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6 results on '"ARN régulateurs bactériens et médecine (BRM)"'

1. The use of TNF-α antagonists in tuberculosis to control severe paradoxical reaction or immune reconstitution inflammatory syndrome: a case series and literature review

Author

Lucas Armange, Adèle Lacroix, Paul Petitgas, Cédric Arvieux, Caroline Piau-Couapel, Patrice Poubeau, Matthieu Revest, Pierre Tattevin, CHU Pontchaillou [Rennes], CHU Saint-Pierre, ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and None

Subjects
Microbiology (medical), TNF-α antagonists, Infectious Diseases, tuberculosis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, General Medicine, infliximab, paradoxical reaction, immune reconstitution inflammatory syndrome
Abstract

International audience; Paradoxical reaction (PR) and immune reconstitution inflammatory syndrome (IRIS) are common complications of tuberculosis treatment. Corticosteroids are first-line treatment for severe PR or IRIS, particularly neurological. We report four cases of severe PR or IRIS during tuberculosis treatment who required TNF-α antagonists, and identified 20 additional cases through literature review. They were 14 women and 10 men, with a median age of 36 years (interquartile range, 28-52). Twelve were immunocompromised before tuberculosis: untreated HIV infection (n=6), or immunosuppressive treatment (TNF-α antagonists, n=5; tacrolimus, n=1). Tuberculosis was mostly neuromeningeal (n=15), pulmonary (n=10), lymph node (n=6), and miliary (n=6), multi-susceptible in 23 cases. PR or IRIS started after a median time of 6 weeks (IQR, 4-9) following anti-tuberculosis treatment start, and consisted primarily of tuberculomas (n=11), cerebral vasculitis (n=8), and lymphadenitis (n=6). First-line treatment of PR or IRIS was high-dose corticosteroids in 23 cases. TNF-α antagonists were used as salvage treatment in all cases, with infliximab (n=17), thalidomide (n=6), and adalimumab (n=3). All patients improved, but 6 had neurological sequelae, and 4 had TNF-α antagonist-related severe adverse events. TNF-α antagonists are safe and effective as salvage or corticosteroid-sparing therapeutic for severe PR or IRIS during tuberculosis treatment.

Published
2023

2. Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease

Author

Benadji, Amine, Danis, Kostas, Brieu, Nathalie, Gaillat, Jacques, Mourvillier, Bruno, Bollaert, Pierre-Edouard, Gaillot, Olivier, Taha, Muhamed-Kheir, Bonacorsi, Stephane, Lecuit, Marc, Frachet, Bruno, Debroucker, Thomas, Levy Bruhl, Daniel, Preau, Marie, Anguel, Nadia, Argaud, Laurent, Arista, Sophie, Armand-Lefevre, Laurence, Balavoine, Stéphanie, Baraduc, Régine, Barnaud, Guilène, Béraud, Guillaume, Bernars, Georges, Bertei, Dominique, Bessede, Emilie, Billard Pomares, Typhaine, Biron, Charlotte, Bland, Stéphane, Boileau, Julien, Boubeau, Patrice, Bourdon, Sandra, Bousquet, Aurore, Boyer, Sophie, Bozorg-Grayeli, Alexis, Bretonniere, Cédric, Bricaire, François, Brocas, Elsa, Brun, Michel, Buret, Jennifer, Burucoa, Christophe, Cabalion, Jean, Cabon, Mathieu, Cambau, Emmanuelle, Camuset, Guillaume, Canevet, Christophe, Caron, François, Carricajo, Anne, Castan, Bernard, Caumes, Eric, Cazanave, Charles, Chabrol, Amélie, Challan-Belval, Thibaut, Chanteperdrix-Marillier, Vanessa, Chaplain, Chantal, Charlier-Woerther, Caroline, Chaussade, Hélène, Chirouze, Catherine, Clair, Bernard, Colot, Julien, Conil, Jean-Marie, Cordel, Hugues, Cormier, Philippe, Cousson, Joël, Cronier, Pierrick, Cua, Eric, Dao-Dubremetz, Anne, Dargere, Sylvie, Degand, Nicolas, Dekeyser, Sophie, Delaune, Deborah, Denes, Eric, Dequin, Pierre-Francois, Descamps, Diane, Descloux, Elodie, Desmaretz, Jean-Luc, Diehl, Jean-Luc, Dimet, Jérôme, Dinh, Aurélien, Duval, Xavier, Escaut, Lelia, Fabe, Claude, Faibis, Frédéric, Flateau, Clara, Fonsale, Nathalie, Fortineau, Nicolas, Gagneux-Brunon, Amandine, Garandeau, Caroline, Garcia, Magali, Garot, Denis, Gaudry, Stéphane, Goehringer, François, Gravet, Alain, Gregoire-Faucher, Valérie, Grosset, Marine, Gueit, Isabelle, Guelon, Dominique, Guimard, Thomas, Hadou, Tahar, Helene, Jean-Pierre, Henard, Sandrine, Henry, Benoit, Hochart, Anne-Cécile, Hoen, Bruno, Illes, Gabriela, Jaffuel, Sylvain, Jarrin, Irène, Jaureguy, Françoise, Joseph, Cédric, Juvin, Marie-Emmanuelle, Kayal, Samer, Kerneis, Solen, Lamaury, Isabelle, Laurens, Etienne, Laurichesse, Henri, Le Brun, Cécile, Le Moing, Vincent, Le Turnier, Paul, Lecuyer, Hervé, Ledru, Sylvie, Legrix, Céline, Lemaignen, Adrien, Lemble, Chantal, Lemee, Ludovic, Lesens, Olivier, Lhommet, Claire, Males, Silvija, Malpote, Edith, Martin-Blondel, Guillaume, Marx, Matthieu, Masson, Raphael, Matray, Olivier, Mbadi, Aurore, Mechai, Frédéric, Mellon, Guillaume, Merens, Audrey, Meyohas, Marie Caroline, Michon, Adrien, Mootien Yoganaden, Joy, Morquin, David, Mouly, Stéphane, Mrozek, Natacha, Nguyen, Sophie, Oziol, Eric, Page, Bernard, Patrat-Delon, Solène, Patry, Isabelle, Picot, Sandrine, Pierrejean, Denys, Piroth, Lionel, Plassart, Claire, Plessis, Patrice, Ploy, Marie-Cécile, Portel, Laurent, Poubeau, Patrice, Poupard, Marie, Poyart, Claire, Prazuck, Thierry, Quaesaet, Luc, Raffi, François, Ramanantsoa, Adriatsiferana, Rapp, Christophe, Raskine, Laurent, Raymond, Josette, Revest, Matthieu, Riche, Agnès, Robaday-Voisin, Stéphanie, Robin, Frédéric, Romaszko, Jean-Pierre, Rousseau, Florence, Roux, Anne-Laure, Royer, Cécile, Saada, Matthieu, Salmon, Dominique, Saroufim, Carlo, Schmit, Jean Luc, Sebire, Manuela, Segonds, Christine, Sivadon-Tardy, Valérie, Soismier, Nathalie, Son, Olivia, Sunder, Simon, Suy, Florence, Tande, Didier, Tankovic, Jacques, Valin, Nadia, van Grunderbeeck, Nicolas, Vandenesch, François, Varon, Emmanuelle, Verdon, Renaud, Vergnaud, Michel, Vidal, Magali, Vittecoq, Daniel, Vuotto, Fanny, Gorenne, Isabelle, Laouenan, Cédric, Marcault, Estelle, Mentre, France, Pasquet, Blandine, Roy, Carine, Tubiana, Sarah, Arsac, Philippe, Benoit, Martha, Bernard, Louis, Bissuel, François, Bret, Laurent, Brieu, Natalie, Burret, Jennifer, Carvalhoschneider, Claudia, Champagne, Hélène, Chapalain, Joséphine, Chardon, Hubert, Chavanet, Pascal, Ducruet, Judith, Epaulard, Olivier, Fabre, Marc, Fasquelle, Dominique, Forestier, Emmanuel, Galempoix, Jean-Marc, Gautier, Guillaume, de Curraize, Claire Goulard, Gracet, Alain, Gubavu, Camélia, Guinard, Jérôme, Habet, Tarik, Haudour, Aurélie, Henry, Caroline, Hombrouckalet, Cécile, Janssen, Céline, Kisteman, Jean-Paul, Lanotte, Philippe, Lartigue, Marie-Frédérique, Launois, Claire, Lebrun, Cécile, Legout, Laurence, Levast, Marion, Madoux, Yannick, Maulin, Laurence, Mestrallet, Stéphanie, Mohareb, Abdo, Mootien, Joy, Nguyen, Yohan, Noel, Franck, Ogielska, Maja, Ogier Desserrey, Agathe, Paleau, Anne, Pavel, Simona, Pechinot, André, Pelloux, Isabelle, Petillon, Camille, Petitprez, Hélène, Podac, Bianca, Poirot, Jerome, Ponceau, Bénédicte, Prieur, Nathalie, Recule, Christine, Saraceni, Orlando, Sartre, Jacques, Sifaoui, Farid, Simonin, Catherine, Strady, Christophe, Tellini, Charlotte, Texier, Anthony, Thouvenin, Maxime, Tixier, Anne, Tremeaux, Pauline, Verger, Pascale, Vernet-Garnier, Véronique, Verquin, Jean-Pierre, Vitrat, Virginie, Vray, Isabelle, Zamfir, Oana, Zucchini, Laure, 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), 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), 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, Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), 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], CHI Créteil, 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), The COMBAT study was supported by the Assistance Publique Hopitaux de Paris, French Ministry of Health, Inserm, SPILF, and the Pfizer Pharmaceutical company, which also funded ORP. The study was endorsed by the following professional organizations: Association Pour l’enseignement de la Thérapeutique, Société de Pathologie Infectieuse de Langue Française, Société Française de Microbiologie, Société Nationale Française de Médecine Interne, Société de Réanimation de Langue Française, Société Française de Gérontologie, Société Française d’Anesthésie-Réanimation. The SIIP study was supported by (i) the Société de Pathologie Infectieuse de Langue Fran.aise (SPILF, the French Infectious Diseases Society), (ii) Santé Publique France (SpFrance, the French National Public Health Agency), (iii) the European Centre for Disease Prevention and Control (ECDC), and (iv) Pfizer. The Regional Observatories of Pneumococci (Observatoires Régionaux du Pneumocoque) were supported by Pfizer, BioMerieux, and Sanofi., and Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE)

Subjects
Adult, Microbiology (medical), Serotype, medicine.medical_specialty, Multivariate analysis, Adolescent, [SDV]Life Sciences [q-bio], 30-day mortality, Serogroup, medicine.disease_cause, Logistic regression, Pneumococcal Infections, Cohort Studies, Pneumococcal Vaccines, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Streptococcus pneumoniae, medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, 0303 health sciences, Meningitis, Pneumococcal, 030306 microbiology, business.industry, Mortality rate, Infant, Invasive pneumococcal disease, Pneumococcal vaccine, General Medicine, bacterial infections and mycoses, medicine.disease, 3. Good health, Infectious Diseases, business, Meningitis, Cohort study
Abstract

International audience; Purpose: Invasive pneumococcal disease (IPD) is responsible for substantial mortality and morbidity worldwide. We aimed to identify host and bacterial factors associated with 30-day mortality in 18-year-old patients hospitalized with IPD in France from 2013 to 2015.Methods: This study analyzed data collected from consecutives IPD cases included in two parallel multi-center cohort studies: COMBAT study (280 patients with pneumococcal community-acquired bacterial meningitis) and SIIP study (491 patients with non-meningitis IPD). Factors associated with 30-day mortality were identified using logistic regression.Results: Among the 771 enrolled patients (median age 66 years, IQR [52.0-79.7]), 592/767 (77.2%) had at least one chronic disease. Patients with meningitis were younger (60.2 vs 70.9 years; p < 0.001) and had fewer chronic diseases than those with non-meningitis IPD (73.3% vs 79.4%; p = 0.05). Non-vaccine serotypes were more frequent in meningitis patients than in those with other IPD (36.1% vs 23.1%; p < 0.001). The overall 30-day mortality was 16.7% and patients with concurrent meningitis and extra-cerebral IPD had the highest 30-day mortality rate (26.5%). On multivariate analyses, older age, history of malignant solid tumor, meningeal IPD and serotypes previously identified with high mortality potential were independently associated with 30-day mortality. Of the serotypes with high mortality potential, 80% were included in licensed (PCV13 or PPV23) vaccines.Conclusion: We observed an effect of both host factors and pneumococcal serotypes on 30-day mortality in IPD. This highlights the need for a focused strategy to vaccinate at-risk patients.Clinical trial: ClinicalTrial. Gov identification number: NCT01730690.

Published
2021

3. Lyme arthritis in Western Europe: a multicentre retrospective study

Author

Brigitte Degeilh, Xavier Guennic, Benoit Le Goff, Jean-David Albert, Clémence Corre, Guillaume Coiffier, Solène Patrat-Delon, Pierre Tattevin, Marine Ferreyra, Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), CHU Pontchaillou [Rennes], Centre hospitalier Rene Pleven de Dinan, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de Saint-Brieuc, 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 ), Université de Rennes 1 (UR1), 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
Adult, Male, Microbiology (medical), medicine.medical_specialty, [SDV]Life Sciences [q-bio], Lyme Arthritis, Polymerase Chain Reaction, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Borreliella, Borrelia burgdorferi Group, Interquartile range, Internal medicine, Borrelia, Synovial Fluid, medicine, Monoarthritis, Humans, Synovial fluid, Serologic Tests, Borrelia burgdorferi, Lyme borreliosis, Retrospective Studies, 030304 developmental biology, 030203 arthritis & rheumatology, Doxycycline, Lyme Disease, 0303 health sciences, biology, business.industry, Lyme arthritis, General Medicine, Middle Aged, Amoxicillin, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Antibodies, Bacterial, Anti-Bacterial Agents, 3. Good health, Europe, Infectious Diseases, business, medicine.drug
Abstract

International audience; To characterize Lyme arthritis, with a focus on management, and outcome. Observational retrospective multicentre study in Western France, of all consecutive cases of Lyme arthritis, documented by Borrelia burgdorferi IgG on ELISA serological testing, confirmed by Western blot, with or without positive Borrelia PCR in synovial fluid, with no alternative diagnosis. We enrolled 52 patients (29 males), with a mean age of 43 +/- 19.4 years. Most patients had monoarthritis (n = 43, 82.7%), involving the knee (n = 51, 98.1%), with a median delay between symptoms onset and Lyme arthritis diagnosis of 5 months (interquartile range, 1.5-8). Synovial fluid analysis yielded median white cell count of 16,000/mm(3) (9230-40,500), and positive PCR in 16 cases (39%), for B. burgdorferi sensu stricto (n = 5), B. garinii (n = 5), B. afzelii (n = 3), and undetermined (n = 3). All patients received antibiotics, for a median duration of 28 days (21-30), with doxycycline (n = 44, 84.6%), ceftriaxone (n = 6, 11.5%), or amoxicillin (n = 2). Twelve patients (23.1%) also received intra-articular injection of glucocorticoids as first-line treatment. Of 47 patients with follow-up, 35 (74.5%) had complete resolution of Lyme arthritis. Lyme arthritis in Western Europe may be due to B. burgdorferi ss, B. afzelii, or B. garinii. Clinical presentation is similar to Lyme arthritis in North America (i.e. chronic knee monoarthritis), with low sensitivity of synovial fluid PCR (39%).

Published
2021

4. RNA antitoxin SprF1 binds ribosomes to attenuate translation and promote persister cell formation in Staphylococcus aureus

Author

Brice Felden, Noëlla Germain-Amiot, Régine Brielle, Camille Riffaud, Marie-Laure Pinel-Marie, Norbert Polacek, ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), University of Bern, Agence Nationale pour la Recherche French National Research Agency (ANR) [ANR-15-CE12-0003-01], Fondation pour la Recherche Medicale Fondation pour la Recherche Medicale [DBF20160635724], Institut National de la Sante et de la Recherche Medicale Institut National de la Sante et de la Recherche Medicale (Inserm), School of Pharmacy and Medical Sciences at Rennes University, Swiss National Science Foundation Swiss National Science Foundation (SNSF) [31003A_143388/1, 31003A_166527], university of Rennes, university of Sherbrooke, ANR-15-CE12-0003,sRNA-FIT,Adaptation par ARN régulateurs chez Staphylococcus aureus(2015), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Microbiology (medical), Staphylococcus aureus, [SDV]Life Sciences [q-bio], Immunology, Applied Microbiology and Biotechnology, Microbiology, Ribosome, 03 medical and health sciences, Bacterial Proteins, Polysome, 540 Chemistry, Drug Resistance, Bacterial, Prokaryotic translation, Genetics, Protein biosynthesis, RNA, Messenger, 030304 developmental biology, 0303 health sciences, Messenger RNA, 030306 microbiology, Chemistry, RNA, Toxin-Antitoxin Systems, Translation (biology), Cell Biology, Cell biology, Polyribosomes, Protein Biosynthesis, 570 Life sciences, biology, Antitoxin
Abstract

International audience; Persister cells are a subpopulation of transiently antibiotic-tolerant bacteria associated with chronic infection and antibiotic treatment failure. Toxin-antitoxin systems have been linked to persister cell formation but the molecular mechanisms leading to bacterial persistence are mostly unknown. Here, we show that SprF1, a type I antitoxin, associates with translating ribosomes from the major human pathogen Staphylococcus aureus to reduce the pathogen's overall protein synthesis during growth. Under hyperosmotic stress, SprF1 levels increase due to enhanced stability, accumulate on polysomes and attenuate protein synthesis. Using an internal 6-nucleotide sequence on its 5 '-end, SprF1 binds ribosomes and interferes with initiator transfer RNA binding, thus reducing translation initiation. An excess of messenger RNA displaces the ribosome-bound antitoxin, freeing the ribosomes for new translation cycles; however, this RNA antitoxin can also displace ribosome-bound mRNA. This translation attenuation mechanism, mediated by an RNA antitoxin, promotes antibiotic persister cell formation. The untranslated SprF1 is a dual-function RNA antitoxin that represses toxin expression by its 3 '-end and fine-tunes overall bacterial translation via its 5 '-end. These findings demonstrate a general function for a bacterial RNA antitoxin beyond protection from toxicity. They also highlight an RNA-guided molecular process that influences antibiotic persister cell formation. SprF1, a type I RNA antitoxin, interacts with ribosomes via its 5 '-end to reduce translation initiation, thus promoting persister cell formation in Staphylococcus aureus.

Published
2021

5. Back pain following instillations of BCG for superficial bladder cancer is not a reactive complication: review of 30 Mycobacterium bovis BCG vertebral osteomyelitis cases

Author

Raphaël Guillin, Eric Houvenagel, Omar Al Tabaa, Pascal Guggenbuhl, Guillaume Coiffier, Chi-Duc Nguyen, Edouard Pertuiset, Matthieu Revest, Marine Faccin, S. Cadiou, CHU Pontchaillou [Rennes], Centre Hospitalier René Dubos [Pontoise], 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 ), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1)

Subjects
Male, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, BCG instillation, 03 medical and health sciences, Interferon-γ release assay, 0302 clinical medicine, Vertebral osteomyelitis, Rheumatology, medicine, Back pain, Humans, Reactive arthritis, 030212 general & internal medicine, Ethambutol, Aged, 030203 arthritis & rheumatology, Mycobacterium bovis, Bladder cancer, biology, business.industry, Osteomyelitis, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, General Medicine, medicine.disease, biology.organism_classification, Magnetic Resonance Imaging, 3. Good health, Surgery, Administration, Intravesical, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Urinary Bladder Neoplasms, Back Pain, Concomitant, BCG Vaccine, medicine.symptom, Complication, business, medicine.drug
Abstract

International audience; Mycobacterium bovis Bacillus Calmette-Guérin (BCG) instillations are used in bladder cancer treatment. Adverse effects can occur. Osteoarticular complications are mainly reactive arthritis, but true infections have been described, such as vertebral osteomyelitis. We made a review of M. bovis BCG vertebral osteomyelitis after instillations for bladder cancer using PubMed search. We added three new French cases. Twenty-seven cases of BCG vertebral osteomyelitis had been reported on PubMed. Of the 30 cases, all were male, averaging 73.4 ± 8.7 years old. Median time between diagnosis and first and last instillation was 22.5 and 14 months respectively. Half of vertebral osteomyelitis was thoracic and lumbar in the other half. Sensitivo-motor deficit was present at diagnosis in 42% of cases. Other infectious locations were common, mainly infectious abdominal aortic aneurysms (20%). Rifampicin, ethambutol and isoniazid were the usual therapy. Poor outcomes were reported with 50% of one or more spine surgery. M. bovis BCG vertebral osteomyelitis following bladder instillation for bladder cancer is a rare complication. However, the late onset of back pain after instillations differentiates them from reactive arthritis. Concomitant septic location such as infectious abdominal aortic aneurysms must be known.

Published
2019

6. An outbreak in intravenous drug users due to USA300 Latin-American variant community-acquired methicillin-resistant Staphylococcus aureus in France as early as 2007

Author

Mohamed Sassi, Yoann Augagneur, Matthieu Revest, Brice Felden, Pierre-Yves Donnio, Pierre Tattevin, ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Region Bretagne grant SAD SARS [8254], Region Bretagne grant SAD SARS_2 [9181], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Methicillin-Resistant Staphylococcus aureus, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, [SDV]Life Sciences [q-bio], Clone (cell biology), Microbial Sensitivity Tests, Biology, medicine.disease_cause, DNA sequencing, Disease Outbreaks, Drug Users, 03 medical and health sciences, Medical microbiology, Arginine catabolic mobile element, medicine, Humans, Whole genome sequencing, Phylogenetic tree, Outbreak, General Medicine, Staphylococcal Infections, Virology, Methicillin-resistant Staphylococcus aureus, Anti-Bacterial Agents, 3. Good health, Surgery, Community-Acquired Infections, 030104 developmental biology, Infectious Diseases, France
Abstract

International audience; Intravenous drug users are at increased risk of Staphylococcus aureus infections. Most cases are related to clones prevalent in the community. We report an outbreak of community-acquired methicillin-resistant Staphylococcus aureus infections that occurred from 2007 to 2009 in intravenous drug users and their close contacts in Northwestern France. Clinical and molecular investigations suggested that the clones were more similar than those usually isolated in the American continent although none of the patients traveled abroad or had contact with individuals who had traveled to the Americas. Then, a retrospective whole genome sequencing and phylogenetic analyses demonstrated that the strains isolated from the first case belong to the USA300 Latin-American variant clone, based on the absence of arginine catabolic mobile element (ACME), and the presence of copper and mercury resistance mobile element (COMER), a distinctive feature of the South American variant. Our study shows genetic evidence for introduction of this clone as early as 2007 in France. This report also illustrates the importance of genome sequencing to finely characterize and monitor the emergence of unexpected S. aureus clones among high-risk populations, especially when living in promiscuity.

Published
2017

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