首页 > 最新文献

Medecine et maladies infectieuses最新文献

英文 中文
Increasing procoagulant activity of circulating microparticles in patients living with HIV HIV患者循环微粒的促凝活性增加
IF 5 Q3 Medicine Pub Date : 2020-10-01 DOI: 10.1016/j.medmal.2019.09.013
S. Snopkova , M. Matyskova , K. Havlickova , J. Jarkovsky , M. Svoboda , J. Zavrelova , R. Svacinka , M. Penka , P. Husa

Objectives

HIV-infected individuals are at higher risk of non-AIDS diseases associated with procoagulant status. Microparticles are elevated in disorders associated with thrombosis (e.g., cardiovascular diseases). We investigated the association between microparticle levels in untreated and treated HIV-infected subjects, and determined the association with immune status, viral replication, and duration of antiretroviral therapy.

Patients and methods

We included 144 HIV-infected subjects, including 123 on antiretroviral therapy (ART) and 21 before treatment initiation. A control group of 40 HIV-negative healthy adults matched for age and sex was used for comparison of microparticle levels. Treated subjects were divided into five groups depending on the period of antiretroviral exposure. Statistically significant differences were determined by Kruskal–Wallis test and Chi2 test. The relation between microparticles and other parameters was assessed using Spearman's coefficient of correlation.

Results

Microparticle levels were significantly higher in treated and untreated HIV-infected subjects than in non-HIV-infected controls (P < 0.001). The microparticle level was similar between the groups on treatment (P = 0.913). No association between the microparticle level and CD4+ count, CD4+/CD8+ ratio, number of HIV-1 RNA copies, or duration of exposure to antiretroviral treatment was observed.

Conclusion

Increased levels of microparticles may be due to processes independent of viral replication and CD4+ cell count, and microparticle release might persist even during viral suppression by antiretroviral treatment. Elevated microparticle levels might occur in response to other triggers.

目的hiv感染者与促凝剂状态相关的非艾滋病疾病风险较高。在与血栓形成相关的疾病(如心血管疾病)中,微颗粒升高。我们调查了未经治疗和接受治疗的hiv感染者中微粒水平之间的关系,并确定了与免疫状态、病毒复制和抗逆转录病毒治疗持续时间的关系。患者和方法纳入144例hiv感染者,其中123例接受抗逆转录病毒治疗(ART), 21例未接受治疗。40名年龄和性别相匹配的艾滋病毒阴性健康成年人作为对照组,用于比较微粒水平。根据接受抗逆转录病毒治疗的时间,将受试者分为五组。经Kruskal-Wallis检验和Chi2检验,差异有统计学意义。用Spearman相关系数评价微粒与其他参数之间的关系。结果治疗组和未治疗组hiv感染者的微颗粒水平均显著高于非hiv感染者(P <0.001)。治疗组间微粒水平比较,差异无统计学意义(P = 0.913)。未观察到微粒水平与CD4+计数、CD4+/CD8+比值、HIV-1 RNA拷贝数或抗逆转录病毒治疗持续时间之间的关联。结论微颗粒水平的升高可能与病毒复制和CD4+细胞计数无关,即使在抗逆转录病毒治疗抑制病毒的过程中,微颗粒释放也可能持续存在。微粒水平升高可能是对其他触发因素的反应。
{"title":"Increasing procoagulant activity of circulating microparticles in patients living with HIV","authors":"S. Snopkova ,&nbsp;M. Matyskova ,&nbsp;K. Havlickova ,&nbsp;J. Jarkovsky ,&nbsp;M. Svoboda ,&nbsp;J. Zavrelova ,&nbsp;R. Svacinka ,&nbsp;M. Penka ,&nbsp;P. Husa","doi":"10.1016/j.medmal.2019.09.013","DOIUrl":"10.1016/j.medmal.2019.09.013","url":null,"abstract":"<div><h3>Objectives</h3><p>HIV-infected individuals are at higher risk of non-AIDS diseases associated with procoagulant status. Microparticles are elevated in disorders associated with thrombosis (e.g., cardiovascular diseases). We investigated the association between microparticle levels in untreated and treated HIV-infected subjects, and determined the association with immune status, viral replication, and duration of antiretroviral therapy.</p></div><div><h3>Patients and methods</h3><p>We included 144 HIV-infected subjects, including 123 on antiretroviral therapy (ART) and 21 before treatment initiation. A control group of 40 HIV-negative healthy adults matched for age and sex was used for comparison of microparticle levels. Treated subjects were divided into five groups depending on the period of antiretroviral exposure. Statistically significant differences were determined by Kruskal–Wallis test and Chi<sup>2</sup> test. The relation between microparticles and other parameters was assessed using Spearman's coefficient of correlation.</p></div><div><h3>Results</h3><p>Microparticle levels were significantly higher in treated and untreated HIV-infected subjects than in non-HIV-infected controls (<em>P</em> <em>&lt;</em> <!-->0.001). The microparticle level was similar between the groups on treatment (<em>P</em> <!-->=<!--> <!-->0.913). No association between the microparticle level and CD4+ count, CD4+/CD8+ ratio, number of HIV-1 RNA copies, or duration of exposure to antiretroviral treatment was observed.</p></div><div><h3>Conclusion</h3><p>Increased levels of microparticles may be due to processes independent of viral replication and CD4+ cell count, and microparticle release might persist even during viral suppression by antiretroviral treatment. Elevated microparticle levels might occur in response to other triggers.</p></div>","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 555-561"},"PeriodicalIF":5.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2019.09.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86284567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection 一期人工关节置换术后6周抗生素治疗髋关节和膝关节假体周围感染
IF 5 Q3 Medicine Pub Date : 2020-10-01 DOI: 10.1016/j.medmal.2020.03.003
G. Chieffo , S. Corsia , G. Rougereau , M. Enser , L.J. Eyrolle , S. Kernéis , P. Morand , J. Loubinoux , R. Gauzit , P. Leclerc , P. Wipff , Y. Allanore , P. Anract , D. Salmon

Objectives

One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.

Patients and methods

Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-χ2 and Wilcoxon tests were used to compare categorical and continuous variables.

Results

Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for Staphylococcus spp. in 29 patients (58%), Cutibacterium acnes in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.

Conclusions

A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.

目的一期人工关节置换术治疗假体周围关节感染(PJI)的治愈率与二期相似(约85-92%),但抗生素治疗时间尚不明确。本研究的目的是评估6周短期抗生素疗程对手术置换后假体周围关节感染的疗效。患者和方法2010年1月1日至2015年12月31日在巴黎Cochin医院骨科进行回顾性观察性研究。包括微生物学证实的PJI患者,接受一期替代治疗和6周(+/1周)抗菌治疗。使用Pearson's-χ2和Wilcoxon检验比较分类变量和连续变量。结果50例假体周围关节感染患者(42例髋关节,8例膝关节PJI)行一期人工关节置换术。中位年龄69.3岁(IQR 24.5-97.4)。感染发生时间平均为36个月(IQR 1-216)。骨活检培养阳性葡萄球菌29例(58%),痤疮表皮杆菌19例(38%),革兰氏阴性杆菌6例(12%)。12例(24%)发生多微生物感染。静脉注射抗生素的中位时间为11天(IQR 4-45), 46名患者(92%)转为口服治疗。中位随访32个月(IQR 12-101)。总缓解率为90%。结论在本开放研究中,单期RA治疗膝关节和髋关节PJIs, 6周疗程的抗生素治疗有令人满意的缓解率。
{"title":"Six-week antibiotic therapy after one-stage replacement arthroplasty for hip and knee periprosthetic joint infection","authors":"G. Chieffo ,&nbsp;S. Corsia ,&nbsp;G. Rougereau ,&nbsp;M. Enser ,&nbsp;L.J. Eyrolle ,&nbsp;S. Kernéis ,&nbsp;P. Morand ,&nbsp;J. Loubinoux ,&nbsp;R. Gauzit ,&nbsp;P. Leclerc ,&nbsp;P. Wipff ,&nbsp;Y. Allanore ,&nbsp;P. Anract ,&nbsp;D. Salmon","doi":"10.1016/j.medmal.2020.03.003","DOIUrl":"10.1016/j.medmal.2020.03.003","url":null,"abstract":"<div><h3>Objectives</h3><p>One-stage replacement arthroplasty for treatment of periprosthetic joint infection (PJI) results in similar cure rate than two-stage (around 85–92%), but antibiotic therapy duration is not well established. The aim of this study was to evaluate the efficacy of a short six-week antibiotic course in periprosthetic joint infections after onstage exchange.</p></div><div><h3>Patients and methods</h3><p>Retrospective, observational study conducted at Orthopaedic Department of Cochin Hospital, Paris, between 1st January 2010 and 31 December 2015. Patients with a microbiologically proven PJI, treated with one-stage replacement and 6 weeks (+/1week) of antimicrobial therapy were included. Pearson's-<em>χ</em><sup>2</sup> and Wilcoxon tests were used to compare categorical and continuous variables.</p></div><div><h3>Results</h3><p>Fifty patients with periprosthetic joint infections (42 hip, 8 knee PJI) treated with one-stage replacement arthroplasty were included. Median age was 69.3 years (IQR 24.5–97.4). Infections occurred after a mean of 36 months (IQR 1–216). Bone biopsy cultures were positive for <em>Staphylococcus</em> spp. in 29 patients (58%), <em>Cutibacterium acnes</em> in 19 (38%), Gram-negative bacilli in 6 (12%). Polymicrobial infections occurred in 12 (24%). Intravenous antibiotics were administered for a median of 11 days (IQR 4–45) and 46 patients (92%) were switched to an oral therapy. Medium follow-up was of 32 months (IQR 12–101). Overall remission rate was 90%.</p></div><div><h3>Conclusions</h3><p>A six-week course of antibiotics in knee and hip PJIs treated with one-stage RA has a satisfactory remission rate in this open study.</p></div>","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 567-574"},"PeriodicalIF":5.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2020.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37830063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
COVID reverse transcriptase PCR in private laboratories: From theory to reality 私营实验室的COVID逆转录酶PCR:从理论到现实
IF 5 Q3 Medicine Pub Date : 2020-10-01 DOI: 10.1016/j.medmal.2020.06.001
M. Autissier , G. Guiraud , Y. Lévy
{"title":"COVID reverse transcriptase PCR in private laboratories: From theory to reality","authors":"M. Autissier ,&nbsp;G. Guiraud ,&nbsp;Y. Lévy","doi":"10.1016/j.medmal.2020.06.001","DOIUrl":"10.1016/j.medmal.2020.06.001","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 627-629"},"PeriodicalIF":5.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2020.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38042262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical evacuations of members of the French armed forces for infectious diseases in foreign operations 法国武装部队成员在国外行动中因传染病进行医疗后送
IF 5 Q3 Medicine Pub Date : 2020-10-01 DOI: 10.1016/j.medmal.2019.09.011
K. Simon , P.-Y. Cordier , V. Pommier de Santi , A. Luft , C. Brossier , E. Peytel , F. Simon

Objectives

Medical evacuations from foreign settings are a major health and strategic problem for the armed forces. This work aimed to study the characteristics of French military evacuations due to infectious diseases.

Patients and methods

We performed a retrospective study based on the registers of the French operational military staff for health to assess the characteristics of the strategic medical evacuation of French armed forces members on missions abroad between January 1, 2011 and December 31, 2016.

Results

Out of 4633 included cases, 301 medical evacuations (6.5%) were carried out due to infectious situations. More than half of patients were repatriated to surgical wards (162 patients, 54%), 108 patients (36%) to medical wards, 21 patients (7%) to intensive care units, six patients (2%) to an armed forces medical center, and four files (1%) were incomplete. Among infectious emergencies, malaria led to 30 evacuations (10%) including 11 to intensive care units and one death before evacuation. Infectious diseases requiring medical evacuation were most often mild and community-acquired. Most soldiers were evacuated without medical assistance.

Conclusions

Infectious diseases during missions and medical repatriations carried out for infectious reasons are important epidemiological indicators to monitor. They make it possible to adapt preventive measures, training, and diagnostic and therapeutic tools which can be made available to front-line military physicians.

目的国外医疗后送是武装部队面临的一个重大健康和战略问题。本研究旨在研究法国军队因传染病而撤离的特点。患者与方法基于法国作战军事人员卫生登记资料,开展回顾性研究,评估2011年1月1日至2016年12月31日期间法国武装部队海外任务人员战略医疗后送的特点。结果4633例病例中,有301例因感染情况进行了医疗后送,占6.5%。超过一半的患者被送回外科病房(162例,占54%),108例(36%)被送回内科病房,21例(7%)被送回重症监护病房,6例(2%)被送回武装部队医疗中心,4例(1%)的档案不完整。在传染性紧急情况中,疟疾导致30人(10%)撤离,其中11人被送往重症监护病房,1人在撤离前死亡。需要医疗后送的传染病通常是轻微的和社区获得的。大多数士兵在没有医疗援助的情况下撤离。结论特派团期间的传染病和因传染病原因进行的医疗遣返是重要的流行病学监测指标。它们使调整预防措施、培训以及诊断和治疗工具成为可能,这些都可以提供给前线军医。
{"title":"Medical evacuations of members of the French armed forces for infectious diseases in foreign operations","authors":"K. Simon ,&nbsp;P.-Y. Cordier ,&nbsp;V. Pommier de Santi ,&nbsp;A. Luft ,&nbsp;C. Brossier ,&nbsp;E. Peytel ,&nbsp;F. Simon","doi":"10.1016/j.medmal.2019.09.011","DOIUrl":"10.1016/j.medmal.2019.09.011","url":null,"abstract":"<div><h3>Objectives</h3><p>Medical evacuations from foreign settings are a major health and strategic problem for the armed forces. This work aimed to study the characteristics of French military evacuations due to infectious diseases.</p></div><div><h3>Patients and methods</h3><p>We performed a retrospective study based on the registers of the French operational military staff for health to assess the characteristics of the strategic medical evacuation of French armed forces members on missions abroad between January 1, 2011 and December 31, 2016.</p></div><div><h3>Results</h3><p>Out of 4633 included cases, 301 medical evacuations (6.5%) were carried out due to infectious situations. More than half of patients were repatriated to surgical wards (162 patients, 54%), 108 patients (36%) to medical wards, 21 patients (7%) to intensive care units, six patients (2%) to an armed forces medical center, and four files (1%) were incomplete. Among infectious emergencies, malaria led to 30 evacuations (10%) including 11 to intensive care units and one death before evacuation. Infectious diseases requiring medical evacuation were most often mild and community-acquired. Most soldiers were evacuated without medical assistance.</p></div><div><h3>Conclusions</h3><p>Infectious diseases during missions and medical repatriations carried out for infectious reasons are important epidemiological indicators to monitor. They make it possible to adapt preventive measures, training, and diagnostic and therapeutic tools which can be made available to front-line military physicians.</p></div>","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 545-554"},"PeriodicalIF":5.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2019.09.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79817360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Infection d’endoprothèse aortique à Coxiella burnetii 伯纳蒂克氏主动脉支架感染
IF 5 Q3 Medicine Pub Date : 2020-10-01 DOI: 10.1016/j.medmal.2020.02.002
A. Hamon , F. El Sayed , F. Bouchand , B. Davido , C. Duran , M. Coggia , I. Javerliat , A. Dinh
{"title":"Infection d’endoprothèse aortique à Coxiella burnetii","authors":"A. Hamon ,&nbsp;F. El Sayed ,&nbsp;F. Bouchand ,&nbsp;B. Davido ,&nbsp;C. Duran ,&nbsp;M. Coggia ,&nbsp;I. Javerliat ,&nbsp;A. Dinh","doi":"10.1016/j.medmal.2020.02.002","DOIUrl":"https://doi.org/10.1016/j.medmal.2020.02.002","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 7","pages":"Pages 620-623"},"PeriodicalIF":5.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2020.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91968361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Caractéristiques épidémiologiques et cliniques des infections à entérobactéries productrices de carbapénémases en urologie 泌尿科产生碳青霉烯瘤的肠杆菌感染的流行病学和临床特征
IF 5 Q3 Medicine Pub Date : 2020-09-01 DOI: 10.1016/j.medmal.2020.06.063
S. Zaghbib, M. Chakroun, A. Saadi, S. Zouari, A. Bouzouita, H. Ayed, M. Chebil, A. Ferjani, I. Boutiba

Introduction

La prévalence des infections associées aux soins à entérobactéries productrices de carbapénémases (EPC) est en augmentation dans le monde. Ces infections, difficiles à traiter et souvent source d’impasses thérapeutiques, représentent un danger pour les patients avec un risque d’épidémies hospitalières pouvant devenir incontrôlables.

Matériels et méthodes

Une étude rétrospective a été menée entre janvier 2015 et décembre 2019, portant sur les patients qui ont été hospitalisés au service d’urologie chez qui une EPC a été identifiée sur l’examen cytobactériologique des urines (ECBU). Les caractéristiques épidémiologiques, cliniques et bactériologiques de ces infections ont été étudiées.

Résultats

Au cours de la période d’étude, nous avons identifié 25 patients porteurs d’EPC. L’âge moyen était de 50,5 ans. Une hospitalisation dans les 3 mois précédents a été retrouvée dans 11 cas (44 %), la prise d’antibiotiques dans les 6 mois précédant l’infection a été retrouvée dans 13 cas (52 %), et 11 patients (44 %) avaient un ECBU positif à un autre germe dans les 12 mois précédant l’infection. Au cours de l’hospitalisation, un geste urologique a été réalisé dans 20 cas (80 %), un matériel étranger urologique était en place dans 15 cas (60 %) et le délai moyen entre l’hospitalisation et l’infection était de 12 jours ± 4,8. Sur le plan bactériologique, les souches identifiées étaient K. pneumoniae (n = 20), E. cloacae (n = 2), E. coli (n = 2) et R. terrigena (n = 1). L’étude de la sensibilité aux antibiotiques a montré qu’elles étaient toutes résistantes à l’ertapénème, que 10 l’étaient à l’imipénème (40 %) et que 13 l’étaient au méropénème (52 %). Par ailleurs, toutes les souches étaient résistantes aux céphalosporines de 3e génération et sept l’étaient à l’amikacine (28 %). Une souche était résistante à la colistine (étudiée dans 18 cas), et quatre souches l’étaient à la tigecycline (étudiée dans 21 cas). Cliniquement, les EPC étaient responsables d’une bactériurie asymptomatique dans 14 cas (56 %), et d’une infection déclarée dans 11 cas (44 %), le plus souvent une pyélonéphrite aiguë (5 cas). Deux patients ont présenté un choc septique dont un est décédé des suites de l’infection. En cas d’infection déclarée (11 cas), une double antibiothérapie adaptée a été prescrite, associant colistine/amikacine(cinq cas), colistine/imipeneme (quatre cas) et imipeneme/amikacine (deux cas).

Conclusion

Les EPC représentent une menace réelle et préoccupante car elles sont capables de provoquer des infections contre lesquelles les moyens thérapeutiques sont extrêmement limités, de se disséminer rapidement et possèdent un potentiel épidémiogène important. Les bonnes pratiques d’hygiène hospitalière son

在世界范围内,与产生碳青霉烯的肠杆菌(EPC)护理相关的感染流行率正在上升。这些感染难以治疗,往往是治疗僵局的根源,对病人来说是一种危险,医院流行病的风险可能变得无法控制。材料和方法2015年1月至2019年12月进行了一项回顾性研究,研究对象是在泌尿科住院的患者,这些患者在尿液细胞细菌学检查(becu)中发现了EPC。研究了这些感染的流行病学、临床和细菌学特征。结果在研究期间,我们确定了25例epc患者。需要住院的平均年龄50岁。在此前3月被发现在11例(44%)、决策中抗生素被发现在感染前的6月13例(52%),11名患者(44%),一个积极的ECBU到另一个细菌感染之前12个月之内。住院期间,20例(80%)进行泌尿科手术,15例(60%)安装外来泌尿科设备,住院至感染的平均时间为12天±4.8天。细菌学的基础上,确定的菌株是k .肺炎(n = 20), e . cloacae (n = 2),大肠杆菌(n = 2)和r . terrigena (n = 1)。抗生素的敏感性的研究已经表明,他们都是耐培南、10比胺培(40%),而13迫美罗培南(52%)。此外,所有菌株对第三代头孢菌素耐药,7株对阿米卡星耐药(28%)。1株对粘菌素耐药(18例),4株对替格环素耐药(21例)。临床上,EPC导致14例(56%)无症状细菌尿,11例(44%)公开感染,最常见的是急性肾盂肾炎(5例)。2例患者出现脓毒症休克,1例因感染死亡。在报告感染的病例(11例)中,处方了结合粘菌素/阿米卡星(5例)、粘菌素/亚胺培美(4例)和亚胺培美/阿米卡星(2例)的适当双抗生素治疗。结论:cps是一个真正和令人担忧的威胁,因为它们能够引起治疗手段极其有限的感染,传播迅速,并具有重要的流行病潜力。良好的医院卫生做法是控制这些细菌的基石,同时谨慎和有限地使用碳青霉烯类药物,以减少产生碳青霉烯的菌株的选择压力。
{"title":"Caractéristiques épidémiologiques et cliniques des infections à entérobactéries productrices de carbapénémases en urologie","authors":"S. Zaghbib,&nbsp;M. Chakroun,&nbsp;A. Saadi,&nbsp;S. Zouari,&nbsp;A. Bouzouita,&nbsp;H. Ayed,&nbsp;M. Chebil,&nbsp;A. Ferjani,&nbsp;I. Boutiba","doi":"10.1016/j.medmal.2020.06.063","DOIUrl":"10.1016/j.medmal.2020.06.063","url":null,"abstract":"<div><h3>Introduction</h3><p>La prévalence des infections associées aux soins à entérobactéries productrices de carbapénémases (EPC) est en augmentation dans le monde. Ces infections, difficiles à traiter et souvent source d’impasses thérapeutiques, représentent un danger pour les patients avec un risque d’épidémies hospitalières pouvant devenir incontrôlables.</p></div><div><h3>Matériels et méthodes</h3><p>Une étude rétrospective a été menée entre janvier 2015 et décembre 2019, portant sur les patients qui ont été hospitalisés au service d’urologie chez qui une EPC a été identifiée sur l’examen cytobactériologique des urines (ECBU). Les caractéristiques épidémiologiques, cliniques et bactériologiques de ces infections ont été étudiées.</p></div><div><h3>Résultats</h3><p>Au cours de la période d’étude, nous avons identifié 25 patients porteurs d’EPC. L’âge moyen était de 50,5 ans. Une hospitalisation dans les 3 mois précédents a été retrouvée dans 11 cas (44 %), la prise d’antibiotiques dans les 6 mois précédant l’infection a été retrouvée dans 13 cas (52 %), et 11 patients (44 %) avaient un ECBU positif à un autre germe dans les 12 mois précédant l’infection. Au cours de l’hospitalisation, un geste urologique a été réalisé dans 20 cas (80 %), un matériel étranger urologique était en place dans 15 cas (60 %) et le délai moyen entre l’hospitalisation et l’infection était de 12<!--> <!-->jours<!--> <!-->±<!--> <!-->4,8. Sur le plan bactériologique, les souches identifiées étaient <em>K. pneumoniae</em> (<em>n</em> <!-->=<!--> <!-->20), <em>E. cloacae</em> (<em>n</em> <!-->=<!--> <!-->2), <em>E. coli</em> (<em>n</em> <!-->=<!--> <!-->2) et <em>R. terrigena</em> (<em>n</em> <!-->=<!--> <!-->1). L’étude de la sensibilité aux antibiotiques a montré qu’elles étaient toutes résistantes à l’ertapénème, que 10 l’étaient à l’imipénème (40 %) et que 13 l’étaient au méropénème (52 %). Par ailleurs, toutes les souches étaient résistantes aux céphalosporines de 3<sup>e</sup> génération et sept l’étaient à l’amikacine (28 %). Une souche était résistante à la colistine (étudiée dans 18 cas), et quatre souches l’étaient à la tigecycline (étudiée dans 21 cas). Cliniquement, les EPC étaient responsables d’une bactériurie asymptomatique dans 14 cas (56 %), et d’une infection déclarée dans 11 cas (44 %), le plus souvent une pyélonéphrite aiguë (5 cas). Deux patients ont présenté un choc septique dont un est décédé des suites de l’infection. En cas d’infection déclarée (11 cas), une double antibiothérapie adaptée a été prescrite, associant colistine/amikacine(cinq cas), colistine/imipeneme (quatre cas) et imipeneme/amikacine (deux cas).</p></div><div><h3>Conclusion</h3><p>Les EPC représentent une menace réelle et préoccupante car elles sont capables de provoquer des infections contre lesquelles les moyens thérapeutiques sont extrêmement limités, de se disséminer rapidement et possèdent un potentiel épidémiogène important. Les bonnes pratiques d’hygiène hospitalière son","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"50 6","pages":"Page S37"},"PeriodicalIF":5.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medmal.2020.06.063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42067159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distribution d’Helicobacter pylori : où et comment biopsier pour détecter l’infection et l’antibiorésistance ? 幽门螺杆菌的分布:在哪里和如何活检检测感染和抗生素耐药性?
IF 5 Q3 Medicine Pub Date : 2020-09-01 DOI: 10.1016/j.medmal.2020.06.257
M. Pichon, G. Motillon, J. Cremniter, J. Faure, P. Vasseur, D. Tougeron, C. Burucoa
{"title":"Distribution d’Helicobacter pylori : où et comment biopsier pour détecter l’infection et l’antibiorésistance ?","authors":"M. Pichon, G. Motillon, J. Cremniter, J. Faure, P. Vasseur, D. Tougeron, C. Burucoa","doi":"10.1016/j.medmal.2020.06.257","DOIUrl":"https://doi.org/10.1016/j.medmal.2020.06.257","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"8 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74148150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Une consultation dédiée à la prise en charge des mineurs isolés étrangers : une opportunité de rattrapage vaccinal et d’entretien de santé sexuelle et globale 专门照顾外国孤立未成年人的咨询:一个赶上疫苗接种和保持性健康和全球健康的机会
IF 5 Q3 Medicine Pub Date : 2020-09-01 DOI: 10.1016/j.medmal.2020.06.476
M. Ruellan, A. Frachon, J. Philippe, K. Kpossou, B. Nsitou, S. Diamantis, J. Eff, N. Vignier
{"title":"Une consultation dédiée à la prise en charge des mineurs isolés étrangers : une opportunité de rattrapage vaccinal et d’entretien de santé sexuelle et globale","authors":"M. Ruellan, A. Frachon, J. Philippe, K. Kpossou, B. Nsitou, S. Diamantis, J. Eff, N. Vignier","doi":"10.1016/j.medmal.2020.06.476","DOIUrl":"https://doi.org/10.1016/j.medmal.2020.06.476","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"233 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74687869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Couverture vaccinale antigrippale des professionnels de santé en Île-de-France : qu’en est-il dans les établissements de santé, dans les établissements médicosociaux et en ville ? 法兰西岛卫生专业人员的流感疫苗接种覆盖率:卫生机构、医疗社会机构和城市的情况如何?
IF 5 Q3 Medicine Pub Date : 2020-09-01 DOI: 10.1016/j.medmal.2020.06.380
É. Seringe, A. Deslandes, K. Lebascle, P. Astagneau
{"title":"Couverture vaccinale antigrippale des professionnels de santé en Île-de-France : qu’en est-il dans les établissements de santé, dans les établissements médicosociaux et en ville ?","authors":"É. Seringe, A. Deslandes, K. Lebascle, P. Astagneau","doi":"10.1016/j.medmal.2020.06.380","DOIUrl":"https://doi.org/10.1016/j.medmal.2020.06.380","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"268 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74726194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Épidémie de fièvre typhoïde en 2019 2019年伤寒流行
IF 5 Q3 Medicine Pub Date : 2020-09-01 DOI: 10.1016/j.medmal.2020.06.232
H. Brahimi, S. Benchouk
{"title":"Épidémie de fièvre typhoïde en 2019","authors":"H. Brahimi, S. Benchouk","doi":"10.1016/j.medmal.2020.06.232","DOIUrl":"https://doi.org/10.1016/j.medmal.2020.06.232","url":null,"abstract":"","PeriodicalId":18464,"journal":{"name":"Medecine et maladies infectieuses","volume":"14 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75312232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Medecine et maladies infectieuses
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1