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Saint-Georges-sur-Loire, France

Joubrel C.,Hopitaux Universitaires Paris Center Site Cochin | Joubrel C.,Center National Of Reference Des Streptocoques | Joubrel C.,University of Paris Descartes | Joubrel C.,French Institute of Health and Medical Research | And 26 more authors.
Clinical Microbiology and Infection

Streptococcus agalactiae (group B streptococcus (GBS)) is the leading cause of invasive infections among newborns in industrialized countries, with two described syndromes: early-onset disease (EOD) and late-onset disease (LOD). Since the introduction in many countries of intrapartum antibioprophylaxis (IAP), the incidence of EOD has dramatically decreased, whereas that of LOD remains unchanged. We describe the clinical and bacteriological characteristics of 438 GBS neonatal invasive infections notified to the French National Reference Centre for Streptococci in France from 2007 to 2012. Clinical data were retrieved from hospitalization reports or questionnaires. Capsular type, assignment to the hypervirulent clonal complex (CC)17 and antibiotic susceptibility profiles were determined. One hundred and seventy-four (39.7%) and 264 (60.3%) isolates were responsible for EOD, including death in utero, and LOD, respectively. EOD was associated with bacteraemia (n = 103, 61%) and LOD with meningitis (n = 145, 55%). EOD was mainly due to capsular polysaccharide (CPS) III isolates (n = 99, 57%) and CPS Ia isolates (n = 40, 23%), and CPS III isolates were responsible for 80% (n = 211) of LOD cases. CC17 accounted for 80% (n = 121) of CPS III isolates responsible for meningitis (n = 151; total cases of meningitis, 188). Bad outcome risk factors were low gestational age and low birthweight. LOD represents almost 60% of cases of neonatal GBS disease in France and other countries in which IAP has been implemented. This observation reinforces the need to develop new prevention strategies targeting CC17, which is predominant in GBS neonatal infections. © 2015 European Society of Clinical Microbiology and Infectious Diseases. Source

Cordelle C.,Hopitaux Universitaires Paris Center Site Cochin | Coat B.,Hopitaux Universitaires Paris Center Site Cochin | Kramer L.,Hopitaux Universitaires Paris Center Site Cochin | Abbas N.,Hopitaux Universitaires Paris Center Site Cochin | And 2 more authors.
Pharmacien Hospitalier et Clinicien

Introduction: To avoid rilpivirine's under-dosing, intake during a meal and warning about drug-interaction with antacids and antisecretories must be recommended to patients. Two audits were conducted a year apart to assess patient knowledge about these advices, and thus to evaluate the pharmaceutical and medical practices in our hospital pharmacy. Materials and methods: A prospective method for assessing professional practices, a clinical audit, was retained. The evaluation grid to patients was a questionnaire. An information leaflet on intaking and interactions was given to them. A new questionnaire was proposed a year later, assessing the impact of the leaflet dispensation. Results: There was no significant improvement in the knowledge of intaking rilpivirine with food (92% versus 89%) and the interaction with the gastric pH modifiers (50% versus 54%). The information document has not been kept by all patients and only 33% of patients who responded to both questionnaires reported having received it. Discussion/Conclusion: Information leaflet given to each new rilpivirine's dispensation is insufficient given to each first dispensation of rilpivirine is insufficient; it is now proposed more regularly. The information reinforced by an oriented pharmaceutical meeting remains essential. © 2016 Elsevier Masson SAS. Source

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