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1. Chronic Osteomyelitis of the Jaw: Pivotal Role of Microbiological Investigation and Multidisciplinary Management—A Case Report

Author

Quentin Lucidarme, Delphine Lebrun, Véronique Vernet-Garnier, Joey Le Gall, Saïdou Diallo, Cédric Mauprivez, and Stéphane Derruau

Subjects
osteomyelitis, jaw, child, microbiology, MALDI-TOF analysis, case report, Therapeutics. Pharmacology, RM1-950
Abstract

A 15-year-old girl with a history of recurrent painful orofacial swelling was diagnosed on the basis of clinical findings, histopathological examination and imaging modalities as having primary chronic osteomyelitis of the jaw. Initial microbiological samples were performed but were inconclusive. She received multiple empirical antibiotic therapies and NSAIDs for 3 years without complete remission. Only MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization–Time Of Flight) analysis after additional multiple microbiological bone samples with adequate techniques yielded the final diagnosis of bacterial chronic osteomyelitis of the jaw. Its management requires a multidisciplinary approach, involving oral and maxillofacial surgeons, infectiologists and microbiologists, to limit treatment failure. Antibiotic therapy without surgery for 6 months achieved the complete radiographic resolution of the CBCT (Cone Beam Computed Tomography) and the normalization of laboratory tests. After 2 years of follow-up, no relapse had been reported. Modern microbiological investigation and sampling techniques are critical for the accurate diagnosis and management of osteomyelitis of the jaw, especially in unusual and clinically misleading forms of this infection.

Published
2022
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2. Cutibacterium acnes Biofilm Study during Bone Cells Interaction

Author

Céline Mongaret, Jennifer Varin-Simon, Fabien Lamret, Taghrid S. El-Mahdy, Lucien Brasme, Véronique Vernet-Garnier, Sophie C. Gangloff, Xavier Ohl, and Fany Reffuveille

Subjects
joint infections, biofilms, host–pathogen interactions, Cutibacterium acnes, internalization, Biology (General), QH301-705.5
Abstract

Cutibacterium acnes is an opportunistic pathogen involved in Bone and Prosthesis Infections (BPIs). In this study, we observed the behavior of commensal and BPI C. acnes strains in the bone environment through bacterial internalization by osteoblast-like cells and biofilm formation. For the commensal strains, less than 1% of the bacteria were internalized; among them, about 32.7 ± 3.9% persisted intracellularly for up to 48 h. C. acnes infection seems to have no cytotoxic effect on bone cells as detected by LDH assay. Interestingly, commensal C. acnes showed a significant increase in biofilm formation after osteoblast-like internalization for 50% of the strains (2.8-fold increase). This phenomenon is exacerbated on a titanium support, a material used for medical devices. For the BPI clinical strains, we did not notice any increase in biofilm formation after internalization despite a similar internalization rate by the osteoblast-like cells. Furthermore, fluorescent staining revealed more live bacteria within the biofilm after osteoblast-like cell interaction, for all strains (BPIs and commensal). The genomic study did not reveal any link between their clinical origin and phylotype. In conclusion, we have shown for the first time the possible influence of internalization by osteoblast-like cells on commensal C. acnes.

Published
2020
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3. Staphylococcus aureus CC30 Lineage and Absence of sed,j,r-Harboring Plasmid Predict Embolism in Infective Endocarditis

Author

Jean-Philippe Rasigade, Amélie Leclère, François Alla, Adrien Tessier, Michèle Bes, Catherine Lechiche, Véronique Vernet-Garnier, Cédric Laouénan, François Vandenesch, Catherine Leport, The AEPEI Study Group, B. Hoen, X. Duval, F. Alla, A. Bouvet, S. Briancxon, E. Cambau, M. Celard, C. Chirouze, N. Danchin, T. Doco-Lecompte, F. Delahaye, J. Etienne, B. Iung, V. Le Moing, J. F. Obadia, C. Leport, C. Poyart, M. Revest, C. Selton-Suty, C. Strady, P. Tattevin, F. Vandenesch, Y. Bernard, S. Chocron, P. Plesiat, I. Abouliatim, C. De Place, P. Y. Donnio, J. P. Carteaux, C. Lion, N. Aissa, B. Baehrel, R. Jaussaud, P. Nazeyrollas, V. Vernet, P. Nataf, C. Chidiac, H. Aumaître, J. M. Frappier, E. Oziol, A. Sotto, C. Sportouch, M. Bes, P. Abassade, E. Abrial, C. Acar, J. F. Alexandra, N. Amireche, D. Amrein, P. Andre, M. Appriou, M. A. Arnould, P. Assayag, A. Atoui, F. Aziza, N. Baille, N. Bajolle, P. Battistella, S. Baumard, A. Ben Ali, J. Bertrand, S. Bialek, M. Bois Grosse, M. Boixados, F. Borlot, A. Bouchachi, O. Bouche, S. Bouchemal, J. L. Bourdon, L. Brasme, F. Bricaire, E. Brochet, F. J. Bruntz, A. Cady, J. Cailhol, M. P. Caplan, B. Carette, O. Cartry, C. Cazorla, H. Chamagne, H. Champagne, G. Chanques, J. Chastre, B. Chevalier, F. Chometon, C. Christophe, A. Cohen, N. Colin de Verdiere, V. Daneluzzi, L. David, P. De Lentdecker, V. Delcey, P. Deleuze, E. Donal, B. Deroure, V. Descotes-Genon, K. Didier Petit, A. Dinh, V. Doat, F. Duchene, F. Duhoux, M. Dupont, S. Ederhy, O. Epaulard, M. Evest, J. F. Faucher, B. Fantin, E. Fauveau, T. Ferry, M. Fillod, T. Floch, T. Fraisse, J. M. Frapier, L. Freysz, B. Fumery, B. Gachot, S. Gallien, I. Gandjbach, P. Garcon, A. Gaubert, J. L. Genoud, S. Ghiglione, C. Godreuil, A. Grentzinger, L. Groben, D. Gherissi, P. Gue'ret, A. Hagege, N. Hammoudi, F. Heliot, P. Henry, S. Herson, P. Houriez, L. Hustache-Mathieu, O. Huttin, S. Imbert, S. Jaureguiberry, M. Kaaki, A. Konate, J. M. Kuhn, S. Kural Menasche, A. Lafitte, B. Lafon, F. Lanternier, V. Le Chenault, C. Lechiche, S. Lefèvre-Thibaut, A. Lefort, A. Leguerrier, J. Lemoine, L. Lepage, C. Lepouse', J. Leroy, P. Lesprit, L. Letranchant, D. Loisance, G. Loncar, C. Lorentz, P. Mabo, I. Magnin-Poull, T. May, A. Makinson, H. Man, M. Mansouri, O. Marcxon, J. P. Maroni, V. Masse, F. Maurier, M. C. Meyohas, P. L. Michel, C. Michelet, F. Mechaï, O. Merceron, D. Messika-Zeitoun, Z. Metref, V. Meyssonnier, C. Mezher, S. Micheli, M. Monsigny, S. Mouly, B. Mourvillier, O. Nallet, V. Noel, T. Papo, B. Payet, A. Pelletier, P. Perez, J. S. Petit, F. Philippart, E. Piet, C. Plainvert, B. Popovic, J. M. Porte, P. Pradier, R. Ramadan, J. Richemond, M. Rodermann, M. Roncato, I. Roigt, O. Ruyer, M. Saada, J. Schwartz, M. Simon, B. Simorre, S. Skalli, F. Spatz, J. Sudrial, L. Tartiere, A. Terrier De La Chaise, M. C. Thiercelin, D. Thomas, M. Thomas, L. Toko, F. Tournoux, A. Tristan, J. L. Trouillet, L. Tual, A. Vahanian, F. Verdier, V. Vernet Garnier, V. Vidal, P. Weyne, M. Wolff, A. Wynckel, N. Zannad, and P. Y. Zinzius

Subjects
S. aureus, MRSA, infective endocarditis, stroke, CC30, enterotoxin, Microbiology, QR1-502
Abstract

Staphylococcus aureus induces severe infective endocarditis (IE) where embolic complications are a major cause of death. Risk factors for embolism have been reported such as a younger age or larger IE vegetations, while methicillin resistance conferred by the mecA gene appeared as a protective factor. It is unclear, however, whether embolism is influenced by other S. aureus characteristics such as clonal complex (CC) or virulence pattern. We examined clinical and microbiological predictors of embolism in a prospective multicentric cohort of 98 French patients with monomicrobial S. aureus IE. The genomic contents of causative isolates were characterized using DNA array. To preserve statistical power, genotypic predictors were restricted to CC, secreted virulence factors and virulence regulators. Multivariate regularized logistic regression identified three independent predictors of embolism. Patients at higher risk were younger than the cohort median age of 62.5 y (adjusted odds ratio [OR] 0.14; 95% confidence interval [CI] 0.05–0.36). S. aureus characteristics predicting embolism were a CC30 genetic background (adjusted OR 9.734; 95% CI 1.53–192.8) and the absence of pIB485-like plasmid-borne enterotoxin-encoding genes sed, sej, and ser (sedjr; adjusted OR 0.07; 95% CI 0.004–0.457). CC30 S. aureus has been repeatedly reported to exhibit enhanced fitness in bloodstream infections, which might impact its ability to cause embolism. sedjr-encoded enterotoxins, whose superantigenic activity is unlikely to protect against embolism, possibly acted as a proxy to others genes of the pIB485-like plasmid found in genetically unrelated isolates from mostly embolism-free patients. mecA did not independently predict embolism but was strongly associated with sedjr. This mecA-sedjr association might have driven previous reports of a negative association of mecA and embolism. Collectively, our results suggest that the influence of S. aureus genotypic features on the risk of embolism may be stronger than previously suspected and independent of clinical risk factors.

Published
2018
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4. Symptomatic and Asymptomatic Neurological Complications of Infective Endocarditis: Impact on Surgical Management and Prognosis.

Author

Christine Selton-Suty, François Delahaye, Pierre Tattevin, Claire Federspiel, Vincent Le Moing, Catherine Chirouze, Pierre Nazeyrollas, Véronique Vernet-Garnier, Yvette Bernard, Sidney Chocron, Jean-François Obadia, François Alla, Bruno Hoen, Xavier Duval, and AEPEI (Association pour l'Etude et la Prévention de l'Endocardite Infectieuse)

Subjects
Medicine, Science
Abstract

Symptomatic neurological complications (NC) are a major cause of mortality in infective endocarditis (IE) but the impact of asymptomatic complications is unknown. We aimed to assess the impact of asymptomatic NC (AsNC) on the management and prognosis of IE.From the database of cases collected for a population-based study on IE, we selected 283 patients with definite left-sided IE who had undergone at least one neuroimaging procedure (cerebral CT scan and/or MRI) performed as part of initial evaluation.Among those 283 patients, 100 had symptomatic neurological complications (SNC) prior to the investigation, 35 had an asymptomatic neurological complications (AsNC), and 148 had a normal cerebral imaging (NoNC). The rate of valve surgery was 43% in the 100 patients with SNC, 77% in the 35 with AsNC, and 54% in the 148 with NoNC (p

Published
2016
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5. Mobile insertion cassette elements found in small non-transmissible plasmids in Proteeae may explain qnrD mobilization.

Author

Thomas Guillard, Antoine Grillon, Christophe de Champs, Céline Cartier, Janick Madoux, Béatrice Berçot, Anne-Laure Lebreil, Alain Lozniewski, Jacques Riahi, Véronique Vernet-Garnier, and Emmanuelle Cambau

Subjects
Medicine, Science
Abstract

qnrD is a plasmid mediated quinolone resistance gene from unknown origin, recently described in Enterobacteriaceae. It encodes a pentapeptide repeat protein 36-60% different from the other Qnr (A, B, C, S and VC). Since most qnrD-positive strains were described as strains belonging to Proteus or Providencia genera, we hypothesized that qnrD originated in Proteeae before disseminating to other enterobacterial species. We screened 317 strains of Proteeae for qnrD and its genetic support by PCR. For all the seven qnrD-positive strains (4 Proteus mirabilis, 1 Proteus vulgaris and 2 Providencia rettgeri) the gene was carried onto a small non-transmissible plasmid, contrarily to other qnr genes that are usually carried onto large multi-resistant plasmids. Nucleotide sequences of the qnrD-bearing plasmids were 96% identical. Plasmids contained 3 ORFs apart from qnrD and belonged to an undescribed incompatibility group. Only one plasmid, in P. vulgaris, was slightly different with a 1,568-bp insertion between qnrD and its promoter, leading to absence of quinolone resistance. We sought for similar plasmids in 15 reference strains of Proteeae, but which were tested negative for qnrD, and found a 48% identical plasmid (pVERM) in Providencia vermicola. In order to explain how qnrD could have been inserted into such native plasmid, we sought for gene mobilization structures. qnrD was found to be located within a mobile insertion cassette (mic) element which sequences are similar to one mic also found in pVERM. Our conclusions are that (i) the small non-transmissible qnrD-plasmids described here may result from the recombination between an as-yet-unknown progenitor of qnrD and pVERM, (ii) these plasmids are maintained in Proteeae being a qnrD reservoir (iii) the mic element may explain qnrD mobilization from non-transmissible plasmids to mobilizable or conjugative plasmids from other Enterobacteriaceae, (iv) they can recombined with larger multiresistant plasmids conjugated in Proteeae.

Published
2014
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6. Staphylococcus aureus endocarditis: Identifying prognostic factors using a method derived from morbidity and mortality conferences

Author

Benjamin Lefèvre, Antoine Legoff, Mathilde Boutrou, François Goehringer, Willy Ngueyon-Sime, Catherine Chirouze, Matthieu Revest, Véronique Vernet Garnier, Xavier Duval, François Delahaye, Vincent Le Moing, Christine Selton-Suty, Laura Filippetti, Bruno Hoen, Nelly Agrinier, Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Université de Lorraine (UL), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service des maladies infectieuses, Hopital Andree Rosemond, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), 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), 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), 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 ), 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), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Cardiologie [CHRU Nancy], Université de Lorraine, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CIC Hôpital Bichat, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, and Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI)

Subjects
Staphylococcus aureus, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, morbidity and mortality conference method, infective endocarditis, [SDV]Life Sciences [q-bio], morbidity and mortality, prognostic factors, conference method, General Medicine, survival, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

ObjectivesLethality of Staphylococcus aureus (Sa) infective endocarditis (IE) is high and might be due to yet unidentified prognostic factors. The aim of this study was to search for new potential prognostic factors and assess their prognostic value in SaIE.Materials and methodsWe used a two-step exploratory approach. First, using a qualitative approach derived from mortality and morbidity conferences, we conducted a review of the medical records of 30 patients with SaIE (15 deceased and 15 survivors), randomly extracted from an IE cohort database (NCT03295045), to detect new factors of possible prognostic interest. Second, we collected quantitative data for these factors in the entire set of SaIE patients and used multivariate Cox models to estimate their prognostic value.ResultsA total of 134 patients with modified Duke definite SaIE were included, 64 of whom died during follow-up. Of the 56 candidate prognostic factors identified at the first step, 3 had a significant prognostic value in multivariate analysis: the prior use of non-steroidal anti-inflammatory drugs [aHR 3.60, 95% CI (1.59–8.15), p = 0.002]; the non-performance of valve surgery when indicated [aHR 1.85, 95% CI (1.01–3.39), p = 0.046]; and the decrease of vegetation size on antibiotic treatment [aHR 0.34, 95% CI (0.12–0.97), p = 0.044].ConclusionWe identified three potential SaIE prognostic factors. These results, if externally validated, might eventually help improve the management of patients with SaIE.

Published
2022

7. Fusidic acid in a tertiary hospital: an observational study focusing on prescriptions, tolerance and susceptibility of Staphylococcus and Cutibacterium spp. strains from bone samples

Author

Juliette Romaru, Anne Limelette, Delphine Lebrun, Morgane Bonnet, Véronique Vernet Garnier, and Yohan N’Guyen

Subjects
Microbiology (medical), Staphylococcus aureus, Staphylococcus, Osteomyelitis, General Medicine, Microbial Sensitivity Tests, Propionibacteriaceae, Staphylococcal Infections, Anti-Bacterial Agents, Tertiary Care Centers, Infectious Diseases, Prescriptions, Humans, Fusidic Acid
Abstract

Adverse drug reactions of broad-spectrum fluoroquinolones or rifampicin are not uncommon during osteomyelitis and orthopaedic implant infections (OOII). Thus, we made an overview (i) of the prescription of fusidic acid (FA) and (ii) of FA susceptibility of Staphylococcus sp. and Cutibacterium sp. strains isolated from bone samples. All prescriptions of FA and all bone samples with positive culture for Staphylococcus sp. or Cutibacterium sp. (Reims University Hospital June 2017-May 2021) were included. All Staphylococcus aureus strains were considered as significant, whereas Coagulase-negative Staphylococcus and Cutibacterium spp. strains were not if these strains grew only on one sole sample. The antibiotic susceptibility of Staphylococcus sp. strains and the susceptibility to FA of Cutibacterium sp. strains had been determined using disk diffusion methods, as described for Staphylococcus sp. in the CASFM/EUCAST guidelines. The mean FA consumption was 0.6 daily defined doses/1000 patient days. FA was prescribed for OOII due to Staphylococcus sp. and Cutibacterium sp. in 24 and 2 cases, respectively. Among 401 Staphylococcus sp. strains, there were 254 S. aureus (63.3%), 84 methicillin-resistant (20.9%) and 333 FA-susceptible (83.0%) strains. S. aureus and methicillin-sensitive strains were more likely to be susceptible to FA (p 0.001). Among 39 Cutibacterium sp. strains, the FA inhibition zone diameter geometric mean was 28.6 mm (24-35 mm), suggesting that all these strains could be considered as susceptible to FA. These data suggested that FA could be more frequently used in OOII due to Staphylococcus sp. and Cutibacterium sp., subject to the absence of other resistant bacteria.

Published
2022

8. A prospective, observational study of fidaxomicin use for infection in France

Author

Benoit Guery, Pierre Berger, Remy Gauzit, Magali Gourdon, Frédéric Barbut, DAFNE study group, Pascale Bémer, Emilie Bessède, Fabrice Camou, Vincent Cattoir, Carine Couzigou, Dominique Descamps, Aurélien Dinh, Caroline Laurans, Jean-Philippe Lavigne, Catherine Lechiche, Véronique Leflon-Guibout, Alban Le Monnier, Marion Levast, Joy Yoganaden Mootien, Yohan N’Guyen, Lionel Piroth, Thierry Prazuck, Olivier Rogeaux, Anne-Laure Roux, Anne Vachée, Véronique Vernet Garnier, and Frédéric Wallet

Subjects
Medicine (General), R5-920, genetic structures
Abstract

Objective To describe the characteristics, management and outcomes of hospitalised patients with Clostridioides difficile infection (CDI) treated with and without fidaxomicin. Methods This prospective, multicentre, observational study (DAFNE) enrolled hospitalised patients with CDI, including 294 patients treated with fidaxomicin (outcomes recorded over a 3-month period) and 150 patients treated with other CDI therapies during three 1-month periods. The primary endpoint was baseline and CDI characteristics of fidaxomicin-treated patients. Results At baseline, the fidaxomicin-treated population included immunocompromised patients (39.1%) and patients with severe (59.2%) and recurrent (36.4%) CDI. Fidaxomicin was associated with a high rate of clinical cure (92.2%) and low CDI recurrence (16.3% within 3 months). Clinical cure rates were ≥90% in patients aged ≥65 years, those receiving concomitant antibiotics and those with prior or severe CDI. There were 121/296 (40.9%) patients with adverse events (AEs), 5.4% with fidaxomicin-related AEs and 1.0% with serious fidaxomicin-related AEs. No fidaxomicin-related deaths were reported. Conclusions Fidaxomicin is an effective and well-tolerated CDI treatment in a real-world setting in France, which included patients at high risk of adverse outcomes. Trial registration: Description of the use of fidaxomicin in hospitalised patients with documented Clostridium difficile infection and the management of these patients (DAFNE), NCT02214771, www.ClinicalTrials.gov.

Published
2021

9. Treatment of bone and joint infections caused by Enterobacter cloacae with a fluoroquinolone–cotrimoxazole combination

Author

Véronique Vernet-Garnier, Hawa Cisse, Morgane Bonnet, Delphine Lebrun, Saidou Diallo, Maxime Hentzien, X. Ohl, Firouzé Bani-Sadr, Odile Bajolet, Centre Hospitalier Universitaire de Reims (CHU Reims), Technocentre Renault [Guyancourt], RENAULT, Service de Médecine interne, Maladies Infectieuses et Immunologie Clinique [Reims], Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Vieillissement, Fragilité (VIEFRA - EA 3797), Université de Reims Champagne-Ardenne (URCA), Médecine interne, maladies infectieuses, immunologie clinique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Institut de Biomécanique Humaine Georges Charpak, and parent

Subjects
Male, 0301 basic medicine, [SDV]Life Sciences [q-bio], 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, Pharmacology (medical), 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Antiinfective agent, biology, Sulfamethoxazole, Enterobacteriaceae Infections, Osteomyelitis, General Medicine, Enterobacter, Middle Aged, Anti-Bacterial Agents, 3. Good health, Treatment Outcome, Infectious Diseases, Drug Therapy, Combination, Female, Fluoroquinolones, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Prosthesis-Related Infections, Adolescent, Drug-Related Side Effects and Adverse Reactions, 030106 microbiology, Bone Infection, Young Adult, 03 medical and health sciences, Enterobacter cloacae, Trimethoprim, Sulfamethoxazole Drug Combination, Humans, Aged, Retrospective Studies, business.industry, Arthritis, medicine.disease, biology.organism_classification, Trimethoprim, Surgery, Pseudarthrosis, business
Abstract

Although the frequency of bone and joint infections caused by Enterobacter spp. is increasing, studies regarding the optimal antibiotic therapy are scarce. The objective of this retrospective study was to assess the clinical outcomes and safety of a fluoroquinolone-cotrimoxazole combination for the treatment of bone and joint infections caused by Enterobacter cloacae. Between 2010 and 2017, 30 patients with bone and joint infections caused by E. cloacae were treated with a fluoroquinolone-cotrimoxazole combination for 8-12 weeks. There were 26 cases (87%) of infection of an internal fixation device, two cases (6.6%) of pseudarthrosis with chronic osteomyelitis, and two cases (6.6%) of infection of knee and ankle prosthetic devices. The cure rate of the fluoroquinolone-cotrimoxazole combination was 80% by intention-to-treat analysis, with a mean follow-up of 29.3 ± 19.1 months. The fluoroquinolone-cotrimoxazole combination for 8-12 weeks is effective for the treatment of bone and joint infections caused by E. cloacae.

Published
2019

10. Interaction of implant infection-related commensal bacteria with mesenchymal stem cells: a comparison between Cutibacterium acnes and Staphylococcus aureus

Author

Cédric Mauprivez, Jennifer Varin-Simon, Fabien Lamret, Véronique Vernet-Garnier, Taghrid S. El-Mahdy, Fany Reffuveille, Céline Mongaret, Halima Kerdjoudj, Hassan Rammal, Sophie C. Gangloff, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biomatériaux et inflammation en site osseux - EA 4691 (BIOS), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), and Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)

Subjects
Cytoplasm, Staphylococcus aureus, Prosthesis-Related Infections, Cell Survival, [SDV]Life Sciences [q-bio], media_common.quotation_subject, Virulence, Context (language use), medicine.disease_cause, Microbiology, 03 medical and health sciences, Genetics, medicine, Humans, Propionibacterium acnes, Internalization, Molecular Biology, 030304 developmental biology, media_common, 0303 health sciences, biology, 030306 microbiology, Mesenchymal stem cell, Biofilm, Mesenchymal Stem Cells, biology.organism_classification, medicine.anatomical_structure, Biofilms, Host-Pathogen Interactions, Bone marrow, Bacteria
Abstract

Staphylococcus aureus and Cutibacterium acnes are involved in several tissue infections and can encounter mesenchymal stem cells (MSCs) during their role in tissue regenerative process. C. acnes and S. aureus internalization by three types of MSCs derived from bone marrow, dental pulp and Wharton's jelly; and bacterial biofilm production were compared. Internalization rates ranged between 1.7–6.3% and 0.8–2.7% for C. acnes and S. aureus, respectively. While C. acnes strains exhibited limited cytotoxic effect on MSCs, S. aureus were more virulent with marked effect starting after only 3 h of interaction. Both bacteria were able to produce biofilms with respectively aggregated and monolayered structures for C. acnes and S. aureus. The increase in C. acnes capacity to develop biofilm following MSCs’ internalization was not linked to the significant increase in number of live bacteria, except for bone marrow-MSCs/C. acnes CIP 53.117 with 79% live bacteria compared to the 36% before internalization. On the other hand, internalization of S. aureus had no impact on its ability to form biofilms composed mainly of living bacteria. The present study underlined the complexity of MSCs-bacteria cross-interaction and brought insights into understanding the MSCs behavior in response to bacterial infection in tissue regeneration context.

Published
2021

11. Bone and joint infections caused by Clostridium perfringens: a case series

Author

Firouzé Bani-Sadr, X. Ohl, Maxime Hentzien, Véronique Vernet-Garnier, Delphine Lebrun, Margaux Visse, Odile Bajolet, Saidou Diallo, Morgane Bonnet, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, medicine.drug_class, Clostridium perfringens, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030106 microbiology, Antibiotics, Microbial Sensitivity Tests, Joint infections, medicine.disease_cause, Prosthesis, Bone Infection, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Internal medicine, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Aged, 80 and over, business.industry, Clindamycin, General Medicine, Middle Aged, Antimicrobial, 3. Good health, Anti-Bacterial Agents, Metronidazole, Infectious Diseases, Clostridium Infections, Female, Bone Diseases, Joint Diseases, Rifampin, business, medicine.drug
Abstract

The objective of this study was to evaluate antimicrobial therapy outcomes of bone and joint infections (BJI) caused by Clostridium perfringens. We investigated remission of symptoms and the absence of relapse or reinfection during follow-up. Among the 8 patients with C. perfringens BJI, the type of infection was early prosthesis infection (n = 2), osteosynthetic device infection (n = 4), and chronic osteomyeletis (n = 2). Clindamycin-rifampicin combination was given in 4 cases and metronidazole in 4 cases. The overall success rate was 87.5%. Among the 7 patients who completed antibiotic treatment, the success rate was 100%. The clindamycin-rifampicin combination appeared to be effective in patients with C. perfringens BJI.

Published
2021

12. Cutibacterium acnes Biofilm Study during Bone Cells Interaction

Author

Lucien Brasme, Céline Mongaret, Jennifer Varin-Simon, Sophie C. Gangloff, X. Ohl, Fabien Lamret, Véronique Vernet-Garnier, Taghrid S. El-Mahdy, Fany Reffuveille, dormoy, valerian, Biomatériaux et inflammation en site osseux - EA 4691 (BIOS), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Centre Hospitalier Universitaire de Reims (CHU Reims), Université de Reims Champagne-Ardenne (URCA), Helwan University [Caire], Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, Microbiology (medical), media_common.quotation_subject, 030106 microbiology, Cell, education, Microbiology, Article, joint infections, 03 medical and health sciences, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Bone cell, medicine, Cutibacterium acnes, Cytotoxic T cell, host-pathogen interactions, Internalization, [SDV.IB.BIO]Life Sciences [q-bio]/Bioengineering/Biomaterials, lcsh:QH301-705.5, health care economics and organizations, media_common, Phylotype, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, biology, Chemistry, Biofilm, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, [SDV.IB.BIO] Life Sciences [q-bio]/Bioengineering/Biomaterials, internalization, 030104 developmental biology, medicine.anatomical_structure, lcsh:Biology (General), [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, biofilms, Bacteria, host–pathogen interactions
Abstract

Cutibacterium acnes is an opportunistic pathogen involved in Bone and Prosthesis Infections (BPIs). In this study, we observed the behavior of commensal and BPI C. acnes strains in the bone environment through bacterial internalization by osteoblast-like cells and biofilm formation. For the commensal strains, less than 1% of the bacteria were internalized, among them, about 32.7 &plusmn, 3.9% persisted intracellularly for up to 48 h. C. acnes infection seems to have no cytotoxic effect on bone cells as detected by LDH assay. Interestingly, commensal C. acnes showed a significant increase in biofilm formation after osteoblast-like internalization for 50% of the strains (2.8-fold increase). This phenomenon is exacerbated on a titanium support, a material used for medical devices. For the BPI clinical strains, we did not notice any increase in biofilm formation after internalization despite a similar internalization rate by the osteoblast-like cells. Furthermore, fluorescent staining revealed more live bacteria within the biofilm after osteoblast-like cell interaction, for all strains (BPIs and commensal). The genomic study did not reveal any link between their clinical origin and phylotype. In conclusion, we have shown for the first time the possible influence of internalization by osteoblast-like cells on commensal C. acnes.

Published
2020

13. Infective endocarditis related to unusual microorganisms: a prospective population-based study

Author

Silvia, Limonta, Emmanuelle, Cambau, Marie-Line, Erpelding, Caroline, Piau-Couapel, François, Goehringer, Patrick, Plésiat, Matthieu, Revest, Véronique, Vernet-Garnier, Vincent Le, Moing, Bruno, Hoen, Xavier, Duval, Pierre, Tattevin, P Y, Zinzius, 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), Emergence de la résistance bactérienne in vivo (EA3964), Université Paris Diderot - Paris 7 (UPD7), 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), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), 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), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], 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), 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 ), Société Française de Cardiologie, European Society of Clinical Microbiology and Infectious Diseases, Novartis, French Ministry of Health, 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 Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), 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
AcademicSubjects/MED00290, HACEK, [SDV]Life Sciences [q-bio], Pseudomonas aeruginosa, Major Article, endocarditis, Candida sp, Cutibacterium acnes
Abstract

Background Increased access to heart valves through early surgery and progress in molecular microbiology have reduced the proportion of infective endocarditis (IE) with no microbiological documentation and increased the proportion of IE associated with unusual microorganisms. Methods We performed an ancillary study of a large prospective population-based survey on IE. Unusual-microorganism IE was defined as definite IE (Duke-Li criteria) due to microorganisms other than streptococci, staphylococci, or enterococci. Results Of 471 cases of documented IE, 46 (9.8%) were due to unusal microorganisms; the following were involved in >1 case: Candida albicans (n = 4), Cutibacterium acnes (n = 4), Pseudomonas aeruginosa (n = 3), Cardiobacterium hominis (n = 3), and Coxiella burnetii (n = 2). Cases were documented with blood cultures (n = 37, 80.4%), heart valve polymerase chain reaction (PCR; n = 5), heart valve culture (n = 2), PCR on vertebral biopsy (n = 1), or serology (n = 1). As compared with IE due to staphylococci, streptococci, or enterococci (n = 420), IE due to unusual microorganisms occurred more frequently in patients with previously known heart disease (69.0% vs 44.3%; P = .002), prosthetic valve (40.5% vs 18.1%; P = .0006), longer duration of fever (mean, 35.1 ± 46.8 days vs 12.5 ± 17.8; P = .003), and who were more often nosocomial (38.1% vs 20.2%; P = .02). Conclusions In this population-based study, 9.8% of IE cases were due to unusual microorganisms, with a predominance of anaerobes, yeast, and gram-negative bacilli. As compared with IE related to staphylococci, streptococci, or enterococci, IE cases related to unusual microorganisms were associated with previously known heart disease, prosthetic valve, longer duration of fever, and nosocomial acquisition. Trial registration ORCID 0000-0003-3617-5411, In this population-based study, 10% of endocarditis were due to microorganisms other than staphylococci, streptococci, and enterococci. These included anaerobes, yeasts, or Gram-negative bacilli, with an increased risk in patients with heart disease, prosthetic valve, prolonged fever, and nosocomial endocarditis.

Published
2020

14. Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceae in North-Eastern France and outcomes of infected patients

Author

Thomas Guillard, Anne Limelette, Aurore Thierry, Lucien Brasme, Véronique Vernet-Garnier, Anaëlle Muggeo, Coralie Barbe, Odile Bajolet, Christophe de Champs, Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Reims Champagne-Ardenne (URCA), CHU Reims (CHU Reims), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, 0301 basic medicine, Carbapenem, Multivariate analysis, Klebsiella pneumoniae, [SDV]Life Sciences [q-bio], Antibiotics, 0302 clinical medicine, Risk Factors, Pharmacology (medical), 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Cross Infection, biology, Mortality rate, Enterobacteriaceae Infections, Middle Aged, Hospitals, Anti-Bacterial Agents, 3. Good health, Infectious Diseases, Carrier State, Female, France, medicine.drug, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Microbial Sensitivity Tests, Microbiology, 03 medical and health sciences, Internal medicine, Enterobacter cloacae, medicine, Humans, Aged, Pharmacology, business.industry, biology.organism_classification, Klebsiella Infections, Carbapenem-Resistant Enterobacteriaceae, Carriage, Carbapenems, Case-Control Studies, Concomitant, business
Abstract

Background Carbapenems are frequently used as a last resort to treat infections caused by multidrug-resistant Gram-negative organisms, thus carbapenem-non-susceptible Enterobacteriaceae (CNSE) is an emerging health threat. Objectives To assess risk factors and outcomes of CNSE carriage. Patients and methods We conducted a matched case-control study in six hospitals in North-Eastern France. The controls were patients harbouring carbapenem-susceptible Enterobacteriaceae. Fifty-five cases and 110 controls were included. Results Most of the CNSE isolates were Enterobacter cloacae and Klebsiella pneumoniae . Carbapenemase production was observed in 40% of isolates and they produced OXA-48 only. CNSE carriage was significantly associated with recent antibiotic use ( P = 0.014), particularly carbapenems ( P = 0.03) and fluoroquinolones ( P = 0.016). A multivariate analysis using conditional logistic regression showed that the presence of concomitant infection(s) (OR: 9.83; 95% CI 3.04-21.39, P = 0.0031), nosocomial infections (OR: 7.84; 95% CI 2.00-12.54, P = 0.0063) and a high age (OR: 1.07; 95% CI 1.01-1.06, P = 0.038) were independently associated with CNSE carriage. Moreover, patients infected with CNSE had worse outcomes: fewer resolved infections at 1 month ( P = 0.02), and they had a higher mortality rate ( P = 0.0004) and longer hospital stays ( P = 0.02). Conclusions We identified three independent risk factors for CNSE carriage as well as worse outcomes in infected patients in North-Eastern France. This highlights the importance of early detection of CNSE and the need for antimicrobial therapy re-evaluation after bacteriological analysis has been performed.

Published
2017

15. OqxAB and variants of QepA in extended-spectrum β-lactamase-producing Enterobacteriaceae in hospital wastewater in Mali

Author

Christophe de Champs, Véronique Vernet-Garnier, Aminata Maiga, Matthieu Daragon, Thomas Guillard, Mireille Dosso, Lucien Brasme, Ibrahim Maiga, Anaëlle Muggeo, Hôpital du point G [Bamako], Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Reims Champagne-Ardenne (URCA), Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Université Félix Houphouët-Boigny (UFHB), This work was supported by an annual grant from the University of Reims Champagne-Ardenne (Reims, France) [EA 4687]., The authors thank Janick Madoux for excellent technical assistance, and Kayla Williams for careful reading of the manuscript., Centre Hospitalier Universitaire du PointG [Bamako], and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, Microbiology (medical), [SDV]Life Sciences [q-bio], 030106 microbiology, Immunology, Drug resistance, Biology, Mali, Microbiology, beta-Lactamases, 03 medical and health sciences, Enterobacteriaceae, Drug Resistance, Multiple, Bacterial, MESH: Enterobacteriaceae/genetics, Humans, Immunology and Allergy, ComputingMilieux_MISCELLANEOUS, Disease Reservoirs, MESH: Humans, Sewage, MESH: Drug Resistance, Multiple, Bacterial, MESH: Mali, biology.organism_classification, Hospitals, MESH: Hospitals, MESH: beta-Lactamases/genetics, 3. Good health, 030104 developmental biology, Wastewater, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, MESH: Disease Reservoirs/microbiology, MESH: Enterobacteriaceae/drug effects, MESH: Sewage/microbiology
Abstract

International audience; Letter to the Editor

Published
2018

16. Difficult Gram staining: a case of endocarditis due to Cardiobacterium hominis and review of the literature

Author

Thomas, Blanchot, Anaëlle, Muggeo, Anne, Limelette, Albina, Abdelaziz, Lucien, Brasme, Anne, Quinquenel, Véronique, Vernet-Garnier, Alain, Delmer, Christophe, de Champs, and Thomas, Guillard

Subjects
Diagnosis, Differential, Microbiological Techniques, Cardiobacterium, Humans, Phenazines, Female, Gentian Violet, Endocarditis, Bacterial, Middle Aged, Gram-Negative Bacterial Infections, Time-to-Treatment
Abstract

Cardiobacterium hominis est un bacille à Gram négatif responsable d'endocardites infectieuses, principalement chez les patients atteints de pathologies cardiaques ou porteurs de valves. L'identification de cette bactérie est souvent complexe et peut être la cause d'un diagnostic et d'une prise en charge tardifs, source de complications cardiaques. Cet article présente la prise en charge d'une endocardite infectieuse associée à un sepsis à Cardiobacterium hominis, les difficultés d'identification de cette bactérie, ainsi qu'une revue de la littérature sur les infections dues à cette bactérie.

Published
2019

17. Difficile examen direct par coloration de Gram : à propos d’un cas d’endocardite à Cardiobacterium hominis et revue de la littérature

Author

Lucien Brasme, Alain Delmer, Albina Abdelaziz, Anne Quinquenel, Thomas Blanchot, Christophe de Champs, Anaëlle Muggeo, Thomas Guillard, Véronique Vernet-Garnier, Anne Limelette, Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Reims Champagne-Ardenne (URCA), Service d'Hématologie Clinique [CHU Reims], Hôpital universitaire Robert Debré [Reims], Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Service d'hématologie [Reims], Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Gynecology, 030213 general clinical medicine, medicine.medical_specialty, biology, business.industry, [SDV]Life Sciences [q-bio], General Medicine, biology.organism_classification, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Medicine, Cardiobacterium hominis, business, ComputingMilieux_MISCELLANEOUS
Abstract

Cardiobacterium hominis est un bacille a Gram negatif responsable d'endocardites infectieuses, principalement chez les patients atteints de pathologies cardiaques ou porteurs de valves. L'identification de cette bacterie est souvent complexe et peut etre la cause d'un diagnostic et d'une prise en charge tardifs, source de complications cardiaques. Cet article presente la prise en charge d'une endocardite infectieuse associee a un sepsis a Cardiobacterium hominis, les difficultes d'identification de cette bacterie, ainsi qu'une revue de la litterature sur les infections dues a cette bacterie.

Published
2019

18. Septic shock related to community-acquired pneumonia with ecthyma gangrenosum

Author

Maxime Hentzien, O. Passouant, Firouzé Bani-Sadr, Véronique Vernet-Garnier, J. Cousson, M. Viguier, Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier (ICGM ICMMM), Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine interne, Maladies Infectieuses et Immunologie Clinique [Reims], Vieillissement, Fragilité (VIEFRA - EA 3797), Université de Reims Champagne-Ardenne (URCA), and Service de dermatologie (CHU de Reims)

Subjects
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, Septic shock, Pseudomonas aeruginosa, [SDV]Life Sciences [q-bio], medicine.disease, medicine.disease_cause, 3. Good health, Microbiology, Ecthyma gangrenosum, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Community-acquired pneumonia, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030225 pediatrics, medicine, 030212 general & internal medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2019

19. Clindamycin combination treatment for the treatment of bone and joint infections caused by clindamycin-susceptible, erythromycin-resistant Staphylococcus spp

Author

Morgane Bonnet, Maxime Hentzien, Odile Bajolet, Agathe Bonnaire, Delphine Lebrun, Firouzé Bani-Sadr, X. Ohl, Saidou Diallo, Véronique Vernet-Garnier, and Centre Hospitalier Universitaire de Reims (CHU Reims)

Subjects
Male, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Prosthesis-Related Infections, Combination therapy, medicine.drug_class, [SDV]Life Sciences [q-bio], Staphylococcus, 030106 microbiology, Arthritis, Erythromycin, Microbial Sensitivity Tests, medicine.disease_cause, Bone and Bones, Bone Infection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Drug Resistance, Bacterial, medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Arthritis, Infectious, Intention-to-treat analysis, Lincosamides, business.industry, Clindamycin, Osteomyelitis, General Medicine, Middle Aged, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, 3. Good health, Infectious Diseases, Drug Therapy, Combination, Female, Joints, Rifampin, business, medicine.drug
Abstract

The objective of this study was to evaluate the clinical outcomes and safety of clindamycin combination antibiotherapy for the treatment of erythromycin-resistant, lincosamide-susceptible bone and joint infections caused by Staphylococcus spp. Between January 2010 and September 2018, 46 patients with Staphylococcus spp. erythromycin-resistant, lincosamide-susceptible bone and joint infections were treated with clindamycin combination antibiotherapy for 6 to 12 weeks. The type of infection was prosthetic in 20 cases (43.5%), osteosynthetic device in 15 cases (32.6%), chronic osteomyelitis in 7 cases (15.2%), and arthritis in 4 cases (8.7%). The cure rate was 67.4% by intention to treat and 84.6% per protocol, with a median follow-up of 398 days (range 86–843). Only 2 relapses (5.1%) were observed in patients with chronic osteomyelitis; an acquired resistance to lincosamides developed in 1 case. Clindamycin combination therapy appears to be effective for the treatment of bone and joint infection caused by erythromycin-resistant, lincosamide-susceptible Staphylococcus spp.

Published
2021

20. Efficacité de la clindamycine en bithérapie dans les infections ostéoarticulaires à staphylocoque résistant à l’érythromycine et sensible à la clindamycine

Author

Delphine Lebrun, A. Bonnaire, Odile Bajolet, Véronique Vernet-Garnier, S. Diallo, M. Bonnet, Firouzé Bani-Sadr, and X. Ohl

Subjects
Infectious Diseases
Abstract

Introduction La clindamycine represente un antibiotique important dans la prise en charge des IOA (bonne absorption par voie digestive et bonne diffusion osseuse). Les dernieres recommandations de la SPILF concernant les infections osteoarticulaires (IOA) ne recommandent pas son utilisation en cas de resistance a l’erythromycine. Cependant les donnees de la litterature a ce sujet sont peu nombreuses et contradictoires. L’objectif de cette etude etait d’evaluer l’efficacite de la clindamycine en bitherapie dans les IOA monomicrobiennes a staphylocoque resistant a l’erythromycine et sensible a la clindamycine. Materiels et methodes Nous avons mene une etude retrospective monocentrique de janvier 2010 a septembre 2018 chez des patients ayant presente une IOA monomicrobienne a staphylocoque resistant a l’erythromycine et sensible a la clindamycine, traites par clindamycine en association avec un autre antibiotique. Resultats Parmi les 46 patients inclus dans notre etude, la majorite presentait une IOA sur materiel : IOA sur prothese dans 20 cas (43,5 %) et IOA sur materiel d’osteosynthese dans 15 cas (32,6 %). Dans les 11 autres cas, il s’agissait d’une osteite chronique dans 5 cas, (10,8 %) et d’une osteoarthrite dans 6 cas (13,0 %). Staphylococcus aureus etait le germe identifie chez 31 patients (67,4 %). La prise en charge etait medicochirurgicale pour 40 patients (87 %). La clindamycine etait associee a la rifampicine dans 80,4 % des cas (37 patients). La mediane de suivi des patients etait de 398 jours (86 ; 843). La survenue d’effets indesirables necessitait l’interruption du traitement par clindamycine chez 4 patients (8,7 %). Le taux de succes a un an etait de 67,4 % en intention de traiter et de 84,8 % en per-protocole. Sept patients (15,2 %) presentaient un nouvel episode d’IOA. Il s’agissait d’une rechute dans seulement 2 cas (4,3 %), avec acquisition de resistance a la clindamycine dans 1 cas (2,2 %). Conclusion L’utilisation de la clindamycine en association avec un autre antibiotique a bonne diffusion osseuse apparait efficace dans la prise en charge des IOA a staphylocoque resistant a l’erythromycine et sensible a la clindamycine.

Published
2020

21. Are systematic drain tip or drainage fluid cultures predictive of surgical site infections?

Author

L. Vallet-Tadeusz, Véronique Vernet-Garnier, L.S. Aho-Glélé, H. Macaigne, A. Lefebvre, V.G. Ruggieri, Odile Bajolet, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), and Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Catheters, [SDV]Life Sciences [q-bio], Early detection, 030501 epidemiology, Sensitivity and Specificity, 03 medical and health sciences, Predictive Value of Tests, Surgical site, Medicine, Humans, Surgical Wound Infection, Drainage, ComputingMilieux_MISCELLANEOUS, 0303 health sciences, Bacteriological Techniques, 030306 microbiology, business.industry, General Medicine, Exudates and Transudates, Predictive value, Confidence interval, Surgery, Infectious Diseases, Female, 0305 other medical science, business, Surgical site infection
Abstract

Systematic cultures of drain tips or drainage fluids for the early detection of surgical site infections (SSIs) are controversial. To examine the association between the results of systematic drain tip or drainage fluid cultures and the occurrence of SSIs in clean or clean-contaminated surgery. Searches were performed in the PubMed, and Cat.inist databases for observational studies published before 31st March 2017. Studies reporting results of drain tip or drainage fluid systematic cultures and SSIs after clean or clean-contaminated surgeries were included, and meta-analyses were performed. Seventeen studies, including 4390 patients for drain tip cultures and 1288 for drainage fluid cultures, were selected. The pooled negative predictive values were high (99%, 95% confidence interval (CI) 98-100 for drain tip cultures and 98%, 95% CI 94-100 for drainage fluid cultures). The positive predictive values were low (11%, 95% CI 2-24 for drain tip cultures and 12%, 95% CI 3-24 for drainage fluid cultures). The sensitivities were low (41%, 95% CI 12-73 for drain tip cultures and 37%, 95% CI 16-60 for drainage fluid cultures). The specificities were high (93%, 95% CI 88-96) for drain tip cultures and moderate (77%, 95% CI 54-94) for drainage fluid cultures. Systematic cultures of drain tips or drainage fluids appear not to be relevant, because their positive predictive values were low in the prediction of SSIs.

Published
2018

22. Detection of different classes of carbapenemases: Adaptation and assessment of a phenotypic method applied to Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii, and proposal of a new algorithm

Author

Bianca Podac, Véronique Vernet-Garnier, Guillaume Gautier, Christophe de Champs, Thomas Guillard, Béatrice Berçot, Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Entérobactéries Résistance Acquise - EA 4687 (ERA), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), AP-HP Groupe Hospitalier Lariboisière, Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, and Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)

Subjects
0301 basic medicine, Microbiology (medical), Acinetobacter baumannii, Klebsiella pneumoniae, [SDV]Life Sciences [q-bio], 030106 microbiology, Combined use, Microbial Sensitivity Tests, Penicillins, medicine.disease_cause, beta-Lactams, Microbiology, Sensitivity and Specificity, beta-Lactamases, 03 medical and health sciences, chemistry.chemical_compound, Bacterial Proteins, Enterobacteriaceae, medicine, Temocillin, Molecular Biology, ComputingMilieux_MISCELLANEOUS, Bacteriological Techniques, biology, Pseudomonas aeruginosa, Faropenem, biology.organism_classification, Phenotype, chemistry, Reagent Kits, Diagnostic, Algorithm, Algorithms, medicine.drug
Abstract

A new phenotypic method for detecting carbapenemases has been adapted (assembling of two MAST® kits, including one that contains faropenem to which a temocillin disk has been added) then assessed using 101 bacterial strains ( Enterobacteriaceae with assays on Pseudomonas aeruginosa and Acinetobacter baumannii) including 62 which produce genetically identified carbapenemases. Concerning Carbapenemase-Producing Enterobacteriaceae (CPE), there is 100% sensitivity for Klebsiella pneumoniae carbapenemase (KPC, Ambler class A) and OXA-48 (Ambler class D), and 91% for metallo-beta-lactamase (MBL, Ambler class B), with a 97% sensitivity for all carbapenemases, with a specificity of 100%. The test is also efficient for detecting Pseudomonas aeruginosa carbapenemases (sensitivity between 82 and 100% and 100% specificity). The major innovation is the combined use of faropenem and temocillin for reliable detection (excellent performance with 100% sensitivity and specificity) of OXA-48. This study has led to the development of a new algorithm to detect the different classes of carbapenemases, for first-line diagnosis, by combining this modified MAST® test with immunochromatographic methods and molecular biology techniques.

Published
2017

23. Prognostic factors associated with 30-day in-hospital mortality in coagulase-negative Staphylococcus bacteraemia: no impact of vancomycin minimum inhibitory concentration

Author

Alain Delmer, Yohan Nguyen, Véronique Vernet-Garnier, Christophe Strady, Christophe de Champs, Maxime Hentzien, Amélie Servettaz, Firouzé Bani-Sadr, Centre Hospitalier Universitaire de Reims (CHU Reims), Polyclinique Saint André, Service d'hématologie [Reims], Hôpital Robert Debré, and Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)

Subjects
0301 basic medicine, Microbiology (medical), Adult, Coagulase, Male, medicine.medical_specialty, Staphylococcus, [SDV]Life Sciences [q-bio], 030106 microbiology, Bacteremia, Microbial Sensitivity Tests, medicine.disease_cause, Hospitals, University, 03 medical and health sciences, Minimum inhibitory concentration, 0302 clinical medicine, Vancomycin, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Hospital Mortality, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, General Immunology and Microbiology, In hospital mortality, business.industry, Proportional hazards model, cons, General Medicine, Middle Aged, Staphylococcal Infections, University hospital, Prognosis, 3. Good health, Surgery, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Female, business, medicine.drug
Abstract

The impact of a minimum inhibitory concentration (MIC) of vancomycin ≥2 mg/L on mortality and the potential benefit of new antistaphylococcal treatments in coagulase-negative Staphylococcus (CoNS) bacteraemia remain unknown. We assessed the impact of vancomycin MIC on 30-day in-hospital mortality and identified factors independently associated with 30-day in-hospital mortality.All patients presenting significant CoNS bacteraemia in the university hospital of Reims, between 01 January 2008 and 31 December 2012, were included. Data were retrospectively extracted from the patient records. Vancomycin MIC was assessed using the E-test method, and antimicrobial susceptibility testing was performed in accordance with the recommendations of the Antibiogram Committee of the French Microbiology Society. Cox's Proportional Hazards model was used for multivariate analysis.Two hundred and sixty-nine patients (mean age 61.2 ± 15.7 years) were included. Foreign material was present in 92% of patients and 78.4% of isolated methicillin-resistant strains had vancomycin MIC ≥2 mg/l. Thirty-day in-hospital mortality was 16%. There was no association between vancomycin MIC ≥2 mg/l and 30-day in-hospital mortality (adjusted Hazard Ratio (aHR) = .80, 95% confidence interval (95%CI) [.30-2.19], p = .67). Factors independently associated with 30-day in-hospital mortality were age ≥75 vs. ≤60 years (aHR =3.72, 95%CI [1.39-9.97], p = .009), absence of active antibiotic treatment (aHR =5.52, 95%CI [1.13-26.87], p = .03) and acute renal failure (aHR =4.45, 95%CI [2.08-9.56], p .0001). Removal of an infected device had a protective effect against 30-day in-hospital mortality (aHR = .23, 95%CI [.11-.48], p .0001).These results suggest that CoNS bacteraemia should be managed by removal of the infected device and antibiotic treatment such as vancomycin.

Published
2017

24. Knowledge of antibiotics and antibiotic resistance in patients followed by family physicians

Author

Moustapha Dramé, Brigitte Vuillemin, Véronique Vernet-Garnier, Odile Bajolet, Bernard Defoin, Firouzé Bani-Sadr, Yohan Nguyen, Aurélien Robert, Centre d'Ecologie et des Sciences de la COnservation (CESCO), Muséum national d'Histoire naturelle (MNHN)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Unité d’Otologie, implants auditifs et chirurgie de la base du crâne [CHU Pitié-Salpêtrière], Service d'Oto-Rhino-Laryngologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Reims Champagne-Ardenne (URCA), Laboratoire Interdisciplinaire Carnot de Bourgogne (LICB), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre Hospitalier Universitaire de Reims (CHU Reims), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Interdisciplinaire Carnot de Bourgogne (ICB), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Adult, Male, 0301 basic medicine, Health Knowledge, Attitudes, Practice, Pediatrics, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Antibiotics, Target groups, Drug resistance, Logistic regression, Cultural background, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Resistance, Bacterial, medicine, Humans, In patient, 030212 general & internal medicine, Antibiotic use, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, business.industry, Middle Aged, Anti-Bacterial Agents, 3. Good health, Cross-Sectional Studies, Infectious Diseases, Female, Self Report, Family Practice, business
Abstract

Objective We aimed to evaluate factors associated with knowledge of antibiotics and drug resistance. Methods A questionnaire was handed out by 14 family physicians to their patients between December 20, 2014 and April 20, 2015 in Rethel (North-East of France). We conducted a cross-sectional study using a logistical regression model to assess factors associated with antibiotic knowledge. Three criteria were used to assess that knowledge. Results Overall, 293 questionnaires were analysed; 48% of patients had received antibiotics in the previous 12 months. Only 44% and 26% gave a correct answer for the statements “Antibiotics are effective against bacteria and ineffective against viruses” and “Antibiotic resistance decreases if the antibiotic use decreases”, respectively. Characteristics such as female sex, age > 30 years, high level of education, high professional categories, and having received antibiotic information by the media were associated with high level of knowledge about antibiotics and/or antibiotic resistance. In contrast, having received antibiotic information from family physicians was not associated with good knowledge. Conclusion Although media awareness campaigns had an independent impact on a higher public knowledge of antibiotics, the overall public knowledge remains low. It would be necessary to strengthen antibiotic campaigns with clearer information on the relation between the excessive use of antibiotics and the increased risk of antibiotic resistance. Family physicians should be more involved to improve antibiotic knowledge among target groups such as men, young patients, and people from a poor social and cultural background.

Published
2017

25. Prevalence of mupirocin resistance among invasive coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus (MRSA) in France: emergence of a mupirocin-resistant MRSA clone harbouring mupA

Author

Richard Bonnet, Hélène Jean-Pierre, Anne-Sophie Bourrel, J. Etienne, Y. Rio, Jacques Tankovic, M. Biendo, Elisabeth Chachaty, Jean-Winoc Decousser, Véronique Vernet-Garnier, Julien Potier, Nejla Aissa, Alain Lozniewski, Alain Fiacre, Marie-Hélène Nicolas-Chanoine, Frédéric Laurent, Patrice Nordmann, F. Girard-Pipau, Jean-Philippe Lavigne, C. Plouzeau-Jayle, Christian Cattoen, François Vandenesch, Vincent Cattoir, Florence Doucet-Populaire, C. Eloy, Jocelyne Caillon, François Caron, T. Roussel-Gaillard, François Jehl, J. Texier-Maugein, Max Maurin, Laurent Bret, Grégoire Aubert, M. Archambaud, Marie-Cécile Ploy, C. Loiez-Durocher, Isabelle Patry, Gerard Lina, H. Courtade, C. Buisson-Touati, H. Rostane, G. Blanchard-Marche, Nicolas Fortineau, Roland Leclercq, Nadège Bourgeois-Nicolaos, Philippe Morand, Marine Desroches, Frédéric Robin, Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunité infection vaccination (I2V), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-IFR128-Institut National de la Santé et de la Recherche Médicale (INSERM), Bactéries, Pathogènes et Santé (UBaPS), Faculté de Pharmacie, Université Paris-Sud - Paris 11 (UP11)-Université Paris-Sud - Paris 11 (UP11), CHU Henri Mondor, Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges, Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, and Novartis, France

Subjects
DNA, Bacterial, Microbiology (medical), Staphylococcus, Mupirocin, Microbial Sensitivity Tests, Biology, Staphylococcal infections, medicine.disease_cause, Polymerase Chain Reaction, Microbiology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, Bacterial Proteins, law, Drug Resistance, Bacterial, medicine, Pharmacology (medical), Prospective Studies, Polymerase chain reaction, 030304 developmental biology, Lyon clone, Pharmacology, Molecular Epidemiology, 0303 health sciences, 030306 microbiology, Broth microdilution, Nuclear Proteins, invasive staphylococci, Staphylococcal Infections, Microarray Analysis, medicine.disease, Methicillin-resistant Staphylococcus aureus, Anti-Bacterial Agents, Electrophoresis, Gel, Pulsed-Field, 3. Good health, Molecular Typing, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, chemistry, Staphylococcus aureus, [SDV.IMM]Life Sciences [q-bio]/Immunology, decolonization, lipids (amino acids, peptides, and proteins), France, Coagulase
Abstract

OBJECTIVES Mupirocin is the cornerstone of decolonization regimens, a successful strategy to prevent healthcare-associated staphylococcal infections. Several recent studies have reported alarming results: (i) an extending reservoir of mupA, the ancestral mobile resistance gene, among coagulase-negative staphylococci (CoNS); (ii) the emergence of a new resistance gene (mupB); and (iii) a growing number of mupirocin-resistant methicillin-resistant Staphylococcus aureus (MRSA), including highly pathogenic clones. We performed a nationwide prospective study in France to detect such trends among invasive staphylococci. METHODS Between October 2011 and February 2012, 367 MRSA and 708 CoNS invasive isolates were collected from 37 hospitals and analysed centrally. Mupirocin MICs were determined using the broth microdilution method. mupA/B PCR was performed for resistant isolates (MIC >1 mg/L). Genetic relatedness between mupirocin-resistant MRSA isolates was determined by PFGE analysis and related isolates were tested by microarray. RESULTS Among MRSA isolates 2.2% (n = 8) were classified as mupirocin resistant; 1.4% (n = 5) showing low-level resistance (MIC ≤256 mg/L) and 0.8% (n = 3) high-level resistance (MIC >256 mg/L). Only the latter isolates carried mupA. A clonal relationship was identified between two mupA-negative MRSA from the same hospital and three mupA-positive MRSA from three distant towns; these three isolates belonged to the Lyon clone. Mupirocin resistance was identified in 10.3% of CoNS, mainly highly resistant mupA-positive isolates (5.6%). The mupB gene was not detected in mupirocin-resistant MRSA or CoNS. CONCLUSIONS This first large national study indicates the need for thorough epidemiological monitoring and a stewardship programme to prevent and detect mupirocin resistance in staphylococci.

Published
2013

26. Antimicrobial therapy for patients with community-acquired pneumonia in the emergency department: results from a French national audit

Author

Jean-Louis Ducasse, Dominique Pateron, Véronique Vernet-Garnier, Jean-Paul Fontaine, Laure Pourcel, Alain Durocher, and Yann-Erick Claessens

Subjects
medicine.medical_specialty, business.industry, Emergency department, Audit, Pain management, Antimicrobial, medicine.disease, Pneumonia, Community-acquired pneumonia, Intensive care, Emergency medicine, medicine, National audit, business
Abstract

Background: The updated French guidelines for the management of antimicrobial therapy and site-of-care for adults’ community-acquired pneumonia (CAP) were published in July, 2010, stratifying patients in 6 groups depending on age, significant underlying disorders and organ failure. Objectives: We conducted the first national audit of adherence to the latest CAP guidelines. Methods: A web-based audit tool was developed as part of the guidelines. French Emergency Departments (EDs) were invited to participate in the audit capturing data on adults visiting EDs with suspected CAP within the study period(15th October-15th December, 2010). Results: A total of 3.166 cases were provided from 72 EDs. Median age was 75 years (range 15-106 years), 55% were male. CRB65 score was 0 in 22.9 %, 1-2 in 67.8%, and 3-4 in 9.2%; 2630 (83.5%) patients were admitted after ED visit including 335 (12.7%) in intensive care units. Median delay to first antibiotics was 3h45min. Initial empirical antimicrobial treatment was in accordance with French CAP guidelines in 895 (28.3 %) patients. However, adherence widely varied (0%-66.9%) in the patient groups. Of note, 354 (11.2%) did not receive any antibiotics and antimicrobial agents were not in adherence with guidelines in 1917 (60.5%) patients. Conclusions: Management of CAP often differs from guidelines in French emergency departments. This result questions whether emergency physicians are aware of the recommendations or whether recommendations are adequate for emergency CAP patients. Keywords: Audit; Antimicrobial agent; Emergency department; Community-Acquired pneumonia; Site of care

Published
2016

27. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author

Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. 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Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)

Subjects
Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract

International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (

Published
2016

28. Coagulase-negative Staphylococcus bacteraemia accounts for one third of Staphylococcus bacteraemia in a French university hospital

Author

Christophe de Champs, Véronique Vernet-Garnier, Roland Jaussaud, Yohan Nguyen, Sonia Baumard, Christophe Strady, Anne Sophie Batalla, Service de Médecine interne, Maladies Infectieuses et Immunologie Clinique [Reims], and Centre Hospitalier Universitaire de Reims (CHU Reims)

Subjects
Adult, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, Staphylococcus, [SDV]Life Sciences [q-bio], Bacteremia, medicine.disease_cause, Staphylococcal infections, Logistic regression, acute renal failure, Hospitals, University, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, Humans, Medicine, 030212 general & internal medicine, coagulase-negative Staphylococcus, Aged, Retrospective Studies, Aged, 80 and over, 0303 health sciences, General Immunology and Microbiology, 030306 microbiology, business.industry, cons, Retrospective cohort study, General Medicine, Middle Aged, Staphylococcal Infections, bacterial infections and mycoses, medicine.disease, 3. Good health, Surgery, Exact test, Infectious Diseases, Bacteraemia, Female, epidemiology, France, Coagulase, business
Abstract

International audience; Background: We sought to determine the epidemiological patterns of Staphylococcus bacteraemia, with a focus on the proportion of coagulase-negative Staphylococcus (CoNS) as compared to Staphylococcus aureus bacteraemia, and the prognosis. Methods: All patients with signifi cant Staphylococcus bacteraemia at the university hospital in Reims in 2008 were included in the study. Data were retrieved retrospectively from the patient records using a standardized case investigation form. Quantitative variables were compared using the Mann-Whitney U-test and qualitative variables were compared using Fisher ' s exact test or Pearson ' s Chi-square test, as appropriate. Bivariate logistic regression was performed on both S. aureus and CoNS bacteraemia. All variables with a p-value of Ͻ 0.15 were entered into a multiple logistic regression model. Results: CoNS represented 31.6% of all strains isolated. The methicillin resistance rate was higher in CoNS (66.1%) than in S. aureus (19.1%) (p Ͻ 0.0001). CoNS were more frequently associated with intravascular catheters and neoplastic disease, whereas S. aureus was associated with chronic renal failure (p Ͻ 0.0001) and diabetes mellitus (p ϭ 0.004). Mortality was 30.7% for S. aureus and 19.6% for CoNS bacteraemia (p ϭ 0.12). Methicillin resistance was not associated with mortality (p ϭ 0.99). Factors independently associated with mortality in CoNS and S. aureus bacteraemia were age and acute renal failure. The presence of severe sepsis/septic shock was only associated with mortality in S. aureus bacteraemia. Conclusions: CoNS represent one third of Staphylococcus bacteraemia. The mortality difference between CoNS and S. aureus bacteraemia was not statistically signifi cant. Acute renal failure is associated with mortality in both S. aureus and CoNS bacteraemia.

Published
2011

29. Mise au point d’une technique de PCR en temps réel pour la détection rapide des gènes qnr chez des entérobactéries productrices de bêta-lactamases à spectre étendu

Author

Emmanuelle Cambau, Véronique Vernet-Garnier, C. De Champs, Thomas Guillard, Lucien Brasme, J.-D. Cavallo, Odile Bajolet, and Véronique Duval

Subjects
General Medicine, Treatment resistance, Biology, Molecular biology, Antibacterial agent
Abstract

Resume But de l’etude Le but de cette etude etait de developper une methode de PCR en temps reel permettant de detecter rapidement les genes de resistance plasmidique aux quinolones qnr. Methodes La technique de PCR en temps reel avec SYBR Green I a ete developpee sur l’automate Roche LightCycler®. La detection des genes qnr etait realisee par comparaison des courbes de fusion a celle d’un temoin positif. Cette etude a permis d’etudier 138 souches isolees de prelevements diagnostiques ou ecologiques en Champagne-Ardenne en 2004. Resultats Apres optimisation de la technique, la specificite des amorces a ete confirmee en testant les trois controles positifs seuls, puis en presence des souches a tester. Chaque PCR permettait de rechercher sur 30 souches un gene qnr en 60 minutes. Parmi 138 souches, 3,6 % des souches etaient porteuses de qnrA1, 1,5 % de qnrS1 et aucune ne presentait le gene qnrB. La prevalence du determinant de resistance qnr etait de 5 % et atteignait 9,5 % pour les seules souches isolees de prelevements diagnostiques. Conclusion Cette technique de PCR est une methode de detection rapide des genes qnr. Cette etude rapporte une relativement forte prevalence (5 %) de qnr parmi les enterobacteries productrices de beta-lactamases a spectre etendu (EBLSE) isolees en Champagne-Ardenne en 2004.

Published
2010

30. Rapid Detection of aac(6 ′ )-Ib-cr Quinolone Resistance Gene by Pyrosequencing

Author

Christophe de Champs, Lucien Brasme, Véronique Duval, Véronique Vernet-Garnier, Thomas Guillard, and Hélène Moret

Subjects
DNA, Bacterial, Microbiology (medical), Sequence analysis, medicine.medical_treatment, Molecular Sequence Data, Drug resistance, Quinolones, Sensitivity and Specificity, DNA sequencing, Plasmid, Enterobacteriaceae, Drug Resistance, Bacterial, medicine, Humans, Gene, Genetics, Bacteriological Techniques, Base Sequence, biology, Bacteriology, biology.organism_classification, Molecular biology, Anti-Bacterial Agents, Genes, Bacterial, Beta-lactamase, Pyrosequencing, Sequence Analysis, Plasmids
Abstract

Pyrosequencing was used to rapidly detect aac(6 ′ )-Ib and aac(6 ′ )-Ib-cr genes. This plasmid-mediated quinolone resistance determinant is increasing in extended-spectrum beta-lactamase-producing Enterobacteriaceae . This method is faster and more cost-effective than the methods previously described. Sequences obtained with this pyrosequencing method showed 100% concordance with conventional sequencing.

Published
2010

31. Necrotizing pneumonia due to Streptococcus pneumoniae

Author

Véronique Vernet-Garnier, Thomas Guillard, Marie Laure Boubee, Christophe de Champs, Jean Sébastien Petit, Olivier Toubas, Antoine Grillon, Anne Limelette, Entérobactéries Résistance Acquise - EA 4687 (ERA), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), and Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)

Subjects
Serotype, Male, 030213 general clinical medicine, Necrosis, Necrotizing pneumonia, [SDV]Life Sciences [q-bio], Virulence, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Streptococcus pneumoniae, medicine, Humans, ComputingMilieux_MISCELLANEOUS, business.industry, Streptococcus, General Medicine, Middle Aged, Pneumonia, Pneumococcal, medicine.disease, respiratory tract diseases, 3. Good health, Pneumonia, Immunology, medicine.symptom, Complication, business
Abstract

We present a patient with a necrotizing pneumonia due to Streptococcus pneumoniae. This complication often affects children and is relatively rare and unrecognized in adults. Its diagnosis is often difficult on chest-X-ray and need a chest computed tomography. No risk factors predisposing to necrosis are described in literature and its mortality is not different from pneumonia without necrosis. The serotype 3 is the most common type implicated in pneumococcal necrotizing pneumonia. Study of virulence factors of S. pneumoniae and various genetic polymorphisms of the host should allow a better understanding of this complication.

Published
2015

32. Decline in antibiotic resistance and changes in the serotype distribution of [i]Streptococcus pneumoniae[/i] isolates from children with acute otitis media; a 2001-2011 survey by the French Pneumococcal Network

Author

Thierry Fosse, Tahar Hadou, Frédéric Wallet, Marie Kempf, J-L Koeck, Regine Baraduc, S. Luce, Véronique Vernet-Garnier, Julie Cremniter, Laurent Gutmann, Marie-Cécile Ploy, François Dalmay, Emmanuelle Varon, Michel Vergnaud, B. Soullié, Michel Brun, Hubert Chardon, Christine Segonds, M-C Demachy, Isabelle Patry, Carole Grélaud, Philippe Lanotte, Farida Hamdad, Alain Ros, J. Raymond, Jacques Croizé, D. Tandé, S. Mermond, André Pechinot, Agnes Lepoutre, Alain Gravet, Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Centre National de Référence des Pneumocoques (CNRP), Assistance Publique - Hôpitaux de Paris, Institut de Veille Sanitaire (INVS), Unité Fonctionnelle de Recherche Clinique et de Biostatistique (UFRCB), Infectiologie et Santé Publique (UMR ISP), Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT), UR Infectiologie animale et Santé publique (UR IASP), Institut National de la Recherche Agronomique (INRA), and Institut National de la Recherche Agronomique (INRA)-Université de Tours

Subjects
Microbiology (medical), Serotype, Cefotaxime, pneumococcal vaccine, French regional observatories, Epidemiology, Microbial Sensitivity Tests, Drug resistance, Biology, Serogroup, medicine.disease_cause, complex mixtures, Pneumococcal Infections, Microbiology, Pneumococcal Vaccines, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Drug Resistance, Bacterial, Streptococcus pneumoniae, medicine, otorhinolaryngologic diseases, Humans, 030212 general & internal medicine, 0303 health sciences, Otitis Media with Effusion, 030306 microbiology, Incidence, General Medicine, Amoxicillin, Virology, Anti-Bacterial Agents, 3. Good health, Penicillin, Otitis Media, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Pneumococcal vaccine, France, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract

Streptococcus pneumoniae is an important cause of acute otitis media (AOM). The aim of this study was to evaluate trends in antibiotic resistance and circulating serotypes of pneumococci isolated from middle ear fluid of French children with AOM during the period 2001–2011, before and after the introduction of the PCV-7 (2003) and PCV-13 (2010) vaccines. Between 2001 and 2011 the French pneumococcal surveillance network analysed the antibiotic susceptibility of 6683 S. pneumoniae isolated from children with AOM, of which 1569 were serotyped. We observed a significant overall increase in antibiotic susceptibility. Respective resistance (I+R) rates in 2001 and 2011 were 76.9% and 57.3% for penicillin, 43.0% and 29.8% for amoxicillin, and 28.6% and 13.0% for cefotaxime. We also found a marked reduction in vaccine serotypes after PCV-7 implementation, from 63.0% in 2001 to 13.2% in 2011, while the incidence of the additional six serotypes included in PCV-13 increased during the same period, with a particularly high proportion of 19A isolates. The proportion of some non-PCV-13 serotypes also increased between 2001 and 2011, especially 15A and 23A. Before PCV-7 implementation, most (70.8%) penicillin non-susceptible pneumococci belonged to PCV-7 serotypes, whereas in 2011, 56.8% of penicillin non-susceptible pneumococci belonged to serotype 19A. Between 2001 and 2011, antibiotic resistance among pneumococci responsible for AOM in France fell markedly, and PCV-7 serotypes were replaced by non-PCV-7 serotypes, especially 19A. We are continuing to assess the impact of PCV-13, introduced in France in 2010, on pneumococcal serotype circulation and antibiotic resistance.

Published
2015

33. Gastroscopy-associated transmission of extended-spectrum beta-lactamase-producing Pseudomonas aeruginosa

Author

G. Thiefin, Véronique Vernet-Garnier, Lucien Brasme, F. Bureau-Chalot, Odile Bajolet, Dragos Florin Ciocan, C. De Champs, G. Cadiot, C. Vallet, and Thomas Guillard

Subjects
Adult, Microbiology (medical), Cross infection, medicine.medical_specialty, Endoscope, medicine.medical_treatment, medicine.disease_cause, beta-Lactamases, Teaching hospital, Drug Resistance, Multiple, Bacterial, Gastroscopy, Humans, Medicine, Pseudomonas Infections, Hospitals, Teaching, Aged, Gastrointestinal endoscopy, Aged, 80 and over, Disinfection methods, Cross Infection, Infection Control, business.industry, Pseudomonas aeruginosa, Guideline adherence, General Medicine, Middle Aged, Surgery, Disinfection, Infectious Diseases, Beta-lactamase, France, Guideline Adherence, business, Gastroscopes
Abstract

An unusual multi-drug-resistant Pseudomonas aeruginosa (MDR-PA) was isolated in four patients whilst hospitalized in a French teaching hospital between May and August 2011. All four patients had undergone an oesophago-gastro-duodenoscopy with the same gastroscope over a five-month period. This endoscope was associated with a culture positive for the MDR-PA. Observations of endoscope reprocessing identified deviations from the agreed processes: insufficient initial cleaning, shortening of the immersion time and brushing time, insufficient channel flushing, and inadequate drying prior to storage. Since withdrawing the gastroscope and institution of strict adherence to the agreed processes, no other MDR-PA cases have been isolated.

Published
2013

34. Présentations atypiques d'infections a Neisseria meningitidis. À propos de trois observations

Author

D. Ingrand, Odile Bajolet, Lucien Brasme, A. Furco, B. Mouchet, and Véronique Vernet-Garnier

Subjects
medicine.medical_specialty, Pediatrics, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Neisseria meningitidis, medicine.disease, Meningococcal disease, medicine.disease_cause, Asymptomatic, Surgery, Infectious Diseases, Pericardiocentesis, Bacteremia, Medicine, Urethritis, Blood culture, medicine.symptom, business, Myopericarditis
Abstract

Clinical cases – We report three cases of rare or atypical presentations of meningococcal disease. The first concerns urethritis in a 20-year-old man, with no specific clinical presentation. The outcome was favorable after doxycyclin treatment. The second case is an asymptomatic meningococcemia in a five-year-old child, diagnosed by blood culture because there was only one fever episode, and treated with amoxicillin. The last case concerns an early myopericarditis in a 22-year-old man with meningococcal meningitis, with favorable outcome after antibiotherapy and anti-inflammatory treatment. Comments – These case reports show the variable N. meningitidis affinity. Clinical symptoms and treatment of meningococcal urethritis are not specific. Asymptomatic meningococcemia is difficult to recognize. The possible adverse outcome justifies a systematic antibiotherapy. Early myopericarditis is rarely reported. The outcome is favorable following antibiotic and anti-inflammatory treatment, and sometimes pericardiocentesis.

Published
2002

35. Facteurs pronostiques associés à la mortalité intra-hospitalière sur 30 jours lors des bactériémies à staphylocoques à coagulase négative : absence d’impact de la concentration minimale inhibitrice à la vancomycine

Author

Amélie Servettaz, Firouzé Bani-Sadr, Christophe Strady, Véronique Vernet-Garnier, Alain Delmer, Yohan Nguyen, M. Hentzien, and C. De Champs

Subjects
Infectious Diseases
Abstract

Introduction Au cours des bacteriemies a staphylocoques coagulase-negatifs (SCN), l’impact d’une concentration minimale inhibitrice (CMI) a la vancomycine superieure ou egale a 2 mg/l sur la mortalite ainsi que le potentiel benefice des nouveaux antibiotiques antistaphylococciques sont inconnus. Nous avons etudie l’impact de la CMI a la vancomycine sur la mortalite intra-hospitaliere sur 30 jours et recherche les facteurs independamment associes a cette mortalite au cours des bacteriemies a SCN. Materiels et methodes Tous les patients ayant presente une bacteriemie significative a SCN entre le 01/01/2008 et le 31/12/2012 ont ete inclus. Les donnees ont ete retrospectivement extraites des dossiers medicaux des patients. La CMI a la vancomycine a ete mesuree par methode E-test et la recherche de resistance aux antibiotiques a ete realisee en accord avec les recommandations du comite de l’antibiogramme de la societe francaise de microbiologie. Un modele a risques proportionnels de Cox etait utilise pour l’analyse multivariee. Resultats Deux cent soixante-neuf patients (âge moyen 61,2 ± 15,7 ans) ont ete inclus. La presence de materiel etranger etait retrouvee chez 92 % (247/269) des patients, et 78 % (127/188) des souches isolees resistantes a la meticilline avaient egalement une CMI a la vancomycine ≥2 mg/l. La mortalite intra-hospitaliere sur 30 jours etait de 16 % (41/268). On ne retrouvait pas d’association entre une CMI a la vancomycine ≥2 mg/l et la mortalite (Hazard Ratio ajuste (HRa) = 0,90 ; intervalle de confiance a 95 % (IC95 %) [0,30–2,19] ; p = 0,67). Les facteurs independamment associes a la mortalite etaient un âge ≥ 75 vs ≤ 60 ans (HRa = 3,72 ; IC95 %[1,39–9,97] ; p = 0,009), l’absence d’antibiotherapie active sur la souche isolee (HRa = 5,52 ; IC95 %[1,13–26,87], p = 0,03) et l’insuffisance renale aigue (HRa = 4,45 ; IC95 %[2,08–9,56] ; p = 0,0001). L’ablation de materiel infecte etait un facteur protecteur (HRa = 0,23 ; IC95 %[0,11–0,48] ; p Conclusion Ces donnees suggerent que les bacteriemies a SCN devraient etre traitees en premier lieu par l’ablation du materiel infecte et par une antibiotherapie telle que la vancomycine, independamment de la CMI a la vancomycine.

Published
2017

36. Respiratory tract colonization by Pasteurella pneumotropica in a patient with an alpha1-antitrypsin deficiency unexpectedly well identified by automated system Vitek 2

Author

Thomas Guillard, François Lebargy, Véronique Vernet-Garnier, Michèle Martin, Catherine David, Lucien Brasme, Christophe de Champs, and Véronique Duval

Subjects
Microbiology (medical), Pathology, medicine.medical_specialty, Infectious Diseases, medicine.anatomical_structure, business.industry, PASTEURELLA PNEUMOTROPICA, medicine, Colonization, General Medicine, business, Microbiology, Respiratory tract
Published
2010

37. Description of a 2,683-Base-Pair Plasmid Containing qnrD in Two Providencia rettgeri Isolates

Author

Aurore Mbadi, Catherine Neuwirth, Lucien Brasme, Christophe de Champs, Thomas Guillard, Odile Bajolet, Emmanuelle Cambau, Thomas Nenninger, and Véronique Vernet-Garnier

Subjects
DNA, Bacterial, Base pair, Molecular Sequence Data, Microbial Sensitivity Tests, Providencia, Quinolones, Microbiology, Quinolone resistance, Feces, Open Reading Frames, Plasmid, Mechanisms of Resistance, Sequence Homology, Nucleic Acid, Drug Resistance, Bacterial, Humans, Pharmacology (medical), Gene, Pharmacology, Genetics, biology, Base Sequence, Enterobacteriaceae Infections, Salmonella enterica, Providencia rettgeri, biology.organism_classification, Anti-Bacterial Agents, Open reading frame, Infectious Diseases, Salmonella Infections, Plasmids
Abstract

qnr genes are plasmid-mediated quinolone resistance genes mainly harbored on large conjugative multiresistant plasmids. The qnrD gene was recently observed in Salmonella enterica on a small nonconjugative plasmid (p2007057). We describe two strains of Providencia rettgeri harboring qnrD on nonconjugative plasmids. The plasmids were 99% identical, with 2,683 bp and four open reading frames, including qnrD , but exhibited only 53% identity with the plasmid found in S. enterica .

Published
2012

38. Rapid detection of qnr and qepA plasmid-mediated quinolone resistance genes using real-time PCR

Author

Emmanuelle Cambau, Véronique Vernet-Garnier, Christophe de Champs, Hélène Moret, Antoine Carlier, Thomas Guillard, and Lucien Brasme

Subjects
Microbiology (medical), DNA, Bacterial, Microbial Sensitivity Tests, Biology, Diamines, Quinolones, Polymerase Chain Reaction, law.invention, Quinolone resistance, chemistry.chemical_compound, Plasmid, Enterobacteriaceae, law, Drug Resistance, Bacterial, Humans, Multiplex, Benzothiazoles, Organic Chemicals, Gene, Polymerase chain reaction, Genetics, Staining and Labeling, Enterobacteriaceae Infections, General Medicine, biology.organism_classification, Molecular biology, Anti-Bacterial Agents, Infectious Diseases, Real-time polymerase chain reaction, chemistry, Genes, Bacterial, SYBR Green I, Quinolines, Plasmids
Abstract

Plasmid-mediated quinolone resistance genes in clinical strains cannot be detected by phenotypic traits but require gene detection. We developed a multiplex real-time polymerase chain reaction (PCR) assay using high-resolution melting master mix with ResoLight dye to detect qnr genes and a simplex real-time PCR assay using SYBR Green I to detect qepA genes. Using qnr-positive and qepA1-positive control strains, the ResoLight method was able to rapidly identify qnrA, qnrB, qnrS, qnrC, and qnrD genes; the SYBR Green I method identified qepA genes. Among 118 extended spectrum beta-lactamase-producing Enterobacteriaceae isolates, the 2 new assays efficiently detected and identified qnr in 9 strains, but no qepA gene. To our knowledge, this is the first study describing the detection of all 5 qnr and qepA genes using real-time PCR. The 2 tests constitute a significant step forward for screening for plasmid quinolone resistance genes in clinical strains.

Published
2010

40. Mobile Insertion Cassette Elements Found in Small Non-Transmissible Plasmids in Proteeae May Explain qnrD Mobilization

Author

Christophe de Champs, Céline Cartier, Béatrice Berçot, Janick Madoux, Thomas Guillard, Véronique Vernet-Garnier, Anne-Laure Lebreil, Emmanuelle Cambau, Alain Lozniewski, Antoine Grillon, J. Riahi, Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), Entérobactéries Résistance Acquise - EA 4687 (ERA), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), AP-HP Groupe Hospitalier Lariboisière, Emergence de la résistance bactérienne in vivo (EA3964), Université Paris Diderot - Paris 7 (UPD7), Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Laboratoire de Bactériologie [CHU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)

Subjects
Evolutionary Genetics, Bacterial Diseases, Klebsiella pneumoniae, Proteus vulgaris, Salmonella-enterica, lcsh:Medicine, Escherichia-coli, Gene, Plasmid, Gene Order, lcsh:Science, Determinants, Genetics, 0303 health sciences, Multidisciplinary, biology, Klebsiella-pneumoniae, Providencia rettgeri, Mediated quinolone resistance, Enterobacteriaceae, Bacterial Pathogens, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Medical Microbiology, Enterobacter Infections, [SDV.IMM]Life Sciences [q-bio]/Immunology, Medicine, Research Article, Plasmids, Molecular Sequence Data, Providencia, Microbial Sensitivity Tests, Drosophila-melanogaster, Microbiology, Bacillus-cereus, 03 medical and health sciences, Genetic Mutation, Drug Resistance, Bacterial, Biology, 030304 developmental biology, Evolutionary Biology, Base Sequence, 030306 microbiology, lcsh:R, Bacteriology, biology.organism_classification, Proteus mirabilis, Genes, Bacterial, DNA Transposable Elements, lcsh:Q, Mobile genetic elements, Mirabilis, Population Genetics
Abstract

International audience; qnrD is a plasmid mediated quinolone resistance gene from unknown origin, recently described in Enterobacteriaceae. It encodes a pentapeptide repeat protein 36-60% different from the other Qnr (A, B, C, S and VC). Since most qnrD-positive strains were described as strains belonging to Proteus or Providencia genera, we hypothesized that qnrD originated in Proteeae before disseminating to other enterobacterial species. We screened 317 strains of Proteeae for qnrD and its genetic support by PCR. For all the seven qnrD-positive strains (4 Proteus mirabilis, 1 Proteus vulgaris and 2 Providencia rettgeri) the gene was carried onto a small non-transmissible plasmid, contrarily to other qnr genes that are usually carried onto large multi-resistant plasmids. Nucleotide sequences of the qnrD-bearing plasmids were 96% identical. Plasmids contained 3 ORFs apart from qnrD and belonged to an undescribed incompatibility group. Only one plasmid, in P. vulgaris, was slightly different with a 1,568-bp insertion between qnrD and its promoter, leading to absence of quinolone resistance. We sought for similar plasmids in 15 reference strains of Proteeae, but which were tested negative for qnrD, and found a 48% identical plasmid (pVERM) in Providencia vermicola. In order to explain how qnrD could have been inserted into such native plasmid, we sought for gene mobilization structures. qnrD was found to be located within a mobile insertion cassette (mic) element which sequences are similar to one mic also found in pVERM. Our conclusions are that (i) the small non-transmissible qnrD-plasmids described here may result from the recombination between an as-yet-unknown progenitor of qnrD and pVERM, (ii) these plasmids are maintained in Proteeae being a qnrD reservoir (iii) the mic element may explain qnrD mobilization from non-transmissible plasmids to mobilizable or conjugative plasmids from other Enterobacteriaceae, (iv) they can recombined with larger multiresistant plasmids conjugated in Proteeae.

Published
2014

41. Splenic abscess complicating Salmonella typhi infection

Author

R Jaussaud, Véronique Vernet-Garnier, J F Deville, and L Brasme

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, business.industry, Splenic abscess, Spleen, General Medicine, Salmonella typhi, medicine.disease, Typhoid fever, Abscess, Infectious Diseases, medicine.anatomical_structure, Medical microbiology, Immunology, medicine, Humans, Splenic disease, Typhoid Fever, business, Splenic Diseases
Published
2000

42. High Prevalence of CTX-M-Type β-Lactamases among Clinical Isolates of Enterobacteriaceae in Bamako, Mali

Author

Christophe de Champs, Janick Madoux, Lucien Brasme, Ibrahim Maiga, Aminata Maiga, Véronique Duval, Thomas Guillard, Véronique Vernet-Garnier, and D. Forte

Subjects
Pharmacology, biology, Klebsiella pneumoniae, medicine.medical_treatment, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Enterobacteriaceae, Proteus mirabilis, beta-Lactamases, Random Amplified Polymorphic DNA Technique, RAPD, Microbiology, Infectious Diseases, Intensive care, Drug Resistance, Bacterial, polycyclic compounds, Beta-lactamase, medicine, Humans, Pharmacology (medical), Letters to the Editor, Morganella morganii, Enterobacter cloacae
Abstract

In 2004, Weil et al. reported the presence of CTX-M-15 in Salmonella enterica (10), and recently Ruppe et al. reported the carriage of CTX-M-15-producing isolates in children in a remote village in Senegal (8). However, since the report of SHV-type enzymes in Nigeria (1), no survey has been performed on extended-spectrum β-lactamase (ESBL) producers in West African hospitals (4, 7). Between May 2004 and April 2006, in Hopital du Point G, Bamako, Mali, of 1,193 nonrepetitive isolates of Enterobacteriaceae identified by the API 20E system (bioMerieux, Marcy l'Etoile, France), 256 produced an ESBL detected by the double-disk synergy test (9) (156/747 Escherichia coli, 82/217 Klebsiella pneumoniae, 15/81 Enterobacter cloacae, 2/12 Morganella morganii, and 1/36 Proteus mirabilis isolates). Enzymes were identified for 109 E. coli and 63 K. pneumoniae isolates randomly selected every 3 months and for all E. cloacae, M. morganii, and P. mirabilis isolates. These strains were isolated from patients hospitalized in the medical (n = 127 [66.3%]) and surgical (n = 27 [14.0%]) wards and intensive care units (n = 2 [1.2%]) and emergency patients (n = 4 [2.3%]) and outpatients (n = 30 [15.7%]) and from urine (n = 142 [74.7%]), blood (n = 12 [6.3%]), pus (n = 20 [10.4%]), and other sites (n = 16 [8.3%]) (stool, catheter, and pleural and peritoneal fluid). Antimicrobial susceptibility was determined by disk diffusion according to the recommendations of the Antibiogram Committee of the French Society for Microbiology (http://www.sfm.asso.fr/) (Table ​(Table1).1). Isoelectric focusing evidenced only one pI corresponding to a TEM-type enzyme, pI 5.4, in 121/190 isolates. Since this pI was considered as TEM-1 in most cases, we did not screen other TEM-type ESBLs by PCR. All 190 isolates were positive for blaSHV- or blaCTX-M-related genes, as assessed by PCR using previously described specific primers (2). After direct sequencing of PCR products (2), CTX-M-15 (n = 157), CTX-M-14 (n = 17), SHV-12 (n = 17), and SHV-27 (n = 1) were identified. Two isolates produced two ESBLs, CTX-M-15 and SHV-12 or SHV-27 (Table ​(Table1).1). Except in three isolates of E. coli, all SHV-type enzymes were produced by E. cloacae or K. pneumoniae, confirming the role of E. coli CTX-M-15 in the increase in ESBL incidence. To determine whether the ESBL frequency was due to the spread of some predominant strains, randomly amplified polymorphic DNA (RAPD) analysis was performed (2). A great diversity of RAPD types were observed (Table ​(Table1),1), and no isolate was the same as E. coli O25:H4-ST 131 (3, 5). In E. cloacae species, all SHV-12-producing isolates had similar RAPD patterns, in contrast to CTX-M-15-producing isolates, which were all different. TABLE 1. Frequency of resistance to non-β-lactam antibiotics of ESBL-producing Enterobacteriaceae isolates This study confirms that the worldwide diffusion of the CTX-M-15 enzyme has also reached West Africa. This was probably due to plasmid spread, since E. coli isolates, unlike SHV-12-producing E. cloacae isolates, were not genetically related (6). The spread of resistance in this area was more likely due to plasmids carrying antibiotic resistance genes than to bacterial transmission between patients. Maintenance of these plasmids was probably favored by antibiotic pressure. These findings emphasize the need for a policy of careful antibiotic use worldwide.

Published
2009

43. Incidence of class A extended-spectrum -lactamases in Champagne-Ardenne (France): a 1 year prospective study

Author

C. Eloy, Christophe Strady, J. C. Reveil, D. Siméon, I. Baudinat, C. De Champs, Marie-Frédérique Lartigue, F. Noël, P. Bineau, C. Lafaurie, Laurent Poirel, J. P. Verquin, F. Fidel, C. Bouquigny-Saison, J. Madoux, C. Alba-Sauviat, Véronique Vernet-Garnier, D. Forte, Lucien Brasme, Patrice Nordmann, and Odile Bajolet

Subjects
Acinetobacter baumannii, Microbiology (medical), Cefotaxime, Time Factors, Ceftazidime, Biology, Enterobacter aerogenes, medicine.disease_cause, Integron, beta-Lactamases, Microbiology, Enterobacteriaceae, Drug Resistance, Bacterial, medicine, Humans, Pharmacology (medical), Pharmacology, Pseudomonas aeruginosa, Bacterial Infections, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Anti-Bacterial Agents, Infectious Diseases, Population Surveillance, biology.protein, France, medicine.drug, Pseudomonadaceae
Abstract

Objectives: To assess the frequency and diversity of extended spectrum b-lactamases (ESBLs) in the Champagne-Ardenne region France, and to identify genetic elements associated with the blaCTX-M genes. Methods: During 2004, all the non-duplicate isolates of Pseudomonas aeruginosa and Acinetobacter baumannii resistant to ceftazidime and of Enterobacteriaceae intermediate or resistant to ceftazidime and/or cefotaxime, screening samples excluded, were collected in 10 public hospitals and 3 private clinics. bla genes were sequenced and blaCTX-M environment characterized by PCR mapping. Results: In Enterobacteriaceae (138/21 861; 0.6%), ESBLs were predominantly TEM-24 (n 5 52; 37.7%) and CTX-M-15 (n 5 37; 26.8%). Three new enzymes were identified, CTX-M-61 (CTX-M-1 group), TEMand SHV-type. A. baumannii (n 5 5) produced VEB-1 and P. aeruginosa (n 5 2) SHV-2a. ISEcp1 was detected in 22/27 strains, disrupted in 7 of them. The IS903-like element was downstream of blaCTX-M-14 and blaCTX-M-16 .I SCR1 was found upstream of blaCTX-M-2 and blaCTX-M-9, and ISCR1 and blaCTX-M-2 were located on a sul1-type class 1 integron. In comparison with 2001‐02, ESBL distribution among Enterobacteriaceae showed an increase in CTX-M-type (44.9% vs 3.7% P < 10 27 ) due to Escherichia coli CTX-M-15 and to the almost total disappearance of TEM-3 (0.9% vs 51.2%). E. coli was the most frequent species (50.0% vs 5.1% in 1998) despite a similar prevalence to that in 1998 (0.5% vs 0.2%). Conclusions: A careful detection of blaCTX-M-type spread to other species would help to anticipate clonal endemics such as those observed in Enterobacter aerogenes TEM-24.

Published
2007

44. Addendum to: Coagulase-negative Staphylococcus bacteraemia accounts for one third of Staphylococcus bacteraemia in a French university hospital

Author

Yohan N'Guyen, Sonia Baumard, Véronique Vernet-Garnier, Anne Sophie Batalla, Christophe de Champs, Roland Jaussaud, Christophe Strady, and Hôpital universitaire Robert Debré [Reims]

Subjects
Coagulase, Microbiology (medical), Cross Infection, 0303 health sciences, General Immunology and Microbiology, 030306 microbiology, Staphylococcus, Bacteremia, General Medicine, Staphylococcal Infections, 3. Good health, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prevalence, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2012

45. A-04 Épidémiologie descriptive des bactériémies à staphylocoque au CHU de Reims : 2008 versus 1993

Author

Yohan Nguyen, C. De Champs, Christophe Strady, Véronique Vernet-Garnier, Sonia Baumard, Amélie Servettaz, and Roland Jaussaud

Subjects
Infectious Diseases
Abstract

Introduction et objectifs Nous avons mene une etude retrospective comparant l’epidemiologie descriptive des bacteriemies a staphylocoque au sein des services de courts sejours du CHU de Reims en 1993 et en 2008. Materiels et methodes Le nombre de bacteriemies incluses a Staphylococcus aureus [SA] etait de 132 en 1993 et 143 en 2008. Celui des bacteriemies a Staphylocoque coagulase negative [SCN] (au moins deux hemocultures positives avec meme antibiotype) etait de 26 en 1993 et de 64 en 2008. Six dossiers etaient indisponibles en 2008 et 55 en 1993. Resultats L’incidence des bacteriemies a SA est passee de 1,97/1 000 admissions en 1993 a 1,91/1 000 admissions a 2008 et celle des bacteriemies a SCN de 0,42/1 000 admissions a 0,90/1 000 admissions. Les populations etaient comparables, excepte le score de Charlson plus eleve en 2008 (3,15 vs 2,05 p vs 9,8 % p = 0,01, 59,6 % vs 46,6 % p = 0,02 et 23,4 % vs 10,5 % p vs 36 % p = 0,49). La mortalite est passee de 26,1 % en 1993 a 30,7 % en 2008 pour les SA ( p = 0,32) et de 14,3 % a 19,6 % pour les SCN ( p = 0,31). La concentration moyenne inhibitrice (CMI) de la vancomycine est en moyenne en 2008 ( n = 53) a 2 mg/l quelque soit l’espece, le caractere meticillinoresistant ou nosocomial. Conclusion L’incidence des bacteriemies a staphylocoque a augmente entre les 2 periodes, il s’agit surtout d’infections sur catheter, avec une emergence de SCN sur un terrain de comorbidites plus important. La meticillinoresistance et la mortalite sont stables mais on note des CMI elevees pour la vancomycine.

Published
2009

46. B-07 Comparaison de la concentration alvéolaire de ceftazidime administrée en continue versus discontinue dans les pneumonies hypoxémiantes

Author

N. Jovenin, J. Cousson, F. Nicolai, G. Hoizey, A. Leon, Véronique Vernet-Garnier, and T. Floch

Subjects
Infectious Diseases
Abstract

Introduction et objectifs Evaluer l’interet de l’administration continue de ceftazidime en termes de concentration tissulaire pulmonaire dans les pneumonies graves. Materiels et methodes Etude prospective (32 patients) controlee et randomisee comparant 2 modalites d’administration de la ceftazidime chez des patients presentant une pneumonie a bacille a Gram negatif. Le groupe I recevait de la ceftazidime a la posologie de 60 mg/kg/j apres une dose de charge de 20 mg/kg. Le groupe II recevait 20 mg/kg en 30 minutes toutes les 8 h. Dans les 2 groupes la tobramycine etait associee a la posologie de 5 mg/kg. Pour chaque patient 12 (groupe I) et 18 (groupe II) prelevements seriques etaient effectues sur la periode de l’etude (48 h). Le prelevement du liquide alveolaire etait pratique a la periode d’equilibre pharmacocinetique a la 44 e heure. Les concentrations de ceftazidime dans le serum et le film alveolaire etaient determines par chromatographie liquide a haute performance couplee a une detection ultra violette. Du fait de notre ecologie locale (CMI de ceftazidime pour Pseudomonas aeruginosa Resultats Les 2 groupes de patients etaient homogenes en termes de poids, d’age, de clairance de creatinine et d’indice de gravite. La concentration moyenne de ceftazidime dans le film alveolaire etait de 13,2 ± 10,5 mg/l dans le groupe I et de 8,6 ± 7,8 mg/l dans le groupe II. Il y a 2 fois plus de patients dans le groupe I (10/16) que dans le groupe II (5/16) qui repondent au seuil retenu de 8 mg/l. Conclusion Basee sur un objectif de concentration au niveau du tissu cible, cette etude suggere que le debit continu presente un avantage pharmacodynamique en terme predictif d’efficacite dans les pneumonies hypoxemiantes.

Published
2009

47. COL8-03 Évaluation de l’antigénurie Streptococcus pneumoniae dans le diagnostic précoce de 333 pneumonies de l’adulte en réanimation

Author

C. De Champs, E. Bankole, Véronique Vernet-Garnier, J. Cousson, T. Floch, A. Leon, and Véronique Duval

Subjects
Infectious Diseases
Abstract

Introduction L’importance pronostique sur la mortalite et sur l’incidence des complications d’un traitement precoce et adapte des pneumonies a pneumocoque est connue. Streptococcus pneumoniae constitue l’etiologie la plus frequente et la plus grave. Le but de cette etude etait d’evaluer le test BINAX NOW S. pneumoniae dans le diagnostic precoce des pneumonies chez les patients ventiles en reanimation. Materiel et methodes Etude prospective de 2003 a 2006, incluant les pneumopathies communautaires hypoxemiantes (score de FINE V). Le diagnostic de pneumonie reposait sur les criteres d’ANDREW. Recueil : âge, sexe, IGS II, antibiotherapie prealable. Un lavage broncho-alveolaire (LBA), des hemocultures (HC), une antigenurie S. pneumoniae etaient effectues des l’admission. Deux groupes etaient individualises. Groupe I : patients infectes a S. pneumoniae , Groupe II : patients non infectes a S. pneumoniae . Resultats Inclusion de 333 patients. Âge moyen : 59 ans, sex ratio de 3, IGS II a 41, 65 % avaient recu une antibiotherapie avant les prelevements. 52 patients (groupe I) presentaient une pneumonie a S. pneumoniae dont 11 associes a une bacteriemie. Le groupe II comprenait 281 patients. 60 patients avaient une antigenurie positive, 21 patients du groupe I et 39 patients du groupe II. La sensibilite (Se) est egale a 40,4 % [24 %-62,8 %] IC 95 % et la specificite (Sp) a 86,1 % [64,4 %-85,6 %] IC 95 %. La VPP n’etait que de 35 % alors que la VPN etait de 88,6 %. En prenant comme test de reference l’HC seule, la Se etait de 45,5 % [22,1 %-59,3 %] IC 95 % et la Sp de 82,9 % [57,7 %-85,6 %] IC 95 %. Conclusions L’interet du test reside dans la rapidite du resultat et du caractere non invasif de cette technique, mais la sensibilite mediocre de ce test incite a ne plus pratiquer cet examen en reanimation.

Published
2008

49. Serotype Distribution and Antibiotic Resistance of Streptococcus pneumoniaeStrains Isolated from Adults in France: Evolution Between 2001 and 2003.

Author

Micheline Roussel-Delvallez, Véronique Vernet-Garnier, Sandra Bourdon, Michel Brun, Blandine Cattier, Catherine Chanal, Hubert Chardon, Monique Chomarat, Jacques Croizé, Marie-Claude Demachy, Pierre-Yves Donnio, Philippe Dupont, Thierry Fosse, Alain Gravet, Bernadette Grignon, Geneviève Laurans, Jeanne Maugein, André Péchinot, Marie-Françoise Prère, and Pierre-Henri Thoreux

Subjects
*DRUG resistance in microorganisms, *ANTIBIOTICS, *SEROTYPES, *CEREBROSPINAL fluid, *VACCINES, *MICROBIAL sensitivity tests, EFFECT of drugs on streptococcus pneumoniae, BODY fluid examination
Abstract

Antibiotic-resistant Streptococcus pneumoniae(Sp) are described around the world. The present national surveillance study report analyzes more than 6000 Spstrains, isolated from adults across France in 2001 and 2003, from blood cultures (3086 in 2001 and 3164 in 2003), cerebrospinal fluid (respectively, 238 and 240), or middle ear fluid (respectively, 110 and 100). The proportion of isolates with reduced susceptibility to penicillin fell significantly between 2001 and 2003 from 46.5% to 43.9%. The proportion of high-level resistant strains to penicillin minimal inhibitory concentrations (MIC > 1 mg/L), amoxicillin, and cefotaxime (MIC > 2 mg/L) slightly decreased but remained low: 10.6%, 1.2%, and 0.2% in 2003. Resistance to other antibiotics (erythromycin, cotrimoxazole, tetracycline, and chloramphenicol) also decreased. Decrease in prevalence of penicillin-resistant Spvaried according to specimen source. The proportion of penicillin nonsusceptible pneumococci decreased in blood cultures and middle ear fluids between 2001 and 2003 but increased in cerebrospinal fluid (43.4% and 46.5%, respectively). Serotypes covered by the heptavalent vaccine accounted for 42.4% of all isolates recovered in 2001 and 46.1% in 2003. Prevalence of antibiotic-resistant Spdecreased in 2003 in France. [ABSTRACT FROM AUTHOR]

Published
2009
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