#Oseltamivir #resistance in #severe #influenza A #H1N1pdm09 #pneumonia and #ARDS: a #French multicenter observational cohort study (Clin Infect Dis., abstract)

[Source: Clinical Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Sep 20. pii: ciz904. doi: 10.1093/cid/ciz904. [Epub ahead of print]

Oseltamivir resistance in severe influenza A(H1N1)pdm09 pneumonia and acute respiratory distress syndrome: a French multicenter observational cohort study.

Behillil S1, May F2,3, Fourati S4, Luyt CE5, Chicheportiche T5, Sonneville R6, Tandjaoui-Lambiotte Y7, Roux D8, Guérin L9, Mayaux J10, Maury E11, Ferré A12, Georger JF13, Voiriot G14, Enouf V1, van der Werf S1, Dessap AM2,3, de Prost N2,3.

Author information: 1 Unité de Génétique Moléculaire des Virus à ARN et Centre National de Référence des Virus des Infections Respiratoires (dont la grippe), Institut Pasteur, Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 2 Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France. 3 Groupe de Recherche Clinique CARMAS, Université Paris-Est Créteil, IMRB, Créteil,  France. 4 Département de Microbiologie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France. 5 Service de Médecine Intensive Réanimation, Hôpital de La Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France. 6 Service de Médecine Intensive Réanimation, Hôpital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France. 7 Service de Réanimation médico-chirurgicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France. 8 Service de réanimation médico-chirurgicale, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes,  France; IAME, Université Paris Diderot, Paris, France. 9 Service de réanimation médicale, Hôpital Bicètre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicètre, France. 10 Service de Réanimation Médicale et Pneumologie, Hôpital de La Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France. 11 Service de Réanimation Médicale, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France. 12 Service de Réanimation, Centre hospitalier de Versailles, Le Chesnay, France. 13 Service de Réanimation, Centre hospitalier Intercommunal de Villeneuve Saint-Georges, Villeneuve Saint-Georges, France. 14 Service de Réanimation Médicale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.

 

Abstract

In a multicenter cohort study including 22 oseltamivir-treated patients with influenza A(H1N1)pdm09 acute respiratory distress syndrome, prevalence of the H275Y substitution in the neuraminidase, responsible for highly reduced sensitivity to oseltamivir, was 23%. Patients infected with the H275Y mutant virus had higher day-28 mortality than others (80% vs 12%; p=0.011).

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

KEYWORDS: Influenza A Virus, H1N1 Subtype; Oseltamivir; Pneumonia, Viral; Respiratory Distress Syndrome, Adult

PMID: 31538643 DOI: 10.1093/cid/ciz904

Keywords: Seasonal Influenza; H1N1pdm09; Antivirals; Drugs Resistance; Oseltamivir; Pneumonia; ARDS; France.

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Bidirectional #Human-Swine #Transmission of Seasonal #Influenza A #H1N1pdm09 Virus in #Pig Herd, #France, 2018 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 10—October 2019 / Dispatch

Bidirectional Human-Swine Transmission of Seasonal Influenza A(H1N1)pdm09 Virus in Pig Herd, France, 2018

Amélie Chastagner1, Vincent Enouf1, David Peroz, Séverine Hervé, Pierrick Lucas, Stéphane Quéguiner, Stéphane Gorin, Véronique Beven, Sylvie Behillil, Philippe Leneveu, Emmanuel Garin, Yannick Blanchard, Sylvie van der Werf, and Gaëlle Simon

Author affiliations: French Agency for Food, Environmental and Occupational Health, and Safety, Ploufragan, France (A. Chastagner, S. Hervé, P. Lucas, S. Quéguiner, S. Gorin, V. Beven, Y. Blanchard, G. Simon); Institut Pasteur, Paris, France (V. Enouf, S. Behillil, S. van der Werf); Atlantic Vétérinaires, Ancenis, France (D. Peroz); CEVA Santé Animale SA, Libourne, France (P. Leneveu); Coop de France, Paris (E. Garin); Plateforme Epidémiosurveillance Santé Animale, Lyon, France (E. Garin)

 

Abstract

In 2018, a veterinarian became sick shortly after swabbing sows exhibiting respiratory syndrome on a farm in France. Epidemiologic data and genetic analyses revealed consecutive human-to-swine and swine-to-human influenza A(H1N1)pdm09 virus transmission, which occurred despite some biosecurity measures. Providing pig industry workers the annual influenza vaccine might reduce transmission risk.

Keywords: Seasonal Influenza; H1N1pdm09; Human; Pigs; France.

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Personalised #mechanical #ventilation tailored to #lung morphology versus low positive end-expiratory pressure for patients with #ARDS in #France (the LIVE study): a multicentre, single-blind, RCT (Lancet Resp Med., abstract)

[Source: Lancet Respiratory Medicine, full page: (LINK). Abstract, edited.]

Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial

Jean-Michel Constantin, MD, Matthieu Jabaudon, MD, Jean-Yves Lefrant, MD, Samir Jaber, MD, Jean-Pierre Quenot, MD, Olivier Langeron, MD, Martine Ferrandière, MD, Fabien Grelon, MD, Philippe Seguin, MD, Carole Ichai, MD, Benoit Veber, MD, Bertrand Souweine, MD, Thomas Uberti, MD, Sigismond Lasocki, MD, François Legay, MD, Marc Leone, MD, Nathanael Eisenmann, MD, Claire Dahyot-Fizelier, MD, Hervé Dupont, MD, Karim Asehnoune, MD, Achille Sossou, MD, Gérald Chanques, MD, Laurent Muller, MD, Jean-Etienne Bazin, MD, Antoine Monsel, MD, Lucile Borao, PhD, Jean-Marc Garcier, MD, Jean-Jacques Rouby, MD, Bruno Pereira, PhD, Emmanuel Futier, MD, for theAZUREA Network †

Published: August 06, 2019 / DOI: https://doi.org/10.1016/S2213-2600(19)30138-9

 

Summary

Background

The effect of personalised mechanical ventilation on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remains uncertain and needs to be evaluated. We aimed to test whether a mechanical ventilation strategy that was personalised to individual patients’ lung morphology would improve the survival of patients with ARDS when compared with standard of care.

Methods

We designed a multicentre, single-blind, stratified, parallel-group, randomised controlled trial enrolling patients with moderate-to-severe ARDS in 20 university or non-university intensive care units in France. Patients older than 18 years with early ARDS for less than 12 h were randomly assigned (1:1) to either the control group or the personalised group using a minimisation algorithm and stratified according to the study site, lung morphology, and duration of mechanical ventilation. Only the patients were masked to allocation. In the control group, patients received a tidal volume of 6 mL/kg per predicted bodyweight and positive end-expiratory pressure (PEEP) was selected according to a low PEEP and fraction of inspired oxygen table, and early prone position was encouraged. In the personalised group, the treatment approach was based on lung morphology; patients with focal ARDS received a tidal volume of 8 mL/kg, low PEEP, and prone position. Patients with non-focal ARDS received a tidal volume of 6 mL/kg, along with recruitment manoeuvres and high PEEP. The primary outcome was 90-day mortality as established by intention-to-treat analysis. This study is registered online with ClinicalTrials.gov, NCT02149589.

Findings

From June 12, 2014, to Feb 2, 2017, 420 patients were randomly assigned to treatment. 11 patients were excluded in the personalised group and nine patients were excluded in the control group; 196 patients in the personalised group and 204 in the control group were included in the analysis. In a multivariate analysis, there was no difference in 90-day mortality between the group treated with personalised ventilation and the control group in the intention-to-treat analysis (hazard ratio [HR] 1·01; 95% CI 0·61–1·66; p=0·98). However, misclassification of patients as having focal or non-focal ARDS by the investigators was observed in 85 (21%) of 400 patients. We found a significant interaction between misclassification and randomised group allocation with respect to the primary outcome (p<0·001). In the subgroup analysis, the 90-day mortality of the misclassified patients was higher in the personalised group (26 [65%] of 40 patients) than in the control group (18 [32%] of 57 patients; HR 2·8; 95% CI 1·5–5·1; p=0·012.

Interpretation

Personalisation of mechanical ventilation did not decrease mortality in patients with ARDS, possibly because of the misclassification of 21% of patients. A ventilator strategy misaligned with lung morphology substantially increases mortality. Whether improvement in ARDS phenotyping can decrease mortality should be assessed in a future clinical trial.

Funding

French Ministry of Health (Programme Hospitalier de Recherche Clinique InterRégional 2013).

Keywords: ARDS; Intensive Care; France.

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#Clinical #management of respiratory syndrome in #patients hospitalized for suspected #MERS #coronavirus #infection in the #Paris area from 2013 to 2016 (BMC Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMC Infect Dis. 2018 Jul 16;18(1):331. doi: 10.1186/s12879-018-3223-5.

Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016.

Bleibtreu A1,2,3,4, Jaureguiberry S5, Houhou N6, Boutolleau D7, Guillot H5, Vallois D8, Lucet JC9,10,11, Robert J12,13, Mourvillier B10,11,14, Delemazure J15, Jaspard M5, Lescure FX8,10,11, Rioux C8, Caumes E5, Yazdanapanah Y8,10,11.

Author information: 1 APHP, Hôpital Bichat Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris Diderot University, Paris, France. alexandre.bleibtreu@aphp.fr. 2 APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Service des Maladies Infectieuses et Tropicales, Paris, France. alexandre.bleibtreu@aphp.fr. 3 INSERM, IAME, UMR 1137, Paris, France. alexandre.bleibtreu@aphp.fr. 4 Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France. alexandre.bleibtreu@aphp.fr. 5 APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Service des Maladies Infectieuses et Tropicales, Paris, France. 6 Virology Department, APHP-Bichat-Claude Bernard Hospital, Paris, France. 7 AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Service de Virologie, et Sorbonne Universités, UPMC Univ Paris 06, CR7, CIMI, INSERM U1135, Paris, France. 8 APHP, Hôpital Bichat Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris Diderot University, Paris, France. 9 APHP, Infection control unit, Bichat Claude Bernard hospital, Paris Diderot University, Paris, France. 10 INSERM, IAME, UMR 1137, Paris, France. 11 Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France. 12 AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Bactériologie-Hygiène Hospitalière, Paris, France. 13 Faculté de Médecine P. & M. Curie Paris-6 – Site Pitié, Centre d’Immunologie et des Maladies Infectieuses (CIMI) – E13, Paris, France. 14 APHP- Hôpital Bichat Claude Bernard, Service de Réanimation médicale et Infectieuse, Paris, France. 15 Service de pneumologie et réanimation Département R3S, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, unité de Soin de Réadaptation Post Réanimation (SRPR), Paris, France.

 

Abstract

BACKGROUND:

Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV.

METHODS:

We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016.

RESULTS:

Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one Plasmodium falciparum malaria. Microbiological analysis identified Rhinovirus (27.9%), Influenza virus (26.8%), Legionella pneumophila (7.5%), Streptococcus pneumoniae (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1-33) and 24 h (8-92), respectively. Time of isolation decreased over time (P < 0.01). Two patients (2%) died.

CONCLUSION:

The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against S. pneumoniae and L. pneumophila are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.

KEYWORDS: Isolation ward; Legionella; Middle East respiratory syndrome coronavirus (MERS-CoV); Pilgrims; Respiratory tract infection; Saudi Arabia

PMID: 30012113 PMCID: PMC6048819 DOI: 10.1186/s12879-018-3223-5 [Indexed for MEDLINE]  Free PMC Article

Keywords: MERS-CoV; France.

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First year of #PrEP implementation in #France with daily or on-demand #tenofovir disoproxil fumarate/emtricitabine (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

First year of pre-exposure prophylaxis implementation in France with daily or on-demand tenofovir disoproxil fumarate/emtricitabine

M Siguier, R Mera, G Pialoux, M Ohayon, L Cotte, N Valin, J Ghosn, E Cua, C Pintado, J Chas, G Barriere, F Durand, J M Molina

Journal of Antimicrobial Chemotherapy, dkz220, https://doi.org/10.1093/jac/dkz220

Published: 20 June 2019

 

Abstract

Background

In January 2016, the French Medicine Agency initiated a Temporary Recommendation for Use (TRU) to allow the use of oral intake of tenofovir disoproxil fumarate and emtricitabine for pre-exposure prophylaxis (PrEP) in adults at high risk of HIV. We report the results of the first year of PrEP implementation in France.

Methods

Data were collected by physicians using a secured web subject-monitoring interface, with two forms: an initiation form, with patients’ baseline characteristics, and an HIV seroconversion form. Univariate and adjusted multivariate analysis using a logistic regression model were performed to identify baseline factors associated with on-demand PrEP regimen prescription.

Results

From 4 January 2016 to 28 February 2017, 3405 subjects were enrolled, with 2774 initiation forms completed; 98.1% were male and 96.9% were MSM. An on-demand regimen was prescribed to 57% of subjects. Older age (OR for participants older than 50 years = 1.76, 95% CI 1.35–2.3, P < 0.001) and site of prescription (OR of former IPERGAY sites = 2.28, 95% CI 1.84–2.83, P < 0.001) were associated with on-demand prescription. Those reporting sexually transmitted infection (STI) and condomless anal sex with at least two different partners were less likely to receive on-demand PrEP (OR = 0.68, 95% CI 0.57–0.82 and 0.75, 95% CI 0.57–0.98, respectively; P < 0.05 for all). Four breakthrough HIV infections were reported during the study, in the context of PrEP interruption or acute infection at the time of PrEP initiation.

Conclusions

In a real-life setting in France, PrEP was used, either daily or on-demand, mostly by MSM, with breakthrough infections being rare.

Issue Section: ORIGINAL RESEARCH

Keywords: HIV/AIDS; PrEP; Antivirals.

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Multi- #recombinant #Enterovirus A71 Subgenogroup C1 Isolates Associated with #Neurologic Disease, #France, 2016–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 6—June 2019 / Dispatch

Multirecombinant Enterovirus A71 Subgenogroup C1 Isolates Associated with Neurologic Disease, France, 2016–2017

Stéphanie Tomba Ngangas, Alexander Lukashev, Gwendoline Jugie, Olga Ivanova, Jean-Michel Mansuy, Catherine Mengelle, Jacques Izopet, Anne-Sophie L’honneur, Flore Rozenberg, David Leyssene, Denise Hecquet, Stéphanie Marque-Juillet, David Boutolleau, Sonia Burrel, Hélène Peigue-Lafeuille, Christine Archimbaud, Kimberley Benschop, Cécile Henquell, Audrey Mirand, and Jean-Luc Bailly

Author affiliations: Université Clermont Auvergne, Clermont-Ferrand, France (S. Tomba Ngangas, G. Jugie, H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); Sechenov University, Moscow, Russia (A. Lukashev); Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products, Moscow (O. Ivanova); Centre Hospitalier Universitaire de Toulouse, Toulouse, France (J.-M. Mansuy, C. Mengelle, J. Izopet); Assistance Publique-Hôspitaux de Paris Cochin, Paris, France (A.-S. L’honneur, F. Rozenberg); Centre Hospitalier de la Côte Basque, Bayonne, France (D. Leyssene); Centre Hospitalier Universitaire Amiens, Amiens, France (D. Hecquet); Centre Hospitalier de Versailles, Le Chesnay, France (S. Marque-Juillet); Assistance Publique-Hôspitaux de Paris Pitié-Salpêtrière-Charles Foix, Paris (D. Boutolleau, S. Burrel); CHU Clermont-Ferrand, Clermont-Ferrand (H. Peigue-Lafeuille, C. Archimbaud, C. Henquell, A. Mirand, J.-L. Bailly); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (K. Benschop)

 

Abstract

In 2016, an upsurge of neurologic disease associated with infection with multirecombinant enterovirus A71 subgenogroup C1 lineage viruses was reported in France. These viruses emerged in the 2000s; 1 recombinant is widespread. This virus lineage has the potential to be associated with a long-term risk for severe disease among children.

Keywords: EV-A71; Encephalitis; Neurology; Pediatrics; France.

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#Purulent #bronchitis in 1917 and #pandemic #influenza in 1918 (Lancet Infect Dis., summary)

[Source: The Lancet Infectious Diseases, full page: (LINK). Summary, edited.]

Purulent bronchitis in 1917 and pandemic influenza in 1918

Jim Cox, Douglas Gill, Fiona Cox, Michael Worobey

Published: April, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30114-8

___

A remarkable Lancet paper, which is probably the first description of the so-called 1918 Spanish influenza outbreak,1 is omitted from the journal’s Pandemic influenza: 100 years microsite. We wish to draw attention to this work, both to augment the excellent timeline of landmark events in influenza history in the microsite and to describe this early paper’s relevance to understanding the origin of the 1918 influenza pandemic.

(…)

We declare no competing interests.

Keywords: Pandemic Influenza; Spanish Flu; France; Pneumonia.

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