Publications by authors named "Anne-Aurelie Lopes"

7 Publications

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Febrile young infants with abnormal urine dipstick at low risk of invasive bacterial infection.

Arch Dis Child 2020 Nov 27. Epub 2020 Nov 27.

Pediatric Emergency Department, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces. University of the Basque Country, UPV/EHU, Bilbao, Basque Country, Spain.

Objectives: To develop and validate a prediction rule to identify well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of invasive bacterial infections (IBIs, bacteraemia or bacterial meningitis).

Design: Ambispective, multicentre study.

Setting: The derivation set in a single paediatric emergency department (ED) between 2003 and 2017. The validation set in 21 European EDs between December 2017 and November 2019.

Patients: Two sets of well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick (either leucocyte esterase and/or nitrite positive test).

Main Outcome: Prevalence of IBI in low-risk infants according to the RISeuP score.

Results: We included 662 infants in the derivation set (IBI rate:5.2%). After logistic regression, we developed a score (RISeuP score) including age (≤15 days old), serum procalcitonin (≥0.6 ng/mL) and C reactive protein (≥20 mg/L) as risk factors. The absence of any risk factor had a sensitivity of 96.0% (95% CI 80.5% to 99.3%), a negative predictive value of 99.4% (95% CI 96.4% to 99.9%) and a specificity of 32.9% (95% CI 28.8% to 37.3%) for ruling out an IBI. Applying it in the 449 infants of the validation set (IBI rate 4.9%), sensitivity, negative predictive value and specificity were 100% (95% CI 87.1% to 100%), 100% (95% CI 97.3% to 100%) and 29.7% (95% CI 25.8% to 33.8%), respectively.

Conclusion: This prediction rule accurately identified well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of IBI. This score can be used to guide initial clinical decision-making in these patients, selecting infants suitable for an outpatient management.
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http://dx.doi.org/10.1136/archdischild-2020-320468DOI Listing
November 2020

Natural outbreaks and bioterrorism: How to deal with the two sides of the same coin?

J Glob Health 2020 Dec;10(2):020317

Bacteriology Unit, French Armed Forces Biomedical Research Institute (IRBA), Bretigny sur Orge, France.

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http://dx.doi.org/10.7189/jogh.10.020317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7535343PMC
December 2020

Roles of lytic transglycosylases in biofilm formation and β-lactam resistance in methicillin-resistant .

Antimicrob Agents Chemother 2019 Sep 30. Epub 2019 Sep 30.

Department of Bacteriology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, Japan

is responsible for numerous community outbreaks and is one of the most frequent causes of nosocomial infections with significant morbidity and mortality. While the function of lytic transglycosylases (LTs) in relation to cell division, biofilm formation, and antibiotic resistance has been determined for several bacteria, their role in remains largely unknown. The only known LTs in are immunodominant staphylococcal antigen A (IsaA) and D protein (SceD). Our study demonstrates that, in a strain of methicillin-resistant (MRSA), IsaA and SceD contribute differently to biofilm formation and β-lactam resistance. Deletion of , but not , led to decreased biofilm formation. Additionally, in -deleted strains, β-lactam resistance was significantly decreased compared to that of wild-type strains. Plasmid-based expression of , a major determinant of β-lactam resistance in MRSA, in an -deleted strain did not restore β-lactam resistance, demonstrating that the β-lactam susceptibility phenotype is exhibited by mutant regardless of the production level of PBP2a. Overall, our results suggest that IsaA is a potential therapeutic target for MRSA infections.
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http://dx.doi.org/10.1128/AAC.01277-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879220PMC
September 2019

Nutrition of Preterm Infants and Raw Breast Milk-Acquired Cytomegalovirus Infection: French National Audit of Clinical Practices and Diagnostic Approach.

Nutrients 2018 Aug 18;10(8). Epub 2018 Aug 18.

Neonatology Department, AP-HP, Armand Trousseau Hospital, 26 Avenue du Dr Arnold Netter, 75012 Paris, France.

Raw breast milk is the optimal nutrition for infants, but it is also the primary cause of acquired cytomegalovirus (CMV) infection. Thus, many countries have chosen to contraindicate to feed raw breast milk preterm infants from CMV-positive mothers before a corrected age of 32 weeks or under a weight of 1500 g. French national recommendations have not been updated since 2005. An audit of the French practices regarding the nutrition with raw breast milk in preterm infants was carried out using a questionnaire sent to all neonatal care units. Diagnosed postnatal milk-acquired CMV infections have been analysed using hospitalisation reports. Seventy-five percent of the neonatal units responded: 24% complied with the French recommendations, 20% contraindicated raw breast milk to all infants before 32 weeks regardless of the mothers' CMV-status, whereas 25% fed all preterm infants unconditionally with raw breast milk. Thirty-five cases of infants with milk-acquired CMV infections have been reported. The diagnosis was undeniable for five patients. In France, a high heterogeneity marks medical practices concerning the use of raw breast milk and the diagnostic approach for breast milk-acquired CMV infection is often incomplete. In this context, updated national recommendations and monitored CMV infections are urgently needed.
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http://dx.doi.org/10.3390/nu10081119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115774PMC
August 2018

Erratum: Clinical Findings and Autopsy of a Preterm Infant with Breast Milk-Acquired Cytomegalovirus Infection.

AJP Rep 2016 Oct;6(4):e367

Service de Réanimation Néonatale, Centre Hospitalier de Meaux, Meaux, France.

[This corrects the article DOI: 10.1055/s-0035-1566249.].
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http://dx.doi.org/10.1055/s-0036-1593627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056894PMC
October 2016

Clinical Findings and Autopsy of a Preterm Infant with Breast Milk-Acquired Cytomegalovirus Infection.

AJP Rep 2016 Apr;6(2):e198-202

Service de Réanimation Néonatale, Centre Hospitalier de Meaux, Meaux, France.

Background Nonpasteurized, nonfrozen, fresh breast milk from mothers with positive cytomegalovirus (CMV) serology was initially contraindicated to very low-birth-weight infants because of the risk of milk-acquired CMV infection. Recently, the severity of this infection was increasingly discussed and the international guidelines now differ. Since 2012, the American Academy of Pediatrics has recommended nutrition through raw breast milk for all preterm infants. Case We report the case of an infant born prematurely at 27 weeks and 4 days and fed with raw breastmilk from day 12 of life (D12). He presented with a late-onset of CMV infection from D39. The CMV polymerase chain reaction (PCR), negative on D3, was strongly positive on D49, as well as the PCR on breast milk. He had CMV-specific immunoglobulin (Ig) M while his mother had only CMV-specific IgG. On D52, he deteriorated further with septic shock, and a fatal cardiac arrest on D54. His twin presented an asymptomatic CMV infection. The autopsy and histological examination showed evidence of numerous organ damage caused by CMV (with differences compared with congenital infection) but no evidence of bacterial infection. Conclusion Although rare, postnatal CMV infections transmitted by raw breast milk given to very low-birthweight infants can have dramatic consequences.
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http://dx.doi.org/10.1055/s-0035-1566249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889443PMC
April 2016

Livedo Reticularis: A Presenting Sign of Escherichia Coli Sepsis in a Newborn.

Fetal Pediatr Pathol 2015 15;34(5):282-6. Epub 2015 Jul 15.

b Service de Néonatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau , Paris , France.

Unlabelled: Livedo reticularis is a red cutaneous netlike pattern that is caused by abnormalities of the microvascularization and can be associated with many other potential systemic etiologies. We describe a case of a newborn that presented with livedo reticularis on his first day of life without any obvious systemic signs. The livedo reticularis was associated with Escherichia Coli K1 meningitis as revealed by laboratory tests. Clinical infectious signs developed a few hours later. Despite appropriate antibiotics therapy, he died on his second day because of sepsis and disseminated intravascular coagulation. Cerebrospinal fluid culture, blood culture, and culture of samples from trachea showed the presence of Escherichia Coli serotype K1 with many virulence determinants.

Conclusion: In newborn, livedo reticularis must not be considered as physiological, but as a potential sign of unknown severe bacterial infection. Thus, the presence of livedo reticularis must require urgent laboratory tests.
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http://dx.doi.org/10.3109/15513815.2015.1044142DOI Listing
June 2016