Descriptor: "MESH : Cross Infection" / Topic: 03 medical and health sciences - Searchworks@Jio Institute Digital Library Search Results

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24 results on '"MESH : Cross Infection"'

1. Coagulase-negative staphylococcal prosthetic valve endocarditis--a contemporary update based on the International Collaboration on Endocarditis: prospective cohort study

Author: Chu, V. H., Miro, J. M., Hoen, B., Cabel, C. H., Pappa, P. A., Jones, P., Stryjewski, M. E., Anguera, I., Braun, S., Mu&#241, oz, P., Commerford, P., Tornos, P., Francis, J., Oyonarte, M., Selton-Suty, C., Morris, A. J., Habib, G., Almirante, B., Sexton, D. J., Corey, G. R., Fowler, V. G. Jr, International Collaboration on Endocarditis-Prospective Cohort Study Group Investigators: Baršić, Bruno et al., Chu, Vh, Miro, Jm, Hoen, B, Cabell, Ch, Pappas, Pa, Jones, P, Stryjewski, Me, Anguera, I, Braun, S, Muñoz, P, Commerford, P, Tornos, P, Francis, J, Oyonarte, M, Selton Suty, C, Morris, Aj, Habib, G, Almirante, B, Sexton, Dj, Corey, Gr, Fowler VG, Jr, among International Collaboration on Endocarditis Prospective Cohort Study Group, Investigator, Utili, Riccardo, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Department of Physics [Jyväskylä Univ] (JYU), University of Jyväskylä (JYU), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Department of Physics, University of Jyvaskyl ( University of Jyvaskyl ), University of Jyvaskyl, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), AII - Amsterdam institute for Infection and Immunity, Infectious diseases, and Laboratoire Chrono-environnement (UMR 6249) (LCE)
Subjects: Male, Time Factors, MESH: Drug Resistance, Microbial, MESH : Aged, MESH : Prospective Studies, MESH : Coagulase, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Postoperative Complications, MESH: Staphylococcus aureus, MESH : Female, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, MESH : Endocarditis, Bacterial, Abscess, Prospective cohort study, MESH: Aged, Cross Infection, MESH: Statistics, Nonparametric, MESH: Middle Aged, biology, MESH : Staphylococcus aureus, valvular heart disease, cons, Drug Resistance, Microbial, coagulase-negative staphylococci, endoccarditis, prosthetic valves, Middle Aged, Staphylococcal Infections, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Heart Valve Prosthesis, Infective endocarditis, Female, MESH: Coagulase, Cardiology and Cardiovascular Medicine, MESH : Cross Infection, Cohort study, MESH : Time Factors, Coagulase, Staphylococcus aureus, medicine.medical_specialty, Prosthesis-Related Infections, MESH: Heart Valve Prosthesis, MESH : Male, MESH: Staphylococcal Infections, MESH : Bioprosthesis, Statistics, Nonparametric, MESH : Prosthesis-Related Infections, MESH : Heart Valve Prosthesis, MESH : Hospital Mortality, 03 medical and health sciences, MESH : Drug Resistance, Microbial, medicine, Humans, Endocarditis, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH: Hospital Mortality, MESH : Statistics, Nonparametric, Aged, Bioprosthesis, MESH: Humans, business.industry, MESH: Prosthesis-Related Infections, MESH : Humans, MESH: Time Factors, MESH: Cross Infection, Endocarditis, Bacterial, medicine.disease, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Male, MESH: Prospective Studies, Surgery, MESH: Bioprosthesis, Viridans streptococci, MESH : Postoperative Complications, MESH : Staphylococcal Infections, business, MESH: Female
Abstract: International audience; OBJECTIVE: To describe the contemporary features of coagulase-negative staphylococcal (CoNS) prosthetic valve endocarditis (PVE). DESIGN: Observational study of prospectively collected data from a multinational cohort of patients with infective endocarditis. Patients with CoNS PVE were compared to patients with Staphylococcus aureus and viridans streptococcal (VGS) PVE. SETTING: The International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) is a contemporary cohort of patients with infective endocarditis from 61 centres in 28 countries. PATIENTS: Adult patients in the ICE-PCS with definite PVE and no history of injecting drug use from June 2000 to August 2005 were included. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Heart failure, intracardiac abscess, death. RESULTS: CoNS caused 16% (n = 86) of 537 cases of definite non-injecting drug use-associated PVE. Nearly one-half (n = 33/69, 48%) of patients with CoNS PVE presented between 60 days and 365 days of valve implantation. The rate of intracardiac abscess was significantly higher in patients with CoNS PVE (38%) than in patients with either S aureus (23%, p = 0.03) or VGS (20%, p = 0.05) PVE. The rate of abscess was particularly high in early (50%) and intermediate (52%) CoNS PVE. In-hospital mortality was 24% for CoNS PVE, 36% for S aureus PVE (p = 0.09) and 9.1% for VGS PVE (p = 0.08). Meticillin resistance was present in 68% of CoNS strains. CONCLUSIONS: Nearly one-half of CoNS PVE cases occur between 60 days and 365 days of prosthetic valve implantation. CoNS PVE is associated with a high rate of meticillin resistance and significant valvular complications.
Published: 2009
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2. Trends of extended-spectrum β-lactamase-producing Escherichia coli sequence type 131 and its H30 subclone in a French hospital over a 15-year period

Author: Michelle Thouverez, Xavier Bertrand, Andréa Vannier, Marie-Hélène Nicolas-Chanoine, Marlène Sauget, Didier Hocquet, Pascal Cholley, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre de recherche sur l'inflamation - UMR 1149, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)
Subjects: 0301 basic medicine, MESH : Escherichia coli, MESH : Retrospective Studies, MESH : Multilocus Sequence Typing, MESH: beta-Lactamases, MESH : Genotype, Multidrug resistance, medicine.disease_cause, Hospitals, University, MESH: Genotype, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Pharmacology (medical), MESH: Incidence, MESH: Genetic Variation, Escherichia coli Infections, ComputingMilieux_MISCELLANEOUS, Cross Infection, Molecular Epidemiology, Extraintestinal Pathogenic Escherichia coli, MESH: Escherichia coli, Incidence, Incidence (epidemiology), MESH : beta-Lactamases, General Medicine, PFGE, MESH : Incidence, Electrophoresis, Gel, Pulsed-Field, 3. Good health, Infectious Diseases, MESH: Electrophoresis, Gel, Pulsed-Field, MESH: Multilocus Sequence Typing, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Escherichia coli Infections, [SDE]Environmental Sciences, France, MESH : Cross Infection, Microbiology (medical), clone (Java method), Lineage (genetic), Genotype, MESH : Molecular Epidemiology, 030106 microbiology, Biology, beta-Lactamases, Microbiology, 03 medical and health sciences, Extended-spectrum β-lactamase, MESH : Genetic Variation, Escherichia coli, Pulsed-field gel electrophoresis, medicine, Humans, MESH: Molecular Epidemiology, Typing, MESH : France, MESH : Hospitals, University, Retrospective Studies, MESH : Electrophoresis, Gel, Pulsed-Field, MESH: Escherichia coli Infections, MESH: Hospitals, University, MESH: Humans, MESH : Humans, Genetic Variation, MESH: Cross Infection, MESH: Retrospective Studies, bacterial infections and mycoses, Multiple drug resistance, MESH: France, ESBL, Multilocus Sequence Typing
Abstract: International audience; Sequence type 131 (ST131) is a predominant lineage among extraintestinal pathogenic Escherichia coli. It plays a major role in the worldwide dissemination of E. coli producing extended-spectrum β-lactamases (ESBLs). Here we describe the long-term epidemiology of this clonal group in a French university hospital, where the incidence of ESBL-producing E. coli has increased from 0.018 case per 1000 patient-days in the year 2000 to 0.50 case per 1000 patient-days in 2014. The first of the 141 ST131 isolates was recovered in 2006, and the ST131 clonal group accounted for 18.1% of total ESBL-producing E. coli over the whole period (2000-2014). Subclonal typing showed that 75.9% (107/141) of ST131 isolates were H30, of which 81.3% (87/107) were H30-Rx. The large majority (137/141) of ESBLs produced were of the CTX-M group, with 94 CTX-M-15, 19 CTX-M-1, 10 CTX-M-27, 8 CTX-M-14 and four other CTX-M types (n = 6). Pulsed-field gel electrophoresis (PFGE) analysis showed high diversity, which increased during the course of the study. The 141 ST131 isolates clustered in 53 pulsotypes (PTs), with 2 dominant PTs (PT14 and PT13) with 36 and 17 isolates, respectively. These findings showed that ST131 was a predominant clone among ESBL-producing E. coli in our hospital, even though it only accounted for
Published: 2016
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3. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014

Author: Magalie Demar, Pierre Couppié, Hatem Kallel, Mathieu Nacher, Christine Simonnet, Didier Hommel, Félix Djossou, Aba Mahamat, Xavier Bertrand, B. Moreau, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de l’Élevage, Centre Hospitalier Andrée-Rosemond, Epidemiologie des Parasitoses Tropicales ( EPaT Team ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Département de Biologie, Unité de Biochimie des Lipides et des Protéines, Faculté des Sciences de Tunis, Ecosystemes Amazoniens et Pathologie Tropicale ( EPat ), Université de Guyane ( UG ) -Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles ( UA ), Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre d'investigation clinique Antilles-Guyane ( CIC - Antilles Guyane ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine ( COREVIH Guyane ), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Faculté des Sciences Mathématiques, Physiques et Naturelles de Tunis (FST), Université de Tunis El Manar (UTM)-Université de Tunis El Manar (UTM), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane)
Subjects: 0301 basic medicine, Male, Acinetobacter baumannii, Imipenem, MESH : Retrospective Studies, Epidemiology, MESH : Multilocus Sequence Typing, MESH: beta-Lactamases, MESH : Carbapenems, Disease Outbreaks, MESH: Carbapenems, Disk Diffusion Antimicrobial Tests, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, polycyclic compounds, MESH : Bacterial Proteins, Pharmacology (medical), MESH : Female, MESH: Disease Outbreaks, MESH: Bacterial Proteins, Cross Infection, Molecular Epidemiology, MESH: Middle Aged, biology, MESH : beta-Lactamases, General Medicine, Middle Aged, MESH : Adult, MESH: Hospitals, Hospitals, 3. Good health, Electrophoresis, Gel, Pulsed-Field, French Guiana, MESH : Hospitals, Infectious Diseases, MESH: Multilocus Sequence Typing, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Amikacin, MESH: Young Adult, MESH: Disk Diffusion Antimicrobial Tests, Female, MESH: Acinetobacter Infections, MESH : Cross Infection, medicine.drug, Acinetobacter Infections, Microbiology (medical), Adult, MESH : French Guiana, MESH : Male, 030106 microbiology, MESH : Molecular Epidemiology, MESH : Young Adult, Tazobactam, beta-Lactam Resistance, beta-Lactamases, Microbiology, Carbapenem-resistant, 03 medical and health sciences, Young Adult, Bacterial Proteins, MESH : beta-Lactam Resistance, MESH: French Guiana, medicine, Humans, MESH: Molecular Epidemiology, MESH : Acinetobacter Infections, Intensive care unit, MESH : Middle Aged, MESH : Disease Outbreaks, MESH : Disk Diffusion Antimicrobial Tests, MESH : Acinetobacter baumannii, Retrospective Studies, MESH : Electrophoresis, Gel, Pulsed-Field, MESH: Humans, Molecular epidemiology, business.industry, MESH: Acinetobacter baumannii, MESH : Humans, Outbreak, MESH: Cross Infection, MESH: Retrospective Studies, MESH: Adult, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, MESH: Male, MESH: beta-Lactam Resistance, Carbapenems, Colistin, Nosocomial, business, MESH: Female, Piperacillin, Multilocus Sequence Typing
Abstract: International audience; This study investigated the clinical epidemiology and resistance mechanisms of Acinetobacter baumannii and characterised the clonal diversity of carbapenem-resistant A. baumannii (CRAB) during an ICU-associated outbreak at Cayenne Hospital, French Guiana. All non-duplicate A. baumannii isolates from 2008 to 2014 were tested for antibiotic susceptibility by disk diffusion. Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on CRAB. Of the 441 A. baumannii isolates, most were from males (54.0%) and were detected mainly from the ICU (30.8%) and medicine wards (21.8%). In the ICU, strains were mainly isolated from the respiratory tract (44.1%) and bloodstream (14.0%), whereas in medicine wards they mainly were from wound/drainage (36.5%) and bloodstream (25.0%). A. baumannii showed the greatest susceptibility to piperacillin/tazobactam (92.7%), imipenem (92.5%), colistin (95.6%) and amikacin (97.2%), being lower in the ICU and medicine wards compared with other wards. An outbreak of OXA-23-producing CRAB occurred in the 13-bed ICU in 2010. CRAB strains were more co-resistant to other antimicrobials compared with non-CRAB. Molecular genetics analysis revealed five sequence types [ST78, ST107 and ST642 and two new STs (ST830 and ST831)]. Analysis of PFGE profiles indicated cross-transmissions of CRAB within the ICU, between the ICU and one medicine ward during transfer of patients, and within that medicine ward. This study provides the first clinical and molecular data of A. baumannii from French Guiana and the Amazon basin. The ICU was the highest risk unit of this nosocomial outbreak of OXA-23-producing CRAB, which could subsequently disseminate within the hospital.
Published: 2016

4. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants

Author: Y. Aujard, Monique Kaminski, Béatrice Larroque, Antoine Burguet, Pierre-Yves Ancel, Stéphane Marret, Rachel Vieux, Gérard Thiriez, Ayoub Mitha, Patrick Truffert, Catherine Arnaud, Pascal Boileau, Laurence Foix-L’Hélias, Gilles Cambonie, Jean-Christophe Rozé, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Unité de Néonatalogie, Hôpital Jeanne de Flandre [Lille], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d'Epidémiologie Clinique, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement (Néovasc), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Neonatal Intensive Care Unit (NICU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Service Pédiatrie, Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Unité d'Epidémiologie et Recherche Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néonatalogie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service Pédiatrique, Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Médecine Néonatale, Université de Nantes (UN), CIC - Nantes, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche Epidémiologique sur la Qualité des Soins, Université de Lille, Droit et Santé, EPIPAGE study group, Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Epidémiologie clinique et santé publique [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pédiatrie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de pédiatrie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Debs, Nayla, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Hôpital Charles Nicolle [Rouen], Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement ( Néovasc ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institute for Research and Innovation in Biomedicine ( IRIB ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Neonatal Intensive Care Unit ( NICU ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Beaujon, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Centre Hospitalier de Poissy Saint-Germain (CHIPS), Université de Nantes ( UN ), and Université de Nantes ( UN ) -IFR26-Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Male, Pediatrics, MESH : Infant, Premature, Diseases, Developmental Disabilities, Infant, Premature, Diseases, Neuropsychological Tests, MESH : Child, Preschool, MESH : Cerebral Palsy, Cohort Studies, 0302 clinical medicine, MESH : Cross-Sectional Studies, Risk Factors, MESH: Risk Factors, MESH: Gestational Age, Infant, Very Low Birth Weight, MESH : Female, MESH: Infant, Very Low Birth Weight, 030212 general & internal medicine, Longitudinal Studies, MESH : Infant, Very Low Birth Weight, MESH : Infectious Disease Transmission, Vertical, MESH: Longitudinal Studies, MESH: Sepsis, MESH: Cohort Studies, MESH : Longitudinal Studies, education.field_of_study, Cross Infection, MESH: Infant, Newborn, neurodevelopmental outcome, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Neuropsychological Tests, MESH : Risk Factors, MESH: Infant, MESH: Infant, Premature, Diseases, 3. Good health, MESH : Neuropsychological Tests, MESH: Infectious Disease Transmission, Vertical, population-based study, Child, Preschool, Cohort, Gestation, Female, MESH : Sepsis, France, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH: Cerebral Palsy, MESH : Male, Population, MESH : Cohort Studies, Gestational Age, MESH : Infant, Newborn, MESH : Developmental Disabilities, Cerebral palsy, 03 medical and health sciences, MESH : Cognition Disorders, MESH: Cross-Sectional Studies, 030225 pediatrics, Sepsis, medicine, cohort study, Humans, neonatal infection, very preterm infants, education, MESH : France, MESH: Humans, business.industry, Cerebral Palsy, MESH : Humans, MESH: Child, Preschool, Infant, Newborn, Infant, MESH: Cross Infection, Odds ratio, medicine.disease, Confidence interval, Infectious Disease Transmission, Vertical, MESH: Male, MESH: France, Neonatal infection, MESH: Cognition Disorders, Cross-Sectional Studies, MESH: Developmental Disabilities, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pediatrics, Perinatology and Child Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cognition Disorders, MESH: Female, MESH : Gestational Age
Abstract: OBJECTIVE:To determine whether neonatal infections are associated with a higher risk of adverse neurodevelopment at 5 years of age in a population-based cohort of very preterm children.METHODS:We included all live births between 22 and 32 weeks of gestation, from 9 regions in France, in 1997 (EPIPAGE study). Of the 2665 live births, 2277 were eligible for a follow-up evaluation at 5 years of age: 1769 had a medical examination and 1495 underwent cognitive assessment. Cerebral palsy and cognitive impairment were studied as a function of early-onset sepsis (EOS) and late-onset sepsis (LOS), after adjustment for potential confounding factors, in multivariate logistic regression models.RESULTS:A total of 139 (5%) of the 2665 live births included in the study presented with EOS alone (without associated LOS), 752 (28%) had LOS alone (without associated EOS), and 64 (2%) displayed both EOS and LOS. At 5 years of age, the frequency of cerebral palsy was 9% (157 of 1769) and that of cognitive impairment was 12% (177 of 1495). The frequency of cerebral palsy was higher in infants with isolated EOS (odds ratio [OR]: 1.70 [95% confidence interval (CI): 0.84−3.45]) or isolated LOS (OR: 1.71 [95% CI: 1.14−2.56]) than in uninfected infants, and this risk was even higher in cases of combined EOS and LOS (OR: 2.33 [95% CI: 1.02−5.33]). There was no association between neonatal infection and cognitive impairment.CONCLUSIONS:Neonatal infections in these very preterm infants were associated with a higher risk of cerebral palsy at the age of 5 years, particularly in infants presenting with both EOS and LOS.
Published: 2013
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5. Temporal effects of infection control practices and the use of antibiotics on the incidence of MRSA

Author: C. Slekovec, Didier Hocquet, J.M. López-Lozano, Xavier Bertrand, Daniel Talon, Michelle Thouverez, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Hôpital Jean Minjoz, and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon )
Subjects: Antibiotics, Hospitals, University, MESH: Infection Control, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Medicine, Infection control, 030212 general & internal medicine, MESH: Incidence, MESH : Anti-Bacterial Agents, 0303 health sciences, Cross Infection, Incidence (epidemiology), Incidence, General Medicine, Staphylococcal Infections, University hospital, MESH : Incidence, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, France, Negative correlation, MESH : Cross Infection, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, medicine.drug_class, MESH: Staphylococcal Infections, MESH: Methicillin-Resistant Staphylococcus aureus, 03 medical and health sciences, Internal medicine, MESH: Anti-Bacterial Agents, Humans, MESH : Methicillin-Resistant Staphylococcus aureus, Intensive care medicine, MESH : France, Hand disinfection, MESH : Hospitals, University, Hand rub, MESH: Hospitals, University, Infection Control, MESH: Humans, MESH : Infection Control, 030306 microbiology, business.industry, MRSA colonization, MESH : Humans, MESH: Cross Infection, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, MESH: France, MESH : Staphylococcal Infections, business
Abstract: International audience; BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) has spread throughout the world and has become highly endemic worldwide. The need for implementing MRSA control strategies is no longer a matter of debate. AIM: To determine the temporal association between various infection control practices, the use of antibiotics and the incidence of MRSA in a 1200-bed French university hospital. METHODS: A multi-variate time-series analysis, based on monthly data from a nine-year period (January 2000-December 2008), was performed in a 1200-bed French university hospital to determine the temporal association between different variables and the incidence of MRSA. MRSA colonization pressure, infection control practices and use of antibiotics were considered in the analysis. FINDINGS: Time-series analysis showed a positive significant relationship between the incidence of hospital-acquired MRSA (HA-MRSA) and MRSA colonization pressure, the use of antibiotics (fluoroquinolones, macrolides and aminoglycosides) and the use of gloves. Conversely, a global negative correlation was observed between the incidence of HA-MRSA and the use of alcohol-based hand rub. Overall, the model explained 40.5% of the variance in the monthly incidence of MRSA. CONCLUSION: This study showed that admission of patients with MRSA, the use of antibiotics and infection control practices contributed to the incidence of HA-MRSA. This suggests that efforts should be focused on high compliance with hand disinfection. These results also raise concerns about the use of gloves when caring for patients with MRSA.
Published: 2012
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6. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey

Author: Christine Selton-Suty, Claire POYART, Tristan Ferry, Albert HAGEGE, Bernard Iung, Cellier Christophe, Francois Vandenesch, Anne TRISTAN, Francois Philippart, BRUNO MOURVILLIER, Vincent Le Moing, François Alla, Céline Plainvert, Patrick Assayag, Nataf Patrick, Catherine Sportouch, Albert Sotto, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), services de maladies infectieuses, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), CHU Pontchaillou [Rennes], Centre National de référence des Staphylocoques, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Centre d'Epidémiologie Clinique (CIC-EC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, AEPEI Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), 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), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Hospices Civils de Lyon ( HCL ), Centre d'Epidémiologie Clinique ( CIC-EC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université Paris Diderot - Paris 7 (UPD7)-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), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)
Subjects: Male, Staphylococcus, [SDV]Life Sciences [q-bio], MESH : Aged, 030204 cardiovascular system & hematology, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, MESH : Population Surveillance, MESH: Staphylococcus aureus, MESH : Female, 030212 general & internal medicine, MESH: Incidence, Young adult, MESH : Endocarditis, Bacterial, Aged, 80 and over, MESH: Aged, education.field_of_study, Cross Infection, MESH : Prognosis, MESH: Middle Aged, Incidence (epidemiology), Incidence, MESH : Staphylococcus aureus, Hazard ratio, MESH: Staphylococcus, Middle Aged, Staphylococcal Infections, MESH : Adult, Prognosis, MESH: Hospitals, MESH : Risk Factors, Hospitals, MESH : Incidence, 3. Good health, Community-Acquired Infections, MESH : Hospitals, Infectious Diseases, MESH: Community-Acquired Infections, MESH: Young Adult, Infective endocarditis, Population Surveillance, Female, France, MESH : Cross Infection, Microbiology (medical), Adult, MESH : Community-Acquired Infections, medicine.medical_specialty, Staphylococcus aureus, Adolescent, MESH : Male, Population, MESH : Young Adult, MESH: Staphylococcal Infections, [SDU.STU.PE]Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH: Prognosis, MESH: Population Surveillance, 03 medical and health sciences, Young Adult, Internal medicine, MESH : Adolescent, medicine, Endocarditis, Humans, MESH : Middle Aged, MESH: Endocarditis, Bacterial, education, MESH : Aged, 80 and over, MESH : France, Aged, MESH : Staphylococcus, [ SDU.STU.PE ] Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH: Adolescent, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, Proportional hazards model, MESH : Humans, MESH: Cross Infection, MESH: Adult, Endocarditis, Bacterial, medicine.disease, Confidence interval, MESH: Male, Surgery, MESH: France, MESH : Staphylococcal Infections, business, MESH: Female
Abstract: International audience; BACKGROUND: Observational studies showed that the profile of infective endocarditis (IE) significantly changed over the past decades. However, most studies involved referral centers. We conducted a population-based study to control for this referral bias. The objective was to update the description of characteristics of IE in France and to compare the profile of community-acquired versus healthcare-associated IE. METHODS: A prospective population-based observational study conducted in all medical facilities from 7 French regions (32% of French individuals aged ≥18 years) identified 497 adults with Duke-Li-definite IE who were first admitted to the hospital in 2008. Main measures included age-standardized and sex-standardized incidence of IE and multivariate Cox regression analysis for risk factors of in-hospital death. RESULTS: The age-standardized and sex-standardized annual incidence of IE was 33.8 (95% confidence interval [CI], 30.8-36.9) cases per million inhabitants. The incidence was highest in men aged 75-79 years. A majority of patients had no previously known heart disease. Staphylococci were the most common causal agents, accounting for 36.2% of cases (Staphylococcus aureus, 26.6%; coagulase-negative staphylococci, 9.7%). Healthcare-associated IE represented 26.7% of all cases and exhibited a clinical pattern significantly different from that of community-acquired IE. S. aureus as the causal agent of IE was the most important factor associated with in-hospital death in community-acquired IE (hazard ratio [HR], 2.82 [95% CI, 1.72-4.61]) and the single factor in healthcare-associated IE (HR, 2.54 [95% CI, 1.33-4.85]). CONCLUSIONS: S. aureus became both the leading cause and the most important prognostic factor of IE, and healthcare-associated IE appeared as a major subgroup of the disease.
Published: 2012
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7. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices

Author: David Gordon, Emilio Bouza, Víctor José González Ramallo, Christine Selton-Suty, Francesc Marco, Eugene Athan, Emanuele Durante-Mangoni, Anna Lisa Chamis, Zainab Samad, Nuria Fernández-Hidalgo, Carlos Cervera, Jorge Solis, Corentine ALAUZET, François Alla, Sarah Israel, Hussien Rizk, Patricia Carmen Muñoz García, Andrew Wang, Juan M Pericas, Souha Kanj, Carlos Falces, Pierre-Edouard Fournier, Assoc Prof Margaret J Henry, Asunción Moreno Camacho, Martin Stryjewski, Antonio Toniolo, Didier Raoult, Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Monaldi Hospital, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Département de Cardiologie, Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Madrid, Spain - Spanish Network for Research in Infectious Diseases (REIPI RD06/0008), ICE-PCS Investigators, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], 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)-Hôpital Saint-Jacques, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE)
Subjects: Male, Pacemaker, Artificial, MESH: Endocarditis, MESH : Prevalence, [SDV]Life Sciences [q-bio], Heart Valve Diseases, MESH : Aged, MESH : Prospective Studies, MESH: Hospitalization, 030204 cardiovascular system & hematology, 0302 clinical medicine, prevention, MESH: Tricuspid Valve, Interquartile range, MESH : Device Removal, Prevalence, MESH : Female, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, Endocarditis, prosthesis, infection, etiology, survival, Prospective cohort study, MESH: Treatment Outcome, MESH: Aged, Cross Infection, MESH: Middle Aged, Infective endocarditis, Impalntable cardiac device, Mortality rate, Hazard ratio, General Medicine, Middle Aged, Staphylococcal Infections, MESH : Tricuspid Valve, MESH : Endocarditis, Defibrillators, Implantable, 3. Good health, MESH : Heart Valve Diseases, Hospitalization, Treatment Outcome, MESH: Survival Analysis, MESH: Pacemaker, Artificial, MESH : Hospitalization, Female, Tricuspid Valve, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH : Male, MESH: Staphylococcal Infections, [SDU.STU.PE]Sciences of the Universe [physics]/Earth Sciences/Petrography, Context (language use), MESH : Treatment Outcome, MESH: Defibrillators, Implantable, MESH : Hospital Mortality, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Hospital Mortality, MESH: Device Removal, Device Removal, MESH: Prevalence, Aged, [ SDU.STU.PE ] Sciences of the Universe [physics]/Earth Sciences/Petrography, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Pacemaker, Artificial, MESH : Humans, MESH: Cross Infection, MESH: Heart Valve Diseases, medicine.disease, Survival Analysis, MESH: Male, MESH: Prospective Studies, Surgery, MESH : Staphylococcal Infections, MESH : Survival Analysis, business, MESH: Female, MESH : Defibrillators, Implantable
Abstract: International audience; CONTEXT: Infection of implantable cardiac devices is an emerging disease with significant morbidity, mortality, and health care costs. OBJECTIVES: To describe the clinical characteristics and outcome of cardiac device infective endocarditis (CDIE) with attention to its health care association and to evaluate the association between device removal during index hospitalization and outcome. DESIGN, SETTING, AND PATIENTS: Prospective cohort study using data from the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), conducted June 2000 through August 2006 in 61 centers in 28 countries. Patients were hospitalized adults with definite endocarditis as defined by modified Duke endocarditis criteria. MAIN OUTCOME MEASURES: In-hospital and 1-year mortality. RESULTS: CDIE was diagnosed in 177 (6.4% [95% CI, 5.5%-7.4%]) of a total cohort of 2760 patients with definite infective endocarditis. The clinical profile of CDIE included advanced patient age (median, 71.2 years [interquartile range, 59.8-77.6]); causation by staphylococci (62 [35.0% {95% CI, 28.0%-42.5%}] Staphylococcus aureus and 56 [31.6% {95% CI, 24.9%-39.0%}] coagulase-negative staphylococci); and a high prevalence of health care-associated infection (81 [45.8% {95% CI, 38.3%-53.4%}]). There was coexisting valve involvement in 66 (37.3% [95% CI, 30.2%-44.9%]) patients, predominantly tricuspid valve infection (43/177 [24.3%]), with associated higher mortality. In-hospital and 1-year mortality rates were 14.7% (26/177 [95% CI, 9.8%-20.8%]) and 23.2% (41/177 [95% CI, 17.2%-30.1%]), respectively. Proportional hazards regression analysis showed a survival benefit at 1 year for device removal during the initial hospitalization (28/141 patients [19.9%] who underwent device removal during the index hospitalization had died at 1 year, vs 13/34 [38.2%] who did not undergo device removal; hazard ratio, 0.42 [95% CI, 0.22-0.82]). CONCLUSIONS: Among patients with CDIE, the rate of concomitant valve infection is high, as is mortality, particularly if there is valve involvement. Early device removal is associated with improved survival at 1 year.
Published: 2012
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8. Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

Author: Bruno Lina, Corinne Régis, Brigitte Coppéré, Silene Cronenberger, Olivier Robert, Brigitte Comte, Philippe Vanhems, Nicolas Voirin, Thomas Bénet, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Camille Jordan [Villeurbanne] ( ICJ ), École Centrale de Lyon ( ECL ), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), Virologie et pathologie humaine ( VirPath ), Université de Lyon-Université de Lyon, Service de médecine gériatrique, Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Institut Camille Jordan (ICJ), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Virologie et pathologie humaine (VirPath), Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Camille Jordan [Villeurbanne] (ICJ), Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH : Orthomyxoviridae, [SDV]Life Sciences [q-bio], MESH : Aged, MESH : Prospective Studies, MESH: Influenza Vaccines, MESH: Aged, 80 and over, 0302 clinical medicine, Medical microbiology, Acute care, Health care, Medicine, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH : Influenza, Human, Prospective cohort study, MESH: Orthomyxoviridae, MESH: Aged, Aged, 80 and over, Cross Infection, 0303 health sciences, MESH: Middle Aged, biology, MESH: Influenza, Human, Vaccination, MESH: Nose, Healthcare worker, virus diseases, Middle Aged, MESH : Adult, MESH: Hospitals, Orthomyxoviridae, MESH: Case-Control Studies, Hospitals, 3. Good health, MESH : Hospitals, Infectious Diseases, MESH: Hemagglutination Inhibition Tests, Influenza Vaccines, Female, MESH : Nose, MESH : Cross Infection, Research Article, Adult, medicine.medical_specialty, MESH : Case-Control Studies, animal structures, Health Personnel, MESH : Male, education, Nose, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Influenza, Human, Humans, lcsh:RC109-216, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], 030306 microbiology, business.industry, MESH : Humans, Case-control study, MESH: Cross Infection, MESH: Adult, MESH: Vaccination, Hemagglutination Inhibition Tests, biology.organism_classification, MESH: Male, MESH: Prospective Studies, MESH : Hemagglutination Inhibition Tests, MESH : Influenza Vaccines, MESH : Vaccination, Case-Control Studies, Immunology, Emergency medicine, MESH: Health Personnel, MESH : Health Personnel, business, MESH: Female
Abstract: Background In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients. Methods A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients. Results In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (P = 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (P = 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units. Conclusions Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.
Published: 2012
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9. Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment

Author: C. Charpentier, Djillali Annane, Mariette Mercier, Thibault Desmettre, Christophe Faisy, Antoine Roch, Joel Cousson, Gilles Capellier, Samuel Limat, Laurent Papazian, Hélène Mockly, Gilles Blasco, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Médecine Générale et Soins Intensifs, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Service de Réanimation des Détresses Respiratoires et Infections Sévères, Assistance Publique - Hôpitaux de Marseille ( APHM ), Service de soins intensifs, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement (UMR 6249) (LCE), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO)
Subjects: Male, Critical Care and Emergency Medicine, Pulmonology, MESH : Aged, MESH : Prospective Studies, MESH: Pneumonia, Ventilator-Associated, MESH : Pneumonia, Ventilator-Associated, MESH : Drug Resistance, Bacterial, MESH : Intensive Care, law.invention, 0302 clinical medicine, Antibiotics, Odds Ratio, Clinical endpoint, Prospective Studies, lcsh:Science, MESH : Intubation, MESH: Treatment Outcome, Cross Infection, MESH: Middle Aged, Death rates, Drug Information, Pneumonia, Ventilator-Associated, 3. Good health, Cohort, Medicine, MESH : Intensive Care Units, MESH : Bronchoalveolar Lavage, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH : Drug Administration Schedule, MESH : Cohort Studies, MESH: Drug Administration Schedule, Drug Administration Schedule, 03 medical and health sciences, Sepsis, MESH: Anti-Bacterial Agents, Multicenter trial, Drug Resistance, Bacterial, Humans, Clinical Trials, MESH : Middle Aged, MESH: Intensive Care, Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], lcsh:R, MESH : Humans, MESH: Adult, Pneumonia, medicine.disease, 030228 respiratory system, Bacterial Pneumonia, lcsh:Q, Bacterial pathogens, Intubation, MESH: Female, Bacterial Diseases, Time Factors, Nosocomial Infections, [SDV]Life Sciences [q-bio], Enterococcus infections, lcsh:Medicine, Bronchoalveolar Lavage, Cohort Studies, Randomized controlled trial, law, MESH : Female, 030212 general & internal medicine, MESH : Anti-Bacterial Agents, Prospective cohort study, MESH: Cohort Studies, MESH: Aged, Intensive care units, Multidisciplinary, MESH: Bronchoalveolar Lavage, Ventilatory Support, Middle Aged, MESH : Adult, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Female, Research Article, MESH : Time Factors, Adult, Drugs and Devices, Critical Care, Clinical Research Design, Secondary infection, MESH : Male, MESH : Treatment Outcome, Respiratory Failure, Internal medicine, MESH: Drug Resistance, Bacterial, medicine, MESH: Intubation, business.industry, MESH: Time Factors, Respiratory infections, MESH: Cross Infection, MESH: Male, MESH: Odds Ratio, MESH: Prospective Studies, Surgery, MESH: Intensive Care Units, MESH : Odds Ratio, business
Abstract: Purpose The optimal treatment duration for ventilator-associated pneumonia is based on one study dealing with late-onset of the condition. Shortening the length of antibiotic treatment remains a major prevention factor for the emergence of multiresistant bacteria. Objective To demonstrate that 2 different antibiotic treatment durations (8 versus 15 days) are equivalent in terms of clinical cure for early-onset ventilator-associated pneumonia. Methods Randomized, prospective, open, multicenter trial carried out from 1998 to 2002. Measurements The primary endpoint was the clinical cure rate at day 21. The mortality rate was evaluated on days 21 and 90. Results 225 patients were included in 13 centers. 191 (84.9%) patients were cured: 92 out of 109 (84.4%) in the 15 day cohort and 99 out of 116 (85.3%) in the 8 day cohort (difference = 0.9%, odds ratio = 0.929). 95% two-sided confidence intervals for difference and odds ratio were [−8.4% to 10.3%] and [0.448 to 1.928] respectively. Taking into account the limits of equivalence (10% for difference and 2.25 for odds ratio), the objective of demonstrative equivalence between the 2 treatment durations was fulfilled. Although the rate of secondary infection was greater in the 8 day than the 15 day cohort, the number of days of antibiotic treatment remained lower in the 8 day cohort. There was no difference in mortality rate between the 2 groups on days 21 and 90. Conclusion Our results suggest that an 8-day course of antibiotic therapy is safe for early-onset ventilator-associated pneumonia in intubated patients. Trial Registration ClinicalTrials.gov NCT01559753
Published: 2012
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10. Multilevel modelling of the prevalence of hospitalized patients infected with Pseudomonas aeruginosa

Author: Daniel Talon, Houssein Gbaguidi-Haore, Pascal Cholley, C Rabaud, Xavier Bertrand, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier ( LIRMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Male, Pediatrics, Epidemiology, Hospitalized patients, MESH : Prevalence, MESH : Aged, MESH: Logistic Models, MESH : Models, Biological, medicine.disease_cause, 0302 clinical medicine, Outcome variable, Risk Factors, MESH: Risk Factors, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Prevalence, Medicine, MESH : Female, 030212 general & internal medicine, MESH: Aged, Cross Infection, 0303 health sciences, MESH: Middle Aged, Nosocomial pathogens, MESH: Pseudomonas Infections, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, MESH : Pseudomonas aeruginosa, MESH : Pseudomonas Infections, MESH : Risk Factors, Total variability, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Pseudomonas aeruginosa, MESH: Pseudomonas aeruginosa, Female, MESH : Cross Infection, medicine.medical_specialty, MESH : Male, Models, Biological, 03 medical and health sciences, Antibiotic resistance, Humans, Pseudomonas Infections, MESH : Middle Aged, MESH: Prevalence, Aged, MESH: Humans, 030306 microbiology, business.industry, Multilevel modelling, MESH : Humans, MESH: Models, Biological, MESH: Cross Infection, MESH: Male, Logistic Models, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography, MESH : Logistic Models
Abstract: SUMMARYPseudomonas aeruginosais one of the leading nosocomial pathogens. The question of the respective contribution of endogenous and exogenous sources remains controversial. In this study, we shed new light on this issue by means of a multilevel logistic regression analysis which allowed a simultaneous investigation of factors associated with prevalence of patients infected withP. aeruginosaat two levels: patient and healthcare facility (HCF) in the eastern regions of France. A total of 25 533 in-patients from 51 HCFs were included in the analysis. The overall prevalence was 0·37% (range 0–1·65%). Multilevel modelling estimated that P. aeruginosain the eastern HCFs of France.
Published: 2011
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11. Molecular epidemiology of multidrug-resistant Pseudomonas aeruginosa in a French university hospital

Author: Daniel Talon, Michelle Thouverez, Houssein Gbaguidi-Haore, Patrick Plésiat, Pascal Cholley, Xavier Bertrand, Didier Hocquet, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Agents pathogènes et inflammation - UFC (EA 4266) (API), and Université de Franche-Comté (UFC)
Subjects: Imipenem, MESH: beta-Lactamases, MESH : Genotype, Drug resistance, medicine.disease_cause, Hospitals, University, MESH: Genotype, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Drug Resistance, Multiple, Bacterial, MESH: DNA Fingerprinting, Cluster Analysis, MESH: Incidence, MESH : Anti-Bacterial Agents, Cross Infection, Molecular Epidemiology, 0303 health sciences, Incidence, MESH : beta-Lactamases, MESH: Pseudomonas Infections, General Medicine, MESH : DNA Fingerprinting, MESH : Pseudomonas aeruginosa, MESH : Pseudomonas Infections, MESH : Incidence, Anti-Bacterial Agents, Bacterial Typing Techniques, Electrophoresis, Gel, Pulsed-Field, 3. Good health, Infectious Diseases, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Pseudomonas aeruginosa, MESH: Pseudomonas aeruginosa, France, MESH : Cross Infection, medicine.drug, Microbiology (medical), MESH : Drug Resistance, Multiple, Bacterial, Genotype, MESH : Molecular Epidemiology, beta-Lactamases, MESH: Bacterial Typing Techniques, Microbiology, 03 medical and health sciences, MESH: Anti-Bacterial Agents, medicine, Pulsed-field gel electrophoresis, Humans, MESH: Molecular Epidemiology, MESH : Cluster Analysis, Pseudomonas Infections, MESH : France, MESH : Hospitals, University, 030304 developmental biology, MESH : Electrophoresis, Gel, Pulsed-Field, MESH: Hospitals, University, MESH: Humans, Molecular epidemiology, 030306 microbiology, business.industry, MESH : Humans, MESH: Cross Infection, MESH: Drug Resistance, Multiple, Bacterial, DNA Fingerprinting, MESH: Cluster Analysis, Multiple drug resistance, MESH: France, Ticarcillin, MESH : Bacterial Typing Techniques, business, Piperacillin
Abstract: International audience; The aim of this study was to assess the incidence and molecular epidemiology of multidrug-resistant (MDR) Pseudomonas aeruginosa in our university hospital. Analysis included antimicrobial susceptibility profiling, bla gene identification and pulsed-field gel electrophoresis (PFGE). During the one-year study, 654 patients had at least one sample that tested positive for P. aeruginosa, of whom 38 (5.8%) were colonised or infected with an MDR isolate, giving an incidence of 0.1 patient per 1000 patient-days. The 38 non-duplicate isolates yielded 12 different PFGE patterns, three of which included isolates from four patients and one of which included isolates from 15 patients. Two isolates produced acquired extended-spectrum β-lactamase (one OXA-14 and one OXA-28). Genotyping showed that cross-transmission was responsible for about 70% of MDR P. aeruginosa cases although spatio-temporal analysis failed to demonstrate when this might have occurred for most cases. The major epidemic and the three main micro-epidemic clones were already present in our hospital with a more susceptible phenotype. It is likely that some P. aeruginosa clones are endemic in our hospital and that, within these clones, MDR isolates emerge under antibiotic pressure. Our results indicate that cross-transmission plays a major role in the spread of MDR P. aeruginosa and suggest that priority should be given to the improvement of standard hygienic precautions.
Published: 2010
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12. Recent exposure to caspofungin or fluconazole influences the epidemiology of candidemia: a prospective multicenter study involving 2,441 patients

Author: Karine Sitbon, Stéphane Bretagne, Françoise Dromer, Marie Desnos-Ollivier, Olivier Lortholary, Arnaud Fontanet, Centre de Référence Déficits Immunitaires Héréditaires (CEREDIH), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Thérapeutique Recombinante Expérimentale (TIMC-IMAG-TheREx), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre de Référence Déficits Immunitaires Héréditaires ( CEREDIH ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire ( CNRMA ), Epidémiologie des Maladies Emergentes, Conservatoire National des Arts et Métiers [CNAM] ( CNAM ) -Institut Pasteur [Paris]-Pasteur-Cnam risques infectieux et émergents ( PACRI ), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Thérapeutique Recombinante Expérimentale ( TIMC-IMAG-THEREX ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), and Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA )
Subjects: Antifungal Agents, MESH : Prevalence, MESH : Prospective Studies, Drug resistance, MESH : Child, Preschool, MESH: Candidemia, law.invention, chemistry.chemical_compound, Echinocandins, 0302 clinical medicine, MESH : Child, law, Caspofungin, MESH: Child, Epidemiology, Candida albicans, MESH : Population Surveillance, Prevalence, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Child, Fluconazole, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Candida, 0303 health sciences, MESH: Microbial Sensitivity Tests, Cross Infection, MESH: Paris, MESH : Paris, MESH : Adult, Intensive care unit, 3. Good health, Infectious Diseases, Child, Preschool, Population Surveillance, MESH : Fluconazole, MESH: Fluconazole, France, MESH : Cross Infection, medicine.drug, Adult, medicine.medical_specialty, Paris, MESH : Candida albicans, MESH : Antifungal Agents, Microbial Sensitivity Tests, Biology, Clinical Therapeutics, MESH: Drug Resistance, Fungal, MESH: Population Surveillance, 03 medical and health sciences, Lipopeptides, Species Specificity, MESH: Candida, Drug Resistance, Fungal, Internal medicine, medicine, MESH : Species Specificity, MESH : Candidemia, MESH: Species Specificity, Humans, MESH : France, MESH: Prevalence, MESH : Echinocandins, Pharmacology, MESH: Humans, 030306 microbiology, MESH: Candida albicans, MESH: Echinocandins, MESH : Humans, MESH: Child, Preschool, MESH : Drug Resistance, Fungal, MESH: Cross Infection, Candidemia, MESH: Adult, Odds ratio, biology.organism_classification, MESH: Antifungal Agents, MESH: Prospective Studies, Surgery, MESH: France, chemistry, MESH : Microbial Sensitivity Tests, MESH : Candida
Abstract: A prospective multicenter surveillance program on yeast bloodstream infections was implemented in the Paris, France, area without restrictions on ward of hospitalization (intensive care unit, hematology, and surgery) or age (adults and children). The present analysis concerns 2,618 isolates collected over 7 years from 2,441 patients. Centralized species identification and antifungal susceptibility testing using the EUCAST methodology were performed. Almost 10% (232/2,441) of the patients had recently (≤30 days) been treated with antifungal drugs. We analyzed the effect of recent exposure to fluconazole ( n = 159) or caspofungin ( n = 61) on the proportions of the five major Candida species. For both drugs, preexposure was associated with a decreased prevalence of Candida albicans in favor of less drug-susceptible species ( C. glabrata and C. krusei for the former and C. parapsilosis and, to a lesser extent, C. glabrata and C. krusei for the latter; P = 0.001). In the multivariate analysis, the risk of being infected with an isolate with decreased susceptibility to fluconazole was independently associated with an age of ≥15 years (odds ratio [OR] = 2.45; 95% confidence interval [CI] = 1.39 to 4.31; P = 0.002) and with recent exposure to fluconazole (OR = 2.17; 95% CI = 1.51 to 3.13; P < 0.001), while the risk of being infected with an isolate with decreased susceptibility to caspofungin was independently associated with an age P = 0.001) and with recent exposure to caspofungin (OR = 4.79; 95% CI = 2.47 to 9.28; P < 0.001). These findings could influence future recommendations for the management of candidemia.
Published: 2010
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13. A multicentre study of antifungal strategies and outcome of Candida spp. peritonitis in intensive-care units

Author: Philippe Montravers, Olivier Leroy, Jean-Pierre Gangneux, Jean Paul Mira, Olivier Lortholary, Service d'anesthésie - réanimation chirurgicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Parasitologie-Mycologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Signalisation et Réponses aux Agents Infectieux et Chimiques (SeRAIC), Université de Rennes (UR), Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Gustave Dron, 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 Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris] (IP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-IFR140, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Signalisation et Réponses aux Agents Infectieux et Chimiques ( SeRAIC ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140, CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris]
Subjects: Male, Antifungal Agents, MESH : Prospective Studies, MESH : Aged, MESH : Candidiasis, chemistry.chemical_compound, MESH: Aged, 80 and over, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Amphotericin B, fluconazole, MESH : Female, 030212 general & internal medicine, Prospective Studies, caspofungin, MESH: Treatment Outcome, Candida, MESH: Aged, Aged, 80 and over, MESH: Microbial Sensitivity Tests, 0303 health sciences, education.field_of_study, Cross Infection, MESH: Middle Aged, Candidiasis, General Medicine, MESH : Adult, Middle Aged, MESH: Candidiasis, 3. Good health, Intensive Care Units, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Treatment Outcome, MESH: Young Adult, Female, France, MESH : Intensive Care Units, MESH : Cross Infection, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, MESH: Peritonitis, Adolescent, MESH : Male, MESH : Antifungal Agents, Population, MESH : Young Adult, Peritonitis, MESH : Peritonitis, MESH : Treatment Outcome, Microbial Sensitivity Tests, Biology, Microbiology, 03 medical and health sciences, Young Adult, MESH: Candida, MESH : Adolescent, Internal medicine, Intensive care, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : France, education, Mycosis, intensive-care unit, Aged, MESH: Adolescent, Voriconazole, MESH: Humans, 030306 microbiology, MESH : Humans, MESH: Cross Infection, MESH: Adult, MESH: Antifungal Agents, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: France, chemistry, MESH: Intensive Care Units, MESH : Microbial Sensitivity Tests, Caspofungin, MESH: Female, MESH : Candida, Fluconazole
Abstract: International audience; Information on the species causing Candida peritonitis, their in vitro susceptibility, antifungal strategies in this setting and patient outcome is still scarce. AmarCand was a prospective, non-interventional study in 271 adult intensive-care unit (ICU) patients with proven invasive Candida infection who received systemic antifungal therapy (France, 2005-2006). Of these ICU patients, 93 (median age 65 years, simplified acute physiology score II 52) had Candida peritonitis, including 73 nosocomial peritonitis, 53 concomitant bacterial peritoneal infections and 26 candidaemias. Candida species were C. albicans (n = 63/108 isolates, 58%), C. glabrata (n = 22, 20%), C. krusei (n = 9), C. kefyr (n = 5), C. parapsilosis (n = 3), C. tropicalis (n = 3), C. ciferii (n = 2) and C. lusitaniae (n = 1). Of tested isolates, 28% were fluconazole-resistant or susceptible dose-dependent (C. albicans 3/32, C. glabrata 9/14, C. krusei 4/4). Empiric antifungal treatment was started 1 day (median) after peritonitis diagnosis, with fluconazole (n = 2 patients), caspofungin (n = 12), voriconazole (n = 3), amphotericin B (n = 2), or a combination (n = 4). Following susceptibility testing, empiric antifungal treatment was judged inadequate in 9/45 (20%) patients and modified in 30 patients (fluconazole was replaced by caspofungin (n = 14) or voriconazole (n = 4)). Mortality in ICU was 38% (35/93) and was not influenced by type of Candida species, fluconazole susceptibility, time to treatment, candidaemia, nosocomial acquisition, or concomitant bacterial infection. No specific factors for death were identified. In summary, a high proportion of fluconazole-resistant or susceptible dose-dependent strains was cultured. These results confirm the high mortality rates of Candida peritonitis and plead for additional investigation in this population. Antifungal treatment for severe cases of Candida peritonitis in ICU patients remains the standard care.
Published: 2010
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14. Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital

Author: Daniel Talon, Xavier Bertrand, Houssein Gbaguidi-Haore, Michelle Thouverez, Gérard Couetdic, Pascal Cholley, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: MESH : Leukocidins, Male, MESH : Retrospective Studies, MESH : Aged, MESH: Leukocidins, Hospitals, University, 0302 clinical medicine, MESH : Child, MESH: Superantigens, MESH: Child, MESH : Superantigens, Child, Aged, 80 and over, 0303 health sciences, Cross Infection, MESH: Middle Aged, Superantigens, MESH : Genes, Bacterial, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Staphylococcal Infections, Antimicrobial, MESH: Infant, 3. Good health, Electrophoresis, Gel, Pulsed-Field, MESH : Phenotype, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Staphylococcus aureus, MESH: Young Adult, Child, Preschool, MESH : Cross Infection, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, Fusidic acid, MESH : Molecular Epidemiology, MESH: Staphylococcal Infections, MESH : Young Adult, Exotoxins, MESH: Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, MESH: Phenotype, Microbiology, 03 medical and health sciences, Antibiotic resistance, MESH : Adolescent, MESH: Molecular Epidemiology, MESH : Methicillin-Resistant Staphylococcus aureus, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : Hospitals, University, MESH : Electrophoresis, Gel, Pulsed-Field, Aged, Retrospective Studies, MESH: Adolescent, MESH: Humans, MESH: Methicillin Resistance, 030306 microbiology, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Virology, MESH : Methicillin Resistance, MESH : Exotoxins, MESH : Staphylococcal Infections, MESH: Female, Meticillin, Drug resistance, MESH : Child, Preschool, medicine.disease_cause, Enterotoxins, MESH: Aged, 80 and over, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Leukocidins, MESH: Enterotoxins, MESH : Female, 030212 general & internal medicine, MESH : Enterotoxins, MESH: Aged, MESH: Microbial Sensitivity Tests, Molecular Epidemiology, MESH: Infant, Newborn, MESH : Adult, Middle Aged, Phenotype, Female, France, MESH: Genes, Bacterial, medicine.drug, Adult, Adolescent, MESH : Male, Bacterial Toxins, MESH : Infant, Newborn, Young Adult, medicine, MESH : France, MESH: Hospitals, University, business.industry, Infant, Newborn, MESH: Cross Infection, MESH: Exotoxins, MESH: Male, Multiple drug resistance, MESH: France, MESH: Bacterial Toxins, Genes, Bacterial, MESH : Bacterial Toxins, Multilocus sequence typing, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Methicillin Resistance, MESH : Microbial Sensitivity Tests, business
Abstract: Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton–Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing. Demographic and clinical data were collected from all patients. For PVL-positive MRSA, the typical antimicrobial resistance pattern (susceptible to fluoroquinolones, non-susceptible to fusidic acid, kanamycin resistant and susceptible to gentamicin and tobramycin) had a sensitivity of 77.8 % and a positive predictive value (PPV) of 100 %. For tst-positive MRSA, the antimicrobial resistance pattern (susceptible to fluoroquinolones and non-susceptible to fusidic acid) had a sensitivity of 100 % and a PPV of 72.4 %. These results suggest that phenotypic rules based on antimicrobial resistance patterns are potentially useful for the detection of PVL- and tst-positive MRSA isolates.
Published: 2009
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15. Is there a threshold above which hand-rub solution consumption is efficient for decreasing MRSA incidence?

Author: Michelle Thouverez, Daniel Talon, Xavier Bertrand, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement ( LCE ), and Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC )
Subjects: Microbiology (medical), Cross infection, medicine.medical_specialty, MESH: Staphylococcal Infections, MESH: Methicillin-Resistant Staphylococcus aureus, 030501 epidemiology, MESH: Handwashing, Toxicology, 03 medical and health sciences, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, medicine, MESH : Methicillin-Resistant Staphylococcus aureus, 030212 general & internal medicine, MESH: Incidence, Intensive care medicine, Hand disinfection, ComputingMilieux_MISCELLANEOUS, Consumption (economics), Which hand, MESH: Humans, business.industry, Incidence (epidemiology), MESH : Humans, MESH: Disinfectants, MESH: Cross Infection, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, MESH : Incidence, MESH : Disinfectants, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Handwashing, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Staphylococcal Infections, 0305 other medical science, business, MESH : Intensive Care Units, MESH : Cross Infection, Beta lactam antibiotics
Abstract: International audience
Published: 2009
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16. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006)

Author: Leroy , Olivier, Gangneux , Jean-Pierre, Montravers , Philippe, Mira , Jean-Paul, Gouin , François, Sollet , Jean-Pierre, Carlet , Jean, Reynes , Jacques, Rosenheim , Michel, Regnier , Bernard, Lortholary , Olivier, Renseigné , Non, Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Gustave Dron, Signalisation et Réponses aux Agents Infectieux et Chimiques ( SeRAIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140, Régulations des équilibres fonctionnels du foie normal et pathologique, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département anesthésie-réanimation chirurgicale, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Physiopathologie de la Résorption Osseuse et Thérapie des Tumeurs Osseuses Primitives, Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), service de réanimation polyvalente, Centre Hospitalier Victor Dupuy, Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, Centre d'infectiologie Necker-Pasteur [CHU Necker], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Mycologie moléculaire, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Signalisation et Réponses aux Agents Infectieux et Chimiques (SeRAIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), Groupe Hospitalier Paris Saint-Joseph (hpsj), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-IFR140, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-IFR140-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1)
Subjects: Male, critically ill, MESH : Aged, MESH : Prospective Studies, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Case fatality rate, Hospital Mortality, Prospective Studies, MESH: Incidence, Fungemia, MESH: Treatment Outcome, Cause of death, Aged, 80 and over, Cross Infection, 0303 health sciences, MESH: Middle Aged, Incidence, Candidiasis, MESH: Follow-Up Studies, MESH : Incidence, 3. Good health, Survival Rate, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Young Adult, MESH: Critical Illness, MESH : Intensive Care Units, MESH : Cross Infection, medicine.medical_specialty, MESH: Probability, Critical Illness, MESH : Young Adult, MESH : Cohort Studies, Statistics, Nonparametric, MESH : Hospital Mortality, 03 medical and health sciences, MESH: Critical Care, MESH: Fungemia, Intensive care, MESH : Adolescent, Humans, MESH : Middle Aged, MESH: Hospital Mortality, MESH : Aged, 80 and over, Mycosis, Aged, MESH: Adolescent, MESH: Humans, 030306 microbiology, MESH : Humans, MESH: Adult, MESH : Follow-Up Studies, MESH: Antifungal Agents, medicine.disease, chemistry, MESH: Female, Fluconazole, Antifungal Agents, MESH : Critical Illness, Cohort Studies, MESH: Cause of Death, chemistry.chemical_compound, MESH : Candidiasis, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Cause of Death, MESH : Female, 030212 general & internal medicine, MESH: Cohort Studies, MESH : Critical Care, Candida, intensive care, MESH: Aged, MESH: Statistics, Nonparametric, fungemia, Middle Aged, MESH : Adult, MESH : Survival Rate, MESH : Risk Factors, MESH: Candidiasis, Intensive Care Units, Treatment Outcome, Female, epidemiology, France, medicine.drug, Adult, Adolescent, Critical Care, MESH: Survival Rate, MESH : Male, MESH : Probability, MESH : Antifungal Agents, MESH : Treatment Outcome, Young Adult, Internal medicine, medicine, MESH : France, MESH : Statistics, Nonparametric, Probability, MESH : Cause of Death, Voriconazole, business.industry, MESH: Cross Infection, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, MESH : Fungemia, MESH: Intensive Care Units, Caspofungin, business, Follow-Up Studies
Abstract: International audience; OBJECTIVE: To describe the evolving epidemiology, management, and risk factors for death of invasive Candida infections in intensive care units (ICUs). DESIGN: Prospective, observational, national, multicenter study. SETTING: One hundred eighty ICUs in France. PATIENTS: Between October 2005 and May 2006, 300 adult patients with proven invasive Candida infection who received systemic antifungal therapy were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One hundred seven patients (39.5%) with isolated candidemia, 87 (32.1%) with invasive candidiasis without documented candidemia, and 77 (28.4%) with invasive candidiasis and candidemia were eligible. In 37% of the cases, candidemia occurred within the first 5 days after ICU admission. C. albicans accounted for 57.0% of the isolates, followed by C. glabrata (16.7%), C. parapsilosis (7.5%), C. krusei (5.2%), and C. tropicalis (4.9%). In 17.1% of the isolates, the causative Candida was less susceptible or resistant to fluconazole. Fluconazole was the empirical treatment most commonly introduced (65.7%), followed by caspofungin (18.1%), voriconazole (5.5%), and amphotericin B (3.7%). After identification of the causative species and susceptibility testing results, treatment was modified in 86 patients (31.7%). The case fatality ratio in ICU was 45.9% and did not differ significantly according to the type of episode. Multivariate analysis showed that factors independently associated with death in ICU were type 1 diabetes mellitus (odds ratio [OR] 4.51; 95% confidence interval [CI] 1.72-11.79; p = 0.002), immunosuppression (OR 2.63; 95% CI 1.35-5.11; p = 0.0045), mechanical ventilation (OR 2.54; 95% CI 1.33-4.82; p = 0.0045), and body temperature >38.2 degrees C (reference, 36.5-38.2 degrees C; OR 0.36; 95% CI 0.17-0.77; p = 0.008). CONCLUSIONS: More than two thirds of patients with invasive candidiasis in ICU present with candidemia. Non-albicans Candida species reach almost half of the Candida isolates. Reduced susceptibility to fluconazole is observed in 17.1% of Candida isolates. Mortality of invasive candidiasis in ICU remains high.
Published: 2009
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17. Meticillin-resistant Staphylococcus aureus contamination of healthcare workers' uniforms in long-term care facilities

Author: S. Gayet, D. Gunther, Philippe Gaspard, Daniel Talon, Xavier Bertrand, E. Eschbach, ARELIN, ARELIN, Strasbourg, France, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Meticillin, MESH : Aged, Nurses, 030501 epidemiology, medicine.disease_cause, MESH: Long-Term Care, MESH: Infection Control, 0302 clinical medicine, Protective Clothing, Hygiene, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Nursing Assistants, Infection control, Homes for the Aged, MESH: Nurses' Aides, 030212 general & internal medicine, MESH: Incidence, Antibacterial agent, media_common, MESH: Aged, Cross Infection, Incidence, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Staphylococcal Infections, MESH : Incidence, 3. Good health, Infectious Diseases, MESH: Nurses, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Fomites, MESH : Protective Clothing, France, MESH : Long-Term Care, 0305 other medical science, MESH: Equipment Contamination, MESH : Cross Infection, medicine.drug, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, media_common.quotation_subject, MESH: Staphylococcal Infections, MESH: Methicillin-Resistant Staphylococcus aureus, MESH : Fomites, Staphylococcal infections, MESH: Protective Clothing, 03 medical and health sciences, MESH : Nurses' Aides, Environmental health, MESH : Nurses, medicine, MESH : Methicillin-Resistant Staphylococcus aureus, Humans, Intensive care medicine, MESH: Homes for the Aged, MESH : France, MESH : Homes for the Aged, Aged, Infection Control, MESH: Humans, MESH : Infection Control, business.industry, MESH : Humans, MESH: Cross Infection, medicine.disease, MESH: Fomites, Methicillin-resistant Staphylococcus aureus, Long-Term Care, Nursing Homes, MESH: France, Long-term care, MESH: Nursing Homes, MESH : Equipment Contamination, Equipment Contamination, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Staphylococcal Infections, business, MESH : Nursing Homes
Abstract: International audience; Meticillin-resistant Staphylococcus aureus (MRSA) and other multiply resistant bacteria are frequently isolated in long-term care facilities (LTCFs). This study evaluated the contamination of staff clothing in three LTCFs. Over 500 samples were taken from uniforms and their pockets and these samples showed a high level of MRSA contamination. Wearing plastic aprons and managing pocket contents improved the contamination rate. Our results highlight the continued importance of hand hygiene, since staff have frequent contact with their uniforms and could potentially contaminate their hands before care.
Published: 2008
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18. Are antibiotic-resistant Pseudomonas aeruginosa isolated from hospitalised patients recovered in the hospital effluents?

Author: Xavier Bertrand, Michelle Thouverez, I. Patry, Houssein Gbaguidi-Haore, E. Tuméo, Daniel Talon, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Antibiotics, Drug resistance, 010501 environmental sciences, medicine.disease_cause, MESH : Drug Resistance, Bacterial, 01 natural sciences, Waste Disposal, Fluid, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Medical Waste Disposal, Medical Waste Disposal, Antibacterial agent, 0303 health sciences, MESH: Microbial Sensitivity Tests, Cross Infection, MESH : Waste Disposal, Fluid, MESH: Pseudomonas Infections, MESH : Pseudomonas Infections, 6. Clean water, Drug Resistance, Multiple, 3. Good health, Bacterial Typing Techniques, Electrophoresis, Gel, Pulsed-Field, MESH: Electrophoresis, Gel, Pulsed-Field, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Wastewater, France, Water Microbiology, MESH : Cross Infection, medicine.drug_class, Microbial Sensitivity Tests, MESH: Bacterial Typing Techniques, Microbiology, MESH: Drug Resistance, Multiple, 03 medical and health sciences, Antibiotic resistance, MESH: Drug Resistance, Bacterial, Drug Resistance, Bacterial, Pulsed-field gel electrophoresis, medicine, Humans, Pseudomonas Infections, MESH : France, MESH: Medical Waste Disposal, 0105 earth and related environmental sciences, MESH : Electrophoresis, Gel, Pulsed-Field, MESH: Humans, 030306 microbiology, Pseudomonas aeruginosa, business.industry, MESH : Water Microbiology, MESH : Humans, Public Health, Environmental and Occupational Health, MESH: Cross Infection, MESH: Water Microbiology, MESH: France, MESH : Bacterial Typing Techniques, MESH : Microbial Sensitivity Tests, MESH: Waste Disposal, Fluid, business, Waste disposal, MESH : Drug Resistance, Multiple
Abstract: International audience; Previous reports have studied the presence of antibiotic-resistant Pseudomonas aeruginosa strains in hospital wastewater without determination of their clonal relationship with the clinical strains of this species. The objectives of this study were to quantify the presence of P. aeruginosa in wastewater of our hospital, to determine their antibiotic-resistance profile and to potentially trace clinical antibiotic-resistant strains from patients to wastewater. Specimens were taken at the end of the wastewater network of our hospital just before the reject in the collective network of the town. Two specimens were taken each Monday during 12 weeks. All P. aeruginosa isolates recovered from hospitalised patients during the study period were collected. Genotyping of both clinical and wastewater isolates was determined by using pulsed-field gel electrophoresis (PFGE). The antibiotic-resistance profile of wastewater isolates was different from that of clinical isolates. The mechanisms involved in antibiotic resistance were different according to the origin of the isolates (wastewater versus human isolates). There was no common PFGE pattern in antibiotic-resistant P. aeruginosa from humans and wastewater. This study suggests that the risk of spread of antibiotic resistance in hospital wastewater is limited.
Published: 2008
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19. Nosocomial dermatitis caused by Dermanyssus gallinae

Author: Françoise Foulet, Anne-Pauline Bellanger, Françoise Botterel, Stéphane Bretagne, C. Bories, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Parasitologie-Mycologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de parasitologie [Mondor], Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), and Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 )
Subjects: Veterinary medicine, Dermanyssus gallinae, Epidemiology, MESH : Aged, Dermatitis, medicine.disease_cause, MESH : Dermatitis, MESH : Mite Infestations, 0403 veterinary science, 030207 dermatology & venereal diseases, 0302 clinical medicine, Nest, Medicine, MESH : Female, MESH: Animals, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Aged, Cross Infection, Mites, biology, 04 agricultural and veterinary sciences, 3. Good health, Infectious Diseases, Female, France, MESH : Cross Infection, Microbiology (medical), Mite Infestations, 040301 veterinary sciences, MESH: Mites, 03 medical and health sciences, Infestation, parasitic diseases, Mite, Pruritic dermatitis, Animals, Humans, MESH: Dermatitis, MESH : Mites, Columbidae, MESH : France, Aged, MESH: Columbidae, MESH: Humans, business.industry, MESH : Humans, MESH: Cross Infection, biology.organism_classification, MESH: France, MESH: Mite Infestations, Immunology, MESH : Animals, MESH : Columbidae, business, MESH: Female
Abstract: The mite Dermanyssus gallinae may cause pruritic dermatitis in humans. We describe a case of nosocomial infestation with D. gallinae from an abandoned pigeon nest suspended on the front wall of the Hôpital Henri Mondor near a window. Close surveillance and regular destruction of pigeon nests could prevent these incidents of infection in humans.
Published: 2008
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20. Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis

Author: Christopher H. Cabell, Pilar Tornos, Paul A. Pappas, David L. Gordon, Christopher W. Woods, Bruno Hoen, Tom S.J. Elliott, Eugene Athan, Francesc Marco, Claudio Querido Fortes, Francisco Nacinovich, G. Ralph Corey, Jerome J. Federspiel, Vivian H. Chu, Riccardo Utili, José M. Miró, Vance G. Fowler, Martin E. Stryjewski, Donald P. Levine, François Delahaye, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Male, Pacemaker, Artificial, Staphylococcus, MESH : Aged, MESH : Prospective Studies, MESH : Coagulase, Heart Valve Diseases, 030204 cardiovascular system & hematology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Epidemiology, MESH : Female, Prospective Studies, MESH : Endocarditis, Bacterial, Prospective cohort study, MESH: Aged, 0303 health sciences, Cross Infection, MESH: Middle Aged, Mortality rate, cons, MESH: Staphylococcus, MESH : Adult, Middle Aged, MESH : Heart Valve Diseases, 3. Good health, Community-Acquired Infections, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infectious Diseases, MESH: Community-Acquired Infections, MESH: Pacemaker, Artificial, Female, MESH: Coagulase, MESH : Cross Infection, MESH : Community-Acquired Infections, Microbiology (medical), Adult, Coagulase, medicine.medical_specialty, MESH : Male, 03 medical and health sciences, Internal medicine, medicine, Endocarditis, Humans, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH : Staphylococcus, Aged, Heart Failure, Native Valve Endocarditis, MESH: Humans, MESH: Methicillin Resistance, 030306 microbiology, business.industry, MESH : Pacemaker, Artificial, MESH : Humans, MESH: Cross Infection, MESH: Adult, Odds ratio, Endocarditis, Bacterial, MESH: Heart Valve Diseases, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH : Methicillin Resistance, Surgery, Bacteremia, MESH: Heart Failure, Methicillin Resistance, MESH : Heart Failure, business, MESH: Female
Abstract: International audience; BACKGROUND: Coagulase-negative staphylococci (CoNS) are an infrequent cause of native valve endocarditis (NVE), and our understanding of NVE caused by CoNS is incomplete. METHOD: The International Collaboration on Endocarditis-Prospective Cohort Study includes patients with endocarditis from 61 centers in 28 countries. Patients with definite cases of NVE caused by CoNS who were enrolled during the period June 2000-August 2006 were compared with patients with definite cases of NVE caused by Staphylococcus aureus and patients with NVE caused by viridans group streptococci. Multivariable logistic regression was used to determine factors associated with death in patients with NVE caused by CoNS. RESULTS: Of 1635 patients with definite NVE and no history of injection drug use, 128 (7.8%) had NVE due to CoNS. Health care-associated infection occurred in 63 patients (49%) with NVE caused by CoNS. Comorbidities, long-term intravascular catheter use, and history of recent invasive procedures were similar among patients with NVE caused by CoNS and among patients with NVE caused by S. aureus. Surgical treatment for endocarditis occurred more frequently in patients with NVE due to CoNS (76 patients [60%]) than in patients with NVE due to S. aureus (150 [33%]; P=.01) or in patients with NVE due to viridans group streptococci (149 [44%]; P=.01). Despite the high rate of surgical procedures among patients with NVE due to CoNS, the mortality rates among patients with NVE due to CoNS and among patients with NVE due to S. aureus were similar (32 patients [25%] and 124 patients [27%], respectively; P=.44); the mortality rate among patients with NVE due to CoNS was higher than that among patients with NVE due to viridans group streptococci (24 [7.0%]; P=.01). Persistent bacteremia (odds ratio, 2.65; 95% confidence interval, 1.08-6.51), congestive heart failure (odds ratio, 3.35; 95% confidence interval, 1.57-7.12), and chronic illness (odds ratio, 2.86; 95% confidence interval, 1.34-6.06) were independently associated with death in patients with NVE due to CoNS (c index, 0.73). CONCLUSIONS: CoNS have emerged as an important cause of NVE in both community and health care settings. Despite high rates of surgical therapy, NVE caused by CoNS is associated with poor outcomes.
Published: 2008
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21. Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection

Author: C. Husson, A.-G. Venier, M. Badoz, Daniel Talon, J. Crouzet, Xavier Bertrand, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Institut de Mécanique des Fluides et des Solides (IMFS), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de Mécanique des Fluides et des Solides ( IMFS ), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique ( CNRS ), Institut de Chimie des Substances Naturelles ( ICSN ), Centre National de la Recherche Scientifique ( CNRS ), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Time Factors, MESH : Prevalence, medicine.medical_treatment, MESH : Prospective Studies, MESH : Aged, MESH: Logistic Models, MESH: Urinary Tract Infections, Logistic regression, Hospitals, University, 0302 clinical medicine, MESH: Aged, 80 and over, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Epidemiology, Prevalence, MESH : Urinary Tract Infections, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH: Incidence, Prospective cohort study, Aged, 80 and over, MESH: Aged, Cross Infection, 0303 health sciences, MESH: Middle Aged, Incidence, Incidence (epidemiology), MESH : Urinary Catheterization, General Medicine, MESH : Adult, Middle Aged, MESH : Incidence, 3. Good health, Catheter, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Intervention Studies, Urinary Tract Infections, Female, Urinary Catheterization, MESH : Cross Infection, MESH : Time Factors, Adult, Microbiology (medical), medicine.medical_specialty, Adolescent, MESH : Male, Urinary system, Urinary catheterization, 03 medical and health sciences, MESH : Adolescent, medicine, Humans, MESH : Middle Aged, Risk factor, MESH : Aged, 80 and over, MESH : Hospitals, University, MESH: Prevalence, Aged, MESH: Adolescent, MESH: Hospitals, University, MESH: Humans, 030306 microbiology, business.industry, MESH : Humans, MESH: Time Factors, MESH: Cross Infection, MESH: Adult, MESH: Male, MESH: Prospective Studies, Surgery, Logistic Models, Emergency medicine, MESH: Urinary Catheterization, MESH : Intervention Studies, business, MESH: Female, MESH : Logistic Models
Abstract: International audience; Catheter-associated urinary tract infection (CAUTI) is one of the most common types of nosocomial infection. Reducing the duration of catheterization may be a key intervention in CAUTI prevention. We carried out a prospective time-sequence, non-randomized intervention study in five departments of our university hospital. We wished to determine the impact of daily reminders from nurses to physicians to remove unnecessary urinary catheters four days after insertion. The intervention significantly decreased the duration of catheterization in two out of five departments. The frequency of late CAUTI (LCAUTI) among catheterized patients in all five departments decreased from 10.6 to 1.1 per 100 patients (P = 0.003) and the incidence of LCAUTI decreased from 12.3 to 1.8 per 1000 catheter-days (P = 0.03). Logistic regression analysis showed that duration of catheterization and iterative catheter changes were associated with LCAUTI. This study demonstrates that a simple measure can reduce the frequency of LCAUTI.
Published: 2007
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22. Comparison of several commercial serologic kits and Em18 serology for detection of human alveolar echinococcosis

Author: Jean-Mathieu Bart, Akira Ito, Renaud Piarroux, Solange Bresson-Hadni, Yasuhito Sako, Martine Piarroux, Frédéric Grenouillet, WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), Frontier Research Center for Global Change ( FRCGC ), Japan Agency for Marine-Earth Science and Technology ( JAMSTEC ), Asahikawa Medical College, Dept of Parasitology ( AMC ), Asahikawa Medical College, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Frontier Research Center for Global Change (FRCGC), Japan Agency for Marine-Earth Science and Technology (JAMSTEC), and Asahikawa Medical College, Dept of Parasitology (AMC)
Subjects: Male, Pathology, Screening techniques, MESH : Retrospective Studies, MESH: Hemagglutination Tests, MESH: Reagent Kits, Diagnostic, Medical laboratory, MESH : Aged, Alveolar echinococcosis, Serology, MESH: Infection Control, MESH : Candidiasis, MESH : Hemagglutination Tests, MESH: Hygiene, Medicine, MESH: Animals, MESH : Female, MESH: Incidence, MESH: Disease Outbreaks, MESH : Reagent Kits, Diagnostic, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH : Immunoblotting, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Academic Medical Centers, Immunoassay, MESH: Aged, 0303 health sciences, MESH: Middle Aged, MESH: Immunoblotting, Indirect hemagglutination, MESH: Echinococcosis, Hepatic, MESH : Questionnaires, MESH : Hygiene, General Medicine, Middle Aged, MESH : Adult, MESH : Immunoassay, Echinococcosis, MESH: Candidiasis, MESH : Incidence, 3. Good health, MESH : Serologic Tests, Infectious Diseases, MESH : Academic Medical Centers, Female, MESH : Sensitivity and Specificity, MESH: Immunoassay, MESH : Cross Infection, Adult, Microbiology (medical), Echinococcosis, Hepatic, medicine.medical_specialty, MESH : Male, Immunoblotting, Helminthiasis, Sensitivity and Specificity, 03 medical and health sciences, Animals, Humans, Serologic Tests, MESH : Middle Aged, MESH : Disease Outbreaks, MESH : France, Aged, 030304 developmental biology, MESH: Humans, MESH : Infection Control, 030306 microbiology, business.industry, MESH: Questionnaires, MESH: Serologic Tests, MESH : Humans, MESH: Cross Infection, MESH: Retrospective Studies, MESH: Adult, Hemagglutination Tests, medicine.disease, MESH: Male, MESH: Sensitivity and Specificity, MESH: France, Reagent Kits, Diagnostic, MESH : Animals, business, MESH : Echinococcosis, Hepatic, MESH: Female
Abstract: International audience; The aim of this study was to design the best serologic strategy for diagnosing human alveolar echinococcosis (AE) cases in medical laboratory routine procedures. By combining 2 screening techniques, indirect hemagglutination with Em(2plus)-ELISA and/or recEm18-ELISA, 46 of 47 AE cases were detected. The necessary confirmation of results is then obtained by using immunoblot (LDBIO-IB and/or recEm18-IB).
Published: 2007
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23. Results from a four-year study on the prevalence of nosocomial infections in Franche-Comté: attempt to rank the risk of nosocomial infection

Author: A. Picard, P. Bailly, C. Louis-Martinet, Daniel Talon, B. Claude, Xavier Bertrand, N. Floret, N. Tueffert, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire de Physique Nucléaire et de Hautes Énergies (LPNHE), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire de Physique Nucléaire et de Hautes Énergies ( LPNHE ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire Chrono-environnement (UMR 6249) (LCE), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Pediatrics, MESH: Chi-Square Distribution, MESH : Prevalence, MESH : Aged, 030501 epidemiology, MESH: Catheterization, Patient type, MESH: Infection Control, MESH : Catheterization, 0302 clinical medicine, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Risk Factors, MESH: Risk Factors, Epidemiology, Prevalence, MESH: Immunocompromised Host, 030212 general & internal medicine, MESH: Aged, Cross Infection, MESH: Middle Aged, Age Factors, MESH : Immunocompromised Host, General Medicine, Middle Aged, MESH : Risk Factors, 3. Good health, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, France, 0305 other medical science, MESH : Cross Infection, Microbiology (medical), medicine.medical_specialty, Catheterization, Immunocompromised Host, 03 medical and health sciences, medicine, Humans, MESH : Middle Aged, Risk factor, MESH : France, MESH: Prevalence, Aged, MESH: Age Factors, Infection Control, Chi-Square Distribution, MESH: Humans, MESH : Chi-Square Distribution, MESH : Infection Control, business.industry, Public health, MESH : Humans, MESH: Cross Infection, MESH: France, Prevalence studies, Endogenous risk, MESH : Age Factors, business
Abstract: International audience; The aim of this study was to rank the risk of nosocomial infection (NI) according to patient type by analysing the results of annual prevalence studies carried out in Franche-Comté from 2001 to 2004. Patients (N=14,905) were divided into four categories according to the number of endogenous risk factors (age, immunodepression, MacCabe score). The overall prevalence of infection was 6.1% and varied according to the category of patient from 1.93% (no risk factors) to 15.2% (three risk factors). The frequencies of NI related to an invasive procedure and to cross-contamination with multi-drug-resistant (MDR) bacteria were 30.9% and 12.3%, respectively; these percentages did not depend on the type of patient. The prevalence of NI decreased over time for patients with two or three risk factors, but was stable for patients with no risk factors. More than 40% of NIs were potentially avoidable (related to invasive procedures or involving cross-transmission of an MDR bacterium) regardless of the category of patient. This study suggests that at least 30% of NIs could be avoided.
Published: 2006
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24. Pontiac fever: an operational definition for epidemiological studies

Author: Philippe Hartemann, Denis Zmirou-Navier, Laurence Mathieu, Paul Tossa, M. Deloge-Abarkan, Evaluations et prévention des risques professionnels et environnementaux, Cancéropôle du Grand Est-Université Henri Poincaré - Nancy 1 ( UHP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire d'Hydroclimatologie Médicale Santé Environnement, École pratique des hautes études ( EPHE ), Faculté de Médecine [UHP], Université Henri Poincaré - Nancy 1 ( UHP ), This study was funded by AFSSE (French Agency for Environemental Sanitary Security), the French ministry of Health and Véolia. M. Deloge-Abarkan was recipient of a doctoral scholarship from ADEME and EDF. The design of the aerosol exposure assessment was extensively discussed with Enric Robine, from CSTB, the French Building Research Center. The water system critical point analysis procedure was elaborated by Veolia Environnement. Nathalie Diguio, a Master student at Inserm, contributed to the study follow-up., Cancéropôle du Grand Est-Université Henri Poincaré - Nancy 1 (UHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Université Henri Poincaré - Nancy 1 (UHP), and Zmirou, Denis
Subjects: myalgia, Male, Hot Temperature, MESH : Aged, MESH : Research Suppo, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, MESH: Incidence, MESH: In Situ Hybridization, Fluorescence, Toilet Facilities, Aged, 80 and over, 0303 health sciences, education.field_of_study, Cross Infection, Incidence, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Incidence, 3. Good health, MESH : In Situ Hybridization, Fluorescence, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Population Surveillance, MESH: Research Suppo, MESH : Fever, Coxiella Burnetii, MESH : Cross Infection, medicine.medical_specialty, Shower Water, Legionella, MESH : Legionellosis, Sampling Studies, MESH: Population Surveillance, 03 medical and health sciences, MESH: Fever, Humans, education, MESH : Aged, 80 and over, High Attack Rate, Aged, MESH: Humans, Legionellosis, 030306 microbiology, Public health, MESH: Questionnaires, MESH : Humans, Public Health, Environmental and Occupational Health, Outbreak, lcsh:RA1-1270, medicine.disease, Nursing Homes, Pontiac Fever, Immunology, MESH: Female, MESH : Nursing Homes, Pediatrics, Time Factors, MESH: Aerosols, MESH: Aged, 80 and over, Epidemiology, MESH: Antibodies, Bacterial, MESH : Population Surveillance, MESH : Female, 030212 general & internal medicine, In Situ Hybridization, Fluorescence, MESH: Aged, biology, lcsh:Public aspects of medicine, Incidence (epidemiology), MESH : Questionnaires, Antibodies, Bacterial, Nursing Home, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Aerosols, Female, medicine.symptom, Water Microbiology, Research Article, Fever, MESH : Male, Population, MESH: Heat, MESH : Legionella, MESH : Heat, medicine, MESH : Antibodies, Bacterial, Aerosols, business.industry, Pontiac fever, MESH: Cross Infection, biology.organism_classification, MESH: Male, MESH: Legionellosis, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Nursing Homes, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Legionella
Abstract: Background Pontiac fever is usually described in epidemic settings. Detection of Pontiac fever is a marker of an environmental contamination by Legionella and should thereby call for prevention measures in order to prevent outbreak of Legionnaire's disease. The objective of this study is to propose an operational definition of Pontiac fever that is amenable to epidemiological surveillance and investigation in a non epidemic setting. Methods A population of 560 elderly subjects residing in 25 nursing homes was followed during 4 months in order to assess the daily incidence of symptoms associated, in the literature, with Pontiac fever. The water and aerosol of one to 8 showers by nursing home were characterized combining conventional bacterial culture of Legionella and the Fluorescence In Situ Hybridization (FISH) technique that used oligonucleotides probes specific for Legionellaceae. A definition of Pontiac fever was devised based on clinical symptoms described in epidemic investigations and on their timing after the exposure event. The association between incidence of Pontiac fever and shower contamination levels was evaluated to test the relevance of this definition. Results The proposed definition of Pontiac fever associated the following criteria: occurrence of at least one symptom among headache, myalgia, fever and shivers, possibly associated with other 'minor' symptoms, within three days after a shower contaminated by Legionella, during a maximum of 8 days (minimum 2 days). 23 such cases occurred during the study (incidence rate: 0.125 cases per person-year [95% CI: 0.122–0.127]). A concentration of Legionella in water equal to or greater than 104.L-1 (FISH method) was associated with a significant increase of incidence of Pontiac fever (p = 0.04). Conclusion Once validated in other settings, the proposed definition of Pontiac fever might be used to develop epidemiological surveillance and help draw attention on sources of Legionella.
Published: 2005
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24 results on '"MESH : Cross Infection"'

1. Coagulase-negative staphylococcal prosthetic valve endocarditis--a contemporary update based on the International Collaboration on Endocarditis: prospective cohort study

2. Trends of extended-spectrum β-lactamase-producing Escherichia coli sequence type 131 and its H30 subclone in a French hospital over a 15-year period

3. Clinical epidemiology and resistance mechanisms of carbapenem-resistant Acinetobacter baumannii, French Guiana, 2008-2014

4. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants

5. Temporal effects of infection control practices and the use of antibiotics on the incidence of MRSA

6. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey

7. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices

8. Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

9. Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment

10. Multilevel modelling of the prevalence of hospitalized patients infected with Pseudomonas aeruginosa

11. Molecular epidemiology of multidrug-resistant Pseudomonas aeruginosa in a French university hospital

12. Recent exposure to caspofungin or fluconazole influences the epidemiology of candidemia: a prospective multicenter study involving 2,441 patients

13. A multicentre study of antifungal strategies and outcome of Candida spp. peritonitis in intensive-care units

14. Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital

15. Is there a threshold above which hand-rub solution consumption is efficient for decreasing MRSA incidence?

16. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006)

17. Meticillin-resistant Staphylococcus aureus contamination of healthcare workers' uniforms in long-term care facilities

18. Are antibiotic-resistant Pseudomonas aeruginosa isolated from hospitalised patients recovered in the hospital effluents?

19. Nosocomial dermatitis caused by Dermanyssus gallinae

20. Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis

21. Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection

22. Comparison of several commercial serologic kits and Em18 serology for detection of human alveolar echinococcosis

23. Results from a four-year study on the prevalence of nosocomial infections in Franche-Comté: attempt to rank the risk of nosocomial infection

24. Pontiac fever: an operational definition for epidemiological studies

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24 results on '"MESH : Cross Infection"'

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