First Case of Streptococcus oligofermentans Endocarditis Determined Based on sodA Gene Sequences after Amplification Directly from Valvular Samples▿

We report the first case of infection due to Streptococcus oligofermentans, which is a recently described oral Streptococcus species. It was responsible for the endocarditis and left forearm abscess of a 43-year-old woman. Identification was made using molecular techniques performed directly from valvular and surgical samples

Non-HACEK gram-negative bacilli endocarditis: a multicentre retrospective case-control study

International audienceBACKGROUND: Infective endocarditis (IE) caused by non-HACEK gram-negative bacilli (GNB) is poorly characterised and may be emerging as a consequence of medical progress. METHODS: We performed an observational retrospective case-control study. Cases were non-HACEK GNB IE, definite or possible (modified Duke criteria), diagnosed in adults between 2007 and 2020 in six French referral hospitals. Two controls were included for each case (IE due to other bacteria, matched by sites and diagnosis date). RESULTS: Non-HACEK GNB were identified in 2.4% (77/3230) of all IE during the study period, with a mean age of 69.2 ± 14.6 years, and a large male predominance (53/77, 69%). Primary pathogens were Escherichia coli (n = 33), Klebsiella sp. (n = 12) and Serratia marcescens (n = 9), including eight (10%) multidrug-resistant GNB. Compared to controls (n = 154: 43% Streptococcus sp., 41% Staphylococcus sp. and 12% Enterococcus sp.), non-HACEK GNB IE were independently associated with intravenous drug use (IVDU, 8% vs. 2%, p = .003), active neoplasia (15% vs. 6%, p = .009), haemodialysis (9% vs. 3%, p = .007) and healthcare-associated IE (36% vs. 18%, p = .002). Urinary tract was the main source of infection (n = 25, 33%) and recent invasive procedures were reported in 29% of cases. Non-HACEK GNB IE were at lower risk of embolism (31% vs. 47%, p = .002). One-year mortality was high (n = 28, 36%). Comorbidities, particularly malignant hemopathy and cirrhosis, were associated with increased risk of death. CONCLUSIONS: Non-HACEK GNB are rarely responsible for IE, mostly as healthcare-associated IE in patients with complex comorbidities (end-stage renal disease, neoplasia), or in IVDUs

Characteristics and Prognosis Factors of Pneumocystis jirovecii Pneumonia According to Underlying Disease

International audienceBackground: Pnemocystis jirovecii pneumonia (PcP) remains associated with high rates of mortality, and the impact of immunocompromising underlying disease on the clinical presentation, severity, and mortality of PcP has not been adequately evaluated.Research question: Does the underlying disease and immunosuppression causing PcP impact the outcome and clinical presentation of the disease?Study design and methods: In this multicenter retrospective observational study, conducted from January 2011 to December 2021, all consecutive patients admitted with a proven or probable diagnosis of PcP according to The European Organisation for Research and Treatment of Cancer consensus definitions were included to assess the epidemiology and impact of underlying immunosuppressive diseases on overall and 90-day mortality.Results: Overall, 481 patients were included in the study; 180 (37.4%) were defined as proven PcP and 301 (62.6%) were defined as probable PcP. Patients with immune-mediated inflammatory diseases (IMIDs) or solid tumors had a statistically poorer prognosis than other patients with PcP at day 90. In multivariate analysis, among the HIV-negative population, solid tumor underlying disease (OR, 5.47; 95% CI, 2.16-14.1; P < .001), IMIDs (OR, 2.19; 95% CI, 1.05-4.60; P = .037), long-term corticosteroid exposure (OR, 2.07; 95% CI, 1.03-4.31; P = .045), cysts in sputum/BAL smears (OR, 1.92; 95% CI, 1.02-3.62; P = .043), and SOFA score at admission (OR, 1.58; 95% CI, 1.39-1.82; P < .001) were independently associated with 90-day mortality. Prior corticotherapy was the only immunosuppressant associated with 90-day mortality (OR, 1.67; 95% CI, 1.03-2.71; P = .035), especially for a prednisone daily dose ≥ 10 mg (OR, 1.80; 95% CI, 1.14-2.85; P = .010).Interpretation: Among patients who were HIV-negative, long-term corticosteroid prior to PcP diagnosis was independently associated with increased 90-day mortality, specifically in patients with IMIDs. These results highlight both the needs for PcP prophylaxis in patients with IMIDs and to early consider PcP curative treatment in severe pneumonia among patients with IMIDs

Clinical recurrences of COVID-19 symptoms after recovery: Viral relapse, reinfection or inflammatory rebound?

International audienceFor the first 3 months of COVID-19 pandemic, COVID-19 was expected to be an immunizing non-relapsing disease. We report a national case series of 11 virologically-confirmed COVID-19 patients having experienced a second clinically- and virologically-confirmed acute COVID-19 episode. According to the clinical history, we discuss either re-infection or reactivation hypothesis. Larger studies including further virological, immunological and epidemiologic data are needed to understand the mechanisms of these recurrences

Prevalence of Post-Acute COVID-19 Symptoms Twelve Months after Hospitalisation in Participants Retained in Follow-up: Analyses Stratified by Gender from a Large Prospective Cohort.

International audienceOBJECTIVES: Persistent post-acute COVID-19 symptom (PACS) have been reported up to 6-months (M6) after hospital discharge. Here we assessed, in the longitudinal prospective national French COVID cohort, symptoms that persisted 12-months (M12) after admission for COVID-19. METHODS: Hospitalized patients with a virologically-confirmed COVID-19 were enrolled. Follow-up was planned until M12 post-admission. Associations between persistence of ≥q3 PACS at M12 and clinical characteristics at admission were assessed through logistic regression according to gender. RESULTS: We focused on participants enrolled between January 24(th) and July 15(th) 2020, in order to allow M12 follow-up. M12 data were available for 737 participants. Median age was 61~years, 475 (64%) were men and 242/647 (37%) were admitted to ICU during the acute phase. At M12, 194/710 (27%) of participants had ≥q3 persistent PACS, mostly fatigue, dyspnea and joint pain. Among those who had a professional occupation before the acute phase 91/339 (27%) were still on sick leave at M12. Presence of ≥q3 persistent PACS was associated with female gender, both anxiety and depression, impaired health-related quality of life (HRQL) and mMRC scale 3 persistent PACS (98/253, 39% vs 96/457, 21%), depression and anxiety (18/152, 12% vs 17/268, 6% and 33/156, 21% vs 26/264, 10%, respectively), impaired physical HRQL (76/141, 54% vs 120/261, 46%). Women had less often returned to work than men (77/116, 66% vs 171/223, 77%). CONCLUSIONS: A fourth of individuals admitted to hospital for COVID-19 still had ≥q3 persistent PACS at M12 post-discharge. Women reported more often ≥q3 persistent PACS, suffered more from anxiety and depression, and had less often returned to work than men

Case-Control Study of the Etiology of Infant Diarrheal Disease in 14 Districts in Madagascar

<div><h3>Background</h3><p>Acute diarrhea is a major cause of childhood morbidity and mortality worldwide. Its microbiological causes and clinico-epidemiological aspects were examined during the rainy seasons from 2008 to 2009 in 14 districts in Madagascar.</p> <h3>Methods</h3><p>Stool specimens of 2196 children with acute diarrhea and 496 healthy children were collected in a community setting. Intestinal parasites were diagnosed by microscopy and bacteria by culturing methods. Rota-, astro and adenoviruses were identified using commercially available ELISA kits and rotaviruses were confirmed using reverse transcriptase polymerase chain reaction (RT-PCR).</p> <h3>Results</h3><p>Intestinal microorganisms were isolated from 54.6% of diarrheal patients and 45.9% of healthy subjects (p = <0.01). The most common pathogens in diarrheic patients were intestinal parasites (36.5%). Campylobacter spp. and Rotavirus were detected in 9.7% and 6.7% of diarrheic patients. The detection rates of <em>Entamoeba histolytica</em>, <em>Trichomonas intestinalis</em> and <em>Giardia lamblia</em> were much greater in diarrheal patients than in non diarrheal subjects (odds ratios of 5.1, 3.2, 1.7 respectively). The abundance of other enteropathogens among the non diarrheal group may indicate prolonged excretion or limited pathogenicity.</p> <h3>Conclusion</h3><p>In developing countries, where the lack of laboratory capacities is great, cross sectional studies of enteropathogens and their spatial distribution, including diarrheal and non diarrheal subjects, are interesting tools in order to advise regional policies on treatment and diarrheic patient management.</p> </div

Le Paris des étrangers depuis 1945

Paris, Ville Lumière, miroir du monde, Babel des temps modernes, voilà l’image que nous a léguée le XIXe siècle. Exilés, sans-patrie, poètes, romanciers, peintres, musiciens, étudiants y ont trouvé refuge. De telle manière que tous ces étrangers de Paris ont constitué le Paris des étrangers. Mais après le traumatisme de la Deuxième Guerre mondiale, Paris est-il toujours la capitale des libertés ? Les victimes des révolutions et des répressions ; se dirigent-elles encore vers la capitale de la France ? Paris reste-t-il ce centre de légitimation intellectuelle et culturelle qu’il a si longtemps été ? Quel rôle joue-t-il dans le monde pour la création artistique, la musique, le cinéma, l’édition ? Quel accueil réserve-t-il à ceux qui pensent y trouver un moyen de subsistance ? Les vingt-trois contributions de ce livre, poursuite d’un projet amorcé en 1987 à l’initiative du professeur Jean-Baptiste Duroselle (1917-1994), fondateur de l’Institut d’Histoire des Relations internationales contemporaines, s’efforcent de répondre à la question du pouvoir d’attraction de Paris depuis 1945 : elles jettent des éclairages variés, contradictoires, complexes, qui interdisent des conclusions univoques. Chaque jour, un congrès, un sommet international, une vague touristique, une révolution ou un drame dans le monde, un afflux d’étudiants, de nouvelles dispositions d’entrée sur le territoire viennent modifier le paysage d’un Paris des étrangers qui demeure d’une extraordinaire diversité. Italiens, Espagnols, Catalans, Portugais constituent l’immense apport latin à la France, qui n’a cessé depuis la fin du XIXe siècle. Mais l’Europe centrale et orientale est également présente, avec les différentes composantes de l’Union soviétique (Russes, Arméniens, Géorgiens), les Hongrois, les Polonais, les Roumains ou les Tchécoslovaques. Les anciennes colonies françaises ne sont pas absentes : l’Afrique du Nord et l’Afrique noire ont marqué Paris, et réciproquement, que leurs ressortissants s’y soient formés, qu’ils s’y soient déterminés contre leur colonisateur ou qu’ils aient contribué à sa construction et à son entretien. Mais Paris, c’est aussi le monde entier, avec ses Américains, ses Latino Américains, ses Chinois et tous ceux qui auraient eu légitimement leur place si le temps et l’espace avaient été suffisants. À travers l’étude du passé récent, il s’est agi de poser les jalons d’une dédramatisation de phénomènes millénaires et de réhabiliter le concept de « creuset », instrument indispensable d’une intégration, lace aux exclusions, qui ne peuvent que créer de redoutables ghettos.Nous dédions ce livre à la mémoire de Jean-Baptiste DUROSELLE, qui fut à l'origine de cette entreprise