Publications by authors named "Claire Hobson"

Article Synopsis
  • Overuse of antibiotics in nursing homes often leads to negative outcomes and the rise of resistant bacteria, prompting the need for better antimicrobial stewardship interventions.
  • This study conducted interviews with prescribing physicians in nursing homes in France to determine factors influencing antibiotic prescribing, resources used, and necessary interventions.
  • Key findings revealed that perceived risks, difficulties in obtaining microbiological samples, and staff shortages contribute to inappropriate prescribing practices, while tailored guidelines and enhanced multidisciplinary communication could improve antibiotic use.
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Background: The 2023 Duke-ISCVID and 2023 ESC classifications have recently issued independent diagnostic criteria for infective endocarditis (IE), updating the 2015 ESC criteria.

Objectives: The specificity of the 2023 ESC criteria should be evaluated and compared to the two other classifications in IE suspected patients.

Methods: We retrospectively collected the characteristics of patients hospitalised in Bichat University Hospital, in 2021, who had been evaluated for suspicion of IE, and in whom IE diagnosis was finally rejected.

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Article Synopsis
  • The study focuses on endocarditis caused by a specific micro-organism, highlighting its high relapse rate and serious implications for patient management.
  • A retrospective analysis was conducted on 54 hospitalized patients, mostly men aged around 75, revealing that a significant portion had previous histories of endocarditis or heart surgery, with the aortic valve being the most affected.
  • Results indicate that although many patients required surgery, only half underwent the procedure, and 29% needed suppressive antibiotic therapy, with a 6% relapse rate observed over the study period.
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Background: The 2023 Duke-ISCVID (International Society of Cardiovascular Infectious Diseases) classification is a new diagnostic tool for infective endocarditis, updating the 2000 modified Duke and the 2015 European Society for Cardiology (ESC) classifications. In comparison, its sensitivity is higher; however, its specificity remains to be evaluated and compared to that of the 2 other classifications in endocarditis suspected patients.

Methods: We retrospectively collected the characteristics of patients hospitalized in Bichat University's Hospital, Paris, in 2021, who had been evaluated for clinical suspicion of endocarditis, have had at least a transthoracic echocardiography, 2 pairs of blood cultures, 3-month follow-up and in whom endocarditis diagnosis was finally rejected.

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First variants of the Klebsiella pneumoniae carbapenemase (KPC), KPC-2 and KPC-3, have encountered a worldwide success, particularly in K. pneumoniae isolates. These beta-lactamases conferred resistance to most beta-lactams including carbapenems but remained susceptible to new beta-lactam/beta-lactamase inhibitors, such as ceftazidime-avibactam.

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Objectives: New antibiotics have been developed to treat multidrug-resistant Enterobacterales. We evaluated the impact of the inoculum size on minimal inhibitory concentrations (MICs) of recently commercialized antibiotics.

Methods: We focused on 40 clinical carbapenemase-producing Enterobacterales and evaluated the impact of the inoculum size on the MICs to cefiderocol and to new β-lactams/β-lactamase inhibitors (ceftolozane-tazobactam, ceftazidime-avibactam, imipenem-relebactam, and meropenem-vaborbactam) at usual and high inocula (10 and 10 CFU/mL, respectively).

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Background: Anticancer drug efficacy is linked to the gut microbiota's composition, and there is a dire need to better understand these interactions for personalized medicine. microbiota models are promising tools for studies requiring controlled and repeatable conditions. We evaluated the impact of two anticancer drugs on human feces in the MiniBioReactor Array (MBRA) microbiota system.

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Due to their rapid evolution and their impact on healthcare, beta-lactamases, protein degrading beta-lactam antibiotics, are used as generic models of protein evolution. Therefore, we investigated the mutation effects in two distant beta-lactamases, TEM-1 and CTX-M-15. Interestingly, we found a site with a complex pattern of genetic interactions.

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Cancer being an increasing burden on human health, the use of anticancer drugs has risen over the last decades. The physiological effects of these drugs are not only perceived by the host's cells but also by the microbial cells it harbors as commensals, notably the gut microbiota. Since the early '50 s, the cytotoxicity of anticancer chemotherapy was evaluated on bacteria revealing some antimicrobial activities that result in an established perturbation of the gut microbiota.

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Objectives: Multiplex gastrointestinal PCR (GI-PCR) allows fast and simultaneous detection of 22 enteric pathogens (including , /enteroinvasive , among other bacteria, parasites and viruses). However, its impact on the management of children with infectious diarrhoea remains unknown.

Patients/design: All children eligible for stool culture from May to October 2018 were prospectively included in a monocentric study at Robert-Debré University-Hospital.

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We described and characterized Shiga-toxin-producing Escherichia coli (STEC) strains with high levels of resistance to azithromycin isolated in France between 2004 and 2020. Nine of 1,715 (0.52%) STEC strains were resistant to azithromycin, with an increase since 2017.

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Article Synopsis
  • The study investigates how multi-drug resistant Enterobacterales affect the effectiveness of oral antibiotics for treating febrile urinary tract infections (FUTIs) in children, focusing on β-lactamase profiles and genotypes.
  • A total of 251 ESBL-producing Enterobacterales isolates were analyzed for their susceptibility to various antibiotics, revealing that all were resistant to cefixime and cefpodoxime but that the combination of cefixime with amoxicillin/clavulanate restored susceptibility in most cases.
  • The findings suggest that cefixime combined with amoxicillin/clavulanate is an effective treatment option, with no failures reported, and mecillinam combined with amoxicillin/clavulanate is recommended as an
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Objectives: Ceftazidime-avibactam (CZA) and cefiderocol are recently commercialized molecules active against highly drug-resistant bacteria, including carbapenem-resistant members of the Enterobacteriaceae. Mutants resistant to CZA have been described, notably in Klebsiella pneumoniae carbapenemase (KPC) producers. Considering the structural similarities between ceftazidime and cefiderocol, we hypothesized that resistance to CZA in KPC-producing members of the Enterobacterales may lead to cross-resistance to cefiderocol.

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To explore the mutational possibilities of insertions and deletions (indels) in the carbapenemase (KPC) beta-lactamase, we selected for ceftazidime-avibactam-resistant mutants. Of 96 screened mutants, we obtained 19 indels (2 to 15 amino acids), all located in the loops surrounding the active site. Three antibiotic susceptibility phenotypes emerged: an extended-spectrum-beta-lactamase-like phenotype, an activity restricted to ceftazidime, and a carbapenem-susceptible KPC-like phenotype.

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Introduction: Rapid detection of extended-spectrum β-lactamases is essential. In this study, we evaluated the potential impact of β-lacta test on both the times to appropriate antibiotic therapy and to the implementation of patient isolation measures.

Patients And Methods: We included prospectively all the patients admitted to the emergency department for clinical suspicion of urinary tract infection.

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Primary fungal infection of the central nervous system (CNS) is rare but often associated with severe prognosis. Diagnosis is complicated since cerebrospinal fluid (CSF) samples obtained from lumbar puncture usually remain sterile. Testing for fungal antigens in CSF could be a complementary diagnostic tool.

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Through their action on DNA replication, anticancer chemotherapies could increase the basal mutation rate in bacteria and increase the risk of selecting antibiotic resistant mutants. We investigated the impact of several drugs on a beta-lactamase model using KPC-type carbapenemase-producing Enterobacteriaceae. We studied the impact of anticancer chemotherapies used in pediatric hematologic malignancies on 7 clinical isolates of Enterobacteriaceae producing KPC-type carbapenemases.

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Objectives: Although nontyphoidal infections have a prevalence of 0.2-1.8%.

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The rapid detection of carbapenemase allows implementation of infection control measures and adaptation of antibiotic therapy. We evaluated the performances of the Xpert Carba-R V2 assay for the direct detection and identification of carbapenemase on positive blood cultures. We focused our evaluation on its detection capacity and on the risks of interference due to the patient's blood.

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Article Synopsis
  • The study investigates the genetic diversity of antibiotic-resistant Escherichia coli (ESBL-E) causing urinary infections in children in France from 2014 to 2017.
  • The research identifies a total of 1983 samples, with E. coli and Klebsiella pneumoniae being the main pathogens, focusing on specific strains (STs) like ST131, ST38, and ST1193 that show rising trends.
  • Findings highlight the dominance of the CTX-M type ESBL gene, particularly blaCTX-M-15, necessitating ongoing surveillance due to their potential health risks.
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Article Synopsis
  • * A study identified 35 ESBL-producing ST131 isolates among nearly 1,900 French children over five years, with a significant number linked to a specific resistant cluster (C1-M27).
  • * Independent risk factors for carrying the CTX-M-27 strain included being hospitalized since birth and attending daycare, highlighting several resistance mechanisms that may contribute to the spread of these isolates.
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The dissemination of carbapenemase-producing (CPE) is a major threat to public health. Rapid and accurate detection of CPE is essential for initiating appropriate antimicrobial treatment and establishing infection control measures. The carbapenem inactivation method (CIM), which has good sensitivity and specificity but a detection time of 20 h, was recently described.

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