevre, Annick
Subjects: 0301 basic medicine, bloodstream infections, Epidemiology, RNAIII, lcsh:Medicine, Bacteremia, multilocus sequence typing, medicine.disease_cause, Staphylococcus aureus Regulatory RNAs as Potential Biomarkers for Bloodstream Infections, sepsis, immune evasion protein, bacteria, Pathogen, Phylogeny, small pathogenicity island RNAs, musculoskeletal, neural, and ocular physiology, spr RNAs, Staphylococcal Infections, 3. Good health, RNA, Bacterial, Infectious Diseases, Staphylococcus aureus, RNA, Viral, Microbiology (medical), nasal carrier, regulatory RNAs, Virulence Factors, 030106 microbiology, Virulence, macromolecular substances, Biology, Staphylococcal infections, lcsh:Infectious and parasitic diseases, Microbiology, Sepsis, 03 medical and health sciences, Bacterial Proteins, small RNAs, medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Humans, lcsh:RC109-216, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, transfer–messenger RNA, staphylococci, Research, lcsh:R, biomarkers, Gene Expression Regulation, Bacterial, medicine.disease, small pathogenicity island RNA, Pathogenicity island, Virology, spa typing, second immunoglobulin-binding protein, nasal colonization, nervous system, Asymptomatic Diseases, septic shock, S. aureus protein A typing
Abstract: These RNAs predict disease severity and provide targets for therapeutic approaches., Staphylococcus aureus is a commensal bacterium and pathogen. Identifying biomarkers for the transition from colonization to disease caused by this organism would be useful. Several S. aureus small RNAs (sRNAs) regulate virulence. We investigated presence and expression of 8 sRNAs in 83 S. aureus strains from 42 patients with sepsis or septic shock and 41 asymptomatic colonized carriers. Small pathogenicity island sRNAs sprB and sprC were clade specific. Six sRNAs had variable expression not correlated with clinical status. Expression of RNAIII was lower in strains from septic shock patients than in strains from colonized patients. When RNAIII was associated with expression of sprD, colonizing strains could be discriminated from strains in patients with bloodstream infections, including patients with sepsis and septic shock. Isolates associated with colonization might have sRNAs with target expression different from those of disease isolates. Monitoring expression of RNAIII and sprD could help determine severity of bloodstream infections.
Published: 2016
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22. Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis

Author: Lawrence P. Park, Vivian H. Chu, Gail Peterson, Athanasios Skoutelis, Tatjana Lejko‐Zupa, Emilio Bouza, Pierre Tattevin, Gilbert Habib, Ren Tan, Javier Gonzalez, Javier Altclas, Jameela Edathodu, Claudio Querido Fortes, Rinaldo Focaccia Siciliano, Orathai Pachirat, Souha Kanj, Andrew Wang, Liliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, Catherine Campagnac, Thanh Doco‐Lecompte, Christine Selton‐Suty, Jean‐Paul Casalta, Pierre‐Edouard Fournier, Didier Raoult, Franck Thuny, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Efthymia Giannitsioti, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Amos Cahan, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Emanuele Durante‐Mangoni, Irene Mattucci, Daniela Pinto, Federica Agrusta, Alessandra Senese, Enrico Ragone, Riccardo Utili, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Giampiero Carosi, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif‐Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O.M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Magid Halim, Yee‐Yun Liew, Ru‐San Tan, Mateja Logar, Manica Mueller‐Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina Garcia‐de‐la‐Maria, Guillermina Fita, Jose M. Gatell, Magda Heras, Jaime Llopis, Francesc Marco, Carlos A. Mestres, José M. Miró, Asuncion Moreno, Salvador Ninot, Carlos Paré, Juan M. Pericas, Jose Ramirez, Irene Rovira, Marta Sitges, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Miguel Angel Garcia Fernández, Victor Gonzalez‐Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez‐Créixems, Jorge Solis, Benito Almirante, Nuria Fernandez‐Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg‐Martin, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Vance G. Fowler, Thomas Holland, Tahaniyat Lalani, Daniel Mudrick, Zaniab Samad, Daniel Sexton, Martin Stryjewski, Christopher W. Woods, Stamatios Lerakis, Robert Cantey, Lisa Steed, Dannah Wray, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara‐Jane Salstrom, John Baddley, Mukesh Patel, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Khaula Baloch, Christy C. Dixon, Tina Harding, Marian Jones‐Richmond, Bob Sanderford, Judy Stafford, Kevin Anstrom, Arnold S. Bayer, A. W. Karchmer, Daniel J. Sexton, Vivian Chu, David T. Durack, Susannah Eykyn, Phillipe Moreillon, Duke University Medical Center, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, 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 ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Jonchère, Laurent, Universitat de Barcelona, Mazaheri, Bahram (Beitragende*r), Naber, Christoph (Beitragende*r), and Neuerburg, Carl (Beitragende*r)
Subjects: Male, Infeccions quirúrgiques, Surgical wound infection, Medizin, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Clinical Studies, Registries, 030212 general & internal medicine, Original Research, Framingham Risk Score, Endocarditis, Hazard ratio, Middle Aged, Prognosis, infection, mortality, prognosis, surgery, valves, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Infective endocarditis, Cohort, Female, Mortality/Survival, Cardiology and Cardiovascular Medicine, Risk assessment, Infection, Cohort study, Adult, medicine.medical_specialty, Lower risk, Risk Assessment, Sensitivity and Specificity, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Mortalitat, medicine, Humans, Infectious Endocarditis, Mortality, Propensity Score, Aged, Models, Statistical, Cirurgia, business.industry, Proportional hazards model, Reproducibility of Results, medicine.disease, Surgery, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Valvular Heart Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Background Host factors and complications have been associated with higher mortality in infective endocarditis ( IE ). We sought to develop and validate a model of clinical characteristics to predict 6‐month mortality in IE . Methods and Results Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ ICE ]–Prospective Cohort Study [ PCS ], 2000–2006, n=4049), a model to predict 6‐month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry ( ICE ‐ PLUS , 2008–2012, n=1197). The 6‐month mortality was 971 of 4049 (24.0%) in the ICE ‐ PCS cohort and 342 of 1197 (28.6%) in the ICE ‐ PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE , causative organism, left‐sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6‐month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62–0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions Six‐month mortality after IE is ≈25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE .
Published: 2016
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23. Infection à Nocardia farcinica chez un patient porteur d’une mucoviscidose

Author: E. Deneuville, Chantal Belleguic, Pierre-Yves Donnio, G. Brinchault, J. Beucher, and Michel Roussey
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, Nocardia farcinica, 0303 health sciences, Bronchiectasis, biology, 030306 microbiology, business.industry, Respiratory disease, Nocardiosis, Nocardia, medicine.disease, biology.organism_classification, 3. Good health, Surgery, Pneumonia, Sputum, Allergic bronchopulmonary aspergillosis, medicine.symptom, business
Abstract: Infections by Nocardia species are uncommon and generally affect immunocompromised patients. This bacteria has rarely been isolated from cystic fibrosis patients (CF), especially those who are not taking oral corticosteroids. We report a case of a patient with CF harbouring Nocardia farcinica. An 18-year-old male diagnosed with CF at the age of eight (F508 del/G85E) had been treated for allergic bronchopulmonary aspergillosis in 1998 with itraconazole, and a first colonization with Pseudomonas aeruginosa was eradicated in 2003. From May 2006, he presented with recurrent left- and right-sided pneumothorax. In June 2006, he presented with dyspnoea, fever, and nodular eruption on his ankles. Chest X-ray and CT scan revealed a right pneumothorax, severe bronchiectasis and bilateral alveolar consolidation. N. farcinica was idolated from his sputum without any other pathogens. Treatment with intravenous cotrimoxazole associated with imipenem and amikacin was initiated for three weeks followed by oral cotrimoxazole for a further nine months. The patient's symptoms and alveolar consolidation on CT scan improved. During 2007, his respiratory condition worsened and his FEV(1) declined from 50 to 26 % predicted. His pneumothorax recurred. He had chronic colonization with P. aeruginosa and was on the list for lung transplantation. Nocardia, a Gram positive bacillus, causes mainly pulmonary infection, usually in the context of immune suppression. The most frequent species is N. asteroides. In CF, very few cases have been reported; almost always N. asteroides, but exceptionally N. farcinica. In CF patients with worsening pulmonary condition, Nocardia should be considered, as well as other unusual pathogens.
Published: 2010
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24. Late-Onset Ventilator-Associated Pneumonia in Nontrauma Intensive Care Unit Patients

Author: Sonia Isslame, Yves Le Tulzo, R. Thomas, Sylvain Salomon, Sophie Marqué, Sylvain Lavoué, Nicolas Barbarot, Christophe Camus, Arnaud Gacouin, and Pierre-Yves Donnio
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Population, Risk Assessment, Severity of Illness Index, law.invention, Enteral Nutrition, Risk Factors, law, Intensive care, Internal medicine, Intubation, Intratracheal, Odds Ratio, medicine, Humans, Prospective Studies, Simplified Acute Physiology Score, education, Prospective cohort study, Aged, Mechanical ventilation, Respiratory Distress Syndrome, education.field_of_study, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Equipment Design, Odds ratio, Middle Aged, medicine.disease, Respiration, Artificial, Intensive care unit, respiratory tract diseases, Surgery, Intensive Care Units, Logistic Models, Anesthesiology and Pain Medicine, Chest Tubes, Hospital Bed Capacity, under 100, Multivariate Analysis, Female, business
Abstract: BACKGROUND: Most studies designed to determine the factors associated with the acquisition of late-onset ventilator-associated pneumonia (VAP) were performed in critically ill trauma patients. The impact of enteral nutrition (EN) on the risk of acquiring VAP has been discussed. In this study, we assessed factors associated with late-onset VAP in nontrauma patients and determined whether nutrition provided early was associated with development of late-onset VAP in this population. METHODS: We performed a prospective observational cohort study in a 21-bed polyvalent intensive care unit in a university hospital. RESULTS: Three hundred sixty-one intubated adult patients with a duration of mechanical ventilation (MV) of 6 days or more were admitted over a 28-mo period. Late-onset VAP was confirmed in 76 patients (21%) by the presence of at least one microorganism at a concentration >or=10(4) colony-forming units/mL on the bronchoalveolar lavage. Gram-negative bacilli represented 75% and Staphylococcus aureus 21% of recovered organisms. Factors independently associated with late-onset VAP by multivariate analysis included a high simplified acute physiology score II score (odds ratio: 1.021; 95% confidence interval [CI]: 1.005-1.038; P = 0.01), development of acute respiratory distress syndrome during the first 5 days of MV (odds ratio: 1.98; 95% CI: 1.05-3.67; P = 0.04), and size of the endotracheal tube >or=7.5 (odds ratio: 2.06; 95% CI: 1.88-3.90; P = 0.03). EN started within 48 h of MV onset was not associated with a higher risk for late-onset VAP. CONCLUSION: In our nontrauma patient population, early EN was not associated with development of late-onset VAP. In this population, severity of the disease during the first 5 days of MV seemed to be associated with late-onset VAP. In addition, our results suggest that the risk of late-onset VAP is higher in patients with a tube size >or=7.5 than in patients with a tube size
Published: 2009
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25. At-risk drinkers are at higher risk to acquire a bacterial infection during an intensive care unit stay than abstinent or moderate drinkers*

Author: Anne-Claire Volatron, R. Thomas, Christophe Camus, Nicolas Barbarot, Yves Le Tulzo, Arnaud Gacouin, François Legay, and Pierre-Yves Donnio
Subjects: Male, Risk, medicine.medical_specialty, Alcohol Drinking, Temperance, Critical Care and Intensive Care Medicine, law.invention, Cohort Studies, Postoperative Complications, law, Intensive care, medicine, Humans, Hospital Mortality, Prospective Studies, Risk factor, Intensive care medicine, Prospective cohort study, APACHE, Aged, Cross Infection, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Bacterial Infections, Length of Stay, Middle Aged, medicine.disease, Intensive care unit, Liver Transplantation, respiratory tract diseases, Alcoholism, Intensive Care Units, Pneumonia, Cohort, Female, France, business, Cohort study
Abstract: To determine whether excessive alcohol consumption increases the risk for intensive care unit (ICU)-acquired bacterial infection, especially ventilator-associated pneumonia (VAP), in nontrauma patients.Prospective observational cohort study.A 21-bed polyvalent ICU in a university hospital.A total of 358 adult patients admitted over a 1-yr period who had an ICU stayor = 3 days and in whom alcohol consumption could be assessed.None. MEASUREMENTS AND MEAN RESULTS: Thirty-one percent of the patients (111 of 358) were identified as at-risk drinkers according to the National Institute on Alcohol Abuse and Alcoholism criteria. Among these, 61 had a daily intake of five or more drinks per day and 73 had Simplified Michigan Alcohol Short Test scoresor = 3. ICU-acquired bacterial infections were diagnosed in 88 patients, and 69 patients had one or more VAPs. Forty (36%) at-risk drinkers acquired bacterial infections vs. 48 (19%) not-at-risk drinkers (p.001). Among at-risk drinkers, the proportion of patients who developed bacterial infection was higher in at-risk drinkers consuming five or more drinks per day compared with at-risk drinkers consuming fewer than five drinks per day (p = .048). After adjustment for age, gender, Simplified Acute Physiology Score II, length of hospital stay before ICU admission, prior antibiotic administration within 24 hrs before ICU admission, type of admission, immunosuppression, duration of mechanical ventilation, and central venous and urinary catheter exposure, at-risk drinking remained significantly associated with the acquisition of bacterial infection at any site (hazard ratio 1.92; 95% confidence interval, 1.17-3.14; p = .009) and of VAP (hazard ratio 1.76; 95% confidence interval, 1.05-3.06; p = .04).At-risk drinking was a significant risk factor for acquisition of ICU-acquired bacterial infection.
Published: 2008
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26. Molecular and Epidemiological Evidence for Spread of Multiresistant Methicillin-Susceptible Staphylococcus aureus Strains in Hospitals

Author: Nathalie Wilhelm, Michel Cormier, Christèle Kervégant, Frédéric Fevrier, Alain Le Coustumier, Pierre-Yves Donnio, Marie Dehem, Nathalie Lafforgue, Pablo Bifani, and Anne-Lise Gautier-Lerestif
Subjects: clone (Java method), Staphylococcus aureus, Micrococcaceae, Microbial Sensitivity Tests, Biology, medicine.disease_cause, Polymerase Chain Reaction, Microbiology, Methicillin, Bacterial Proteins, Mechanisms of Resistance, Drug Resistance, Multiple, Bacterial, medicine, Humans, Penicillin-Binding Proteins, Pharmacology (medical), Pharmacology, Cross Infection, Molecular Epidemiology, Geography, Models, Genetic, Molecular epidemiology, SCCmec, respiratory system, Staphylococcal Infections, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Virology, Bacterial Typing Techniques, Electrophoresis, Gel, Pulsed-Field, Infectious Diseases, Genes, Bacterial, Multilocus sequence typing, France, Methicillin Susceptible Staphylococcus Aureus, Bacteria
Abstract: The excision of the staphylococcal chromosomal cassette mec (SCC mec ) from methicillin-resistant Staphylococcus aureus (MRSA) strains results in methicillin-susceptible S. aureus (MSSA) strains. In order to determine the proportion and diversity of multidrug-resistant MSSA (MR-MSSA) strains derived from MRSA strains, 247 mecA -negative isolates recovered in 60 French hospitals between 2002 and 2004 were characterized. The spa types of all strains were determined, and a subset of the strains ( n = 30) was further genotyped by multilocus sequence typing. The IDI-MRSA assay was used to test the isolates for the presence of the SCC mec element, which was detected in 68% of all isolates analyzed. Molecular analysis of the samples suggested that 92% of the MR-MSSA isolates were derived from MRSA clones of diverse genetic backgrounds, of which the clone of sequence type 8 and SCC mec type IV A accounted for most of the samples. High variations in incidence data and differences in the molecular characteristics of the isolates from one hospital to another indicate that the emergence of MR-MSSA resulted from independent SCC mec excisions from epidemic MRSA isolates, as well as the diffusion of methicillin-susceptible strains after the loss of SCC mec . MR-MSSA could constitute a useful model for the study of the respective genetic and environmental factors involved in the dissemination of S. aureus in hospitals.
Published: 2007
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27. La PCR en temps réel : principe et application en infectiologie

Author: Vanessa Mathys, M. Dehem, Véronique Fontaine, A. Le Coustoumier, P. Bifani, F. Février, Philippe Lefèvre, and Pierre-Yves Donnio
Subjects: Infectious Diseases, Philosophy, Pharmacology (medical), Humanities
Abstract: Resume Objectifs La reaction de polymerisation en chaine en temps reel, ou quantitative, represente une methode rapide, sensible et specifique pour la mise en evidence d’agents pathogenes. Methodes La fluorescence est utilisee pour mesurer l’accumulation des produits de la reaction de polymerisation en chaine apres chacun de ses cycles. Les mesures de fluorescence permettent d’extrapoler la quantite d’ADN cible present dans l’echantillon avant l’amplification ; la detection et la quantification sont ainsi obtenues dans un meme test. Les limites de detection sont habituellement de l’ordre du femtogramme pour de l’ADN purifie d’agent pathogene et du picogramme pour de l’ADN d’agent pathogene dans un echantillon. Applications La reaction de polymerisation en chaine en temps reel est deja consideree comme un outil valable pour les etudes d’epidemiologie moleculaire, la detection d’agents pathogenes emergents et la mise en evidence de resistances aux antibiotiques. Dans cette revue, nous decrivons quatre des principales techniques utilisees pour la detection et la quantification en temps reel. Nous abordons aussi les applications actuelles de la reaction de polymerisation en chaine en temps reel pour la detection de divers agents pathogenes et les points a considerer pour le developpement de nouveaux tests.
Published: 2007
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28. The Antibacterial Activity of Tramadol Against Bacteria Associated with Infectious Complications After Local or Regional Anesthesia

Author: Martine Bonnaure-Mallet, Jean-Marie Vo Van, Martine Repère, Anne Jolivet-Gougeon, Pierre-Yves Donnio, Zohreh Tamanai-Shacoori, and Valliollah Shacoori
Subjects: Staphylococcus aureus, Time Factors, medicine.drug_class, Analgesic, Microbial Sensitivity Tests, Pharmacology, medicine.disease_cause, Postoperative Complications, Anesthesia, Conduction, Staphylococcus epidermidis, Medicine, Local anesthesia, Tramadol, Antibacterial agent, Dose-Response Relationship, Drug, biology, business.industry, Local anesthetic, Bacterial Infections, biology.organism_classification, Anti-Bacterial Agents, Anesthesiology and Pain Medicine, Anesthesia, Pseudomonas aeruginosa, Antibacterial activity, business, Anesthesia, Local, medicine.drug
Abstract: BACKGROUND: Tramadol is a synthetic analog of codeine with opioid and local anesthetic properties. It is used as a central-acting analgesic, and recently, in subcutaneous or intradermal injections, as a local anesthetic. We investigated in vitro the antibacterial activity of tramadol in the absence of any local anesthetics against Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa pathogens that can cause infectious complications after local or regional anesthesia. METHODS: Bacterial cultures were grown for 18 h, diluted in sterile physiological saline, and incubated for 6 or 24 h at 37°C with 6.25, 12.5, or 25 mg/mL tramadol. The mixtures were then plated onto blood agar and colony counts were recorded after 24 h incubation at 37°C. RESULTS: Tramadol had bactericidal activity against E. coli and S. epidermidis compared with controls: at 25 mg/mL fo r6ho r at12.5 mg/mL for 24 h, tramadol decreased by approximately 7 log10 (P 0.001) the colony counts of E. coli (100% kill). Similar results were obtained with S. epidermidis, with approximately 6 log10 reduction (100% kill) when tramadol was used at 25 mg/mL for 24 h (P 0.001). The antibacterial effect of 25 mg/mL tramadol was lower against S. aureus and P. aeruginosa, reducing the growth of these strains by approximately 3log10 after 24 h (P 0.001). CONCLUSIONS: Tramadol has dose- and time-dependent bactericidal activity against E. coli and S. epidermidis, as well as antibacterial activity against S. aureus and P. aeruginosa. The antibacterial properties of tramadol may be useful for reducing the risk of bacterial infection after local or regional anesthesia. (Anesth Analg 2007;105:524‐7)
Published: 2007
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29. Factors associated with multidrug-resistant bacteria in secondary peritonitis: impact on antibiotic therapy

Author: Philippe Seguin, C. Chanavaz, Bruno Laviolle, Pierre-Yves Donnio, Anne-Lise Gautier-Lerestif, Yannick Mallédant, and Jean-Pierre Campion
Subjects: Adult, Microbiology (medical), medicine.medical_specialty, Antibiotic resistance, Antimicrobial susceptibility, Peritonitis, Risk Factors, Drug Resistance, Multiple, Bacterial, Internal medicine, Antibiotic therapy, medicine, Humans, Prospective Studies, peritonitis, risk-factors, Intensive care medicine, Aged, Cross Infection, therapy, Univariate analysis, biology, business.industry, Incidence, multiresistance, General Medicine, Middle Aged, biology.organism_classification, medicine.disease, Antimicrobial, Anti-Bacterial Agents, Community-Acquired Infections, Infectious Diseases, Multidrug resistant bacteria, business, Secondary Peritonitis, Bacteria
Abstract: Secondary peritonitis includes community-acquired and nosocomial peritonitis. These intra-abdominal infections have a common pathogenesis but some microbiological differences, particularly with respect to the type of bacteria recovered and the level of antimicrobial susceptibility. This report describes a prospective observational study of 93 consecutive patients with secondary peritonitis during an 11-month period. Community-acquired peritonitis accounted for 44 cases and nosocomial peritonitis for 49 cases (post-operative in 35 cases). Fifteen multidrug-resistant (MDR) bacteria were recovered from 14 patients. In univariate analysis, the presence of MDR bacteria was associated significantly with pre-operative and total hospital lengths of stay, previous use of antimicrobial therapy, and post-operative antimicrobial therapy duration and modifications. A 5-day cut-off in length of hospital stay had the best specificity (58%) and sensitivity (93%) for predicting whether MDR bacteria were present. In multivariate analysis, only a composite variable associating pre-operative hospital length of stay and previous use of antimicrobial therapy was a significant independent risk-factor for infection with MDR bacteria. In conclusion, knowledge of these two factors may provide a more rational basis for selecting initial antimicrobial therapy for patients with secondary peritonitis.
Published: 2006
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30. Changes in staphylococcal cassette chromosome type and antibiotic resistance profile in methicillin-resistant Staphylococcus aureus isolates from a French hospital over an 11 year period

Author: Nathalie Lafforgue, Pierre-Yves Donnio, Laure Preney, Anne-Lise Gautier-Lerestif, and Jean-Loup Avril
Subjects: Microbiology (medical), Staphylococcus aureus, medicine.drug_class, Staphylococcus, Antibiotics, Coccus, Biology, medicine.disease_cause, Microbiology, Antibiotic resistance, Drug Resistance, Bacterial, medicine, Pulsed-field gel electrophoresis, Humans, Pharmacology (medical), Typing, Antibacterial agent, Pharmacology, Reverse Transcriptase Polymerase Chain Reaction, Chromosomes, Bacterial, Staphylococcal Infections, Methicillin-resistant Staphylococcus aureus, Virology, Electrophoresis, Gel, Pulsed-Field, stomatognathic diseases, Infectious Diseases, Methicillin Resistance, France
Abstract: Background: In this study, we investigated the relationship between changes in antibiotic resistance and distribution of staphylococcal cassette chromosome (SCC) types amongst methicillin-resistant Staphylo- coccus aureus (MRSA) isolates expressing the most frequently encountered profiles of antibiotic resistance over an 11 year period in the University Hospital of Rennes, France. Methods: Antibiotic susceptibilities were determined by agar diffusion. SCC typing was performed using PCR. PFGE demonstrated that isolates were phylogenetically related. Results: Fourteen profiles of antibiotic resistance were defined among MRSA isolates. For each resistance profile, only one SCC type was associated: four patterns corresponded to SCC type I or IA, nine to SCC type IV or IVA, and none to types II and III. One was not typed. PFGE indicated that isolates with SCC type I or IA belong to a single genetic lineage, which also includes most of the epidemic isolates, which carry SCC type IVA. In contrast to type I or IA, isolates with SCC type IV or IVA were found to be associated with several differ- ent PFGE clusters, although not all of these represent epidemic isolates. Conclusions: During the course of the study, the spectrum of antibiotic resistance in MRSA isolates decreased. This occurred due to the emergence of strains with SCC type IV or IVA, which are susceptible to more antibiotics than type I or IA strains. The greater prevalence of such isolates could not be linked conclu- sively to the presence of SCC type IV or IVA, or to one particular PFGE cluster.
Published: 2004
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31. Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis-Prospective Cohort Study

Author: Richard Watkin, Pierre-Edouard Fournier, David R. Murdoch, Yoav Keynan, Florent Chevalier, Tania Mara Varejão Strabelli, Imran Zainal Abidin, Denis Spelman, Roger Bedimo, Jeffrey J. Post, Francesc Marco, Alan C Street, Claudio Querido Fortes, Francisco Nacinovich, Antonio Goglio, Stephen T. Chambers, Fredy Suter, Claire Sorel, Alessandro Tebini, Phillip Jones, Robyn Dever, Emilio Bouza, G. Ralph Corey, Karina Kennedy, Alfredo José Mansur, Nigel Raymond, Guillermina Fita, Martin E. Stryjewski, Joan R. Guma, Asunción Moreno, John W. Baddley, Johnson Francis, Magnus Johansson, José H. Casabé, Margaret M. Hannan, Krishnan Venugopal, Thanh Doco-Lecompte, Jacob Strahilevitz, Annibale Raglio, Carl Neuerburg, Vichai Senthong, Cass Hansa, Ana Pangerčić, Adina Ionac, Vladimir Krajinović, Christine Selton-Suty, Marwa Mishaal, Mateja Logar, Erwan Donal, Elena Mylona, Clara Weksler, Joseph Di Persio, Antoine Jeu, Pilar Tornos, Konstantinos Papanicolaou, François Vandenesch, Tom S.J. Elliott, Jan van der Meer, Patricia Muñoz, Regina Aparecida De Medeiros Tranchesi, Lathi Nair, Dannah Wray, Arnold S. Bayer, Pamela Konecny, David L. Gordon, Gilbert Habib, Armênio Costa Guimarães, Alberto Fica, Mercedes Marín, Francesco Giuseppe De Rosa, Marian Jones-Richmond, Marcelo Luiz Campos Vieira, Max Grinberg, Luis Afonso, Khaula Baloch, Pimchitra Pachirat, Anna Lisa Crowley, Marie Line Erpelding, Miguel Pedromingo, Daniel W. Mudrick, John Harkness, Barbora Zaloudikova, Christophe Tribouilloy, Cristina Garcia-de-la-Maria, Kerry Read, Athanasios Skoutelis, Marco Rizzi, Michael J. Rybak, Ioannis Deliolanis, Stuart Dickerman, Carol A. Kauffman, John L Klein, Suzanne Ryan, Christopher W. Woods, Gautam Sharma, Silvia Magri, Susannah J. Eykyn, Veronica Ravasio, Auristela De Oliveira Ramos, J. Leroy, Bruno Baršić, Burabha Pussadhamma, Jameela Edathodu, Franck Thuny, Eduan Deetlefs, Yvette Bernard, Rinaldo Focaccia Siciliano, Lito E. Papanicolas, Salvador Ninot, Nuria Fernández-Hidalgo, Zaniab Samad, Arístides de Alarcón, Neijla Aissa, Claudia Cortés, Thomas L. Holland, Tina Harding, Tania A. Baban, Irene Rovira, Ethan Rubinstein, Jorge Solis, Maya Korem, Giampiero Carosi, Marie Francoise Tripodi, Andrew Wang, Orathai Pachirat, Davide Forno, Ana Cláudia Passos De Brito, Catherine Campagnac, Anna L. Casey, Ana del Río, Gail E. Peterson, Carlos Falces, Christopher H. Cabell, François Delahaye, Emanuele Durante-Mangoni, Mattucci Irene, Despina Kotsanas, Javier Bermejo, Pierre Tattevin, Richard Lawrence, John Pyros, José M. Gatell, Jérémie Violette, Igor Rudez, Peter A. Lambert, Jean Paul Casalta, Jiri Pol, Kulichenko Vadim, Pablo Fernandez Oses, Ximena Castañeda, José Ramírez, Rita Trinchero, Sarah Israel, Mariangela Lattanzio, Eugene Athan, Arthur J. Morris, Bahram Mazaheri, Leeanne Grigg, Mohamad Yasmine, Adriana Andrade, Owen Harris, Syahidah Syed Tamin, Adolf W. Karchmer, Joan Pericas, Manica Mueller-Premru, Ozerecky Kirill, Eduardo Rivera Martínez, Christina Eyton, Josip Vincelj, Marisa Santos, Marisa Sanchez, David T. Durack, Dan Gilon, Marcelo Goulart Paiva, G. Ferraiuoli, Susanna Cuccurullo, Chipigina Ns, Lars Olaison, Patrick Plésiat, Michael P. Feneley, Amy B. Stancoven, Efthymia Giannitsioti, Cristiane da Cruz Lamas, Silvia Kogan, Kevin J. Anstrom, Manuel Almela, Liliana Clara, Stamatios Lerakis, Massimo Imazio, Rainer Gattringer, Javier Altclas, Wilma F. Golebiovski, Cristian Mornos, Damon P. Eisen, Pierre-Yves Donnio, Bernat Font, Eric Alestig, Liana Signorini, Sandra Braun Jones, Pamela S. Douglas, Helen Giamarellou, Gabriel Israel Soto Nieto, Tatjana Lejko-Zupanc, Benito Almirante, Dan Rusinaru, Anita Commerford, Yolanda Armero, Donald P. Levine, Mukesh Patel, M. Azqueta, Mpiko Ntsekhe, Phillipe Moreillon, Matthieu Revest, Adriana Sucari, Ashour Zainab, Olga Paniara, Víctor González-Ramallo, Miguel Ángel García Fernández, Ricardo Parra, Christoph Naber, Hector Bonilla, John P. Hurley, Rodrigo Montagna Mella, James A. Karlowsky, Lisa L. Steed, Armelle Delahaye, Marta Rodríguez-Créixems, José M. Miró, Enrico Cecchi, Enrico Ragone, Catherine Chirouze, J. Roda, David Holland, Marta Sitges, Luh Nah Lum, Patricia García, Thomas Redick, Theresa Kulman, Paul A. Pappas, Carlos Paré, Riccardo Utili, Stefan Dragulescu, Robert Cantey, Paolo Grossi, Vivian H. Chu, Porl Reinbott, Bruno Hoen, Amani El Kholy, Judy Stafford, Tomáš Freiberger, Hussien Rizk, Corentine Alauzet, Ricardo Ronderos, Ru San Tan, Christian Michelet, Suzanne F. Bradley, R. Casillo, Thomas Tsaganos, M. Cereceda, Laura A. Drew, Magid Halim, François Alla, Tahaniyat Lalani, Carlos A. Mestres, David Rees, Sara Jane Salstrom, O. M. Butkevich, Patrick J. Commerford, Ignasi Anguera, Franz Wiesbauer, Ulrika Snygg-Martin, Lawrence P. Park, Didier Raoult, Tony M. Korman, Giovanni Dialetto, Zeina Kanafani, Antonio Toniolo, Suzana Bukovski, Christy C. Dixon, Tatiana Vinogradova, Jorge Thierer, Souha S. Kanj, Vinod Thomas, Daniel J. Sexton, Vance G. Fowler, Andrew M. Morris, S. Athanasia, Ren Tan, Carlos Cervera, Chirouze, C, Alla, F, Fowler VG, Jr, Sexton, Dj, Corey, Gr, Chu, Vh, Wang, A, Erpelding, Ml, DURANTE MANGONI, Emanuele, Fernández Hidalgo, N, Giannitsioti, E, Hannan, Mm, Lejko Zupanc, T, Miró, Jm, Muñoz, P, Murdoch, Dr, Tattevin, P, Tribouilloy, C, Hoen, B., Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Duke University Medical Center, Monaldi Hospital, Mater Hospitals, University Medical Center Ljubljana, Institut d'Investigacions Biomèdiques August Pi i Sunyer ( IDIBAPS ), Universitat de Barcelona ( UB ), Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] ( UCM ), Department of Pathology, University of Otago, Microbiology Unit, Canterbury Health Laboratories, Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne ( UPJV ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of Otago [Dunedin, Nouvelle-Zélande], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Service des maladies infectieuses et réanimation médicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: Male, diagnosis, International Cooperation, Medizin, blood culture, Cohort Studies, surgery, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Prospective Studies, Prospective cohort study, Endocarditis, Mortality rate, heart valve, Middle Aged, Staphylococcal Infections, Heart Valves, prosthetic valve, 3. Good health, Treatment Outcome, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infective endocarditis, Cohort, endocarditis, Female, Cohort study, Adult, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Endocarditis, Staphylococcus aureus, heart valve, combined treatment, blood culture, clinical microbiology, etiology, diagnosis, Prosthesis-Related Infections, etiology, Staphylococcal infections, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, 1-year mortality, Prosthetic valve, Surgery, Aged, Humans, Survival Analysis, medicine, combined treatment, clinical microbiology, Proportional hazards model, business.industry, medicine.disease, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background - The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods - Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results - EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions - In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.
Published: 2015
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32. Influence du fond génétique des souches de Staphylococcus aureus lors de l’étude de leur virulence sur le modèle Galleria mellonella

Author: S. Hüssler, V. Le Mabecque, Pierre-Yves Donnio, R. Lecomte, and J. Caillon
Subjects: Infectious Diseases
Abstract: Introduction Devant l’importance des infections a Staphylococcus aureus en pathologie humaine, il est essentiel de mieux comprendre les mecanismes impliques dans la virulence. L’impact du fond genetique des souches de S. aureus pour l’etude de la virulence reste a eclaircir. De meme le choix du modele in vivo reste delicat car il existe des controverses a propos du choix de l’animal d’experience pour l’etude de la virulence de S. aureus. La larve de la fausse teigne de la cire Galleria mellonella est un modele recent de screening pour l’etude de la virulence. Dans cette perspective, l’objectif de notre etude etait d’etudier l’influence du fond genetique des souches de S. aureus sur la virulence dans le modele Galleria mellonella. Materiels et methodes La caracterisation des clones de 46 souches de S. aureus sensibles et resistantes a la meticilline (SASM et SARM) isolees de bacteriemies a ete realisee par MLST (multilocus sequence typing) et par typage spa. Vingt souches de differents sequence types (ST) : 8 ST8 (4 SASM et 4 SARM), 8 ST5 (4 SASM et 4 SARM) et 4 SASM ST398 ont ete selectionnees et caracterisees : typage agr, cassette SCCmec, recherche de facteurs de virulence. L’impact du fond genetique de ces 20 souches a ete etudie in vivo dans le modele Galleria mellonella. Les larves infectees par differents inocula (104 UFC/mL, 105 UFC/mL, 106 UFC/mL) ont ete suivies sur 6 jours. Resultats L’inoculum a 106 UFC/mL a ete retenu pour comparer la virulence des souches. Chez les SASM, le clone ST8 etait le plus virulent. La difference de virulence etait significative par rapport au S. aureus du clone ST5 (p = 0,0026) qui etait moins virulent. Le clone ST398 avait une virulence intermediaire. Chez les SARM, le clone ST8 avait une virulence superieure, compare au clone ST5 mais la difference de virulence n’etait pas significative. Conclusion Notre etude met en evidence l’impact du fond genetique des isolats de S. aureus sur leur virulence dans le modele Galleria mellonella. Elle demontre l’importance de connaitre le fond genetique des souches de S. aureus utilisees dans l’etude de la virulence. Cette etude doit etre confirmee sur des modeles plus evolues comme la pneumonie de la souris ou l’endocardite chez le rat ou le lapin.
Published: 2017
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33. Failure of antibiotic-lock technique using daptomycin for subcutaneous injection ports in a patient on home parenteral nutrition

Author: Olivier Tribut, Cédric Arvieux, Matthieu Revest, Pierre-Yves Donnio, Pierre Tattevin, Christian Michelet, Thomas Guimard, Brébion, Alice, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hôpital Pontchaillou, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Antibiotics, MESH: Daptomycin, Antibiotic-lock technique, chemistry.chemical_compound, Subcutaneous injection, Catheters, Indwelling, 0302 clinical medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Antibacterial agent, 0303 health sciences, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Staphylococcus spp, Lipopeptide, Middle Aged, Catheter-Related Infections, Anti-Bacterial Agents, 3. Good health, Infectious Diseases, Female, Parenteral Nutrition, Home, Catheter related infections, medicine.drug, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, Injections, Subcutaneous, MESH: Catheters, Indwelling, 03 medical and health sciences, Daptomycin, MESH: Anti-Bacterial Agents, medicine, Humans, Antibiotic lock, Home parenteral nutrition, MESH: Humans, 030306 microbiology, business.industry, MESH: Injections, Subcutaneous, MESH: Catheter-Related Infections, Surgery, Parenteral nutrition, chemistry, MESH: Parenteral Nutrition, Home, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2010
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34. Multiple Brain Abscesses Caused by Pseudomonas luteola

Author: Patrick Pladys, Pierre Bétrémieux, Pierre-Yves Donnio, Jérémie Violette, Anne Gaschet, Charlotte Engrand, Pierre Tattevin, Anne Jolivet-Gougeon, and Caroline Piau
Subjects: Microbiology (medical), biology, medicine.drug_class, business.industry, Antibiotics, biology.organism_classification, Meropenem, Dysphagia, Microbiology, Ciprofloxacin, Metronidazole, Infectious Diseases, Multiple Brain Abscesses, Pediatrics, Perinatology and Child Health, medicine, Pseudomonas luteola, medicine.symptom, business, medicine.drug, Beta lactam antibiotics
Published: 2009
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35. Comparative antimicrobial resistance and genomic diversity of Escherichia coli isolated from urinary tract infections in the community and in hospitals

Author: J. L. Avril, M.F. Travert, M. Perrin, C. Heurtin-Lecorre, and Pierre-Yves Donnio
Subjects: DNA, Bacterial, Microbiology (medical), medicine.drug_class, Antibiotics, Biology, medicine.disease_cause, Microbiology, Antibiotic resistance, Genotype, Escherichia coli, medicine, Pulsed-field gel electrophoresis, Cluster Analysis, Humans, Escherichia coli Infections, Antibacterial agent, Cross Infection, Drug Resistance, Microbial, General Medicine, biology.organism_classification, Enterobacteriaceae, Anti-Bacterial Agents, Electrophoresis, Gel, Pulsed-Field, Community-Acquired Infections, Infectious Diseases, Urinary Tract Infections, Bacteria
Abstract: Well-defined community- and nosocomially-acquired isolates of Escherichia coli responsible for urinary tract infections were studied for their resistance to β-lactams, quinolones, and co-trimoxazole, antibiotics widely used for treatment of urinary infections. For each strain, an antibiogram was obtained using the Vitek ® automat, which estimates the minimal inhibitory concentrations of various drugs. Nosocomial strains were significantly more amoxycillin-resistant than community strains ( P =0·01) and were also significantly more resistant to co-trimoxazole ( P =0·025) and first generation quinolones ( P =0·02) than the latter. To determine whether this was due to transmission of strains within the hospital, DNA restriction patterns, established using Xba I enzyme and separation by pulsed-field gel electrophoresis, were compared. Extreme genomic diversity was found among both the community and nosocomial strains. The increased frequency of resistance among nosocomial strains is thus not due to transmission of resistant hospital strains but probably results from the selection of resistant strains from the endogenous flora of patients.
Published: 1999
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36. L'hémoculture: un examen en apparence simple

Author: J.-L. Avril, Pierre-Yves Donnio, M. Perrin, and Patrick Boiron
Subjects: Infectious Diseases, media_common.quotation_subject, Art, Humanities, media_common
Abstract: Resume La detection de la presence de microorganismes dans le sang a une importance clinique considerable. Au cours de la derniere decennie, des avancees technologiques importantes ont ete realisees dans le domaine des hemocultures, notamment avec la mise au point d'automates detectant la croissance en continu. Les procedures d'hemocultures sont maintenant fondees sur des bases scientifiques solides. Cette revue generale souligne l'importance de l'antisepsie cutanee, du nombre de prelevements et du volume de sang a inoculer dans les flacons, des milieux de culture et des conditions d'incubation requises pour les germes banals ou pour les microorganismes emergents a croissance delicate. Les procedures innovantes contribuent a ameliorer la qualite et la precocite de la detection des microorganismes. Neanmoins, les resultats d'hemocultures positives doivent toujours etre interpretes pour distinguer les contaminants des pathogenes.
Published: 1999
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37. A portrait of Staphylococcus aureus from the other side of the Mediterranean Sea: molecular characteristics of isolates from Western Algeria

Author: F. Itim, P. Gautier, A. Cady, Pierre-Yves Donnio, and S. N. Bekkhoucha
Subjects: Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Micrococcaceae, Genotype, Bacterial Toxins, Exotoxins, Drug resistance, medicine.disease_cause, Genetic analysis, Microbiology, Medical microbiology, Bacterial Proteins, Leukocidins, Molecular genetics, Prevalence, medicine, Cluster Analysis, Humans, Genetic diversity, biology, SCCmec, Sequence Analysis, DNA, General Medicine, Staphylococcal Infections, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, DNA Fingerprinting, Hospitals, Bacterial Typing Techniques, Infectious Diseases, Algeria
Abstract: Algerian hospitals have experienced a dramatic increase in methicillin-resistant Staphylococcus aureus (MRSA) prevalence in recent years. To investigate this phenomenon, we have determined molecular characteristics of 61 methicillin-resistant or -susceptible strains isolated between 2003 and 2007 in Oran Hospital. Susceptible isolates were related to diverse genetic backgrounds, of which clone with sequence type (ST) 8 accounted for most of the samples. Resistance to methicillin was almost limited to two international spreading clones; the most frequent, ST80, contained isolates producing Panton-Valentine leukocidine, with SCCmec type IV. The increase of MRSA prevalence observed in Western Algeria, in outpatients as well as in hospitalized patients, is linked to dissemination of ST80 strains usually considered as community-acquired MRSA.
Published: 2008
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38. Increasing Incidence and Comparison of Nalidixic Acid-Resistant Salmonella enterica subsp. enterica Serotype Typhimurium Isolates from Humans and Animals

Author: Pierre-Yves Donnio, Jean-Loup Avril, Monique Perrin, Christine Heurtin-Le Corre, and Marie-France Travert
Subjects: DNA, Bacterial, Microbiology (medical), Serotype, Nalidixic acid, Swine, medicine.drug_class, Microbial Sensitivity Tests, Drug resistance, Microbiology, Nalidixic Acid, Anti-Infective Agents, Gene Frequency, medicine, Animals, Antibacterial agent, biology, Salmonella enterica, Bacteriology, Drug Resistance, Microbial, Quinolone, biology.organism_classification, Virology, Electrophoresis, Gel, Pulsed-Field, Ciprofloxacin, DNA Topoisomerases, Type II, Mutation, Cattle, Salmonella enterica subsp. enterica, Chickens, Polymorphism, Restriction Fragment Length, medicine.drug
Abstract: We determined the resistance to quinolone of 309 Salmonella enterica subsp. enterica serotype Typhimurium strains isolated from humans and animals (cattle, pigs, or poultry) in 1995 or 1996. Nalidixic acid resistance increased from 8.5% in 1995 to 18.6% in 1996. The highest resistance levels correlated with a mutation at Ser-83 (or Asp-82). All strains remained ciprofloxacin susceptible. Human and animal isolates were compared by pulsed-field gel electrophoresis, and the banding patterns of the human isolates most closely matched those of the bovine isolates.
Published: 1999
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39. Comparaison des souches de Burkholderia cepaciaisolées dans une même unité de soins chez des sujets atteints de mucoviscidose

Author: P. Plessis, D. Tande, J. Tubert, Pierre-Yves Donnio, F. Autuly, M. Roussey, and J.L. Avril
Subjects: Ribotyping, Infectious Diseases, business.industry, Respiratory disease, medicine, medicine.disease, business, Molecular biology, Antibacterial agent
Abstract: Resume L'utilisation d'un milieu selectif pour l'isolement de Burkholderia (Pseudomonas) cepacia a conduit a la mise en evidence de la bacterie dans les secretions respiratoires de 4 patients suivis en 1993 par la Consultation Multidisciplinaire de Mucoviscidose du CHRU de Rennes. Une transmission inter-humaine etant suspectee, ces 4 souches ont ete ribotypees et comparees, entre elles, et avec 9 autres souches isolees dans 2 autres centres de surveillance et de traitement de la meme region. Onze ribotypes ont ete retrouves parmi les 13 souches etudiees. Les 4 souches isolees a Rennes avaient des profils differents, ce qui excluait une origine commune de la contamination.
Published: 1998
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40. Mycobacterium chelonae Pseudoepidemic Due to Contamination of Flexible Bronchoscopes

Author: Hervé Lena, E. Briens, Benoit Desrues, Pierre-Yves Donnio, Marie-Line Quinquenel, Françoise Riou, Philippe Delaval, Jeanie Kernec, and Chantal Belleguic
Subjects: Pulmonary and Respiratory Medicine, biology, business.industry, Medicine, Mycobacterium chelonae, Contamination, business, Flexible bronchoscopes, biology.organism_classification, Microbiology
Published: 1998
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41. Effect of oropharyngeal povidone-iodine preventive oral care on ventilator-associated pneumonia in severely brain-injured or cerebral hemorrhage patients: a multicenter, randomized controlled trial

Author: Philippe, Seguin, Bruno, Laviolle, Claire, Dahyot-Fizelier, Romain, Dumont, Benoit, Veber, Soizic, Gergaud, Karim, Asehnoune, Olivier, Mimoz, Pierre-Yves, Donnio, Eric, Bellissant, Yannick, Malledant, Eddy, Lebas, Foie, métabolismes et cancer, 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 ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes], Modélisations pharmacocinétiques-pharmacodynamiques pour un meilleur usage des anti-infectieux, Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anesthésie-Réanimation [CHU Limoges], CHU Limoges, Service de réanimation médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'anesthésie et réanimation chirurgicale, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Unité de contrôle infectieux, Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Study of Povidone Iodine to Reduce Pulmonary Infection in Head Trauma and Cerebral Hemorrhage Patients (SPIRIT) ICU Study and AtlanRéa Groups., 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 ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Poitiers, Hôpital Charles Nicolle [Rouen]-CHU Rouen, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, povidone-iodine, Population, Oropharynx, intensive care medicine, Critical Care and Intensive Care Medicine, Placebo, 03 medical and health sciences, ventilator-associated pneumonia, 0302 clinical medicine, Double-Blind Method, prevention, Internal medicine, Intensive care, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, education, Cerebral Hemorrhage, Mechanical ventilation, education.field_of_study, business.industry, oral care, Respiratory disease, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, 030208 emergency & critical care medicine, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Respiration, Artificial, 3. Good health, Surgery, Intensive Care Units, Pneumonia, Brain Injuries, Anti-Infective Agents, Local, Female, business
Abstract: International audience; OBJECTIVE: To evaluate the efficacy and safety of oral care with povidone-iodine on the occurrence of ventilator-associated pneumonia in a high-risk population. DESIGN: A multicenter, placebo-controlled, randomized, double-blind, two-parallel-group trial performed between May 2008 and May 2011. SETTING: Six ICUs in France. PATIENTS: One hundred seventy-nine severely brain-injured patients (Glasgow Coma Scale ≤ 8) or cerebral hemorrhage expected to be mechanically ventilated for more than 24 hours. INTERVENTIONS: Participants were randomly assigned to receive oropharyngeal care with povidone-iodine (n = 91) or placebo (n = 88) six times daily until mechanical ventilation withdrawal. MEASUREMENTS AND MAIN RESULTS: Primary endpoint was the rate of ventilator-associated pneumonia. Secondary endpoint included the rates of ventilator-associated tracheobronchitis and acute respiratory distress syndrome and patient's outcome. The number of patients evaluable for the primary endpoint (preplanned modified intention-to-treat population) was 150 (78 in the povidone-iodine group, 72 in the placebo group). Ventilator-associated pneumonia occurred in 24 patients (31%) in the povidone-iodine group and 20 (28%) in the placebo group (relative risk, 1.11 [95% CI, 0.67-1.82]; p = 0.69). There was no significant difference between the two groups for ventilator-associated tracheobronchitis: eight patients (10%) in the povidone-iodine group and five patients (7%) in the placebo group (relative risk, 1.48 [95% CI, 0.51-4.31]; p = 0.47). Acute respiratory distress syndrome occurred in five patients in the povidone-iodine group but not in the placebo group (p = 0.06). There was no difference between groups for ICU and hospital lengths of stay, as well as ICU and 90-day mortality. CONCLUSIONS: There is no evidence to recommend oral care with povidone-iodine to prevent ventilator-associated pneumonia in high-risk patients. Furthermore, this strategy seems to increase the rate of acute respiratory distress syndrome.
Published: 2014
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42. Clostridium difficile infections: do we know the real dimensions of the problem?

Author: Christian Michelet, Matthieu Revest, Sylvie Buffet-Bataillon, Pierre Tattevin, Pierre-Yves Donnio, Fonction structure et inactivation d'ARN bactérien, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes]-Fonction, structure et inactivation d'ARN bactériens, 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 )-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 ), Unité de contrôle infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Microbiologie, Unité de maladies infectieuses, CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), 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 )-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 ), Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]-Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), and Coval, Nathalie
Subjects: genetic structures, polymerase chain reaction, Toxin B, Disease, Global Health, 0302 clinical medicine, Epidemiology, Pharmacology (medical), 030212 general & internal medicine, MESH: Incidence, Cross Infection, 0303 health sciences, Incidence, Diagnostic test, General Medicine, Clostridium difficile, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Clostridium difficile infections, Anti-Bacterial Agents, 3. Good health, Community-Acquired Infections, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, MESH: Diarrhea, Infectious Diseases, MESH: Community-Acquired Infections, Homogeneous, Diagnostic tests, Diarrhea, Microbiology (medical), medicine.medical_specialty, MESH: Clostridium Infections, Enzyme immunoassay, 03 medical and health sciences, Glutamate dehydrogenase, Antibiotic therapy, MESH: Anti-Bacterial Agents, medicine, Humans, Antibiotic use, Intensive care medicine, MESH: Clostridium difficile, MESH: Humans, Clostridioides difficile, 030306 microbiology, business.industry, MESH: Cross Infection, Surgery, Clostridium Infections, business, MESH: World Health
Abstract: International audience; Clostridium difficile infection (CDI) is the primary cause of nosocomial diarrhoea in industrialised countries, usually occurring as a complication of antibiotic therapy in elderly patients. Landmark events contributed to boosting interest in CDI over the last 10 years, including the emergence of unusually severe and recurrent CDI due to the NAP1/BI/027 strain, as well as reports suggesting that CDI is also significantly encountered in patients previously considered at no risk, such as community-acquired CDI in patients with no recent antibiotic use, or CDI during pregnancy. Despite this growing interest from the medical community, we do not know the real dimensions of the disease for the following reasons: (i) despite comprehensive guidelines published in Europe and in the USA, most laboratories still use diagnostic tests with suboptimal sensitivity as a 'rule-out' test, hence a significant proportion of CDIs remain undiagnosed; (ii) use of PCR as a stand-alone test by others will probably overestimate the real incidence of CDI and jeopardise any comparison between institutions with different diagnostic procedures; and (iii) transversal studies, with optimum design and diagnostic tests, are rapidly outdated due to the dramatic changes in CDI epidemiology that may occur from one year to another. To get an accurate picture of the real dimensions of the CDI issue, we need more systematic use of an adequate and homogeneous diagnostic strategy in the field as well as the implementation of continuous monitoring of CDI incidence through surveillance programmes.
Published: 2013
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43. Colonisation d'un cathéter par une bactérie produisant un pigment rosé appartenant au 'pink coccoid group' ou Roseomonas

Author: F. Autuly, P. Plessis, S. Rouzet-Gras, J.L. Avril, Pierre-Yves Donnio, and A. Gacouin
Subjects: Opportunistic pathogen, Infectious Diseases, Biology, Molecular biology, Roseomonas
Abstract: Resume Les auteurs rapportent l'isolement d'une bacterie pigmentee en rose sur un catheter chez une patiente atteinte d'insuffisance respiratoire chronique. La numeration selon la technique de Maki et coll. etait theoriquement significative. Neanmoins, cette souche a ete consideree comme colonisante et non responsable du syndrome febrile observe. Cette bacterie pigmentee etait constituee de bacilles a Gram negatif trapus, se disposant sous forme de “cocci en chainettes”, non fermentant, oxydase, catalase et urease positives. Elle etait resistante aux cephalosporines et a l'association trimethoprime + sulfamethoxazole. A l'occasion de cet isolement, nous envisageons les criteres d'identification biochimiques et de diagnostic differentiel des bacteries a Gram negatif aerobies pigmentees en rose. Selon les criteres de Wallace et coll. cette souche appartiendrait au groupe I des “pink coccoid group”. Le role pathogene de cette bacterie pigmentee n'est pas encore clair, cependant elle pourrait se comporter comme pathogene opportuniste.
Published: 1996
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44. CC9 Livestock-Associated Staphylococcus aureus Emerges in Bloodstream Infections in French Patients Unconnected With Animal Farming

Author: F. Grobost, Jacques Schrenzel, M. Archambault, M. F. Guillon, C. Denis, C. Neveu, F. Fongauffier, M. N. Bachelier, M. Boucher, N. Girard, F. Perigois, S. Watt, V. Chevereau, Pierre-Yves Donnio, Virginie Morange, P. Amirault, B. Cattier, Sandra C. dos Santos, O. Paba, P. Foloppe, D. Poitvin, C. Decreux, E. Morel-Desjardins, A. Roussin, P. Harriau, M. Prevost-Oussar, C. Hombrouck-Alet, A. Lepineux da Rocha, J. L. Graveron, C. de Gialluly, T. Gourdet, D. Jehanno, C. Fievre, C. Chandesris, G. Petit le Gouas, D. Imbault, B. Rousseau, C. Naudion, Anne-Sophie Valentin, R. Fournier-Hoock, Aline Berthelot, A. L. Lesimple, Nicole Girard, D. Ratovohery, Sophie Thiais, Xavier Bertrand, E. Morin, X. Louvier, F. Deperrois, Nathalie van der Mee-Marquet, V. Morange, A. Secher, D. Narbey, O. Laurent, G. Courouble, Cindy Lamamy, D. Bloc, Roland Quentin, Patrice Francois, M. C. Courtin, V. Michel, F. Guinard, M. J. Kourta, O. Lehiani, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Infectiologie et Santé Publique (UMR ISP), Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT), Service de bactériologie et d'hygiène hospitalière [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Genomic research lab, Geneva University Hospital (HUG), Laboratory of bacteriology, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut National de la Recherche Agronomique (INRA)-Université de Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-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), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Infectiologie et Santé Publique ( ISP ), Université de Tours-IFR136, CHRU Tours-CHU Trousseau [APHP], and Geneva University Hospital ( HUG )
Subjects: Microbiology (medical), Male, METHICILLIN-RESISTANT, Staphylococcus aureus, Livestock associated, Livestock, bloodstream infections, Operon, Virulence Factors, Virulence, Bacteremia, ANIMAL EXPOSURE, Biology, medicine.disease_cause, ST398, Microbiology, 03 medical and health sciences, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, CC9, Bloodstream infection, medicine, Animals, Humans, PIGS, Longitudinal Studies, MOLECULAR CHARACTERIZATION, 030304 developmental biology, Aged, Oligonucleotide Array Sequence Analysis, ddc:616, Aged, 80 and over, 0303 health sciences, 030306 microbiology, Microarray analysis techniques, STRAINS, Agriculture, Middle Aged, Staphylococcal Infections, 3. Good health, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Genes, Bacterial, France
Abstract: International audience; We report 4 bloodstream infections associated with CC9 agr type II Staphylococcus aureus in individuals without animal exposure. We demonstrate, by microarray analysis, the presence of egc cluster, fnbA, cap operon, lukS, set2, set12, splE, splD, sak, epiD, and can, genomic features associated with a high virulence potential in humans.
Published: 2013
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45. Analysis of prophages harbored by the human-adapted subpopulation of Staphylococcus aureus CC398

Author: Xavier Bertrand, Pierre-Yves Donnio, Jan Kluytmans, David Hernandez, Roland Quentin, Patrice Francois, Anne-Sophie Valentin, Nathalie van der Mee-Marquet, Anna-Rita Corvaglia, Myriam Girard, Service de bactériologie et d'hygiène hospitalière [Tours], CHRU Tours-CHU Trousseau [APHP], Réseau des Hygiénistes du Centre, CHRU Tours, Genomic Research Laboratory, Geneva University Hospital ( HUG ), Service d'Hygiène, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratory for Microbiology and Infection Control, Amphia Hospital, Microbiologie : Risques Infectieux, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Bactériologie et Hygiène Hospitalière, CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Geneva University Hospital (HUG), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Laboratoire de Bactériologie et Hygiène Hospitalière [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-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), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Medical Microbiology and Infection Prevention, and CCA - Disease profiling
Subjects: Microbiology (medical), Staphylococcus aureus, Livestock, Prophages, Virulence, Biology, medicine.disease_cause, Microbiology, 03 medical and health sciences, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Lysogenic cycle, Zoonoses, Drug Resistance, Bacterial, Genetics, medicine, Animals, Humans, Molecular Biology, Gene, Pathogen, Lysogeny, Ecology, Evolution, Behavior and Systematics, Prophage, 030304 developmental biology, Oligonucleotide Array Sequence Analysis, ddc:616, 0303 health sciences, Chi-Square Distribution, 030306 microbiology, Genetic transfer, Staphylococcal Infections, 3. Good health, Temperateness, Infectious Diseases, HEK293 Cells, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Host specificity, Sequence type 398
Abstract: Supplementary data (ANNEX); International audience; Staphylococcus aureus clonal complex 398 is a livestock-associated pathogen that poses a worldwide threat because of its ability to colonize and infect both humans and animals. We used high-resolution whole-genome microarrays, prophage profiling, immune evasion cluster characterization and whole-genome sequencing to investigate the roles of prophages in the emerging human-adapted subpopulation of CC398 that has been associated with invasive infections in humans living in animal-free environments. We characterized one phage and two prophages specifically harbored by CC398 isolates belonging to the emerging subpopulation. We introduced the phage into permissive prophage-free isolates. We investigated the effects of lysogeny on the host ability to resist further phage infection and transformation, to acquire the capacity to invade human cells, and to express virulence factors encoded by prophages. We report evidence of a defective ϕMR11-like helper prophage, named StauST398-5pro, specifically associated with the emerging non-LA CC398 subpopulation. StauST398-5pro confers substantial protection against horizontal genetic transfer to its host. It interacts with a human-associated β-converting prophage encoding immune-modulating proteins such that virulence genes are expressed during stress situations. Our findings provide insight into the role of phages in the expression of virulence and in the spread of genetic information among new host-adapted S. aureus isolates. We demonstrate that functional prophage elements can condition host specificity and confer new virulence traits on emerging intra-species clones of bacteria.
Published: 2013
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46. Use of ribotyping to investigate tracheal colonisation byStaphylococcus epidermidis as a source of bacteremia in ventilated newborns

Author: Pierre-Yves Donnio, P. Pladys, and P. Bétrémieux
Subjects: DNA, Bacterial, Microbiology (medical), Artificial ventilation, medicine.medical_specialty, Micrococcaceae, medicine.medical_treatment, Bacteremia, Infant, Premature, Diseases, Biology, DNA, Ribosomal, Microbiology, Ribotyping, Medical microbiology, Staphylococcus epidermidis, Intubation, Intratracheal, medicine, Humans, Infant, Newborn, General Medicine, Staphylococcal Infections, biology.organism_classification, medicine.disease, Tracheal aspirate, Respiration, Artificial, Bacterial Typing Techniques, Trachea, Colonisation, Infectious Diseases, Equipment Contamination, Infant, Premature
Abstract: Ribotyping was used to determine whether a relationship exists between endotracheal tube colonisation with Staphylococcus epidermidis and bacteremia with this organism. Over a three-week period, four mechanically ventilated preterm babies presented with five episodes of infection and bacteremia. For each blood specimen obtained for culture a tracheal aspirate sample was collected at the same time by suctioning. After DNA extraction and cleavage by EcoRI, hybridisation was performed with a digoxigenin-labelled 16S-rDNA probe from Escherichia coli. Five different band patterns were recognised on the membrane. In two children the same band pattern was found in Staphylococcus epidermidis isolated from both blood and tracheal aspirate. Ribotyping thus could be used to differentiate a series of infections from an outbreak and showed that a relationship may exist between tracheal colonisation and bacteremia in mechanically ventilated newborns.
Published: 1995
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47. Are enterococci playing a role in postoperative peritonitis in critically ill patients?

Author: Pierre-Yves Donnio, Yannick Mallédant, Philippe Seguin, C. Brianchon, Nicolas Nesseler, Bruno Laviolle, Yoann Launey, Foie, métabolismes et cancer, 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 ), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Microbiologie : Risques Infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), 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 ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Brébion, Alice, and Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, 0302 clinical medicine, Postoperative Complications, MESH: Postoperative Complications, 030212 general & internal medicine, Prospective Studies, MESH: Drug Utilization, Abscess, Postoperative peritonitis, MESH: Aged, First episode, 0303 health sciences, MESH: Middle Aged, biology, General Medicine, Middle Aged, 3. Good health, Predictive factor, Anti-Bacterial Agents, Infectious Diseases, MESH: Young Adult, MESH: Survival Analysis, MESH: Critical Illness, Female, MESH: Enterococcus, Microbiology (medical), Adult, medicine.medical_specialty, MESH: Peritonitis, Abdominal Abscess, Adolescent, Critical Illness, Peritonitis, 03 medical and health sciences, Young Adult, MESH: Abdominal Abscess, MESH: Anti-Bacterial Agents, Intensive care, Internal medicine, medicine, Humans, Antibiotic use, Gram-Positive Bacterial Infections, Aged, MESH: Adolescent, MESH: Humans, 030306 microbiology, business.industry, Critically ill, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, biology.organism_classification, medicine.disease, Survival Analysis, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: Male, MESH: Prospective Studies, Drug Utilization, Surgery, Enterococcus, MESH: Gram-Positive Bacterial Infections, business, MESH: Female
Abstract: International audience; This prospective non-interventional study is aimed at evaluating the role of enterococci in the postoperative course of postoperative peritonitis (POP) and the predictive factors for isolating Enterococcus spp. All adult patients, hospitalized in intensive care, who had POP between September 2006 and February 2010 were analysed. The patients' baseline clinical characteristics and microbiological and surgical characteristics of the first episode of POP were recorded. The rates of surgical and non-surgical complications and mortality were studied. A total of 139 patients were analysed and Enterococcus spp. were recovered in 61 patients (43%). The presence of enterococci was associated with significantly more intra-abdominal abscesses (26% vs 12%, p=0.025), but did not affect the rate of reoperation or mortality. Antibiotic use before reoperation was the only independent predictive factor for isolating enterococci (OR=2.19, CI95%: 1.02-4.70, p
Published: 2011
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48. Epidemiology and antimicrobial resistance of Streptococcus pneumoniae in France in 2007: data from the pneumococcus surveillance network

Author: Michel Brun, Christine Segonds, Laurent Gibel, Bernadette Grignon, Hubert Chardon, Veronique Vernet-Garnier, Jean Louis Koeck, Marie Kempf, Michel Vergnaud, Emmanuelle Varon, Micheline Roussel-Delvallez, Henri Bonnabau, Gérard Chabanon, Jeanne Maugein, Laurent Gutmann, Jacques Croizé, Marie-Cécile Ploy, Thierry Fosse, Tahar Hadou, Alain Gravet, André Pechinot, Agnes Lepoutre, Josette Raymond, Pierre-Yves Donnio, Regine Baraduc, Farida Hamdad, Philippe Dupont, Alain Ros, Philippe Lanotte, Marie Claude Demachy, Marie-Laure Joly-Guillou, Microbiologie : Risques Infectieux, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire de bactériologie, CHU Bordeaux [Bordeaux], Laboratoire de Microbiologie Médicale et Moléculaire, Université de Bourgogne (UB), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Pathogenèse de Helicobacter, Institut Pasteur [Paris], Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Centre de Référence du Pneumocoque, 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), Service de bactériologie-virologie [Tours], Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Faculté de Médecine, Université de Tours, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Bourgogne ( UB ), Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Infectiologie et Santé Publique ( ISP ), Université de Tours-IFR136, Hôpital Bretonneau-CHRU Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Institut Pasteur [Paris] (IP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Brébion, Alice, and Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Cefotaxime, Heptavalent Pneumococcal Conjugate Vaccine, Drug resistance, MESH : Child, Preschool, medicine.disease_cause, MESH: Immunization Programs, Pneumococcal conjugate vaccine, Pneumococcal Vaccines, 0302 clinical medicine, MESH : Child, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Drug Resistance, Multiple, Bacterial, MESH: Child, MESH : Population Surveillance, 030212 general & internal medicine, MESH : Pneumococcal Infections, MESH: Pneumococcal Infections, MESH : Anti-Bacterial Agents, Child, 0303 health sciences, MESH: Microbial Sensitivity Tests, ANTIBIOTIC USE, Age Factors, MESH : Infant, MESH : Adult, MESH: Infant, 3. Good health, Anti-Bacterial Agents, Pneumococcal infections, Streptococcus pneumoniae, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Child, Preschool, Population Surveillance, MESH : Pneumococcal Vaccines, France, MESH: Streptococcus pneumoniae, medicine.drug, Microbiology (medical), Adult, MESH: Pneumococcal Vaccines, MESH : Drug Resistance, Multiple, Bacterial, Adolescent, Immunology, education, Microbial Sensitivity Tests, Microbiology, MESH : Immunization Programs, Pneumococcal Infections, MESH: Population Surveillance, 03 medical and health sciences, Antibiotic resistance, MESH : Adolescent, MESH: Anti-Bacterial Agents, medicine, Humans, MESH : France, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Pharmacology, MESH: Adolescent, MESH: Age Factors, MESH: Humans, 030306 microbiology, business.industry, Immunization Programs, MESH : Streptococcus pneumoniae, MESH : Humans, MESH: Child, Preschool, Infant, MESH: Adult, MESH: Drug Resistance, Multiple, Bacterial, Amoxicillin, medicine.disease, TRENDS, Penicillin, MESH: France, REDUCTION, MESH : Microbial Sensitivity Tests, MESH : Age Factors, business
Abstract: International audience; Antimicrobial resistance of Streptococcus pneumoniae in France is closely monitored by the pneumococcus surveillance network, founded in 1995, which collects data from regional observatories (Observatoire Régionaux du Pneumocoque [ORP]). In 2007, 23 ORPs analyzed the antibiotic susceptibility of 5,302 isolates of S. pneumoniae recovered in France from cerebrospinal fluid, blood, middle ear fluid, and pleural fluid, as well as from adult respiratory samples. The study showed that 38.2% of the strains were nonsusceptible to penicillin, 19.3% nonsusceptible to amoxicillin, and 10.5% nonsusceptible to cefotaxime. The percentage of pneumococcus nonsusceptible to penicillin varied according to both the sample and the age of the patient (child/adult): blood (27.8%/32.5%), cerebrospinal fluid (33.7%/34.6%), middle ear fluid (60.2%/27.5%), and pleural fluid (50.0%/31.0%). Between 2003 and 2007, the frequency of penicillin resistance in invasive pneumococcal disease gradually decreased from 46.4% to 29.0% in children and from 43.8% to 32.7% in adults. This decrease coincided with the introduction of a seven-valent pneumococcal conjugate vaccine into immunization programs and with a general reduction in levels of antibiotic consumption in France.
Published: 2011
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49. Clonal spread of Streptococcus pyogenes emm44 among homeless persons, Rennes, France

Author: Céline Plainvert, Matthieu Revest, Anne Cady, Samer Kayal, Pierre-Yves Donnio, Anne Bouvet, Didier Huguenet, Pascaline Loury, Alain Briand, Microbiologie : Risques Infectieux, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Brébion, Alice
Subjects: MESH: Tetracycline Resistance, Male, Epidemiology, medicine.medical_treatment, lcsh:Medicine, Skin infection, medicine.disease_cause, MESH: Tetracycline, Polymerase Chain Reaction, 0302 clinical medicine, MESH: Streptococcal Infections, 030212 general & internal medicine, Fasciitis, ComputingMilieux_MISCELLANEOUS, MESH: Aged, MESH: Microbial Sensitivity Tests, 0303 health sciences, MESH: Middle Aged, drug users, homeless persons, 1. No poverty, Tetracycline Resistance, Immunosuppression, Middle Aged, Pharyngitis, 3. Good health, Anti-Bacterial Agents, Electrophoresis, Gel, Pulsed-Field, skin infections, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, MESH: Young Adult, Cellulitis, Ill-Housed Persons, Female, France, medicine.symptom, MESH: Streptococcus pyogenes, Bacterial Outer Membrane Proteins, Microbiology (medical), Adult, Streptococcus pyogenes, letter, MESH: Carrier Proteins, Microbial Sensitivity Tests, Biology, lcsh:Infectious and parasitic diseases, Microbiology, 03 medical and health sciences, Young Adult, MESH: Anti-Bacterial Agents, Streptococcal Infections, medicine, Humans, lcsh:RC109-216, Epidemics, Letters to the Editor, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Epidemics, Aged, Antigens, Bacterial, MESH: Humans, Bacteria, 030306 microbiology, lcsh:R, MESH: Bacterial Outer Membrane Proteins, MESH: Homeless Persons, Toxic shock syndrome, MESH: Adult, MESH: Polymerase Chain Reaction, Tetracycline, medicine.disease, MESH: Male, MESH: France, emm typing, Bacteremia, Immunology, Carrier Proteins, MESH: Female, MESH: Antigens, Bacterial
Abstract: To the Editor: Streptococcus pyogenes, or group A streptococci (GAS), are human pathogens responsible for pharyngitis as well as skin and soft tissue infections. Invasive GAS diseases, including bacteremia, cellulitis, and necrotizing fasciitis, are life-threatening, especially when associated with toxic shock syndrome. Several risk factors for GAS infections are known, such as diabetes, immunosuppression, drug use, and skin lesions (1,2).
Published: 2011
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50. Randomized comparison of 2 protocols to prevent acquisition of methicillin-resistant Staphylococcus aureus: results of a 2-center study involving 500 patients

Author: R. Thomas, Bernard Branger, Annick Legras, Dominique Perrotin, Eric Bellissant, Yves Le Tulzo, Sylvain Lavoué, Pascal Le Corre, Alain Renault, Christophe Camus, Pierre-Yves Donnio, Arnaud Gacouin, Brébion, Alice, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Microenvironnement et cancer (MiCa), 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 ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and 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 )
Subjects: Male, Pediatrics, Epidemiology, medicine.disease_cause, law.invention, Patient Isolation, chemistry.chemical_compound, MESH: Infection Control, Randomized controlled trial, law, Hygiene, media_common, MESH: Aged, Cross Infection, MESH: Middle Aged, Chlorhexidine, MESH: Mupirocin, MESH: Nose, Middle Aged, Staphylococcal Infections, Intensive care unit, Anti-Bacterial Agents, 3. Good health, MESH: Chlorhexidine, Intensive Care Units, Mupirocin, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Guideline Adherence, Female, France, Guideline Adherence, Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), medicine.medical_specialty, Isolation (health care), media_common.quotation_subject, MESH: Staphylococcal Infections, MESH: Methicillin-Resistant Staphylococcus aureus, Nose, MESH: Anti-Infective Agents, Local, MESH: Anti-Bacterial Agents, medicine, Humans, Hospitals, Teaching, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Aged, Protocol (science), Infection Control, MESH: Humans, business.industry, MESH: Cross Infection, MESH: Hospitals, Teaching, Methicillin-resistant Staphylococcus aureus, MESH: Male, MESH: Patient Isolation, Clinical trial, MESH: France, chemistry, Emergency medicine, Anti-Infective Agents, Local, MESH: Intensive Care Units, business, MESH: Female
Abstract: Objective.To compare an interventional protocol with a standard protocol for preventing the acquisition of methicillin-resistantStaphylococcus aureus(MRSA) in the intensive care unit (ICU).Design.Prospective, randomized, controlled, parallel-group, nonblinded clinical trial.Setting.Medical ICUs of 2 French university hospitals.Participants.Five hundred adults with an expected length of stay in the ICU greater than 48 hours.Interventions.For the intervention group, the protocol required repeated MRSA screening, contact and droplet isolation precautions for patients at risk for MRSA at ICU admission and for MRSA-positive patients, and decontamination with nasal mupirocin and chlorhexidine body wash for MRSA-positive patients. For the standard group, the standard precautions protocol was used, and the results of repeated MRSA screening in the standard group were not communicated to investigators.Main Outcome Measure.MRSA acquisition rate in the ICU. An audit was conducted to assess compliance with hygiene and isolation precautions.Results.In the intent-to-treat analysis (n= 488), the MRSA acquisition rate in the ICU was similar in the standard (13 [5.3%] of 243) and intervention (16 [6.5%] of 245) groups (P=.58). The audit showed that the overall compliance rate was 85.5% in the standard group and 84.1% in the intervention group (P=.63), although compliance was higher when isolation precautions were absent than when they were in place (88.2% vs 79.1%;PP=.01).Conclusions.Individual allocation to MRSA screening, isolation precautions, and decontamination do not provide individual benefit in reducing MRSA acquisition, compared with standard precautions, although the collective risk was lower during the periods of isolation.Trial Registration.Clinicaltrials.gov identifier: NCT00151606.
Published: 2011
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