Service des Maladies Infectieuses et Tropicales

Port-Saint-Louis-du-Rhône, France

Service des Maladies Infectieuses et Tropicales

Port-Saint-Louis-du-Rhône, France

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Angelakis E.,Unite de Recherche de Maladies Infectieuses Transmissibles et Emergents | Pulcini C.,Nice University Hospital Center | Waton J.,Nancy University Hospital Center | Imbert P.,Service des Maladies Infectieuses et Tropicales | And 4 more authors.
Clinical Infectious Diseases | Year: 2010

Rickettsia slovaca and Rickettsia raoultii have been associated with a syndrome characterized by scalp eschar and neck lymphadenopathy following tick bites. However, in many cases, the causative agent remains undetermined. We report 3 cases of this syndrome caused by Bartonella henselae, and we propose the term "SENLAT" to collectively describe this clinical entity. © 2010 by the Infectious Diseases Society of America. All rights reserved.


Baize S.,National Reference Center for Viral Hemorrhagic Fevers | Baize S.,Institute Pasteur | Baize S.,French Institute of Health and Medical Research | Pannetier D.,National Reference Center for Viral Hemorrhagic Fevers | And 33 more authors.
New England Journal of Medicine | Year: 2014

In March 2014, the World Health Organization was notified of an outbreak of a communicable disease characterized by fever, severe diarrhea, vomiting, and a high fatality rate in Guinea. Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013. This study demonstrates the emergence of a new EBOV strain in Guinea. Copyright © 2014 Massachusetts Medical Society. All rights reserved.


Vaudaux P.,University of Geneva | Huggler E.,University of Geneva | Bernard L.,University of Tours | Ferry T.,Service des Maladies Infectieuses et Tropicales | And 2 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2010

Broth microdilution was compared with tube macrodilution and a simplified population analysis agar method for evaluating vancomycin and teicoplanin MICs and detecting glycopeptide-intermediate isolates of Staphylococcus aureus. Modal vancomycin and teicoplanin MICs recorded by tube macrodilution and the agar plate assay, which both used inocula of 106 CFU, were significantly higher (2 μg/ml) against a panel of borderline glycopeptide-susceptible and glycopeptide-intermediate methicillin-resistant S. aureus (MRSA) bloodstream isolates compared to broth microdilution (1 μg/ml). Vancomycin and teicoplanin MIC distributions by tube macrodilution and agar testing were also markedly different from those evaluated by broth microdilution. The 20-fold-lower inoculum size used for broth microdilution compared to macrodilution and agar MIC assays explained in part, but not entirely, the systematic trend toward lower vancomycin and teicoplanin MICs by microdilution compared to other methods. Broth microdilution assay led to underdetection of the vancomycin-intermediate S. aureus (VISA) phenotype, yielding only three VISA isolates, for which vancomycin MICs were 4 μg/ml compared to 8 and 19 VISA isolates detected by macrodilution and agar testing, respectively. While macrodilution and agar testing detected 7 and 22 isolates with elevated teicoplanin MICs (8 μg/ml), respectively, broth microdilution failed to detect such isolates. Detection rates of isolates with elevated vancomycin and teicoplanin MICs by macrodilution and agar testing assays were higher at 48 h than at 24 h. In conclusion, the sensitivity of broth microdilution MIC testing is questionable for reliable detection and epidemiological surveys of glycopeptide-intermediate resistance in S. aureus isolates. Copyright © 2010, American Society for Microbiology. All Rights Reserved.


Aoun O.,Center Medical Des Armees Of Colmar | Roqueplo C.,Antenne Veterinaire Du Center Medical Des Armees Of Strasbourg | Rapp C.,Service des Maladies Infectieuses et Tropicales
Travel Medicine and Infectious Disease | Year: 2014

Background More than 15 000 French soldiers are continuously deployed abroad. Along with combat-related injuries, they are exposed to non-combat-related diseases with an underestimated burden. Our objectives were to assess the incidence and impact of health problems on their operating capacity. Methods A prospective multicenter study was conducted over more than three months in Lebanon, Côte d'Ivoire and Afghanistan including exclusively French soldiers. Results We collected 4349 consultations (Afghanistan {n = 719}, Lebanon {n = 1401} and Côte d'Ivoire {n = 2229}) encompassing 4600 health problems. Injuries (21%), diarrhea (19%), dermatoses (17.5%) and respiratory tract infections (10.45%) were the most frequent health issues. Infectious diseases represented 41% of all health problems. Almost nine out of ten patients were managed as outpatients. Ten combat-related deaths were observed. We reported 68 (1.5%) medical repatriations of which 28 and 26 were psychiatric and trauma cases respectively. Partial or complete incapacity was estimated 724 days/1000 men/month. Etiological spectrum was similar in all three countries however, the incidence of diarrhea (p < 0.05) as well as inpatient management and medical evacuation rates were higher (p < 0.0001) in Afghanistan. Conclusions There was a wide spectrum of health problems occurring during military deployments with a predominance of common infections. Non-combat-related pathology represented an important burden for the loss of operating capacity. © 2013 Elsevier Ltd. All rights reserved.


Gautret P.,Service des Maladies Infectieuses et Tropicales | Tantawichien T.,King Chulalongkorn Memorial Hospital | Hai V.V.,Service des Maladies Infectieuses et Tropicales | Piyaphanee W.,Mahidol University
Vaccine | Year: 2011

Important variations were observed regarding the proportion of backpackers seeking information about travel-associated diseases before departing for Thailand. The main determinants were nationality, reason for travel and age. Sources of information used by travelers varied substantially according to nationality. Moreover, significant differences were recorded regarding pre-exposure vaccination rates against rabies. Having British or Irish citizenship and seeking advice from travel clinic specialists or friends were the strongest and most significant determinants of rabies vaccination history. A significant relationship between vaccine cost and vaccination coverage was also evidenced. © 2011 Elsevier Ltd.


Rouzioux C.,University of Paris Descartes | Hocqueloux L.,Service des Maladies Infectieuses et Tropicales | Saez-Cirion A.,Institute Pasteur Paris
Current Opinion in HIV and AIDS | Year: 2015

Purpose of review: The posttreatment controllers (PTCs), as described for the Viro-Immunological Sustained COntrol after Treatment Interruption patients, are able to maintain durable HIV control after interruption of early antiretroviral therapy (ART). They are different from spontaneous HIV controllers who achieve HIV control without prior ART. PTCs provide proof-of-concept that prolonged ART-free remission is possible.Recent findings: PTCs support the idea that early treatment could be especially beneficial. They show that a stable equilibrium between a small HIV reservoir and HIV-1-specific immune responses can be achieved. PTCs occur at a frequency of 5 and 15% of patients with early combination ART interruption, which might be considered too infrequent to support early combination ART in all individuals. However, it will be necessary to use more potent ART, with good penetration into lymphoid tissues, initiated earlier and maintained for at least 4 years to see if this frequency might be increased.Summary: Understanding the mechanisms underlying durable HIV control among PTCs will provide critical insights into how this might be achieved in others. PTCs give hope that the objective of durable HIV remission is a realistic goal in the medium term. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Merlet A.,Service des Maladies Infectieuses et Tropicales | Cazanave C.,Service des Maladies Infectieuses et Tropicales | Dutronc H.,Service des Maladies Infectieuses et Tropicales | De Barbeyrac B.,Laboratoire Of Bacteriologie | And 2 more authors.
Clinical Microbiology and Infection | Year: 2012

Since the mid-1980s, Klebsiella pneumoniae hypermucoviscous isolates have emerged in Taiwan and other Asian countries. We reported the first autochthonous European liver abscess due to an ST57 isolate, which belongs to virulent clonal complex CC23-K1. This case highlights the emergence in France and Europe of hypermucoviscous virulent K. pneumoniae isolates. © 2012 European Society of Clinical Microbiology and Infectious Diseases.


Kumsa B.,Aix - Marseille University | Parola P.,Service des Maladies Infectieuses et Tropicales | Raoult D.,Aix - Marseille University | Socolovschi C.,Aix - Marseille University
American Journal of Tropical Medicine and Hygiene | Year: 2014

Fleas are important vectors of several Rickettsia and Bartonella spp. that cause emerging zoonotic diseases worldwide. In this study, 303 fleas collected from domestic dogs and cats in Ethiopia and identified morphologically as Ctenocephalides felis felis, C. canis, Pulex irritans, and Echidnophaga gallinacea were tested for Rickettsia and Bartonella DNA by using molecular methods. Rickettsia felis was detected in 21% of fleas, primarily C. felis, with a similar prevalence in fleas from dogs and cats. A larger proportion of flea-infested dogs (69%) than cats (37%) harbored at least one C. felis infected with R. felis. Rickettsia typhi was not detected. Bartonella henselae DNA was detected in 6% (2 of 34) of C. felis collected from cats. Our study highlights the likelihood of human exposure to R. felis, an emerging agent of spotted fever, and B. henselae, the agent of cat-scratch disease, in urban areas in Ethiopia. Copyright © 2014 by The American Society of Tropical Medicine and Hygiene.


Gautret P.,Service des Maladies Infectieuses et Tropicales | Wilder-Smith A.,National University Hospital Singapore
Travel Medicine and Infectious Disease | Year: 2010

This paper reviews the risk and vaccine recommendations for tetanus, diphtheria, pertussis and poliomyelitis for adult travellers. The travel clinic presents a unique opportunity to evaluate whether routine vaccinations are up-to-date. Tetanus, diphtheria and pertussis occur worldwide but are more common in low resource countries due to incomplete childhood vaccination coverage, environmental and socio-economic factors. Diphtheria has been reported in travellers without adequate protection. A booster against tetanus and diphtheria is recommended for all adult travellers, regardless of travel destination and duration. The incidence of pertussis in general adult travellers has been poorly studied. Extrapolating from the reported high incidence in travellers to the Hajj, the risk may be more substantial than thought. There are no universal recommendations for pertussis vaccination for adult travellers, and studies are needed to develop evidence based guidelines. Poliomyelitis is well controlled and now only occurs in a small number of countries. Travellers to and from endemic and re-infected countries should be fully vaccinated against poliomyelitis. © 2010 Elsevier Ltd. All rights reserved.


Godet C.,Service des maladies infectieuses et tropicales
Revue des Maladies Respiratoires Actualites | Year: 2015

There is an association between sensitisation to moulds, uncontrolled fungal infections and bad asthma control. The diagnosis of allergic broncho-pulmonary aspergillosis (ABPA) is based on three indispensible criteria: a reversible ventilatory disorder or mucoviscidosis, a total IgE > 1000 UI / ml ml and a specific Aspergillus IgE> 0,35 KUA /l, associated with two of the following: a positive Aspergillus precipintin test, a characteristic CT-scan and a blood eosinophilia > 500 cells / μ moL (without taking corticoids). The treatment is based on reduction of the local inflammation by systemic corticoids and on the decrease of mycelial proliferation during exacerbations by Itraconazole. The prevalence of severe asthma with fungal sensitisation (SAFS) is about 30 % and the use of azoles should be time-limited and reserved for refractory situations in severe asthma. © 2015 Elsevier Inc.

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