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Article ; Online: Intravenous cefuroxime as a first-line treatment for women hospitalized for pyelonephritis.

Everard, Céline / Schampaert, Axelle / Doyen, Louise / Verbelen, Valérie / Marot, Jean-Christophe / Wieërs, Grégoire

JAC-antimicrobial resistance

2024 Volume 6, Issue 3, Page(s) dlae071

Abstract: Background: Empirical treatment of pyelonephritis in the emergency ward includes broad-spectrum antibiotics. Such a strategy favours broad-spectrum antibiotic overuse. Local antibiotic stewardship teams can propose local recommendations to adapt ... ...

Abstract	Background: Empirical treatment of pyelonephritis in the emergency ward includes broad-spectrum antibiotics. Such a strategy favours broad-spectrum antibiotic overuse. Local antibiotic stewardship teams can propose local recommendations to adapt empirical antibiotic treatment devoted to spare precious molecules that remain active on MDR bacteria, such as fluoroquinolones or other broad-spectrum antibiotics. Objectives: We aimed to evaluate the incidence of urinary tract infection recurrence within 3 months after hospital discharge following empirical antibiotic therapy with cefuroxime in women with pyelonephritis in the emergency room. Patients and methods: We conducted a retrospective, single-centre study. We identified 109 women treated for pyelonephritis, 95 with cefuroxime at any time, and 14 with only other antibiotics, and divided them into subgroups based on antibiotic switch to other molecules. We compared the incidence of urinary tract infection recurrence in the subgroups. Results: In the group of patients treated with cefuroxime only, we identified five cases of recurrence (9.4%) in a total of 53 patients, but only 1 (1.9%) case of recurrence associated with the same uropathogen. No significant difference in clinical outcome, length of antibiotic treatment, or urinary tract infection recurrence was observed between the subgroups. Conclusions: Our study supports that a strategy elaborated by an antibiotic stewardship team based on local ecology and aimed at proposing the narrowest-spectrum antibiotic upon treatment initiation in the emergency room is safe.
Language	English
Publishing date	2024-05-06
Publishing country	England
Document type	Journal Article
ISSN	2632-1823
ISSN (online)	2632-1823
DOI	10.1093/jacamr/dlae071
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Article ; Online: Unplanned pregnancy in an HIV positive woman undergoing alectinib treatment for metastatic non-small-cell lung carcinoma.

Carlier, Séverine / Carestia, Luciano / Marot, Jean-Christophe / Wieërs, Grégoire

BMJ case reports

2022 Volume 15, Issue 7

Abstract: We report an unplanned pregnancy in an HIV-positive woman in her 20s who was undergoing treatment for 6 months with alectinib (Alecensa) for stage IV non-small-cell lung carcinoma. Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor alectinib, a ... ...

Abstract	We report an unplanned pregnancy in an HIV-positive woman in her 20s who was undergoing treatment for 6 months with alectinib (Alecensa) for stage IV non-small-cell lung carcinoma. Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor alectinib, a molecule that inhibits proteins involved in tumour cell growth, is the recommended first-line treatment option in case of ALK mutation. Although the patient was informed of the need for definitive contraception, she became pregnant during the treatment with alectinib. A complete tumour response was observed at the time the pregnancy was discovered. Treatment discontinuation was proposed as the patient wanted to keep the pregnancy. Alectinib was temporarily stopped throughout the remaining pregnancy period inline with the patient's wishes. The pregnancy was uncomplicated. She delivered a healthy female baby vaginally, with treatment being resumed after delivery. After 34 follow-up months, the patient remained in oncological remission and the child's physical development is normal.
MeSH term(s)	Anaplastic Lymphoma Kinase ; Carbazoles/therapeutic use ; Carcinoma, Non-Small-Cell Lung/pathology ; Child ; Female ; HIV Infections ; Humans ; Lung Neoplasms/pathology ; Piperidines ; Pregnancy ; Pregnancy, Unplanned ; Protein Kinase Inhibitors/pharmacology ; Protein Kinase Inhibitors/therapeutic use ; Receptor Protein-Tyrosine Kinases/metabolism
Chemical Substances	Carbazoles ; Piperidines ; Protein Kinase Inhibitors ; Anaplastic Lymphoma Kinase (EC 2.7.10.1) ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1) ; alectinib (LIJ4CT1Z3Y)
Language	English
Publishing date	2022-07-13
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-247530
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Article ; Online: Reversibility of valve regurgitation due to cancer-related non-bacterial thrombotic endocarditis after switching direct oral anticoagulation for heparin.

Lepour, Maxence / Wieërs, Grégoire J F G / Vereeke, Justine / Wauters, Aurélien

BMJ case reports

2022 Volume 15, Issue 3

Abstract: Non-bacterial thrombotic endocarditis (NBTE) is a rare condition related to a state of hypercoagulability in advanced neoplastic disease. Most of the time, arterial thromboembolic event precedes the diagnosis of NBTE. We report here a case of NBTE ... ...

Abstract	Non-bacterial thrombotic endocarditis (NBTE) is a rare condition related to a state of hypercoagulability in advanced neoplastic disease. Most of the time, arterial thromboembolic event precedes the diagnosis of NBTE. We report here a case of NBTE responsible for multiple ischaemic strokes, which leads to the diagnosis of metastatic pancreatic adenocarcinoma. Aortic and mitral valvular regurgitations secondary to NBTE appeared within 6 weeks despite therapeutic anticoagulation with direct oral anticoagulant (DOAC) in stroke prevention of paroxysmal atrial fibrillation. Bivalvular regurgitations resolved 8 weeks after therapeutic switch to low-molecular-weight heparin (LMWH) and chemotherapy. DOACs are a possible alternative to LMWH for the prevention of venous thromboembolism in patients with active neoplasia. There is a lack of evidence for a clinical efficiency for the prevention of arterial thromboembolism in NBTE. We propose here a short review of the efficacy of anticoagulant therapy for the prevention of arterial thromboembolism in NBTE.
MeSH term(s)	Adenocarcinoma/drug therapy ; Anticoagulants/therapeutic use ; Endocarditis, Non-Infective/diagnosis ; Endocarditis, Non-Infective/drug therapy ; Endocarditis, Non-Infective/etiology ; Heparin ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/drug therapy
Chemical Substances	Anticoagulants ; Heparin, Low-Molecular-Weight ; Heparin (9005-49-6)
Language	English
Publishing date	2022-03-16
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-247672
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Article ; Online: Kinetics and ability of binding antibody and surrogate virus neutralization tests to predict neutralizing antibodies against the SARS-CoV-2 Omicron variant following BNT162b2 booster administration.

Simon, Germain / Favresse, Julien / Gillot, Constant / Closset, Mélanie / Catry, Émilie / Dogné, Jean-Michel / Douxfils, Jonathan / Wieërs, Grégoire / Bayart, Jean-Louis

Clinical chemistry and laboratory medicine

2023 Volume 61, Issue 10, Page(s) 1875–1885

Abstract: Objectives: To assess the long-term humoral immunity induced by booster administration, as well as the ability of binding antibody and surrogate virus neutralization tests (sVNT) to predict neutralizing antibodies (NAbs) against the SARS-CoV-2 Omicron ... ...

Abstract	Objectives: To assess the long-term humoral immunity induced by booster administration, as well as the ability of binding antibody and surrogate virus neutralization tests (sVNT) to predict neutralizing antibodies (NAbs) against the SARS-CoV-2 Omicron variant. Methods: A total of 269 sera samples were analyzed from 64 healthcare workers who had received a homologous booster dose of BNT162b2. Neutralizing antibodies assessed by sVNT and anti-RBD IgG measured with the sCOVG assay (Siemens Healthineers Results: While Wild-type sVNT percentage of inhibition (POI) remained above 98.6% throughout the follow-up period after booster administration, anti-RBD IgG and NAbs assessed by Omicron BA.1 pVNT showed respectively a 3.4-fold and 13.3-fold decrease after 6 months compared to the peak reached at day 14. NAbs assessed by Omicron sVNT followed a steady decline until reaching a POI of 53.4%. Anti-RBD IgG and Omicron sVNT assays were strongly correlated (r=0.90) and performed similarly to predict the presence of neutralizing antibodies with Omicron pVNT (area under the ROC: 0.82 for both assays). In addition, new adapted cut-off values of anti-RBD IgG (>1,276 BAU/mL) and Omicron sVNT (POI>46.6%) were found to be better predictors of neutralizing activity. Conclusions: This study showed a significant drop in humoral immunity 6 months after booster administration. Anti-RBD IgG and Omicron sVNT assays were highly correlated and could predict neutralizing activity with moderate performance.
MeSH term(s)	Humans ; Antibodies, Neutralizing ; SARS-CoV-2 ; Neutralization Tests ; BNT162 Vaccine ; Kinetics ; COVID-19 ; Immunoglobulin G ; Antibodies, Viral
Chemical Substances	Antibodies, Neutralizing ; BNT162 Vaccine ; Immunoglobulin G ; Antibodies, Viral
Language	English
Publishing date	2023-04-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2022-1258
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Article: Serum SARS-CoV-2 Antigens for the Determination of COVID-19 Severity

Favresse, Julien / Bayart, Jean-Louis / David, Clara / Gillot, Constant / Wieërs, Grégoire / Roussel, Gatien / Sondag, Guillaume / Elsen, Marc / Eucher, Christine / Dogné, Jean-Michel / Douxfils, Jonathan

Viruses. 2022 July 28, v. 14, no. 8

2022

Abstract: The diagnostic of SARS-CoV-2 infection relies on reverse transcriptase polymerase chain reactions (RT-PCRs) performed on nasopharyngeal (NP) swabs. Nevertheless, false-negative results can be obtained with inadequate sampling procedures, making the use ... ...

Abstract	The diagnostic of SARS-CoV-2 infection relies on reverse transcriptase polymerase chain reactions (RT-PCRs) performed on nasopharyngeal (NP) swabs. Nevertheless, false-negative results can be obtained with inadequate sampling procedures, making the use of other biological matrices worthy of investigation. This study aims to evaluate the kinetics of serum N antigens in severe and non-severe patients and compare the clinical performance of serum antigenic assays with NP RT-PCR. Ninety patients were included in the study and monitored for several days. Disease severity was determined according to the WHO clinical progression scale. Serum N antigen levels were measured with a chemiluminescent assay (CLIA) and the Single Molecular Array (Simoa) assay. Viremia thresholds for severity were determined and proposed. In severe patients, the peak antigen response was observed 7 days after the onset of symptoms, followed by a decline. No real peak response was observed in non-severe patients. Severity thresholds for the Simoa and the CLIA provided positive likelihood ratios of 30.0 and 10.9 for the timeframe between day 2 and day 14, respectively. Sensitive detection of N antigens in serum may thus provide a valuable new marker for COVID-19 diagnosis and evaluation of disease severity. When assessed during the first 2 weeks since the onset of symptoms, it may help in identifying patients at risk of developing severe COVID-19 to optimize better intensive care utilization.
Keywords	COVID-19 infection ; Severe acute respiratory syndrome coronavirus 2 ; antigens ; blood serum ; disease severity ; luminescent assay ; risk ; viremia
Language	English
Dates of publication	2022-0728
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2516098-9
ISSN	1999-4915
ISSN	1999-4915
DOI	10.3390/v14081653
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: The Gut-Lung Axis in Health and Respiratory Diseases: A Place for Inter-Organ and Inter-Kingdom Crosstalks.

Enaud, Raphaël / Prevel, Renaud / Ciarlo, Eleonora / Beaufils, Fabien / Wieërs, Gregoire / Guery, Benoit / Delhaes, Laurence

Frontiers in cellular and infection microbiology

2020 Volume 10, Page(s) 9

Abstract: The gut and lungs are anatomically distinct, but potential anatomic communications and complex pathways involving their respective microbiota have reinforced the existence of a gut-lung axis (GLA). Compared to the better-studied gut microbiota, the lung ... ...

Abstract	The gut and lungs are anatomically distinct, but potential anatomic communications and complex pathways involving their respective microbiota have reinforced the existence of a gut-lung axis (GLA). Compared to the better-studied gut microbiota, the lung microbiota, only considered in recent years, represents a more discreet part of the whole microbiota associated to human hosts. While the vast majority of studies focused on the bacterial component of the microbiota in healthy and pathological conditions, recent works have highlighted the contribution of fungal and viral kingdoms at both digestive and respiratory levels. Moreover, growing evidence indicates the key role of inter-kingdom crosstalks in maintaining host homeostasis and in disease evolution. In fact, the recently emerged GLA concept involves host-microbe as well as microbe-microbe interactions, based both on localized and long-reaching effects. GLA can shape immune responses and interfere with the course of respiratory diseases. In this review, we aim to analyze how the lung and gut microbiota influence each other and may impact on respiratory diseases. Due to the limited knowledge on the human virobiota, we focused on gut and lung bacteriobiota and mycobiota, with a specific attention on inter-kingdom microbial crosstalks which are able to shape local or long-reached host responses within the GLA.
MeSH term(s)	Animals ; Dysbiosis ; Gastrointestinal Microbiome/physiology ; Homeostasis ; Host Microbial Interactions ; Humans ; Immunity ; Immunomodulation ; Lung/microbiology ; Microbiota/physiology ; Respiratory Tract Diseases/immunology ; Respiratory Tract Diseases/microbiology ; Respiratory Tract Infections/immunology ; Respiratory Tract Infections/microbiology
Language	English
Publishing date	2020-02-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2020.00009
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Article ; Online: Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing

Wieërs, Grégoire / Verbelen, Valérie / Van Den Driessche, Mieke / Melnik, Ekaterina / Vanheule, Greet / Marot, Jean-Christophe / Cani, Patrice D

Frontiers in public health

2021 Volume 8, Page(s) 578089

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Bifidobacterium ; Gastrointestinal Microbiome ; Hospitals ; Humans ; Lactobacillus ; Pharmaceutical Preparations ; Probiotics/therapeutic use ; Saccharomyces
Chemical Substances	Anti-Bacterial Agents ; Pharmaceutical Preparations
Language	English
Publishing date	2021-03-08
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2020.578089
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Article ; Online: Hypercalcemia Heralding Pneumocystis jirovecii Pneumonia in an HIV-Seronegative Patient with Diffuse Cutaneous Systemic Sclerosis.

Binet, Quentin / Mairesse, Jacques / Vanthuyne, Marie / Marot, Jean-Christophe / Wieers, Grégoire

Mycopathologia

2019 Volume 184, Issue 6, Page(s) 787–793

Abstract: Pneumocystis pneumonia (PCP) is a life-threatening fungal infection occurring in immunocompromised patients such as HIV-positive patients with low CD4 cell count or patients under heavy immunosuppressive therapy. We report the case of a 59-year-old male ... ...

Abstract	Pneumocystis pneumonia (PCP) is a life-threatening fungal infection occurring in immunocompromised patients such as HIV-positive patients with low CD4 cell count or patients under heavy immunosuppressive therapy. We report the case of a 59-year-old male with severe diffuse cutaneous systemic sclerosis presenting with asthenia, dry cough and worsening shortness of breath for the last 15 days. Biological studies were remarkable for PTH-independent severe hypercalcemia with low 25-hydroxyvitamin D and a paradoxically elevated 1,25-dihydroxyvitamin D. Early bronchoalveolar lavage allowed for PCP diagnosis and targeted treatment. We discuss the underlying physiopathology and difficulties regarding prophylaxis and treatment.
MeSH term(s)	Humans ; Hypercalcemia/physiopathology ; Immunocompromised Host ; Immunotherapy/adverse effects ; Male ; Middle Aged ; Opportunistic Infections/diagnosis ; Pneumocystis carinii/drug effects ; Pneumocystis carinii/pathogenicity ; Pneumonia, Pneumocystis/diagnosis ; Pneumonia, Pneumocystis/drug therapy ; Pneumonia, Pneumocystis/physiopathology ; Scleroderma, Diffuse/complications ; Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
Chemical Substances	Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2)
Language	English
Publishing date	2019-11-15
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	391081-7
ISSN	1573-0832 ; 0369-299X ; 0301-486X ; 0027-5530
ISSN (online)	1573-0832
ISSN	0369-299X ; 0301-486X ; 0027-5530
DOI	10.1007/s11046-019-00397-w
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Article ; Online: Fever, bone pain and erectile dysfunction. Where is the cat?

Trefois, Quentin / Marot, Jean-Christophe / Yildiz, Halil / Wieers, Gregoire

BMJ case reports

2017 Volume 2017

Abstract: Cat-scratch disease is due ... ...

Abstract	Cat-scratch disease is due to
MeSH term(s)	Animals ; Anti-Bacterial Agents/therapeutic use ; Bartonella henselae/isolation & purification ; Bartonella henselae/pathogenicity ; Bone and Bones/pathology ; Cat-Scratch Disease/diagnosis ; Cat-Scratch Disease/drug therapy ; Cat-Scratch Disease/microbiology ; Cat-Scratch Disease/physiopathology ; Cats ; Doxycycline/therapeutic use ; Erectile Dysfunction/complications ; Erectile Dysfunction/diagnostic imaging ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/microbiology ; Fever/complications ; Humans ; Male ; Pain/complications ; Pain/diagnostic imaging ; Pain/drug therapy ; Pain/microbiology ; Penis/physiopathology ; Positron Emission Tomography Computed Tomography ; Testis/physiopathology ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Doxycycline (N12000U13O)
Language	English
Publishing date	2017-09-12
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2017-221397
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Article ; Online: Serum SARS-CoV-2 Antigens for the Determination of COVID-19 Severity.

Viruses

2022 Volume 14, Issue 8

Abstract	The diagnostic of SARS-CoV-2 infection relies on reverse transcriptase polymerase chain reactions (RT-PCRs) performed on nasopharyngeal (NP) swabs. Nevertheless, false-negative results can be obtained with inadequate sampling procedures, making the use of other biological matrices worthy of investigation. This study aims to evaluate the kinetics of serum N antigens in severe and non-severe patients and compare the clinical performance of serum antigenic assays with NP RT-PCR. Ninety patients were included in the study and monitored for several days. Disease severity was determined according to the WHO clinical progression scale. Serum N antigen levels were measured with a chemiluminescent assay (CLIA) and the Single Molecular Array (Simoa) assay. Viremia thresholds for severity were determined and proposed. In severe patients, the peak antigen response was observed 7 days after the onset of symptoms, followed by a decline. No real peak response was observed in non-severe patients. Severity thresholds for the Simoa and the CLIA provided positive likelihood ratios of 30.0 and 10.9 for the timeframe between day 2 and day 14, respectively. Sensitive detection of N antigens in serum may thus provide a valuable new marker for COVID-19 diagnosis and evaluation of disease severity. When assessed during the first 2 weeks since the onset of symptoms, it may help in identifying patients at risk of developing severe COVID-19 to optimize better intensive care utilization.
MeSH term(s)	COVID-19/diagnosis ; COVID-19 Testing ; Humans ; Immunologic Tests ; SARS-CoV-2 ; Sensitivity and Specificity ; Severity of Illness Index
Language	English
Publishing date	2022-07-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v14081653
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