Louis Bernard - Academia.edu (original) (raw)
Papers by Louis Bernard
Archives of Cardiovascular Diseases Supplements, 2014
15 patients (age=57±15 years, 73% men) with either severe aortic valve disease (stenosis or regur... more 15 patients (age=57±15 years, 73% men) with either severe aortic valve disease (stenosis or regurgitation) or severe mitral regurgitation, but without coronary artery disease preoperatively underwent ECV measurement by CMR MOLLI T1 mapping. LV biopsies were performed at the time of surgery 7±8 days later and stained with Sirius red. The amount of fibrosis quantified by biopsy was 6.6±4. 8% [2.1;15.9]. ECV by T1 mapping was 28.3±4.7% [23.3;38.6] (values are presented as mean±SD [min;max]). There was a good correlation between histologically measured fibrosis and T1 mapping ECV (r=0.77, p<0.001, cfr figure).
Archives of Cardiovascular Diseases Supplements, 2015
The American journal of cardiology, 2017
There are very few data on the prognosis of possible versus definite infective endocarditis (IE).... more There are very few data on the prognosis of possible versus definite infective endocarditis (IE). We studied data from 365 consecutive patients with IE involving native heart valve seen in an academic institution from 1990 to 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 101, 28%) and those with definite IE (n = 264, 72%). Patients with possible IE were older than those with definite IE (66 ± 15 vs 62 ± 16, p = 0.05). A causative microorganism was identified in 66% of patients with possible IE versus all patients with definite IE (p <0.0001) and only 41% had major echocardiographic criteria (vs 100%; p <0.0001). Overall, 139 patients died over a mean ± SD follow-up of 3.9 ± 4.5 years (median 2.2, interquartile range 5.9 years). Patients with possible and definite IE had a similar risk of death. Independent predictors of long-term mortality were increasing age (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1...
Journal of the American College of Cardiology, 2014
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Jan 7, 2016
The Journal of Infection, Jul 1, 2010
In the treatment of prosthetic joint infections (PJI), the benefit of antibiotic therapy for more... more In the treatment of prosthetic joint infections (PJI), the benefit of antibiotic therapy for more than 6 weeks after surgery is uncertain. We compared PJI cure rates according to the duration of antibiotics, 6 versus 12 weeks. A prospective observational non-randomized study in Geneva University Hospitals 1996-2007. A total of 144 PJI (62 hip arthroplasties, 62 knee arthroplasties, and 20 hip hemiarthroplasties) were included with a prolonged follow-up ranging from 26 to 65 months. Surgical treatment included 60 débridements with implant retention, 10 one-stage exchanges of the prosthesis, 57 two-stage exchanges, and 17 Girdlestone procedures or knee arthrodeses. Seventy episodes (49%) received 6 weeks antibiotic therapy and 74 episodes, 12 weeks. Cure was achieved in 115 episodes (80%). Cure rate did not change according to the duration of intravenous antibiotics (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 days, 8-21 days, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;21 days) (Kruskal-Wallis-test; p = 0.37). In multivariate analysis, none of the following parameters was statistically significantly associated with cure: two-stage exchange (odds ratio 1.1,95%CI 0.2-4.8); number of débridements (0.9, 0.4-1.9); six weeks antibiotherapy (2.7, 0.96-8.3); duration of intravenous course (1.0, 0.96-1.03); sinus tract (0.6, 0.2-1.7); or MRSA infection (0.5, 0.2-1.5), although implant retention showed a tendency for less cure (0.3, 0.1-1.1). Following surgery for treatment of PJI, antibiotic therapy appears able to be limited to a 6-week course, with one week of intravenous administration. This approach needs confirmation in randomized trials.
La Presse Medicale, Apr 1, 2005
INTRODUCTION: Screening strategies among pregnant women have decreased the incidence of group B S... more INTRODUCTION: Screening strategies among pregnant women have decreased the incidence of group B Streptococcus, which causes severe neonatal infections. The incidence of these infections has increased among diabetic patients, however.OBJECTIVES: To specify the characteristics of diabetic foot infections in which surgical samples have isolated one or several germs including group B Streptococcus, study its risk factors and determine its course.MATERIALS AND METHODS: We retrospectively evaluated the records of all patients admitted to the University Hospital of Geneva from January 1999 through October 2004, with diagnoses of severe foot infection (+/- osteomyelitis) documented during surgery.RESULTS: Twenty-five severe diabetic foot infections were identified, 21 with osteomyelitis. The most common risk factors were age older than 60 years (n=10), chronic renal failure (n=7), severe arteriopathy (n=6), and immune depression (n=2). Most lesions were classified as grade 3 or 4 of Wagner's classification. 80% of the surgical samples were polymicrobial. Blood cultures were positive in 4 patients, one in septic shock. Half the patients (n=13) underwent amputation, despite initially appropriate antibiotic treatment. No patients died but 3 relapsed.CONCLUSION: Group B streptococcal foot infections often occur in fragile patients with immune depression or severe arterial disease. Despite intensive antibiotic therapy and adequate debridement, amputation is often required in diabetic patients because of severe damage to the tissue and poor vascularization.
Antimicrobial Agents and Chemotherapy, Dec 12, 2011
Reduced susceptibility to glycopeptides in methicillin-resistant Staphylococcus aureus (MRSA) cli... more Reduced susceptibility to glycopeptides in methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates is considered a risk factor for failure of glycopeptide therapy. We compared the prevalences of MRSA isolates with reduced glycopeptide susceptibility in patients with versus without persistent or recurrent MRSA bloodstream infections. A retrospective cohort study at the University Hospital of Geneva identified 27 patients with persistent or recurrent clonally related MRSA bacteremic episodes over an 8-year period, which included 208 consecutive nosocomial MRSA bacteremic episodes. Vancomycin and teicoplanin MICs were determined by a modified macrodilution assay allowing improved detection of glycopeptide-intermediate MRSA isolates (GISA), characterized by elevated teicoplanin or/and vancomycin MICs (>4 g/ml). For 16 patients (59%), their pretherapy and/or posttherapy MRSA isolates showed elevated teicoplanin MICs, among which 10 (37%) concomitantly displayed elevated vancomycin MICs. In contrast, 11 other patients (41%) were persistently or recurrently infected with non-GISA isolates. In comparison, only 39 (22%) of 181 single isolates from patients with no microbiological evidence of persistent or recurrent infections showed elevated teicoplanin MICs, among which 14 (8%) concomitantly displayed elevated vancomycin MICs. Clinical, microbiological, and pharmacokinetic variables for patients persistently or recurrently infected with GISA or non-GISA isolates were similar. Bacteremic patients with a poor response to glycopeptide therapy had a 2.8-fold-and 4.8-fold-higher rates of MRSA isolates displaying elevated teicoplanin and vancomycin MICs, respectively, than patients with single isolates (P < 0.0001). Detection of elevated teicoplanin MICs may help to predict a poor response to glycopeptide therapy in MRSA bacteremic patients.
La Presse Medicale, Jun 29, 2011
Neurogenic myositis ossificans or para-osteo-arthropathy are part of heterotopic ossifications. T... more Neurogenic myositis ossificans or para-osteo-arthropathy are part of heterotopic ossifications. They concern mostly spinal cord injured or cerebral injured patients. They mostly target the hip and can lead to local or general inflammatory signs which can mimic severe sepsis. We detail the frequent septic like symptomatology and the relevance of echography to make the diagnosis and to start adapted therapy. We conducted a retrospective study from seven patients hospitalized in infectious disease department for suspicion of septical myositis and we compared this cohort with available data. They all have inflammatory syndrome and radiological signs. Diagnosis can be made early by echography, MRI or tomodensitometry. X-ray signs are delayed. Myositis ossificans can have a septical presentation but therapy is, at first, medical with non steroid anti inflammatory drugs and no antibiotic therapy.
Antimicrobial Agents and Chemotherapy, Sep 1, 2010
Staphylococcus aureus. Modal vancomycin and teicoplanin MICs recorded by tube macrodilution and t... more Staphylococcus aureus. Modal vancomycin and teicoplanin MICs recorded by tube macrodilution and the agar plate assay, which both used inocula of 10 6 CFU, were significantly higher (2 g/ml) against a panel of borderline glycopeptide-susceptible and glycopeptide-intermediate methicillin-resistant S. aureus (MRSA) bloodstream isolates compared to broth microdilution (1 g/ml). Vancomycin and teicoplanin MIC distributions by tube macrodilution and agar testing were also markedly different from those evaluated by broth microdilution. The 20-fold-lower inoculum size used for broth microdilution compared to macrodilution and agar MIC assays explained in part, but not entirely, the systematic trend toward lower vancomycin and teicoplanin MICs by microdilution compared to other methods. Broth microdilution assay led to underdetection of the vancomycin-intermediate S. aureus (VISA) phenotype, yielding only three VISA isolates, for which vancomycin MICs were 4 g/ml compared to 8 and 19 VISA isolates detected by macrodilution and agar testing, respectively. While macrodilution and agar testing detected 7 and 22 isolates with elevated teicoplanin MICs (8 g/ml), respectively, broth microdilution failed to detect such isolates. Detection rates of isolates with elevated vancomycin and teicoplanin MICs by macrodilution and agar testing assays were higher at 48 h than at 24 h. In conclusion, the sensitivity of broth microdilution MIC testing is questionable for reliable detection and epidemiological surveys of glycopeptide-intermediate resistance in S. aureus isolates.
The Annals of thoracic surgery, Jan 27, 2016
Information on the long-term prognosis of patients with infective endocarditis (IE) and valve sur... more Information on the long-term prognosis of patients with infective endocarditis (IE) and valve surgical procedures is scarce, and most analyses are based on registries. This study described outcomes and predictors of mortality in a cohort of consecutive patients with IE with a long-term follow-up. A total of 616 of patients with IE seen in an academic institution between 1990 and 2012 were identified and followed. The mean follow-up period was 4.8 ± 5.7 years (median, 2.6 years). Cardiac surgical procedures were performed in 47% of the patients, among whom 77% had surgical procedures in the first 6 months. Six-month and long-term (≥6 month) mortality rates were 15% and 40%, respectively. Older age, male sex, infection in a mechanical valve, Staphylococcus aureus infection, presence of vegetation, stroke, and atrioventricular block were independent predictors of mortality, whereas Streptococcus infection was independently associated with a better prognosis. Valve surgical procedures w...
Data Revues 07554982 00340007 491, Jan 3, 2008
ABSTRACT
BMC Infectious Diseases, 2016
Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its m... more Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its management is not well known. We studied the relationship between antibiotic regimen use and the cure rate of those infections among 112 patients with neurogenic bladder. We studied a retrospective cohort of febrile UTI among patients with neurogenic bladder. Drug selection was left to the discretion of the treating physicians, in accordance with current guidelines. Patients were divided into 3 groups according to antibiotic treatment duration (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10 days, between 10 and 15 days, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15 days). We analysed clinical and microbiogical cure rate one month after the end of antibiotic treatment. The three groups of patients were similar, especially in terms of drug treatment (equal distribution). The cure rates were not significantly different (71.4 %, 54.2 %, and 57.1 %, respectively; p = 0.34). Moreover, there was no difference in cure rate between mono and dual therapy (44 % for monotherapy vs. 40 % for dual therapy; p = 0.71). This descriptive study supports the efficacy of antimicrobial treatment duration of less than 10 days and the use of monotherapy to treat febrile UTI among patients with neurogenic bladder. A randomized control trial is required to confirm these data.
La Revue Du Praticien, 2007
Médecine et Maladies Infectieuses, 2009
Archives of Cardiovascular Diseases Supplements, 2014
15 patients (age=57±15 years, 73% men) with either severe aortic valve disease (stenosis or regur... more 15 patients (age=57±15 years, 73% men) with either severe aortic valve disease (stenosis or regurgitation) or severe mitral regurgitation, but without coronary artery disease preoperatively underwent ECV measurement by CMR MOLLI T1 mapping. LV biopsies were performed at the time of surgery 7±8 days later and stained with Sirius red. The amount of fibrosis quantified by biopsy was 6.6±4. 8% [2.1;15.9]. ECV by T1 mapping was 28.3±4.7% [23.3;38.6] (values are presented as mean±SD [min;max]). There was a good correlation between histologically measured fibrosis and T1 mapping ECV (r=0.77, p<0.001, cfr figure).
Archives of Cardiovascular Diseases Supplements, 2015
The American journal of cardiology, 2017
There are very few data on the prognosis of possible versus definite infective endocarditis (IE).... more There are very few data on the prognosis of possible versus definite infective endocarditis (IE). We studied data from 365 consecutive patients with IE involving native heart valve seen in an academic institution from 1990 to 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 101, 28%) and those with definite IE (n = 264, 72%). Patients with possible IE were older than those with definite IE (66 ± 15 vs 62 ± 16, p = 0.05). A causative microorganism was identified in 66% of patients with possible IE versus all patients with definite IE (p <0.0001) and only 41% had major echocardiographic criteria (vs 100%; p <0.0001). Overall, 139 patients died over a mean ± SD follow-up of 3.9 ± 4.5 years (median 2.2, interquartile range 5.9 years). Patients with possible and definite IE had a similar risk of death. Independent predictors of long-term mortality were increasing age (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1...
Journal of the American College of Cardiology, 2014
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Jan 7, 2016
The Journal of Infection, Jul 1, 2010
In the treatment of prosthetic joint infections (PJI), the benefit of antibiotic therapy for more... more In the treatment of prosthetic joint infections (PJI), the benefit of antibiotic therapy for more than 6 weeks after surgery is uncertain. We compared PJI cure rates according to the duration of antibiotics, 6 versus 12 weeks. A prospective observational non-randomized study in Geneva University Hospitals 1996-2007. A total of 144 PJI (62 hip arthroplasties, 62 knee arthroplasties, and 20 hip hemiarthroplasties) were included with a prolonged follow-up ranging from 26 to 65 months. Surgical treatment included 60 débridements with implant retention, 10 one-stage exchanges of the prosthesis, 57 two-stage exchanges, and 17 Girdlestone procedures or knee arthrodeses. Seventy episodes (49%) received 6 weeks antibiotic therapy and 74 episodes, 12 weeks. Cure was achieved in 115 episodes (80%). Cure rate did not change according to the duration of intravenous antibiotics (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 days, 8-21 days, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;21 days) (Kruskal-Wallis-test; p = 0.37). In multivariate analysis, none of the following parameters was statistically significantly associated with cure: two-stage exchange (odds ratio 1.1,95%CI 0.2-4.8); number of débridements (0.9, 0.4-1.9); six weeks antibiotherapy (2.7, 0.96-8.3); duration of intravenous course (1.0, 0.96-1.03); sinus tract (0.6, 0.2-1.7); or MRSA infection (0.5, 0.2-1.5), although implant retention showed a tendency for less cure (0.3, 0.1-1.1). Following surgery for treatment of PJI, antibiotic therapy appears able to be limited to a 6-week course, with one week of intravenous administration. This approach needs confirmation in randomized trials.
La Presse Medicale, Apr 1, 2005
INTRODUCTION: Screening strategies among pregnant women have decreased the incidence of group B S... more INTRODUCTION: Screening strategies among pregnant women have decreased the incidence of group B Streptococcus, which causes severe neonatal infections. The incidence of these infections has increased among diabetic patients, however.OBJECTIVES: To specify the characteristics of diabetic foot infections in which surgical samples have isolated one or several germs including group B Streptococcus, study its risk factors and determine its course.MATERIALS AND METHODS: We retrospectively evaluated the records of all patients admitted to the University Hospital of Geneva from January 1999 through October 2004, with diagnoses of severe foot infection (+/- osteomyelitis) documented during surgery.RESULTS: Twenty-five severe diabetic foot infections were identified, 21 with osteomyelitis. The most common risk factors were age older than 60 years (n=10), chronic renal failure (n=7), severe arteriopathy (n=6), and immune depression (n=2). Most lesions were classified as grade 3 or 4 of Wagner's classification. 80% of the surgical samples were polymicrobial. Blood cultures were positive in 4 patients, one in septic shock. Half the patients (n=13) underwent amputation, despite initially appropriate antibiotic treatment. No patients died but 3 relapsed.CONCLUSION: Group B streptococcal foot infections often occur in fragile patients with immune depression or severe arterial disease. Despite intensive antibiotic therapy and adequate debridement, amputation is often required in diabetic patients because of severe damage to the tissue and poor vascularization.
Antimicrobial Agents and Chemotherapy, Dec 12, 2011
Reduced susceptibility to glycopeptides in methicillin-resistant Staphylococcus aureus (MRSA) cli... more Reduced susceptibility to glycopeptides in methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates is considered a risk factor for failure of glycopeptide therapy. We compared the prevalences of MRSA isolates with reduced glycopeptide susceptibility in patients with versus without persistent or recurrent MRSA bloodstream infections. A retrospective cohort study at the University Hospital of Geneva identified 27 patients with persistent or recurrent clonally related MRSA bacteremic episodes over an 8-year period, which included 208 consecutive nosocomial MRSA bacteremic episodes. Vancomycin and teicoplanin MICs were determined by a modified macrodilution assay allowing improved detection of glycopeptide-intermediate MRSA isolates (GISA), characterized by elevated teicoplanin or/and vancomycin MICs (>4 g/ml). For 16 patients (59%), their pretherapy and/or posttherapy MRSA isolates showed elevated teicoplanin MICs, among which 10 (37%) concomitantly displayed elevated vancomycin MICs. In contrast, 11 other patients (41%) were persistently or recurrently infected with non-GISA isolates. In comparison, only 39 (22%) of 181 single isolates from patients with no microbiological evidence of persistent or recurrent infections showed elevated teicoplanin MICs, among which 14 (8%) concomitantly displayed elevated vancomycin MICs. Clinical, microbiological, and pharmacokinetic variables for patients persistently or recurrently infected with GISA or non-GISA isolates were similar. Bacteremic patients with a poor response to glycopeptide therapy had a 2.8-fold-and 4.8-fold-higher rates of MRSA isolates displaying elevated teicoplanin and vancomycin MICs, respectively, than patients with single isolates (P < 0.0001). Detection of elevated teicoplanin MICs may help to predict a poor response to glycopeptide therapy in MRSA bacteremic patients.
La Presse Medicale, Jun 29, 2011
Neurogenic myositis ossificans or para-osteo-arthropathy are part of heterotopic ossifications. T... more Neurogenic myositis ossificans or para-osteo-arthropathy are part of heterotopic ossifications. They concern mostly spinal cord injured or cerebral injured patients. They mostly target the hip and can lead to local or general inflammatory signs which can mimic severe sepsis. We detail the frequent septic like symptomatology and the relevance of echography to make the diagnosis and to start adapted therapy. We conducted a retrospective study from seven patients hospitalized in infectious disease department for suspicion of septical myositis and we compared this cohort with available data. They all have inflammatory syndrome and radiological signs. Diagnosis can be made early by echography, MRI or tomodensitometry. X-ray signs are delayed. Myositis ossificans can have a septical presentation but therapy is, at first, medical with non steroid anti inflammatory drugs and no antibiotic therapy.
Antimicrobial Agents and Chemotherapy, Sep 1, 2010
Staphylococcus aureus. Modal vancomycin and teicoplanin MICs recorded by tube macrodilution and t... more Staphylococcus aureus. Modal vancomycin and teicoplanin MICs recorded by tube macrodilution and the agar plate assay, which both used inocula of 10 6 CFU, were significantly higher (2 g/ml) against a panel of borderline glycopeptide-susceptible and glycopeptide-intermediate methicillin-resistant S. aureus (MRSA) bloodstream isolates compared to broth microdilution (1 g/ml). Vancomycin and teicoplanin MIC distributions by tube macrodilution and agar testing were also markedly different from those evaluated by broth microdilution. The 20-fold-lower inoculum size used for broth microdilution compared to macrodilution and agar MIC assays explained in part, but not entirely, the systematic trend toward lower vancomycin and teicoplanin MICs by microdilution compared to other methods. Broth microdilution assay led to underdetection of the vancomycin-intermediate S. aureus (VISA) phenotype, yielding only three VISA isolates, for which vancomycin MICs were 4 g/ml compared to 8 and 19 VISA isolates detected by macrodilution and agar testing, respectively. While macrodilution and agar testing detected 7 and 22 isolates with elevated teicoplanin MICs (8 g/ml), respectively, broth microdilution failed to detect such isolates. Detection rates of isolates with elevated vancomycin and teicoplanin MICs by macrodilution and agar testing assays were higher at 48 h than at 24 h. In conclusion, the sensitivity of broth microdilution MIC testing is questionable for reliable detection and epidemiological surveys of glycopeptide-intermediate resistance in S. aureus isolates.
The Annals of thoracic surgery, Jan 27, 2016
Information on the long-term prognosis of patients with infective endocarditis (IE) and valve sur... more Information on the long-term prognosis of patients with infective endocarditis (IE) and valve surgical procedures is scarce, and most analyses are based on registries. This study described outcomes and predictors of mortality in a cohort of consecutive patients with IE with a long-term follow-up. A total of 616 of patients with IE seen in an academic institution between 1990 and 2012 were identified and followed. The mean follow-up period was 4.8 ± 5.7 years (median, 2.6 years). Cardiac surgical procedures were performed in 47% of the patients, among whom 77% had surgical procedures in the first 6 months. Six-month and long-term (≥6 month) mortality rates were 15% and 40%, respectively. Older age, male sex, infection in a mechanical valve, Staphylococcus aureus infection, presence of vegetation, stroke, and atrioventricular block were independent predictors of mortality, whereas Streptococcus infection was independently associated with a better prognosis. Valve surgical procedures w...
Data Revues 07554982 00340007 491, Jan 3, 2008
ABSTRACT
BMC Infectious Diseases, 2016
Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its m... more Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its management is not well known. We studied the relationship between antibiotic regimen use and the cure rate of those infections among 112 patients with neurogenic bladder. We studied a retrospective cohort of febrile UTI among patients with neurogenic bladder. Drug selection was left to the discretion of the treating physicians, in accordance with current guidelines. Patients were divided into 3 groups according to antibiotic treatment duration (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10 days, between 10 and 15 days, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15 days). We analysed clinical and microbiogical cure rate one month after the end of antibiotic treatment. The three groups of patients were similar, especially in terms of drug treatment (equal distribution). The cure rates were not significantly different (71.4 %, 54.2 %, and 57.1 %, respectively; p = 0.34). Moreover, there was no difference in cure rate between mono and dual therapy (44 % for monotherapy vs. 40 % for dual therapy; p = 0.71). This descriptive study supports the efficacy of antimicrobial treatment duration of less than 10 days and the use of monotherapy to treat febrile UTI among patients with neurogenic bladder. A randomized control trial is required to confirm these data.
La Revue Du Praticien, 2007
Médecine et Maladies Infectieuses, 2009