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排序方式: 共有120条查询结果,搜索用时 15 毫秒
1.
J. R. Zahar M. Lecuit E. Carbonnelle F. Ribadeau-Dumas X. Nassif O. Lortholary 《Clinical microbiology and infection》2007,13(3):219-221
Until recently, most reported cases of bacteraemia caused by multidrug-resistant strains of Enterobacteriacae producing an extended-spectrum beta-lactamase (ESBL) in Europe have been nosocomial in origin. However, increasing numbers of reports of community-acquired bacteraemia and urinary tract infection caused by ESBL-producing microorganisms suggest that the geographical origin of patients should be taken into account as a risk-factor for possible ESBL production. Early identification of patients at high-risk of infection with ESBL-producing microorganisms, based on their geographical origin and travel history, should help to optimise initial antibiotic treatment strategies for severe urinary tract infections in Europe. 相似文献
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François Barbier Sébastien Bailly Carole Schwebel Laurent Papazian Élie Azoulay Hatem Kallel Shidasp Siami Laurent Argaud Guillaume Marcotte Benoît Misset Jean Reignier Michaël Darmon Jean-Ralph Zahar Dany Goldgran-Toledano Étienne de Montmollin Bertrand Souweine Bruno Mourvillier Jean-François Timsit for the OUTCOMEREA Study Group 《Intensive care medicine》2018,44(5):616-626
Purpose
To investigate the clinical significance of infection-related ventilator-associated complications (IVAC) and their impact on carbapenem consumption in mechanically ventilated (MV) patients colonised with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE).Methods
Inception cohort study from the French prospective multicenter OUTCOMEREA database (17 ICUs, 1997–2015) including all ESBLE carriers (systematic rectal swabbing at admission then weekly and/or urinary or superficial surgical site colonisation) with MV duration?>?48 h and?≥?1 episode of IVAC after carriage documentation. All ICU-acquired infections were microbiologically documented.Results
The 318 enrolled ESBLE carriers (median age 68 years; males 67%; medical admission 68%; imported carriage 53%) experienced a total of 576 IVAC comprising 361 episodes (63%) without documented infection, 124 (21%) related to infections other than ventilator-associated pneumonia (VAP), 73 (13%) related to non-ESBLE VAP and 18 (3%) related to ESBLE VAP. Overall, ESBLE infections accounted for only 43 episodes (7%). Carbapenem exposure within the preceding 3 days was the sole independent predictor of ESBLE infection as the causative event of IVAC, with a protective effect (adjusted odds ratio 0.2, 95% confidence interval 0.05–0.6; P?<?0.01). Carbapenems were initiated in 9% of IVAC without infection, 15% of IVAC related to non-VAP infections, 42% of IVAC related to non-ESBLE VAP, and 56% of IVAC related to ESBLE VAP (ESBLE VAP versus non-ESBLE VAP: P?=?0.43).Conclusions
IVAC in ESBLE carriers mostly reflect noninfectious events but act as a strong driver of empirical carbapenem consumption. ESBLE infections are scarce yet hard to predict, strengthening the need for novel diagnostic approaches and carbapenem-sparing alternatives.4.
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Rammaert B Lanternier F Zahar JR Dannaoui E Bougnoux ME Lecuit M Lortholary O 《Clinical infectious diseases》2012,54(Z1):S44-S54
Mucormycosis is a severe emerging invasive fungal infection that occurs as a consequence of environmental exposure. We exhaustively reviewed all the cases of mucormycosis (European Organisation for Research and Treatment of Cancer/Mycoses Study Group 2008 criteria) attributed to healthcare procedures that occurred between 1970 and 2008. A total of 169 cases were studied (29% children, 61% male). Major underlying diseases were solid organ transplantation (24%), diabetes mellitus (22%), and severe prematurity (21%). Skin was the most common localization (57%), followed by gastrointestinal tract (15%). Culture results were available in 75% (92% positive), and results of histological examination were positive in 95%. Rhizopus was the most frequent genus (43%). Infection portal of entry included surgery and presence of medical devices such as catheters or adhesive tape. Outbreaks and clusters were related to adhesive bandages (19 cases), wooden tongue depressors (n = 5), ostomy bags (n = 2), water circuitry damage (n = 2), and adjacent building construction (n = 5). Thorough investigations are mandatory to identify healthcare-associated mucormycosis, notably in neonatology, hematological, and transplantation units. 相似文献
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Jean-Pierre Bédos Bernard Allaouchiche Laurence Armand-Lefèvre Olivier Baldesi Lila Bouadma Dominique Decré Samy Figueiredo Rémy Gauzit Benoit Guery Nicolas Joram Boris Jung Sigismond Lasocki Alain Lepape Fabrice Lesage Olivier Pajot François Philippart Bertrand Souweine Pierre Tattevin Jean-François Timsit Jean-Ralph Zahar Cédric Bretonnière Marc Leone Christophe Milési Benoît Misset 《Réanimation》2014,23(5):558-582
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Yang K Azoulay E Attalah L Zahar JR Van de Louw A Cerf C Soussy CJ Duvaldestin P Brochard L Brun-Buisson C Harf A Delclaux C 《Intensive care medicine》2003,29(3):396-402
OBJECTIVE: Neutrophil function impairment is common in nonneutropenic critically ill patients. Whether granulocyte colony-stimulating factor (G-CSF) may be useful for preventing nosocomial infection in these patients is debated. The response of blood neutrophils from critically ill patients to G-CSF was investigated in vitro. DESIGN AND SETTING: Prospective study, laboratory investigation in two intensive care units. PATIENTS: 52 critically ill patients without immunosuppression. MEASUREMENTS: Neutrophils obtained from 52 patients on the 5th day of their intensive care unit stay were incubated with and without G-CSF (1, 10, 100 ng/ml). Reactive oxygen species (ROS) release and bactericidal activity against Staphylococcus aureus and Pseudomonas aeruginosa were evaluated. Plasma cytokines (interleukin 10, tumor necrosis factor alpha, and G-CSF) were measured. RESULTS: Median values (25th-75th percentiles) indicated no stimulatory effect of G-CSF on neutrophil bactericidal activity against either organism: S. aureus, 100% (95-109) of the unstimulated condition with 1 ng/ml G-CSF, and P. aeruginosa, 102% (98-109) with 1 ng/ml G-CSF. However, wide interindividual variability was found, ranging from marked inhibition to marked stimulation. Similar variability was found for ROS release. No correlations were found between ROS release and bactericidal activities against either bacterial strain. Inhibition of neutrophil bactericidal activity by G-CSF was associated with significantly higher plasma interleukin 10 concentrations. Plasma G-CSF levels were significantly higher in patients whose neutrophil bactericidal activity was unresponsive to G-CSF, suggesting G-CSF receptor downregulation. CONCLUSIONS: The effect of G-CSF on in vitro neutrophil bactericidal activity varied widely, depending on endogenous levels of G-CSF and was not predictable based on severity scores. 相似文献
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El Karoui K Lanternier F Taieb F Poirée S Zahar JR Mechaï F Lortholary O Peyromaure M 《Urology》2008,72(4):778-779
A 59-year-old patient underwent laparoscopic radical prostatectomy (LRP) in our department. After surgery, he had an extensive cellulitis of the right flank develop. Urine, drainage effluent, and blood cultures were all positive for Escherichia coli. Prolonged broad spectrum antibiotherapy allowed progressive resolution of the cellulitis. This case shows that severe cellulitis can occur after LRP. Urinary tract infection and vesicourethral anastomotic leakage may contribute to this complication. 相似文献
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