3 research outputs found
Ăvaluation d'un kit diagnostic des infections respiratoires basses Ă l'AP-HM, intĂ©rĂȘt et application en mĂ©decine gĂ©nĂ©rale
Introduction : la pneumonie aigĂŒe est une des pathologies infectieuses les plus frĂ©quentes et les plus sĂ©vĂšres. La prise en charge thĂ©rapeutique actuelle est basĂ©e sur une antibiothĂ©rapie probabiliste qui peut ĂȘtre adaptĂ©e lorsque le diagnostic microbiologique est Ă©tabli. La mise en place dâoutils diagnostics en mĂ©decine de ville permettrait de guider le clinicien dans sa prise en charge thĂ©rapeutique et favoriserait le bon usage des antibiotiques. Le but de cette Ă©tude est dâĂ©valuer lâintĂ©rĂȘt de la rĂ©alisation systĂ©matique dâexamens microbiologiques Ă visĂ©e diagnostique en cas de pneumonies et la faisabilitĂ© dâun tel dispositif diagnostic en mĂ©decine de ville.MatĂ©riels et mĂ©thodes : il sâagit dâune Ă©tude rĂ©trospective descriptive monocentrique Ă lâAssistance Publique des HĂŽpitaux de Marseille (AP-HM) du 1er janvier 2013 au 30 juin 2019 sur les prĂ©lĂšvements microbiologiques issus dâun kit diagnostic chez les patients prĂ©sentant un tableau clinique de pneumonie aigĂŒe. Les kits Ă©taient constituĂ©s de diffĂ©rents examens microbiologiques : sĂ©rologies, PCR sur Ă©couvillons rhinopharyngĂ©s, hĂ©mocultures, antigĂ©nuries.RĂ©sultats : 1766 kits pneumonie ont Ă©tĂ© rĂ©alisĂ©s, 521 diagnostics microbiologiques ont Ă©tĂ© Ă©tablit soit dans 29,5% des cas. Streptococcus pneumoniae, Haemophilus influenzae, le virus de la grippe A, le rhinovirus/entĂ©rovirus ont Ă©tĂ© les plus documentĂ©es (respectivement 89, 40, 137 et 68 cas). 52 co-infections ont Ă©tĂ© documentĂ©es (soit 10% des pneumonies documentĂ©es) dont 34 cas dâinfections mixtes.Conclusion : un tiers des pneumonies a Ă©tĂ© documentĂ©. Le nombre de co-infections et notamment dâinfections mixtes (bactĂ©riennes et virales) est trĂšs Ă©levĂ©. Proposition dâun nouveau kit diagnostic adaptĂ© aux rĂ©sultats microbiologiques retrouvĂ©s et Ă la mĂ©decine de ville qui pourrait amĂ©liorer la prise en charge thĂ©rapeutique des pneumonies aigĂŒe en mĂ©decine ambulatoire
Contagion Management at the Méditerranée Infection University Hospital Institute
International audienceThe Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients