Publications by authors named "Bruno Fantin"
The combination of aztreonam (ATM) and avibactam (AVI) is an attractive option to treat infections caused by extended spectrum β-lactamase plus NDM-1-producing . Since ATM activity was shown to be severely impacted by an increase in the inoculum size , we wondered whether ATM-AVI activity could be impaired in high-inoculum infections. We analyzed the impact of the inoculum size on ATM-AVI activity and in a murine model of peritonitis due to susceptible CFT073-pTOPO and its isogenic derivatives producing NDM-1 ( CFT073-NDM1) and CTX-M-15 plus NDM-1 ( CFT073-CTXM15-NDM1).
View Article and Find Full Text PDFIntroduction: Cefiderocol is a siderophore cephalosporin active in vitro against carbapenemase-producing Enterobacterales, including New Delhi metallo-β-lactamases (NDM-1). A significant impact of the size of bacterial inoculum on its efficacy has been described in vitro, the clinical impact of which is unclear. Here, we analyse the inoculum effect of cefiderocol against E.
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- Urinary tract infections (UTIs), primarily caused by E. coli, are common and often recur even after antibiotic treatments, posing a challenge for effective management.
- Researchers used a synthetic reporter to observe E. coli cell division in a UTI mouse model, finding that bacteria were more actively dividing in the kidneys and urine than in the bladder, while those surviving antibiotics were consistently non-dividing.
- The study highlights the importance of understanding how different bacterial strains and their environments affect infection persistence and treatment response, which could lead to better strategies for combating recurrent UTIs.
Article Synopsis
- Temocillin is a specific antibiotic effective against multi-drug resistant Enterobacterales, but its resistance mechanisms are not well understood, especially in Escherichia coli strains studied here.
- Researchers analyzed both susceptible and resistant E. coli strains, focusing on genetic mutations and their effects on temocillin effectiveness in lab tests and a mouse infection model.
- Results showed that while temocillin was generally effective against certain resistant strains, one strain (CFTbaeS-AP) proved completely resistant, indicating that high minimum inhibitory concentration (MIC) values don't always predict antibiotic effectiveness.
Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial.
Achim J Kaasch Luis Eduardo López-Cortés Jesús Rodríguez-Baño José Miguel Cisneros M Dolores Navarro Bruno Fantin
Lancet Infect Dis
May 2024
Article Synopsis
- This study investigates the effectiveness and safety of switching from intravenous to oral antibiotics after 5-7 days in patients with low-risk Staphylococcus aureus bloodstream infections.
- Conducted across 31 hospitals in Europe, the trial aimed to determine if early oral therapy could maintain patient safety and reduce complications compared to ongoing intravenous treatment.
- Due to slow participant recruitment, the trial was halted early with 215 participants, and the analysis was adjusted to ensure statistical validity, focusing on whether oral treatment led to acceptable complication rates compared with the traditional intravenous approach.
Article Synopsis
- Candida pyogenic liver abscesses (C-PLA) are rare in patients without blood disorders and often arise from biliary issues with a polymicrobial background.
- Patients with C-PLA tend to have significant underlying health problems, with over half presenting with sepsis requiring intensive care.
- The study indicates a higher risk of recurrence for C-PLA compared to bacterial liver abscesses, suggesting a need for more aggressive management strategies.
Advances in antibacterial treatment of adults with high-risk febrile neutropenia.
J Antimicrob Chemother
September 2023
Article Synopsis
- High-risk febrile neutropenia (HR-FN) is a serious complication for patients dealing with blood cancers or certain chemotherapy treatments that requires updated management strategies, as significant advances have occurred in the last decade.
- The study reviews literature from 2010 to 2023 focusing on antibiotic pharmacokinetics, initial dosing, and strategies for safely reducing or stopping antibiotics in HR-FN treatment.
- Findings suggest that optimizing antibiotic dosages and using strategic discontinuation can improve patient outcomes and should be considered for future guidelines on HR-FN management.
Article Synopsis
- * The new antimicrobial pseudopeptide Pep16 may enhance colistin's effectiveness and reduce resistance when combined, as shown in lab tests and mouse models.
- * In tests, Pep16 alone was ineffective, but when combined with colistin, it significantly lowered bacterial counts and prevented colistin resistance in a murine peritonitis model.
Enterococcal pyogenic liver abscesses: high risk of treatment failure and mortality.
Eur J Clin Microbiol Infect Dis
February 2023
Article Synopsis
- Enterococci are the most common gram-positive bacteria found in pyogenic liver abscesses (PLA), seen in 19% of cases studied from a French university hospital between 2010 and 2019.
- The study found that PLA involving Enterococcus spp. were more frequently linked to biliary causes and post-surgical infections compared to those without the bacteria.
- Additionally, the presence of Enterococcus spp. was associated with increased risks of 3-month mortality and primary treatment failure, especially in cases with portal vein thrombosis.
Clinical and microbiological characteristics of reflux cholangitis following bilio-enteric anastomosis.
Eur J Clin Microbiol Infect Dis
August 2022
Article Synopsis
- - The study focuses on 25 patients with reflux cholangitis (RC), a type of acute cholangitis (AC) occurring over three months post-bilioenteric surgery, and compares them to 116 patients with obstructive AC due to other causes.
- - Patients with RC experienced episodes a median of 4.5 months after surgery, with 72% having recurrent episodes, though these were generally less severe and treated effectively with short antibiotic courses.
- - Among the 25 patients, 80% had multiple recurrent RC episodes, with some benefiting from prophylactic antibiotics, and 2 out of 4 patients had successful outcomes from revision surgery for jejunal loop lengthening.
Article Synopsis
- Pyogenic liver abscess (PLA) is a serious illness that can lead to bad outcomes like treatment failure or death.
- A study looked at 302 patients with PLA to find out what factors might predict these bad outcomes.
- They discovered that certain conditions, like having other diseases or specific types of infections, made patients more likely to have trouble, but treating the abscess helped reduce the chance of dying.
Objectives: To analyze and compare the characteristics and outcomes of spontaneous meningitis (SM) versus postsurgical/traumatic meningitis (PSTM) due to Klebsiella pneumoniae.
Methods: A retrospective multicentric cohort study of all K. pneumoniae meningitis cases managed between January 2007 and May 2018 was carried out in seven university hospitals in the Paris area.
Article Synopsis
- There is a need for alternative treatments against NDM-1-producing E. coli, as existing antibiotics like colistin and fosfomycin often lead to resistant mutations when used alone.
- In experiments with modified E. coli strains, the combination of colistin and fosfomycin showed effective in vitro and reduced mortality and bacterial loads in an animal model, although fosfomycin-resistant mutants still emerged in some cases.
- Overall, while combining these two antibiotics is a promising option for treating NDM-1 E. coli infections, it does not completely prevent resistance in colistin-resistant strains.
Specificities of acute cholangitis in patients with cancer: a retrospective comparative study of 130 episodes.
Eur J Clin Microbiol Infect Dis
January 2022
Article Synopsis
- - Pancreatic and biliary duct cancers are leading causes of acute cholangitis (AC), prompting a study comparing cancer-associated cholangitis (CAC) in 81 patients to non-cancer-associated cholangitis (NCAC) in 49 patients.
- - While both groups showed similar clinical and biological features, CAC had higher rates of antibiotic resistance, more frequent need for multiple biliary drainages, and increased mortality at 28 days compared to NCAC.
- - The study suggests that cholangitis linked to pancreatic or biliary cancers requires tailored antibiotic treatment and that early biliary drainage could enhance patient outcomes.
Article Synopsis
- Rising antibiotic resistance highlights the need for alternatives to carbapenems for treating acute cholangitis (AC).
- A study of 140 AC episodes showed that temocillin is effective, with 26% of cases showing resistance compared to other antibiotics like PIP/TAZ and 3GC.
- Temocillin could help reduce the use of stronger antibiotics like carbapenems in certain cases, but it should not be used as a first-line treatment without prior microbiological testing.
Article Synopsis
- Fosfomycin resistance arises from either chromosomal mutations or plasmid-mediated genes, with some resistant isolates lacking these mechanisms.
- The study examined different groups of isolates, identifying specific mutations that significantly increase resistance levels, as well as analyzing gene expression changes.
- Overall, new mutations in certain genes were linked to fosfomycin resistance in clinical isolates, reinforcing the complexity of antibiotic resistance mechanisms.
Article Synopsis
- - The study aims to evaluate long-term symptoms and quality of life in COVID-19 patients over 100 days post-hospitalization.
- - A total of 120 patients were surveyed, revealing common ongoing issues like fatigue (55%), dyspnea (42%), and memory loss (34%), with no significant differences between those treated in regular wards versus ICUs.
- - The quality of life for both groups showed notable impairments, particularly in mobility and mental health, suggesting that many COVID-19 survivors experience lingering effects that warrant further research with larger sample sizes.
Article Synopsis
- The study aimed to identify predictive factors for unfavorable outcomes in COVID-19 patients hospitalized in Paris, focusing on factors leading to the need for artificial ventilation or death.
- Researchers analyzed data from 279 COVID-19 patients, finding 31.5% experienced unfavorable outcomes, with key risk factors including age, weight, respiratory rate, fever, and specific blood markers.
- A nomogram was developed to predict the probability of adverse outcomes within 14 days, providing a useful tool for early detection and improving clinical care for at-risk patients.
Article Synopsis
- The R-GNOSIS WP3 study was a landmark trial exploring the use of fecal microbiota transplantation (FMT) to eliminate harmful bacteria resistant to antibiotics in patients carrying ESBL-E or CPE.
- The study analyzed fecal samples from 16 patients undergoing treatment, highlighting shifts in gut microbiota biodiversity and the impact of antibiotics on bacterial resistance genes during the process of FMT.
- Results showed that while antibiotic treatment reduced bacterial diversity and increased resistance genes, FMT helped restore beneficial gut bacteria, potentially reducing the presence of harmful bacteria, although this wasn't statistically significant.
Article Synopsis
- Pyogenic liver abscesses (PLA) in liver transplant recipients (PLA-LTR) were studied to understand their unique characteristics compared to those in non-transplanted patients (PLA-C), revealing rare but significant distinctions.
- In a case-control study of 176 PLA patients, 14 were liver transplant recipients; most had positive cultures for bacteria like Enterobacteriaceae and Enterococcus, and a majority also experienced bacteremia.
- While key clinical and microbiological features were similar between PLA-LTR and PLA-C, PLA-LTR patients showed higher instances of ischemic cholangitis and a notable risk of recurrence and retransplantation within the first year after diagnosis.
Article Synopsis
- - The CURB-65 score is used to predict mortality in community-acquired pneumonia, but its relevance for COVID-19 patients' outpatient treatment decisions is uncertain.
- - A study analyzed 279 hospitalized COVID-19 patients, revealing that CURB-65 scores indicated varying levels of risk for poor outcomes, with 31.5% experiencing severe complications like mechanical ventilation or death.
- - Findings suggest that CURB-65 is not a reliable tool for determining which COVID-19 patients can be treated at home, as even those categorized as low risk still faced significant dangers.
Article Synopsis
- * It includes 78 patients, with HPVO surgery typically performed within 72 hours due to neurological deficits, while TVO surgeries occurred later, with better neurological outcomes.
- * The findings suggest that the different progression speeds of these infections influence the timing of surgery and recovery results, with HPVO needing quicker intervention than TVO.
Article Synopsis
- - Despite high Minimum Inhibitory Concentrations (MICs) for imipenem (IMP) and ertapenem (ERT) against carbapenemase-producing bacteria, these antibiotics significantly reduced bacterial counts and prevented mortality in mice with peritonitis.
- - Treatment with subinhibitory concentrations of ERT led to reduced growth rates and changes in bacterial morphology in resistant strains, indicating a potential alternative mechanism of action for these antibiotics.
- - Overall, the study highlights a paradoxical effectiveness of IMP and ERT against tough infections linked to carbapenemase-producing bacteria, suggesting that these drugs may still offer clinical benefits even when traditional susceptibility tests show high resistance.
Article Synopsis
- Gaucher disease (GD) is a rare genetic disorder linked to a deficiency in the enzyme glucocerebrosidase, which can lead to immunoglobulin abnormalities like polyclonal and monoclonal gammopathy in patients.
- A study examined 278 GD patients over an average of 19 years, finding that nearly half exhibited polyclonal gammopathy and about a third showed monoclonal gammopathy, with age at diagnosis being a significant risk factor for developing monoclonal gammopathy.
- The research concluded that while immunoglobulin abnormalities occur commonly in GD, they are not linked to the severity of the disease, but ongoing monitoring is essential due to the potential risk of hematologic cancers developing in these patients.