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Saint-Sauveur-en-Rue, France

Bouguila J.,Service de pediatrie | Khalef I.,Service de pediatrie | Charfeddine B.,Laboratoire Of Biochimie | Ben Rejeb M.,Service dHygiene Hospitaliere | And 5 more authors.
Pathologie Biologie | Year: 2013

Objective: The aim of this study is to compare two biologic parameters; C-reactive protein (CRP) and procalcitonin (PCT) in the detection of acute renal lesions assessed by DMSA scintigraphy in the urinary tract infection in child. Design: In a prospective study, serum PCT, CRP and leukocyte counts were measured for children admitted, between January and December 2010, with a first episode of febrile urinary tract infection. Results: Seventy-five children were enrolled in the study. Thirty-three patients had renal lesions (group A) and 42 had a normal DMSA scintigraphy (group B). The mean PCT level was significantly higher in group A than in group B (8.81. ng/mL versus 1.7. ng/mL, P = 0.01). In this study, using receiver operating characteristic (ROC) curve, we identified that the optimal cut-off value with ideal sensitivity and specificity for PCT in detection of renal lesions was 0.76. ng/mL and for CRP, it was 70. mg/L. The sensitivity, the negative predictive value and the indice of Youden of the cut-off value of PCT were significantly higher than CRP (82% versus 70%; 84% versus 70% and 0.58 versus 0.25). Conclusions: This study confirmed that the serum PCT level was more sensitive and specific than the CRP in the detection of renal lesions in the first urinary tract infection in child. © 2013 Elsevier Masson SAS. Source


Baud O.,Regional Units for HAI Prevention and ControlARLIN Auvergne | Giron S.,Institute of Veille Sanitaire | Aumeran C.,Service dHygiene Hospitaliere | Aumeran C.,CNRS Microorganisms Laboratory: Genome and Environment | And 9 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2014

The first French outbreak of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) USA300 clone was investigated. After outbreak investigation, hygiene measures were implemented in all family households and childminders’ homes. Several decontamination procedures were performed, which used a combination of topical mupirocin, total body application of chlorhexidine, chlorhexidine gargle (if >6 years old) and a course of antibiotic therapy in cases of infection or decontamination failure. Patients were followed up for MRSA skin and soft tissue infections (SSTIs) and carriage. Strains were characterised by antimicrobial drug resistance profile, pulsed-field gel electrophoresis (PFGE) and DNA microarrays. Between June 2011 and June 2012, six children and six adults among the ten corresponding relatives developed 28 SSTIs. None of the family members, including the index case, had any contact with foreigners or individuals known to have SSTIs. After infection control measures and prolonged decontamination have been implemented with a high adherence, six patients remained sustained CA-MRSA USA300 carriers, including one who developed mupirocin resistance and six who experienced minor CA-MRSA-related SSTIs. A baby was identified as an MRSA carrier 2 months after delivery. CA-MRSA decontamination using mupirocin and chlorhexidine in the community setting may also be a questionable strategy, associated with failure and resistance to both agents. Close monitoring of CA-MRSA SSTIs is required in France and in other European countries where MRSA USA300 has recently emerged. We showed that a closed management based on hygiene measures reinforcement, decolonisation and extended screening may fail to suppress CA-MRSA carriage and subsequent infections. © 2014, Springer-Verlag Berlin Heidelberg. Source


Nicolas-Chanoine M.-H.,Service de microbiologie | Nicolas-Chanoine M.-H.,University Paris Diderot | Bertrand X.,Service dHygiene Hospitaliere | Bertrand X.,University of Franche Comte | Madec J.-Y.,Unite Antibioresistance et Virulence Bacteriennes
Clinical Microbiology Reviews | Year: 2014

In 2008, a previously unknown Escherichia coli clonal group, sequence type 131 (ST131), was identified on three continents. Today, ST131 is the predominant E. coli lineage among extraintestinal pathogenic E. coli (ExPEC) isolates worldwide. Retrospective studies have suggested that it may originally have risen to prominence as early as 2003. Unlike other classical group B2 ExPEC isolates, ST131 isolates are commonly reported to produce extended- spectrum β-lactamases, such as CTX-M-15, and almost all are resistant to fluoroquinolones. Moreover, ST131 E. coli isolates are considered to be truly pathogenic, due to the spectrum of infections they cause in both community and hospital settings and the large number of virulence-associated genes they contain. ST131 isolates therefore seem to contradict the widely held view that high levels of antimicrobial resistance are necessarily associated with a fitness cost leading to a decrease in pathogenesis. Six years after the first description of E. coli ST131, this review outlines the principal traits of ST131 clonal group isolates, based on the growing body of published data, and highlights what is currently known and what we need to find out to provide public health authorities with better information to help combat ST131. © 2014, American Society for Microbiology. All Rights Reserved. Source


Bertaut A.,Service dhygiene et depidemiologie | Cassier P.,Service dHygiene Hospitaliere | Rogues A.-M.,Service dhygiene et depidemiologie
Journal des Anti-Infectieux | Year: 2012

Totally implantable venous access device (TIVAD) related infections are scarce. However, they remain one of the most frequent complications after thrombosis, and are responsible for a high rate of surgical withdrawals. In France, guidelines published in 2000 by the Agence nationale d'accréditation et d'évaluation en santé (Anaes - National Agency for Accreditation and Assessment of Health) were the only specific recommendations for prevention of TIVAD related infections. This literature review, dealing with epidemiology and prevention of TIVAD related infections, forms the basis for new practice guidelines developed under the auspices of the French Society for Hospital Hygiene (SF2H) according to the " Formal Expert Consensus" method. © 2012. Source


Gheith S.,Service dHygiene Hospitaliere | Gheith S.,Laboratoire Of Parasitologie Mycologie | Ranque S.,Marseille University Hospital Center | Ranque S.,Aix - Marseille University | And 6 more authors.
Mycoses | Year: 2015

Hospital environment is considered the main source of invasive aspergillosis (IA) in leukemic patients. This study aimed to describe Aspergillus colonisation in leukemic patients and their hospital environment and to test whether Aspergillus environmental contamination was associated with IA. For a 2-year period including 14-month renovation work, 91 acute leukaemia inpatients at the hematology department of University hospital in Sousse (Tunisia) were prospectively included. The incidence of probable IA (EORTC/MSG criteria) was 9.9%. Fifty-six Aspergillus were isolated from 53 (6.5%) of 811 sputa collected from 35 (38.5%) patients. Aspergillus spp. were isolated in 59.7% of 494 air samples and in 52.8% of 1579 surface samples taken in the patients' room. Aspergillus section Nigri (72.7%) was the most frequent. Aspergillus contamination peaked in autumn and winter on surface and in summer and autumn in air samples and was higher (P = 0.03) during the renovation work period. Multivariate analysis showed that for each Aspergillus section Nigri CFU airborne contamination IA risk increased by 1.05 (P = 0.04). In Tunisia, Aspergillus section Nigri and Flavi, but not Fumigati, are chiefly involved in IA. Our findings support swift implementation of airborne fungal contamination control measures in areas where immunocompromised patient are hospitalised. © 2015 Blackwell Verlag GmbH. Source

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