M. Lorrot - Academia.edu (original) (raw)
Papers by M. Lorrot
Perfectionnement en Pédiatrie
Additional file 1: Table S1. Number of all-causes hospitalizations and percentage of RSV associat... more Additional file 1: Table S1. Number of all-causes hospitalizations and percentage of RSV associated hospitalizations among all-causes hospitalizations by age group and type period (RSV season and year (July–June)), from 2010 to 2018 in France. Table S2. Summary of the characteristics of the hospitalizations for RSV infection for
BMC Infectious Diseases, 2021
Background Respiratory syncytial virus (RSV) is the main cause of infant and child hospitalizatio... more Background Respiratory syncytial virus (RSV) is the main cause of infant and child hospitalizations. The study objective is to estimate the RSV-associated hospitalizations and economic burden in young children in France to inform future preventive strategies. Methods We conducted a retrospective analysis of RSV-associated hospitalizations data from the French Hospital database (PMSI-MCO) which covers the entire French population. All children aged < 5 years hospitalized with RSV ICD-10 codes (J210, J219, J45, J121, J205, R062) from 2010 to 2018, were included. Descriptive analyses were conducted by RSV seasons (Oct to March), by respiratory years (July to June) and per age groups. Results On average 50,878 RSV-associated hospitalizations (range: 43,715 – 54,616) per season was reported in France, 69% among children < 1 year old. This represents 28% of all-cause hospitalizations that occurred among children < 1 year old, and less than 10% of all-cause hospitalizations in old...
Revue d'Épidémiologie et de Santé Publique, 2020
Introduction Chaque annee en France, 30 % des enfants âges de moins de deux ans sont infectes par... more Introduction Chaque annee en France, 30 % des enfants âges de moins de deux ans sont infectes par le virus respiratoire syncitial (VRS) a l’origine d’infections respiratoires severes. Ce virus est responsable de nombreuses hospitalisations chez le nourrisson et le jeune enfant. Cette etude vise a estimer le fardeau hospitalier associe au VRS chez l’enfant âge de moins de 5 ans en France. Methodes A partir du PMSI, les enfants âges de moins de 5 ans ayant un sejour hospitalier avec un diagnostic principal ou relie en lien avec le VRS (CIM-10 : J210/J219/J121/J205/J45/R062) ont ete analyses sur huit saisons hivernales (octobre a mars) de 2010/11 et 2017/18. Resultats Entre 2010/11 et 2017/18, l’incidence des hospitalisations pour VRS a augmente de 183 a 240 pour 100 000 personne-mois Discussion/Conclusion Les hospitalisations pour VRS ont augmente sur la periode d’etude et concernent principalement les enfants âges de moins de 2 ans. Un âge
The Journal of antimicrobial chemotherapy, Jan 8, 2016
Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) hav... more Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators inc...
Cellular Microbiology, 2000
Lysteriolysin O (LLO) induces a microtubule-dependent activation of mucin exocytosis in the human... more Lysteriolysin O (LLO) induces a microtubule-dependent activation of mucin exocytosis in the human mucin-secreting HT29-MTX. Cholesterol inhibits the LLO-induced mucin exocytosis, whereas the oxidized form of cholesterol had no inhibitory effect. LLO-induced mucin exocytosis inhibited by cholesterol can be restored by enzymatic treatment with cholesterol oxidase. Inhibition of cholesterol synthesis in HT29-MTX cells results in a decrease in the LLO-induced mucin exocytosis. Other lipids such as gangliosides are able to inhibit the LLO-induced mucin exocytosis, suggesting that the binding of the toxin occurs at a multiplicity of membrane-associated lipids acting as receptors. Incubation of the toxin with lipids such as cholesterol or gangliosides does not decrease binding of LLO to target membranes. The present work also provides evidence that the LLO-induced mucin exocytosis develops independently of the pore-forming activity of the toxin. Finally, we demonstrated that the toxin associates with detergent-insoluble glycolipid microdomains (DIGs) containing VIP/21 caveolin, allowing internalization of the toxin and subsequent activation of the mucin exocytosis.
Archives de Pédiatrie, 2014
Archives de Pédiatrie, 2014
Objectifs description de l’imagerie des OCMR. Materiel et methodes etude multicentrique (12 CHU),... more Objectifs description de l’imagerie des OCMR. Materiel et methodes etude multicentrique (12 CHU),178 patients (123 filles, 55 garcons), âge au diagnostic 10.9±2.9 ans. Patients avec lesions d’OCMR a l’IRM ou scintigraphie osseuse et radiographies, avant 18 ans inclus. Criteres d’exclusion : osteite septique, tumorale, arthrite juvenile idiopathique. Resultats un tiers (54/178) des patients presentait une atteinte clinique oseuse unifocale, 47% aux membres inferieurs. A l’imagerie,52% (28/54) etaient multifocales. Seulement 7% des patients gardaient au final une forme unifocale « vraie ».La radiographie osseuse a detecte 193 lesions. La scintigraphie; 372 lesions principalement au pelvis (n = 64), tibia, femur. L’IRM a detecte 515 lesions surtout au bassin (n = 100), tibia (n = 93) et vertebrales avec des lesions (98%) en hyposignal T1, hyperT2. Chez 15 patients ayant eu scintigraphie et IRM en meme temps,(+ / − 3 mois), l’IRM a detecte en moyenne 6,7±3,1 lesions contre 3,4±2,4 en scintigraphie, p =0.003. Conclusions il s’agit de la plus grande cohorte ayant permis une description detaille de l’imagerie des OCMR. L’IRM confirme sa sensibilite dans la detection d’un plus grand nombre de lesions notamment multifocales devant une atteinte clinique unifocale.
Médecine et Maladies Infectieuses, 2004
IFN-alpha detection is useful in some clinical circumstances, but its use has never been validate... more IFN-alpha detection is useful in some clinical circumstances, but its use has never been validated in young infants with viral infections.Objective. – The authors wanted to determine it there was any difference in the assessment of IFN-alpha production between infants under or over six months of age.Patients and method. – A series of 233 children with identified common viral infections
Arthritis & rheumatology (Hoboken, N.J.), 2015
To document more fully the characteristics of chronic recurrent multifocal osteomyelitis (CRMO) i... more To document more fully the characteristics of chronic recurrent multifocal osteomyelitis (CRMO) in pediatric patients, to collect data on the outcomes and management of the disease, and to define prognostic factors. One hundred seventy-eight patients were included (123 female patients and 55 male patients), with a mean ± SD age at diagnosis of 10.9 ± 2.9 years. Inclusion criteria were a diagnosis of CRMO, evidence of at least one lesion of osteitis confirmed by imaging, and development of the syndrome before age 18 years. Longitudinal clinical and imaging studies revealed that only 12 of 178 CRMO patients (7%) had unifocal lesions at the last medical visit. We were able to apply the clinical chronic nonbacterial osteomyelitis score to 110 of 178 patients (62%), which indicated that bone biopsy could have been avoided in 27 cases (25%). At the last medical visit, disease was in remission in only 73 of 171 patients (43%) (41% receiving therapy) after a mean ± SD of 47.9 ± 38.9 months;...
BMC pediatrics, Jan 16, 2014
Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration ... more Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration caused by acute gastroenteritis (AGE) is oral rehydration solution (ORS). In case of oral route failure, nasogastric tube enteral rehydration is as efficient as intra-venous rehydration and seems to lead to fewer adverse events. The primary objective was to describe rehydration strategies used in cases of AGE in pediatric emergency departments (PEDs) in Belgium, France, The Netherlands, and Switzerland. An electronic survey describing a scenario in which a toddler had moderate dehydration caused by AGE was sent to physicians working in pediatric emergency departments. Analytical data were analyzed with descriptive statistics and Kruskal -Wallis Rank test. We analyzed 68 responses, distributed as follows: Belgium N = 10, France N = 37, The Netherlands N = 7, and Switzerland N = 14. Oral rehydration with ORS was the first line of treatment for 90% of the respondents. In case of first line ...
![Research paper thumbnail of [Recommendations for the use of diagnostic testing in low respiratory infections in children older than three months]](https://attachments.academia-assets.com/115931437/thumbnails/1.jpg)
](Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2014
Recommendations for the use of diagnostic testing in low respiratory infection in children older ... more Recommendations for the use of diagnostic testing in low respiratory infection in children older than 3 months were produced by the Groupe de Recherche sur les Avancées en Pneumo-Pédiatrie (GRAPP) under the auspices of the French Paediatric Pulmonology and Allergology Society (SP(2)A). The Haute Autorité de santé (HAS) methodology, based on formalized consensus, was used. A first panel of experts analyzed the English and French literature to provide a second panel of experts with recommendations to validate. Only the recommendations are presented here, but the full text is available on the SP(2)A website.
Archives de Pédiatrie, 2014
Disponible sur Internet le 7 février 2014 Résumé En France, l'adoption internationale comprend en... more Disponible sur Internet le 7 février 2014 Résumé En France, l'adoption internationale comprend environ 90 000 enfants depuis 1980 et celle des enfants immigrés en 2008 représente plus de 300 000 personnes. Il s'agit d'une population très hétérogène (âge, origine géographique) et non négligeable. Il n'est donc pas toujours simple de faire un bilan vaccinal fiable et complet. La grande variété des situations individuelles rend difficile une décision et des modalités du rattrapage vaccinal homogènes. Cet article propose une mise au point pour la mise à jour des vaccinations de l'enfant arrivant de l'étranger (adopté, réfugié, ou migrant). Le bilan de vaccination d'un enfant nouvellement arrivé dans notre pays est complexe et doit être adapté au pays d'origine. Certains enfants n'ont jamais été vaccinés et d'autres ont un statut vaccinal incertain ou inconnu. L'âge de l'enfant, son pays d'origine et quelques sérologies vaccinales doivent guider la décision vaccinale initiale. La mise à jour vaccinale d'un enfant arrivant de l'étranger doit tenir compte des vaccinations supposées déjà reçues et des recommandations vaccinales françaises, qui vont servir de référence.
Archives de Pédiatrie, 2014
Les 2 germes majoritaires des infections cutanées de l'enfant sont Staphylococcus aureus et le st... more Les 2 germes majoritaires des infections cutanées de l'enfant sont Staphylococcus aureus et le streptocoque ß-hémolytique du groupe A. Les infections bénignes (furoncle et impétigo) se traitent de préférence par antibiothérapie locale (mupirocine ou acide fusidique). Les dermo-hypodermites nécessitent une antibiothérapie générale avec de l'amoxicilline-acide clavulanique par voie orale (80 mg/kg/j) dans les formes simples ou par voie intraveineuse (150 mg/kg/j en 3 injections par jour) dans les formes compliquées : facteurs de risque d'extension de l'infection, extension rapide ou sepsis. La clindamycine (40 mg/kg/j en 3 injections par jour) est ajoutée en cas de choc toxinique et dans les dermo-hypodermites et fasciites nécrosantes, dont la prise en charge est médico-chirurgicale.
Pediatric Rheumatology, 2011
The Journal of Immunology, 2007
We investigated an otherwise healthy patient presenting two episodes of staphylococcal cellulitis... more We investigated an otherwise healthy patient presenting two episodes of staphylococcal cellulitis and abscesses, accompanied by high fever and biological signs of inflammation but, paradoxically, with no detectable increase in serum levels of C-reactive protein (CRP), an IL-6-responsive protein synthesized in the liver. Following in vitro activation of whole blood cells from the patient with multiple cytokines, TLR agonists, heat-killed bacteria, and mitogens, we observed a profound and specific impairment of IL-6 secretion. However, the patient’s PBMCs, activated in the same conditions but in the absence of the patient’s plasma, secreted IL-6 normally. The patient’s serum contained high titers of IgG1 autoantibodies against IL-6, which specifically neutralized IL-6 production by control PBMCs as well as IL-6 responses in the human hepatocellular carcinoma cell line Hep3B. These anti-IL-6 autoantibodies were detected over a period of 4 years, in the absence of any other autoantibodi...
Journal of Clinical Microbiology, 2008
We used real-time PCR to examine the persistence of Bordetella pertussis DNA in serial nasopharyn... more We used real-time PCR to examine the persistence of Bordetella pertussis DNA in serial nasopharyngeal aspirates from 22 children treated for pertussis. After 5 days of treatment, PCR was positive for all 21 assessable patients. After 14 and 21 days, PCR was still positive for 83% (10/12) and 66% (4/6) of assessable patients, respectively. One patient was tested 1 month after treatment initiation, and B. pertussis DNA was still detectable. Quantitative analysis showed that the DNA concentration diminished during treatment in all except one case. The PCR cycle threshold at which B. pertussis DNA became detectable increased by a mean of 1.7 cycles per day (range, 0.86 to 3.68 cycles per day). Real-time PCR can thus be used to diagnose pertussis in young children for up to 3 weeks after treatment initiation. Its potential value for assessing the treatment outcome remains to be determined.
Perfectionnement en Pédiatrie
Additional file 1: Table S1. Number of all-causes hospitalizations and percentage of RSV associat... more Additional file 1: Table S1. Number of all-causes hospitalizations and percentage of RSV associated hospitalizations among all-causes hospitalizations by age group and type period (RSV season and year (July–June)), from 2010 to 2018 in France. Table S2. Summary of the characteristics of the hospitalizations for RSV infection for
BMC Infectious Diseases, 2021
Background Respiratory syncytial virus (RSV) is the main cause of infant and child hospitalizatio... more Background Respiratory syncytial virus (RSV) is the main cause of infant and child hospitalizations. The study objective is to estimate the RSV-associated hospitalizations and economic burden in young children in France to inform future preventive strategies. Methods We conducted a retrospective analysis of RSV-associated hospitalizations data from the French Hospital database (PMSI-MCO) which covers the entire French population. All children aged < 5 years hospitalized with RSV ICD-10 codes (J210, J219, J45, J121, J205, R062) from 2010 to 2018, were included. Descriptive analyses were conducted by RSV seasons (Oct to March), by respiratory years (July to June) and per age groups. Results On average 50,878 RSV-associated hospitalizations (range: 43,715 – 54,616) per season was reported in France, 69% among children < 1 year old. This represents 28% of all-cause hospitalizations that occurred among children < 1 year old, and less than 10% of all-cause hospitalizations in old...
Revue d'Épidémiologie et de Santé Publique, 2020
Introduction Chaque annee en France, 30 % des enfants âges de moins de deux ans sont infectes par... more Introduction Chaque annee en France, 30 % des enfants âges de moins de deux ans sont infectes par le virus respiratoire syncitial (VRS) a l’origine d’infections respiratoires severes. Ce virus est responsable de nombreuses hospitalisations chez le nourrisson et le jeune enfant. Cette etude vise a estimer le fardeau hospitalier associe au VRS chez l’enfant âge de moins de 5 ans en France. Methodes A partir du PMSI, les enfants âges de moins de 5 ans ayant un sejour hospitalier avec un diagnostic principal ou relie en lien avec le VRS (CIM-10 : J210/J219/J121/J205/J45/R062) ont ete analyses sur huit saisons hivernales (octobre a mars) de 2010/11 et 2017/18. Resultats Entre 2010/11 et 2017/18, l’incidence des hospitalisations pour VRS a augmente de 183 a 240 pour 100 000 personne-mois Discussion/Conclusion Les hospitalisations pour VRS ont augmente sur la periode d’etude et concernent principalement les enfants âges de moins de 2 ans. Un âge
The Journal of antimicrobial chemotherapy, Jan 8, 2016
Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) hav... more Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators inc...
Cellular Microbiology, 2000
Lysteriolysin O (LLO) induces a microtubule-dependent activation of mucin exocytosis in the human... more Lysteriolysin O (LLO) induces a microtubule-dependent activation of mucin exocytosis in the human mucin-secreting HT29-MTX. Cholesterol inhibits the LLO-induced mucin exocytosis, whereas the oxidized form of cholesterol had no inhibitory effect. LLO-induced mucin exocytosis inhibited by cholesterol can be restored by enzymatic treatment with cholesterol oxidase. Inhibition of cholesterol synthesis in HT29-MTX cells results in a decrease in the LLO-induced mucin exocytosis. Other lipids such as gangliosides are able to inhibit the LLO-induced mucin exocytosis, suggesting that the binding of the toxin occurs at a multiplicity of membrane-associated lipids acting as receptors. Incubation of the toxin with lipids such as cholesterol or gangliosides does not decrease binding of LLO to target membranes. The present work also provides evidence that the LLO-induced mucin exocytosis develops independently of the pore-forming activity of the toxin. Finally, we demonstrated that the toxin associates with detergent-insoluble glycolipid microdomains (DIGs) containing VIP/21 caveolin, allowing internalization of the toxin and subsequent activation of the mucin exocytosis.
Archives de Pédiatrie, 2014
Archives de Pédiatrie, 2014
Objectifs description de l’imagerie des OCMR. Materiel et methodes etude multicentrique (12 CHU),... more Objectifs description de l’imagerie des OCMR. Materiel et methodes etude multicentrique (12 CHU),178 patients (123 filles, 55 garcons), âge au diagnostic 10.9±2.9 ans. Patients avec lesions d’OCMR a l’IRM ou scintigraphie osseuse et radiographies, avant 18 ans inclus. Criteres d’exclusion : osteite septique, tumorale, arthrite juvenile idiopathique. Resultats un tiers (54/178) des patients presentait une atteinte clinique oseuse unifocale, 47% aux membres inferieurs. A l’imagerie,52% (28/54) etaient multifocales. Seulement 7% des patients gardaient au final une forme unifocale « vraie ».La radiographie osseuse a detecte 193 lesions. La scintigraphie; 372 lesions principalement au pelvis (n = 64), tibia, femur. L’IRM a detecte 515 lesions surtout au bassin (n = 100), tibia (n = 93) et vertebrales avec des lesions (98%) en hyposignal T1, hyperT2. Chez 15 patients ayant eu scintigraphie et IRM en meme temps,(+ / − 3 mois), l’IRM a detecte en moyenne 6,7±3,1 lesions contre 3,4±2,4 en scintigraphie, p =0.003. Conclusions il s’agit de la plus grande cohorte ayant permis une description detaille de l’imagerie des OCMR. L’IRM confirme sa sensibilite dans la detection d’un plus grand nombre de lesions notamment multifocales devant une atteinte clinique unifocale.
Médecine et Maladies Infectieuses, 2004
IFN-alpha detection is useful in some clinical circumstances, but its use has never been validate... more IFN-alpha detection is useful in some clinical circumstances, but its use has never been validated in young infants with viral infections.Objective. – The authors wanted to determine it there was any difference in the assessment of IFN-alpha production between infants under or over six months of age.Patients and method. – A series of 233 children with identified common viral infections
Arthritis & rheumatology (Hoboken, N.J.), 2015
To document more fully the characteristics of chronic recurrent multifocal osteomyelitis (CRMO) i... more To document more fully the characteristics of chronic recurrent multifocal osteomyelitis (CRMO) in pediatric patients, to collect data on the outcomes and management of the disease, and to define prognostic factors. One hundred seventy-eight patients were included (123 female patients and 55 male patients), with a mean ± SD age at diagnosis of 10.9 ± 2.9 years. Inclusion criteria were a diagnosis of CRMO, evidence of at least one lesion of osteitis confirmed by imaging, and development of the syndrome before age 18 years. Longitudinal clinical and imaging studies revealed that only 12 of 178 CRMO patients (7%) had unifocal lesions at the last medical visit. We were able to apply the clinical chronic nonbacterial osteomyelitis score to 110 of 178 patients (62%), which indicated that bone biopsy could have been avoided in 27 cases (25%). At the last medical visit, disease was in remission in only 73 of 171 patients (43%) (41% receiving therapy) after a mean ± SD of 47.9 ± 38.9 months;...
BMC pediatrics, Jan 16, 2014
Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration ... more Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration caused by acute gastroenteritis (AGE) is oral rehydration solution (ORS). In case of oral route failure, nasogastric tube enteral rehydration is as efficient as intra-venous rehydration and seems to lead to fewer adverse events. The primary objective was to describe rehydration strategies used in cases of AGE in pediatric emergency departments (PEDs) in Belgium, France, The Netherlands, and Switzerland. An electronic survey describing a scenario in which a toddler had moderate dehydration caused by AGE was sent to physicians working in pediatric emergency departments. Analytical data were analyzed with descriptive statistics and Kruskal -Wallis Rank test. We analyzed 68 responses, distributed as follows: Belgium N = 10, France N = 37, The Netherlands N = 7, and Switzerland N = 14. Oral rehydration with ORS was the first line of treatment for 90% of the respondents. In case of first line ...
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2014
Recommendations for the use of diagnostic testing in low respiratory infection in children older ... more Recommendations for the use of diagnostic testing in low respiratory infection in children older than 3 months were produced by the Groupe de Recherche sur les Avancées en Pneumo-Pédiatrie (GRAPP) under the auspices of the French Paediatric Pulmonology and Allergology Society (SP(2)A). The Haute Autorité de santé (HAS) methodology, based on formalized consensus, was used. A first panel of experts analyzed the English and French literature to provide a second panel of experts with recommendations to validate. Only the recommendations are presented here, but the full text is available on the SP(2)A website.
Archives de Pédiatrie, 2014
Disponible sur Internet le 7 février 2014 Résumé En France, l'adoption internationale comprend en... more Disponible sur Internet le 7 février 2014 Résumé En France, l'adoption internationale comprend environ 90 000 enfants depuis 1980 et celle des enfants immigrés en 2008 représente plus de 300 000 personnes. Il s'agit d'une population très hétérogène (âge, origine géographique) et non négligeable. Il n'est donc pas toujours simple de faire un bilan vaccinal fiable et complet. La grande variété des situations individuelles rend difficile une décision et des modalités du rattrapage vaccinal homogènes. Cet article propose une mise au point pour la mise à jour des vaccinations de l'enfant arrivant de l'étranger (adopté, réfugié, ou migrant). Le bilan de vaccination d'un enfant nouvellement arrivé dans notre pays est complexe et doit être adapté au pays d'origine. Certains enfants n'ont jamais été vaccinés et d'autres ont un statut vaccinal incertain ou inconnu. L'âge de l'enfant, son pays d'origine et quelques sérologies vaccinales doivent guider la décision vaccinale initiale. La mise à jour vaccinale d'un enfant arrivant de l'étranger doit tenir compte des vaccinations supposées déjà reçues et des recommandations vaccinales françaises, qui vont servir de référence.
Archives de Pédiatrie, 2014
Les 2 germes majoritaires des infections cutanées de l'enfant sont Staphylococcus aureus et le st... more Les 2 germes majoritaires des infections cutanées de l'enfant sont Staphylococcus aureus et le streptocoque ß-hémolytique du groupe A. Les infections bénignes (furoncle et impétigo) se traitent de préférence par antibiothérapie locale (mupirocine ou acide fusidique). Les dermo-hypodermites nécessitent une antibiothérapie générale avec de l'amoxicilline-acide clavulanique par voie orale (80 mg/kg/j) dans les formes simples ou par voie intraveineuse (150 mg/kg/j en 3 injections par jour) dans les formes compliquées : facteurs de risque d'extension de l'infection, extension rapide ou sepsis. La clindamycine (40 mg/kg/j en 3 injections par jour) est ajoutée en cas de choc toxinique et dans les dermo-hypodermites et fasciites nécrosantes, dont la prise en charge est médico-chirurgicale.
Pediatric Rheumatology, 2011
The Journal of Immunology, 2007
We investigated an otherwise healthy patient presenting two episodes of staphylococcal cellulitis... more We investigated an otherwise healthy patient presenting two episodes of staphylococcal cellulitis and abscesses, accompanied by high fever and biological signs of inflammation but, paradoxically, with no detectable increase in serum levels of C-reactive protein (CRP), an IL-6-responsive protein synthesized in the liver. Following in vitro activation of whole blood cells from the patient with multiple cytokines, TLR agonists, heat-killed bacteria, and mitogens, we observed a profound and specific impairment of IL-6 secretion. However, the patient’s PBMCs, activated in the same conditions but in the absence of the patient’s plasma, secreted IL-6 normally. The patient’s serum contained high titers of IgG1 autoantibodies against IL-6, which specifically neutralized IL-6 production by control PBMCs as well as IL-6 responses in the human hepatocellular carcinoma cell line Hep3B. These anti-IL-6 autoantibodies were detected over a period of 4 years, in the absence of any other autoantibodi...
Journal of Clinical Microbiology, 2008
We used real-time PCR to examine the persistence of Bordetella pertussis DNA in serial nasopharyn... more We used real-time PCR to examine the persistence of Bordetella pertussis DNA in serial nasopharyngeal aspirates from 22 children treated for pertussis. After 5 days of treatment, PCR was positive for all 21 assessable patients. After 14 and 21 days, PCR was still positive for 83% (10/12) and 66% (4/6) of assessable patients, respectively. One patient was tested 1 month after treatment initiation, and B. pertussis DNA was still detectable. Quantitative analysis showed that the DNA concentration diminished during treatment in all except one case. The PCR cycle threshold at which B. pertussis DNA became detectable increased by a mean of 1.7 cycles per day (range, 0.86 to 3.68 cycles per day). Real-time PCR can thus be used to diagnose pertussis in young children for up to 3 weeks after treatment initiation. Its potential value for assessing the treatment outcome remains to be determined.