Different epidemiology of bloodstream infections in COVID-19 compared to non-COVID-19 critically ill patients: A descriptive analysis of the Eurobact II study

Background: The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients. Methods: We used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients’ characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models. Results: A total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49–2.45). Conclusions: We showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality. Trial registration ClinicalTrials.org number NCT03937245. Registered 3 May 2019

Development and validation of a lateral flow immunoassay for rapid detection of VanA-producing enterococci

International audienceBackground: VRE are nosocomial pathogens with an increasing incidence in recent decades. Rapid detection is crucial to reduce their spread and prevent infections and outbreaks. Objectives: To evaluate a lateral flow immunoassay (LFIA) (called NG-Test VanA) for the rapid and reliable detection of VanA-producing VRE (VanA-VRE) from colonies and broth. Methods NG-Test VanA was validated on 135 well-characterized enterococcal isolates grown on Mueller–Hinton (MH) agar (including 40 VanA-VRE). Different agar plates and culture broths widely used in routine laboratories for culture of enterococci were tested. Results: All 40 VanA-VRE clinical isolates were correctly detected in less than 15 min irrespective of the species expressing the VanA ligase and the medium used for bacterial growth. No cross-reaction was observed with any other clinically relevant ligases (VanB, C1, C2, D, E, G, L, M and N). Overall, the sensitivity and specificity of the assay were 100% for VanA-VRE grown on MH agar plates. NG-Test VanA accurately detects VanA-VRE irrespective of the culture medium (agar and broth). Band intensity was increased when using bacteria grown on vancomycin-containing culture media or on MH close to the vancomycin disc as a consequence of VanA induction. The limit of detection of the assay was 6.3 × 106 cfu per test with bacteria grown on MH plates and 4.9 × 105 cfu per test with bacteria grown on ChromID® VRE plates. Conclusions: NG-Test VanA is efficient, rapid and easy to implement in the routine workflow of a clinical microbiology laboratory for the confirmation of VanA-VRE

Pour l'hospitalité urbaine. Contre la tentation du repli sécuritaire, ouvrons nos villes

Tribune-Justice spatial/Spatial JusticeCe vendredi noir, le 13 novembre 2015, au Bataclan, nous avons perdu un collègue et un ami, Matthieu Giroud, géographe de l'urbain à l'Université Paris-Est Marne-la-Vallée. Notre peine est aussi grande que notre colère. Et puis la peur, celle du monde qui se dessine désormais après ces attaques. En hommage à Matthieu, dans la continuité du travail que nous avions entamé avec lui, nous voudrions dire quelques mots des villes et des espaces à y construire. Le Bataclan et les nombreuses terrasses frappées lors de cette soirée inouïe, permettent à des citadins-parisiens ou non-de se retrouver et de faire la fête. L'autre lieu visé, le Stade de France, à Saint-Denis, est un lieu de fête populaire et de mélange, même éphémère, autour du sport. Bien entendu, il est difficile d'ignorer que ces lieux de rencontre et de convivialité appréciés participent dans le même temps de la privatisation, de la marchandisation de la ville et de la marginalisation des classes populaires. Les attentats et leurs suites tendent à renforcer les séparations et l'hypersécurisation déjà à l'oeuvre dans nos villes. Ils bousculent encore un peu plus les équilibres précaires de notre société

Pour l'hospitalité urbaine. Contre la tentation du repli sécuritaire, ouvrons nos villes

Tribune-Justice spatial/Spatial JusticeCe vendredi noir, le 13 novembre 2015, au Bataclan, nous avons perdu un collègue et un ami, Matthieu Giroud, géographe de l'urbain à l'Université Paris-Est Marne-la-Vallée. Notre peine est aussi grande que notre colère. Et puis la peur, celle du monde qui se dessine désormais après ces attaques. En hommage à Matthieu, dans la continuité du travail que nous avions entamé avec lui, nous voudrions dire quelques mots des villes et des espaces à y construire. Le Bataclan et les nombreuses terrasses frappées lors de cette soirée inouïe, permettent à des citadins-parisiens ou non-de se retrouver et de faire la fête. L'autre lieu visé, le Stade de France, à Saint-Denis, est un lieu de fête populaire et de mélange, même éphémère, autour du sport. Bien entendu, il est difficile d'ignorer que ces lieux de rencontre et de convivialité appréciés participent dans le même temps de la privatisation, de la marchandisation de la ville et de la marginalisation des classes populaires. Les attentats et leurs suites tendent à renforcer les séparations et l'hypersécurisation déjà à l'oeuvre dans nos villes. Ils bousculent encore un peu plus les équilibres précaires de notre société

For urban hospitality. Against securitarian closure, let's open our cities

International audienceOn a black Friday, November 13th, 2015, at the Bataclan, we lost a colleague and friend, Matthieu Giroud, a geographer and urban scholar at Université Paris-Est Marne-la-Vallée. Our sadness is as deep as our anger. There is also fear, fear of the world being born after these attacks. As a tribute to Matthieu, and a continuation of the work we had started with him, we would like to say a few words about cities and the spaces to be built there

For urban hospitality. Against securitarian closure, let's open our cities

On a black Friday, November 13th, 2015, at the Bataclan, we lost a colleague and friend, Matthieu Giroud, a geographer and urban scholar at Université Paris-Est Marne-la-Vallée. Our sadness is as deep as our anger. There is also fear, fear of the world being born after these attacks. As a tribute to Matthieu, and a continuation of the work we had started with him, we would like to say a few words about cities and the spaces to be built there

Epileptic spasms with terror during sleep in CDKL5 encephalopathy

International audienceStudy objectives: To describe early diagnostic clues in Cyclin-Dependent Kinase-Like 5 (CDKL5) refractory encephalopathy, to improve treatment strategies.Methods: We retrospectively studied 35 patients (25 females, 10 males) with CDKL5 gene mutations or deletion, focusing on their early seizure semiology, the electroencephalogram (EEG) pattern, the effect of treatment, and developmental outcome.Results: The first seizures were recognizable and consisted of tonic, then clonic, and spasms phases, occurring in sleep at a median age of 6 weeks. Clusters of spasms were observed in quiet sleep or slow-wave sleep (SWS), with screaming, staring, and arms' extension that mimicked sleep terror in 28 of 35 patients (80%). Programmed awakening prevented these spasms in 9 of 16 patients and small doses of clonazepam given at night improved epilepsy in 14 of 23 patients.Conclusions: Peculiar seizures with spasms starting in SWS are an early diagnostic clue in infants with CDKL5 encephalopathy. Sleep video-EEG polygraphy is an easy tool to disclose these early seizures and epileptic spasms in infants during the first months of life while polysomnography is unlikely to give a contribution at that early age. While conventional antiepileptic treatment and corticosteroids are poorly, transiently, or not efficient, therapeutic strategy used for sleep terror could help, although the mechanism of spasms generation in SWS needs to be elucidated

LOAC (Light Optical Particle Counter): a new small aerosol counter with particle characterization capabilities for surface and airborne measurements

International audienceThe determination of the size distribution of tropospheric and stratospheric aerosols with conventional optical counters is difficult when different natures of particles are present (droplets, soot, mineral dust, secondary organic or mineral particles...). Also, a light and cheap aerosol counter that can be used at ground, onboard drones or launched under all kinds of atmospheric balloons can be very useful during specific events as volcanic plumes, desert dust transport or local pollution episodes. These goals can be achieved thanks to a new generation of aerosol counter, called LOAC (Light Optical Aerosol Counter). The instrument was developed in the frame of a cooperation between French scientific laboratories (CNRS), the Environnement-SA and MeteoModem companies and the French Space Agency (CNES). LOAC is a small optical particle counter/sizer of ∼250 grams, having a low electrical power consumption. The measurements are conducted at two scattering angles. The first one, at 12 • , is used to determine the aerosol particle concentrations in 19 size classes within a diameter range of 0.3-100 micrometerers. At such an angle close to forward scattering, the signal is much more intense and the measurements are the least sensitive to the particle nature. The second angle is at 60 • , where the scattered light is strongly dependent on the particle refractive index and thus on the nature of the aerosols. The ratio of the measurements at the two angles is used to discriminate between the different types of particles dominating the nature of the aerosol particles in the different size classes. The sensor particularly discriminates wet or liquid particles, soil dust and soot. Since 2011, we have operated LOAC in various environments (Arctic, Mediterranean, urban and peri-urban.. .) under different kinds of balloons including zero pressure stratospheric, tethered, drifting tropospheric, and meteorological sounding balloons. For the last case, the total weight of the gondola including the PTU sonde, transmission and batteries is below 1 kg. The results obtained during these flights and related campaigns such as the ground-based winter campaign Paris-Fog in Ile de France (fog life circle) and the Pre-ChArMEx/TRAQA summer campaign on the French Mediterranean coast will be presented, as well as future campaigns in which LOAC is involved, especially ChArMEx, (flights in the lower troposphere above the Mediterranean Sea), and Strateole (long duration flights in the tropical stratosphere). Balloon operation of LOAC will tentatively been shown during EGU

α-Amylase Mediates Host Acceptance in the Braconid Parasitoid Cotesia flavipes

International audienc