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Objectives: Evaluation of the efficacy of empirical aminoglycoside in critically ill patients with bloodstream infections caused by extended-spectrum &beta, lactamase producing Enterobacteriaceae (ESBL-E BSI). Methods: Patients treated between 2011 and 2018 for ESBL-E BSI in the ICU of six French hospitals were included in a retrospective observational cohort study. The primary endpoint was mortality on day 30. Results: Among 307 patients, 169 (55%) were treated with empirical aminoglycoside. Death rate was 40% (43% with vs. 39% without aminoglycoside, p = 0.55). Factors independently associated with death were age &ge, 70 years (OR: 2.67, 95% CI: 1.09&ndash, 6.54, p = 0.03), history of transplantation (OR 5.2, 95% CI: 1.4&ndash, 19.35, p = 0.01), hospital acquired infection (OR 8.67, 95% CI: 1.74&ndash, 43.08, p = 0.008), vasoactive drugs &gt, 48 h after BSI onset (OR 3.61, 95% CI: 1.62&ndash, 8.02, p = 0.001), occurrence of acute respiratory distress syndrome (OR 2.42, 95% CI: 1.14&ndash, 5.16, p = 0.02), or acute renal failure (OR 2.49, 5.47, p = 0.02). Antibiotherapy appropriateness was more frequent in the aminoglycoside group (91.7% vs. 77%, p = 0.001). Rate of renal impairment was similar in both groups (21% vs. 24%, p = 0.59). Conclusions: In intensive care unit (ICU) patients with ESBL-E BSI, empirical treatment with aminoglycoside was frequent. It demonstrated no impact on mortality, despite increasing treatment appropriateness.

Despite the development of novel therapies, inflammatory bowel diseases remain an innovative treatment challenge. Helminth therapy is a new promising approach, and a key issue is the identification of helminth-derived anti-inflammatory mediators. P28 glutathione-S-transferase (P28GST), a protein derived from schistosomes, a trematode parasitic helminth, was shown to reduce intestinal inflammation in experimental colitis by down-regulating the Th1/Th17 response. In this multicenter, open-label, pilot Phase 2a study, we evaluated the safety of P28GST administered to patients with mild Crohn&rsquo, s disease (CD). We enrolled 10 patients with a baseline Crohn&rsquo, s disease activity index (CDAI) value &lt, 220. Eight patients received two to three subcutaneous injections of recombinant P28GST with adjuvant. This three-month treatment was followed by a nine-month monitoring period. The primary endpoints were the monthly rate and seriousness of adverse events (AEs). Secondary endpoints were clinical recurrence, assessed with the CDAI as well as the levels of immunologic and inflammatory blood and tissue markers. The most common AEs were local or regional events at the injection site and gastrointestinal disorders. At three months after the first injection, CDAI scores and blood calprotectin levels decreased in parallel. These results indicate that P28GST showed promise as a safe and new therapeutic option for treating CD.