Occupational exposure to organic solvent mixtures during pregnancy and the risk of non‐syndromic oral clefts

International audienceOBJECTIVES: To examine the association between maternal occupational exposure to mixtures of organic solvents during pregnancy and the risk of non-syndromic oral clefts. METHODS: A case-control study (164 cleft lip with/without cleft palate (CL/P), 76 cleft palate (CP), 236 controls) was conducted in France to investigate the role of maternal occupational exposure to organic solvents at the beginning of pregnancy in the risk of non-syndromic oral clefts. An expert chemist, guided by a detailed description of the women's occupational tasks, assessed exposure for each. Analysis of the findings used logistic regression. RESULTS: In the control group, 39% of the women who reported working during pregnancy were exposed to at least one type of organic solvent. The risk of oral clefts was associated with oxygenated (for CL/P: OR = 1.8, 95% CI 1.1 to 2.9; and for CP, OR = 1.4, 95% CI 0.7 to 2.7), chlorinated (OR = 9.4, 95% CI 2.5 to 35.3; OR = 3.8, 95% CI 0.7 to 20.7), and petroleum (OR = 3.6, 95% CI 1.5 to 8.8; OR = 1.2, 95% CI 0.3 to 4.9) solvents. The risk of oral clefts increased linearly with level of exposure within the three subgroups of oxygenated solvents we considered (aliphatic alcohols, glycol ethers, and other oxygenated solvents, including esters, ketones, and aliphatic aldehydes). CONCLUSIONS: Results suggest that maternal occupational exposure to organic solvents during pregnancy may play a role in the aetiology of oral clefts. The limited number of subjects and the problem of multiple exposures require that these results be interpreted cautiously

Trends in the proportion of resistant bacteria involved in ventilator-associated pneumonia as the first hospital-acquired infection in intensive care units between 2003 and 2016 in Lyon, France

International audienceThe aim of this study was to describe the proportion of multidrug-resistant microorganisms (MDROs) involved in ventilator-associated pneumonia (VAP) as the first hospital-acquired infection in 536 adults with restricted risk factors for MDRO-related infection. We found a significant decrease in the percentage of MDROs involved in VAP between 2003 and 2016 and this percentage increased when VAP occurred after day 10

Quelles mesures pour maîtriser le risque infectieux chez les patients immunodéprimés ? Recommandations formalisées d’experts

International audienceThe increase use of immunosuppressive treatments in patients with solid cancer and/or inflammatory diseases requires revisiting our practices for the prevention of infectious risk in the care setting. A review of the literature by a multidisciplinary working group at the beginning of 2014 wished to answer the following 4 questions to improve healthcare immunocompromised patients: (I) How can we define immunocompromised patients with high, intermediate and low infectious risk, (II) which air treatment should be recommended for this specific population? (III) What additional precautions should be recommended for immunocompromised patients at risk for infection? (IV) Which global environmental control should be recommended? Based on data from the literature and using the GRADE method, we propose 15 recommendations that could help to reduce the risk of infection in these exposed populations.L’intensification des traitements immunosuppresseurs et la généralisation de leur utilisation aux patients atteints de cancer solide et/ou de maladies inflammatoires nécessitent de revisiter nos pratiques de prévention du risque infectieux en milieu de soin. Cette révision est justifiée aussi par les modifications de nos pratiques avec une intensification des prises en charge en structures de soins de suites réhabilitation et en ambulatoire. Une revue de la littérature menée par un groupe de travail multidisciplinaire réuni début 2014 a souhaité répondre aux 4 questions suivantes : (i) Quelle définition des patients immunodéprimés à risque infectieux élevé, intermédiaire et faible, (ii) Quel traitement d’air recommander pour les patients immunodéprimés à risque d’infections ? (iii) Quelles précautions complémentaires recommander pour les patients immunodéprimés à risque d’infections ? (iv) Quelle maîtrise globale de l’environnement recommander pour les patients immunodéprimés à risque d’infections ? À partir des données de la littérature et en utilisant la méthode GRADE, nous proposons 15 recommandations qui permettront de réduire le risque infectieux dans ces populations exposées