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Levy C.,Nice University Hospital Center | Bidet P.,Unite court sejour | Bidet P.,University Paris Diderot | Bonacorsi S.,Unite court sejour | And 3 more authors.
Archives de Pediatrie | Year: 2014

Group A streptococcal (GAS) meningitis in children are rare. The aim of this study was to analyze the clinical, biological and outcome data on GAS meningitis recorded in the Bacterial Meningitis (BM) French Surveillance Network (GPIP/ACTIV).From 2001 through 2012, 4,564 children suffering from proven bacterial meningitis were recorded in the data base. Among them, 0.7 % were GAS infections. The median age was 5.6 years. A history of community acquired infection before the onset of GAS meningitis was frequent. Apart from the identification of the bacterial species, GAS meningitis were clinically and biologically indistinguishable from meningitis caused by other pathogens notably S. pneumoniae. Case fatality rate was 8 %. © 2014 Elsevier Masson SAS.

Levy C.,SFP Societe Francaise de Pediatrie | Varon E.,SFP Societe Francaise de Pediatrie | Varon E.,Center National Of Reference Des Pneumocoques | Bingen E.,SFP Societe Francaise de Pediatrie | And 5 more authors.
Pediatric Infectious Disease Journal | Year: 2011

In France, despite a high rate of pneumococcal conjugate vaccine coverage, the number of cases of pneumococcal meningitis in children did not decline significantly between 2001-2002 (n = 264) and 2007-2008 (n = 244). A decline was observed among children <2 years old (185 [70.1%] to 134 [54.9%] cases; P = 0.0004), but was counterbalanced by an increase among children 2 years old (79 [29.9%] to 110 [45.1%] cases). Mean age increased significantly, from 2.3 (median 0.8) to 3.8 (median 1.5) years. After pneumococcal conjugate vaccine 7 implementation, a wide diversity of serotypes implicated in pneumococcal meningitis was observed; serotypes 19A and 7F were the most frequent. Copyright © 2011 by Lippincott Williams & Wilkins.

Gergely A.,Institute Pasteur Paris | Bechet S.,ACTIV Association Clinique et Therapeutique Infantile du Val de Marne | Goujon C.,Institute Pasteur Paris | Benabdelmoumen G.,Institute Pasteur Paris | Consigny P.-H.,Institute Pasteur Paris
Travel Medicine and Infectious Disease | Year: 2014

Background Non-immune travelers are at risk of acquiring hepatitis B (HB) in high prevalence countries. Method At the Institut Pasteur Vaccination Center in a retrospective study we retrieved hepatitis B serological data from the vaccination database between 2008 and 2012. Serology (HBsAg, HBsAb and HBcAb) is proposed to travelers who have no information about their previous HB vaccination status if they travel to countries of high or intermediate prevalence of HB, for long or frequent trips. Results Of 1093 people 53.1% were men, mean age was 39.6 ± 13.0 years. Prevalence of chronic HBV infection was 5.86% (64 subjects). Their mean age was 36.2 ± 7.3 years, 65.6% were men. Seroprevalence of people of sub-Saharan African origin was 9.2%, higher than the other geographic groups. Past, resolved HB infection was found in 320 subjects, 29.3% of the population; 90.3% were of sub-Saharan African origin. A subgroup of the "Past, resolved HB infection": 73 people (6.7% of the population) had isolated HB core antibodies. Vaccine induced immunity was found in 286 subjects (26.17% of the total population), 40% of people born in France. All three markers of HB were negative at 38.7% of our total population (423 people), and 54% of people of French origin. -absp Conclusions HB seroprevalence was higher than in general French and European population, due to our large number of individuals with immigrant background. Pre-travel counseling allows screening and vaccination of non-immune travelers and detection of chronic HB infection cases.

Cohen J.,Service de pediatrie generale | Cohen J.,University of Paris Pantheon Sorbonne | Cohen J.,University of Paris Descartes | Levy C.,ACTIV Association Clinique et Therapeutique Infantile du Val de Marne | And 6 more authors.
Archives de Pediatrie | Year: 2014

Group A streptococcus (GAS) is the most frequently identified bacterium in children with acute pharyngitis. Clinical signs and symptoms cannot distinguish accurately between viral and GAS pharyngitis. Rapid antigen detection tests (RADTs) can identify GAS by an immunologic reaction within a few minutes. Compared to throat culture, most RADTs have a high specificity (around 95 %), allowing antibiotic prescribing on the basis of a positive RADT result. Similarly, the negative predictive value of RADTs seems sufficiently high (around 95 %) to ensure against the presence of GAS in case of a negative RADT result. Among several factors affecting RADT sensitivity, the training and expertise of the person performing the test and the quality of the throat swab specimen seem to be key determinants. Available evidence suggests that clinical prediction rules for the triage of children who should undergo GAS testing are not sufficiently accurate. Implementing RADTs into clinical practice has an important impact on antibiotic. prescription rates, for a reduction of about 30 %. French guidelines that recommend using RADTs in all children above 3 years of age presenting with pharyngitis without backup culture of negative tests seem relevant in this context. © 2014 Elsevier Masson SAS.

Cohen R.,ACTIV Association Clinique et Therapeutique Infantile du Val de Marne | Cohen R.,SFP Societe Francaise de Pediatrie | Cohen R.,Center Hospitalier Intercommunal Of Creteil | Levy C.,ACTIV Association Clinique et Therapeutique Infantile du Val de Marne | Levy C.,SFP Societe Francaise de Pediatrie
Archives de Pediatrie | Year: 2012

Vaccines against the polysaccharide meningococcal capsule lead to the prevention of invasive meningococcal diseases due to serotypes A, C, Y, W135. Polysaccharide vaccines, according to their immunological characteristics, could be used only to protect during a risk period relatively short: travel in endemic areas, epidemics and index cases. The dramatic success of the implementation of meningococcal C conjugate vaccines in England, and in several European countries has opened new perspectives. Three ACYW135 conjugate vaccines are or will soon be available. Meningococcal conjugate vaccines may be used for the same indications than polysaccharides vaccines, but also for long term individual protection (both for patient at high risk or without risk factor) and in national immunization programs. They must replace polysaccharide vaccines notably because of the risk of immunologic hypo-responsiveness. © 2012 Elsevier Masson SAS.

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