Publications by authors named "Yvon Ruch"

Article Synopsis
  • - The case involves a patient from Guinea-Conakry who was diagnosed with a pulmonary infection caused by Schistosoma mansoni, a type of parasitic worm.
  • - Key indicators for diagnosis included high eosinophil counts in the blood, positive tests for antibodies, and the presence of multiple nodules in the lungs, despite negative stool and urine tests for the parasite.
  • - Ultimately, the diagnosis was confirmed using a specific serum PCR test, which detects the genetic material of the parasite.
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Article Synopsis
  • * This study analyzed cases of C bantiana infections in France and its territories, involving patients who were diagnosed through a comprehensive surveillance program, focusing on survival rates and the presence of central nervous system (CNS) involvement.
  • * Out of 23 patients identified from 2002 to 2022, 65% had CNS involvement, with a notable increase in cases reported in 2022, indicating a possible correlation with environmental factors like rising temperatures.
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Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE.

Methods: The study included adult patients with definite endocarditis. Data were collected via the Infectious Diseases International Research Initiative (ID-IRI).

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  • This study analyzed 151 cases of mediastinitis at Strasbourg University Hospital, focusing on patient demographics, infection sources, and treatment outcomes over a decade.
  • Cases included poststernotomy mediastinitis (PSM), mediastinitis from esophageal perforation (MEP), and descending necrotizing mediastinitis (DNM), with distinct microbial profiles noted: PSM was mostly caused by staphylococci, while MEP and DNM showed a mix of organisms from digestive or oral sources.
  • The findings indicated a median anti-infective treatment duration of 41 days and a 1-year survival rate of 64.8%, highlighting the importance of understanding infection origins for better management strategies.
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Background: In geriatrics, explicit criteria for potentially inappropriate prescriptions (PIPs) are useful for optimizing drug use.

Objective: To produce an expert consensus on explicit definitions of antibiotic-PIPs for hospitalized older patients.

Methods: We conducted a Delphi survey involving French experts on antibiotic stewardship in hospital settings.

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Background: Throughout HIV infection, productively infected cells generate billions of viral particles and are thus responsible for body-wide HIV dissemination, but their phenotype during AIDS is unknown. As AIDS is associated with immunological changes, analyzing the phenotype of productively infected cells can help understand HIV production during this terminal stage.

Methods: Blood samples from 15 untreated viremic participants (recent infection, n=5; long-term infection, n=5; active opportunistic AIDS-defining disease, n=5) and 5 participants virologically controlled on antiretroviral therapy (ART) enrolled in the Analysis of the Persistence, Reservoir and HIV Latency (APRIL) study (NCT05752318) were analyzed.

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Dolutegravir/lamivudine (DTG/3TC) has a high genetic barrier against the development of human immunodeficiency virus drug resistance. We report 2 cases of R263K + M184V mutations during DTG/3TC failure followed by viral suppression after adherence intervention without treatment change that we attribute to residual drug activity, reduced viral fitness, and robust immune competence.

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We report a rare case of aorto-bi-iliac prosthetic allograft mucormycosis in a 57-year-old immunocompetent patient in France. Outcome was favorable after surgery and dual antifungal therapy with liposomal amphotericin B and isavuconazole. In a literature review, we identified 12 other cases of prosthetic vascular or heart valve mucormycosis; mortality rate was 38%.

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Chest radiography remains the most frequently used examination in emergency departments (ED) for the diagnosis of community-acquired pneumonia (CAP), despite its poor diagnostic accuracy compared with ultra-low-dose (ULD) chest computed tomography (CT). However, although ULD CT appears to be an attractive alternative to radiography, its organizational impact in ED remains unknown. Our objective was to compare the relevant timepoints in ED management of CT and chest radiography.

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Objectives: AmpC β-lactamase-hyperproducing Enterobacterales (ABLHE) bloodstream infections (BSI) are emerging and leading to therapeutic challenges worldwide. Prescriptions of carbapenems may lead to the emergence of resistance. This study aimed to compare cefepime with carbapenems for the treatment of third-generation cephalosporin-resistant ABLHE BSI.

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Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality.

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High-dose amoxicillin and cloxacillin combination therapy is recommended for the empiric treatment of selected patients with infective endocarditis despite a low level of evidence. The main objective of this study was to evaluate the renal tolerance of high-dose intravenous amoxicillin and cloxacillin combination. We studied 27 patients treated with amoxicillin and cloxacillin (≥100 mg/kg daily) for at least 48 h.

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Rare fungal pathogens are emerging as agents of invasive fungal infections. We analyzed 13 cases of fungal infections caused by Kazachstania (Arxiozyma) spp. in Strasbourg University Hospital, Strasbourg, France.

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Background: In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats.

Method: VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income.

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Article Synopsis
  • The study explores the unknown factors driving severe COVID-19 by examining a young patient cohort without major comorbidities, comparing critical and non-critical cases.
  • Researchers used advanced techniques like whole-genome sequencing and artificial intelligence to analyze biological samples and found significant inflammatory responses and immune system alterations in critical patients.
  • A specific gene signature was identified that distinguished critical cases and indicated that inhibiting the ADAM9 gene could reduce SARS-CoV-2 infection and replication, suggesting potential therapeutic options.
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Objective: Correct and timely identification of SARS-CoV-2-positive patients is critical in the emergency department (ED) prior to admission to medical wards. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis of COVID-19 but have lower sensitivity.

Methods: We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly.

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Article Synopsis
  • This study focused on patients with COVID-19 who also developed pneumonia caused by Pneumocystis pneumonia (PCP), highlighting the complexity of diagnosing PCP due to overlapping symptoms. * Out of 57 COVID-19 patients tested, only four were found to have a positive PCR for PCP; these patients were mostly elderly and had various coexisting health conditions, such as diabetes and immunocompromise. * The results indicated that PCP in these patients is rare but highly severe, with all cases resulting in death within two months, emphasizing the need for vigilance in monitoring patients with worsening COVID-19 symptoms for possible PCP.
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According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as "possible" or "rejected" IE despite a persisting high level of clinical suspicion. Herein, we evaluate the F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion).

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Multidrug resistant (MDR) bacteria are increasingly observed in nosocomial and community-acquired settings. Anaerobes are no exception to this rule, but there are fewer reports of MDR in the scientific literature on anaerobes than there are for other bacteria. In this short case report, we describe the first case of bacteraemia caused by a multidrug-resistant , which produces a carbapenemase encoded by the gene.

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We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections.

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