Publications by authors named "Christele Gras-Le-Guen"
Article Synopsis
- Sudden Unexpected Deaths in Infancy (SUDI) includes various causes of infant deaths in the first year of life, with risk factors like sleeping position and passive smoking, but the impact of environmental chemicals—specifically pesticides—remains unclear.
- A systematic review of 92 studies identified 17 relevant studies on the link between SUDI and pesticide exposure, showing mixed results, with some suggesting a connection between SIDS and parental occupational exposure.
- The overall evidence is inconclusive, highlighting the need for more rigorous and modern epidemiological research to better understand the potential association.
Objective: To study the impact of nonpharmaceutical interventions implemented during the COVID-19 pandemic on the monthly incidence of sudden unexpected death in infancy (SUDI) cases overall and those with a viral or bacterial identification.
Study Design: We conducted an interrupted time-series analysis using seasonally adjusted Poisson regression models from the French national prospective and multicenter SUDI registry, that included all SUDI cases below the age of 1 year who died from 2016 to 2021 in mainland France.
Results: Of 998 SUDI cases analyzed, 750 were recorded during the prepandemic period (January 2016 through March 2020) and 248 during the NPI period (April 2020 through December 2021).
Unlabelled: The French "OMIN registry" was established in 2015 to collect nationwide standardised data concerning biological, clinical, environmental and social characteristics of sudden unexpected death in infancy (SUDI) and unexpected death in children aged 1-2 years. A biobank has existed since July 2020 to store biological samples for each case. This article aimed to detail (1) a brief history and the objectives of the registry; (2) a description of the methodology used; (3) the first results of the registry, i.
View Article and Find Full Text PDFImpact of respiratory pathogens detection by a rapid multiplex polymerase chain reaction assay on the management of community-acquired pneumonia for children at the paediatric emergency department. A randomized controlled trial, the Optimization of Pneumonia Acute Care (OPTIPAC) study.
Clin Microbiol Infect
January 2025
Article Synopsis
- The study examines whether rapid multiplex PCR testing in the emergency department can enhance the treatment of community-acquired pneumonia (CAP) in children compared to standard care.
- Conducted in 11 French centers between 2016-2018, the study included 499 children, with some receiving the PCR test and others only standard care, and tracked the effectiveness of initial antibiotic treatments over 15 days.
- Results showed a significant improvement in antibiotic treatment appropriateness in the PCR group, particularly reducing unnecessary antibiotics for viral pneumonia, indicating better antimicrobial stewardship without adverse effects.
Medication errors are one of the causes of iatrogenic medication use in children. The POPI tool for detecting inappropriate drug prescriptions and prescription omissions in paediatrics was the first tool to be published in this field in 2014. Our aim was to update the POPI tool for French use based on current recommendations and practice.
View Article and Find Full Text PDFIntroduction: In light of the burden of traumatic brain injury (TBI) in children and the excessive number of unnecessary CT scans still being performed, new strategies are needed to limit their use while minimising the risk of delayed diagnosis of intracranial lesions (ICLs). Identifying children at higher risk of poor outcomes would enable them to be better monitored. The use of the blood-based brain biomarkers glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) could help clinicians in this decision.
View Article and Find Full Text PDFArticle Synopsis
- A study conducted in a French university hospital investigated the prevalence of SARS-CoV-2 in asymptomatic children who were routinely screened before surgery during the pandemic.
- The retrospective analysis included 816 test samples, revealing a low prevalence of 0.49% positivity, with half of the positive cases linked to close contacts with adults who were infected.
- The findings suggest that asymptomatic children had a low rate of SARS-CoV-2 infection during the initial phases of the pandemic in France.
Objective: To describe the level of inconsistency between pictures on baby diaper packaging and safe infant sleep recommendations (SISRs) in Europe.
Study Design: We attempted to identify all packaging of baby diapers sold in 11 European countries for infants weighing less than 5 kg through internet searches from July 2022 through February 2023. For each type of package, we extracted whether there was a picture depicting a baby, whether the baby was sleeping, and whether the picture of the sleeping baby was inconsistent with ≥1 of 3 SISRs: (i) nonsupine sleeping position, (ii) soft objects or loose bedding, or (iii) sharing a sleep surface with another person.
Article Synopsis
- * Data from a population-based study conducted in western France between 2009 and 2014 was used, involving 227 children who faced severe infections, with a median age of 2.1 years.
- * The results showed that while the median times to antibiotics were 7 hours for the patient interval and 3.3 hours for the medical interval, there was no significant link between the time to antibiotics and child mortality or severe outcomes.
Human rotaviruses attach to histo-blood group antigens glycans and null alleles of the , and genes seem to confer diminished risk of gastroenteritis. Yet, the true extent of this protection remains poorly quantified. Here, we conducted a prospective study to evaluate the risk of consulting at the hospital in non-vaccinated pediatric patients according to the ABO, FUT2 (secretor) and FUT3 (Lewis) polymorphisms, in Metropolitan France and French Guiana.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to evaluate the inadequate medical care received by young children before being diagnosed with severe physical abuse in western France, covering cases from 2016 to 2018.
- - Researchers reviewed medical records of 94 children under six years old, finding that a significant portion had serious injuries, with 37% experiencing suboptimal care—17% faced delayed diagnoses, while 22% had ineffective secondary prevention.
- - The findings highlight the prevalence of suboptimal care in severe child physical abuse cases and suggest areas for improvement to ensure better protection and treatment for vulnerable children.
Article Synopsis
- - The study aimed to evaluate a new clinical decision rule (CDR) for identifying febrile children under 5 years at low risk for invasive bacterial infection (IBI), with a focus on its effects on antibiotic usage.
- - Conducted in a French pediatric emergency department, the prospective study involved children with fever, leading to the development of the CDR based on factors like age, clinical signs, urinalysis, and procalcitonin levels.
- - Results showed that 65.3% of the 1061 children fell into low or intermediate risk categories with a 0% IBI rate in this group; the CDR had high sensitivity (100%) but lower specificity (73.9%), suggesting
Objective: To describe pre-COVID-19 pandemic current practices in virological investigations, including type, frequency of samplings, and documented viruses, in sudden unexpected death in infancy (SUDI) and to compare results according to the cause of death.
Study Design: Between May 2015 and December 2019, infants under 2 years of age included in the French SUDI registry were classified in one of 4 groups by causes of death according to the classification by Goldstein et al. : unexplained (SIDS), infectious, explained but noninfectious, and undetermined.
Article Synopsis
- Incomplete vaccination in young children in high-income countries, particularly in France, is a significant public health concern, with nearly 46.5% of analyzed two-year-olds being incompletely vaccinated.
- Determinants of incomplete vaccination include factors such as having older siblings, living in isolated areas, and parental attitudes towards health recommendations.
- Understanding these determinants can help develop targeted strategies to improve vaccination rates among children.
Background: Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability.
Methods And Findings: A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks.
Article Synopsis
- The study investigated the link between vaccination status and sudden unexpected death in infancy (SUDI) amid vaccine skepticism, using data from a multi-center case-control analysis in France.
- Researchers compared immunization status of 91 infants who died from SUDI with 182 matched controls, finding that 22% of SUDI cases were non-immunized versus 12% of controls.
- The study concluded that being non-immunized for several vaccines is associated with a higher risk of SUDI, highlighting the importance of addressing vaccine hesitancy for public health.
Article Synopsis
- - The study aimed to evaluate how maternal isolation during the post-birth period (especially during COVID-19 lockdown) affected postpartum depression (PPD) rates in 265 new mothers, finding that isolation led to higher PPD symptoms shortly after childbirth but not at later time points.
- - Results showed that during lockdown, 31% of mothers reported higher PPD symptoms on day 3 compared to 17.8% for those outside lockdown, with notable psychological impacts on partners, indicating that isolation may exacerbate emotional distress.
- - Factors that increased PPD risk included prior psychological abuse, stressful life events, and negative birth experiences, while having more than one child appeared to offer some protection against PPD symptoms.
Article Synopsis
- The study aims to assess the quality of initial care for community-onset severe bacterial infections (COSBIs) in children, targeting actions to reduce high morbidity and mortality rates associated with these infections.
- Conducted in western France between 2009 and 2014, the research included a cohort of children aged 1 month to 16 years who either died before being admitted to pediatric intensive care or were admitted with a COSBI.
- Key outcomes focused on evaluating 8 specific areas of care, finding that the quality of initial treatment varied significantly, with a portion of cases deemed certainly suboptimal, which can influence future care strategies.
Objective: Ogival palate (i.e., a narrow and high-arched palate) is usually described in obstructive breath disorder but has been found in infants unexpectedly deceased.
View Article and Find Full Text PDFArticle Synopsis
- Non-pharmaceutical interventions (NPIs) against COVID-19, implemented in March 2020, resulted in a significant reduction in hospitalized community-acquired pneumonia (hCAP) cases in children in France.
- A detailed analysis of 2,972 hCAP cases revealed a 63% drop in monthly cases after NPIs began, with a notable increase in the median age of affected children.
- The study also found that fewer children had high inflammatory markers and there was a trend towards a decrease in pleural effusion cases during the NPI period, suggesting changes in the pathogens causing hCAP.
Aim: To investigate the prevalence of infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses among children admitted to paediatric emergency departments (PEDs).
Methods: From April to July 2020, a prospective, multicentre cohort study was conducted in the PEDs of eight French university hospitals. Regardless of the reason for admission, a nasopharyngeal swab sample from each child was screened using reverse transcription polymerase chain reaction tests for SARS-CoV-2 and other respiratory viruses.
Objective: To compare different antibiotic prophylaxis administered after preterm premature rupture of membranes to determine whether any were associated with differences in obstetric and/or neonatal outcomes and/or neurodevelopmental outcomes at 2 years of corrected age.
Design: Prospective, nationwide, population-based EPIPAGE-2 cohort study of preterm infants.
Setting: France, 2011.