Publications by authors named "Anne Conrad"

Article Synopsis
  • The study investigates the pharmacokinetics (PK) of fluconazole in critically ill patients to identify optimal dosing regimens due to reported variability in drug response.
  • A retrospective analysis included 36 critically ill and 16 non-critically ill patients, revealing that standard dosing often results in inadequate drug levels, particularly against certain pathogens.
  • Findings suggest that higher loading doses are essential for meeting pharmacodynamic (PD) targets, particularly against stronger fungal infections, indicating a need for reconsideration of fluconazole use in severe cases.*
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Importance: There is still considerable controversy in the literature regarding the capacity of intramuscular messenger RNA (mRNA) vaccination to induce a mucosal immune response.

Objective: To compare serum and salivary IgG and IgA levels among mRNA-vaccinated individuals with or without previous SARS-CoV-2 infection.

Design, Setting, And Participants: In this cohort study, SARS-CoV-2-naive participants and those with previous infection were consecutively included in the CoviCompare P and CoviCompare M mRNA vaccination trials and followed up to day 180 after vaccination with either the BNT162b2 (Pfizer-BioNTech) vaccine or the mRNA-1273 (Moderna) vaccine at the beginning of the COVID-19 vaccination campaign (from February 19 to June 8, 2021) in France.

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  • The study analyzed the diagnosis, treatment, and outcomes of osteomyelitis related to bone flaps after cranioplasty in 144 patients from 2008 to 2021.
  • The majority of patients showed wound issues, with common pathogens identified as Staphylococcus aureus and Cutibacterium acnes; surgeries were performed in nearly all cases.
  • Findings indicated a significant treatment failure rate of 26.1%, with factors like the initial surgery for brain tumors and specific surgical techniques affecting outcomes, suggesting a need for specialized, long-term care in dedicated centers.
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Among carbapenem-resistant , metallo-beta-lactamase producing strains represent a growing therapeutic challenge. While the association of aztreonam and ceftazidime-avibactam has been investigated in recent years for the treatment of infections involving these strains, little to no clinical data support the use of this association for the treatment of bone and joint infections. We report two cases of complex bone and joint infections involving metallo-beta-lactamase-producing , successfully treated at our referral center with aztreonam and ceftazidime-avibactam for 12 weeks in continuous infusions through elastomeric infusors.

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During immune reconstitution following allogeneic haematopoietic stem cell transplantation (allo-HSCT), (re)vaccination of allo-HSCT recipients is recommended. Herein, we propose an update of practical recommendations regarding vaccination of allo-HSCT recipients. These recommendations, based on data from the literature, national and international guidelines and the consensus of the participants when no formally proven data are available, were elaborated during the workshop of practice harmonization organized by the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) in Lille in September 2022.

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Purpose Of Review: This review provides an update on specificities of influenza in older adults (≥65-year-old), including epidemiology, burden in terms of hospitalization and mortality, extra-respiratory complications and specific challenges of prevention.

Recent Findings: In the past 2 years, influenza activity was drastically reduced by barrier measures implemented during the COVID-19 pandemic. A recent French epidemiological study covering 2010-2018 epidemic seasons estimated that 75% of costs induced by influenza-associated hospitalizations and complications were attributable to older adults, a population bearing more than 90% of influenza-associated excess mortality.

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Background: Pulmonary mucormycosis (PM) is a life-threatening invasive mold infection. Diagnosis of mucormycosis is challenging and often delayed, resulting in higher mortality.

Research Question: Are the disease presentation of PM and contribution of diagnosis tools influenced by the patient's underlying condition?

Study Design And Methods: All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed.

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Article Synopsis
  • The Modified vaccinia virus Ankara (MVA-BN) vaccine is recommended for individuals who have been exposed to mpox within 14 days, but its effectiveness remains uncertain.
  • In a study of 108 adults who received the vaccine after exposure, 10% experienced breakthrough mpox infections.
  • Sexual contact was identified as a significant risk factor for these breakthrough cases, and vaccinated individuals had similar rates of infectious virus presence compared to unvaccinated cases.
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Immune response induced by COVID-19 vaccine booster against delta and omicron variants was assessed in 65 adults (65-84 years old) early aftesr a first booster dose. An increase in SARS-CoV-2 neutralizing antibodies was shown in individuals not previously infected without evidence of an age-related effect, with lower increase in those infected before a single dose of primary vaccination. Of note, humoral response was observed only starting from the 5th day after the boost.

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Immune reconstitution after allogeneic-hematopoietic-stem-cell transplantation (allo-HSCT) is a complex and individual process. In this cross-sectional study, whole-blood (WB) immune functional assay (IFA) was used to characterize immune function by assessing immune-related gene/pathway alterations. The usefulness of this tool in the context of infection, 6 months after transplantation, was evaluated.

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Herpes zoster, which is due to the reactivation of Varicella zoster virus (VZV), is a leading cause of morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). While cell-mediated immunity (CMI) is critical to inhibiting VZV reactivation, CMI is not routinely assessed due to a lack of reliable tests. In this study, we aimed to evaluate VZV-specific CMI among allo-HSCT recipients (n = 60) and healthy individuals (HI, n = 17) through a panel of three immune functional assays after stimulation by VZV antigen: quantification of (i) IFN-γ release in the supernatants, (ii) T-cell proliferation after a 7-day stimulation of peripheral blood mononuclear cells (PBMC), and (iii) measurement of the - mRNA gene expression level after 24 h of stimulation of a whole-blood sample.

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Objectives: Nocardiosis is a rare opportunistic infection that is frequently associated with dissemination (i.e. involvement of several body sites).

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Background: Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii, a strictly intracellular pathogen that can cause acute and chronic infection. Chronic Q fever can occur in immunocompetent as well as in immuno-compromised hosts, as a persistent localized infection. The main localizations are endocardial, vascular and, less frequently, osteoarticular.

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Daptomycin is a candidate for therapeutic drug monitoring (TDM). The objectives of this work were to implement and compare two pharmacometric tools for daptomycin TDM and precision dosing. A nonparametric population PK model developed from patients with bone and joint infection was implemented into the BestDose software.

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It has been suggested that cancer patients are at higher risk of contracting COVID-19 and at higher risk of developing a severe form of the disease and fatality. This study's objectives were to measure the excess risk of mortality and morbidity of patients with cancer among patients hospitalized for a SARS-CoV-2 infection, and to identify factors associated with the risk of death and morbidity among cancer patients. All first cancer patients hospitalized for COVID-19 in the two main hospitals of the Lyon area were included.

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A prospective cohort study was conducted to evaluate long-term safety of tedizolid as suppressive antimicrobial treatment in patients with implant-associated bone and joint infection caused by multidrug-resistant gram-positive pathogens. Seventeen patients received tedizolid with a median duration of treatment of 6 months. No patients developed a serious adverse event.

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Suppressive parenteral antibiotic therapy with beta-lactams may be necessary in patients with Gram-negative bone and joint infection (BJI). Subcutaneous drug administration can facilitate this therapy in outpatient setting, but there is limited information about this practice. We have developed an original approach for drug dosing in this context, based on therapeutic drug monitoring (TDM) and pharmacokinetic/pharmacodynamic (PK/PD) principles.

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A patient presenting with severe malaria, with hyperparasitaemia, received 7-day artesunate monotherapy. A severe recrudescence was detected and attributed to hyperparasitaemia, monotherapy and a polyclonal infection without Kelch 13 gene mutation. A second treatment with artesunate, then quinine, followed by artemether-lumefantrine, was successful.

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Corynebacteria represent often-neglected etiological agents of post-traumatic and/or post-operative bone and joint infection (BJI). We describe here clinical characteristics and bacteriological determinants of this condition. A retrospective cohort study described characteristics, outcome and determinants of treatment failure of all patients with proven spp.

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Article Synopsis
  • Daptomycin is commonly used for treating bone and joint infections, but its pharmacokinetics and optimal dosage haven't been well-explored, particularly when taken with rifampicin.* -
  • The study analyzed data from 183 patients to determine how factors like sex and renal function affect daptomycin clearance and distribution, finding that women typically clear the drug 26% slower than men.* -
  • Recommended dosages are 8 mg/kg/24 h for women and 10 mg/kg/24 h for men, but due to potential high trough levels, therapeutic drug monitoring is essential for safe and effective treatment.*
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implant-associated bone and joint infections (BJI) is considered to be one of the most difficult to treat BJI. The data focusing specifically on this pathogen are sparse, and it seems difficult to extrapolate the results obtained with . We performed a retrospective observation study of all implant-associated BJI diagnosed at our institution from 2011 to 2018.

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Torque teno virus (TTV) has been proposed as a surrogate biomarker of T-cell function in allogeneic-haematopoietic-stem-cell transplantation (allo-HSCT). Conflicting data exists regarding the value of TTV to assess the degree of immunosuppression. The aim of the present study was to investigate the correlation between TTV viral load and immune function.

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  • The study investigates the safety and effectiveness of TNF-α blockers, specifically infliximab, in treating inflammatory complications in patients with chronic granulomatous disease (CGD).
  • Conducted at Necker-Enfants Malades Hospital, the research involved 14 CGD patients, primarily with gastrointestinal and pulmonary issues, treated from 2006 to 2019.
  • Results showed a positive response to treatment in most patients, but half experienced infections, though all had favorable outcomes, highlighting the need for careful management of infection risks while using anti-TNF-α therapy.
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Histopathological definition of bone and joint infection (BJI) is based on Mirra's criterion (≥ 5 polymorphonuclears (PMNs) per field in 5 high power fields (HPFs)). However, this definition does not seem appropriate for chronic BJIs caused by slow-growing germs such as (). The aim of this study was to confirm that Mirra's criterion is not adequate for diagnosis of BJIs due to .

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For 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.

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