Publications by authors named "Astrid Bouteau"

5 Publications

  • Page 1 of 1

Prone positioning during veno-venous or veno-arterial extracorporeal membrane oxygenation: feasibility and complications after cardiothoracic surgery.

Crit Care 2022 03 21;26(1):66. Epub 2022 Mar 21.

Cardiothoracic Intensive Care Unit, Service de Réanimation adulte, Hôpital Marie Lannelongue, 133 Avenue de la Résistance, 92350, Le Plessis Robinson, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13054-022-03944-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936034PMC
March 2022

Impact of initial respiratory compliance in ventilated patients with acute respiratory distress syndrome related to COVID-19.

Crit Care 2020 07 9;24(1):412. Epub 2020 Jul 9.

Department of Anesthesiology and Intensive Care, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Paris, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13054-020-03133-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347264PMC
July 2020

Countermeasures Defeat a Virulent Bacteriophage.

Viruses 2019 01 10;11(1). Epub 2019 Jan 10.

Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France.

is an opportunistic pathogen that has emerged as a major cause of nosocomial infections worldwide. Many clinical strains are indeed resistant to last resort antibiotics and there is consequently a reawakening of interest in exploiting virulent phages to combat them. However, little is still known about phage receptors and phage resistance mechanisms in enterococci. We made use of a prophageless derivative of the well-known clinical strain V583 to isolate a virulent phage belonging to the subfamily and to the P68 genus that we named Idefix. Interestingly, most isolates of tested-including V583-were resistant to this phage and we investigated more deeply into phage resistance mechanisms. We found that V583 prophage 6 was particularly efficient in resisting Idefix infection thanks to a new abortive infection (Abi) mechanism, which we designated Abiα. It corresponded to the Pfam domain family with unknown function DUF4393 and conferred a typical Abi phenotype by causing a premature lysis of infected . The gene is widespread among prophages of enterococci and other Gram-positive bacteria. Furthermore, we identified two genes involved in the synthesis of the side chains of the surface rhamnopolysaccharide that are important for Idefix adsorption. Interestingly, mutants in these genes arose at a frequency of ~10 resistant mutants per generation, conferring a supplemental bacterial line of defense against Idefix.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/v11010048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356687PMC
January 2019

Impact of a high loading dose of amikacin in patients with severe sepsis or septic shock.

Ann Intensive Care 2016 Dec 2;6(1):106. Epub 2016 Nov 2.

Département d'Anesthésie Réanimation, AP-HP, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018, Paris, France.

Background: The therapeutic effect of aminoglycosides is highest and optimal when the peak plasma concentration (C )/minimal inhibitory concentration (MIC) ratio is between 8 and 10. The French guidelines recommend to use high doses of aminoglycosides for empiric antibiotic therapy in patients suffering from severe sepsis or septic shock. In clinical practice, the recommended target is an amikacin C between 60 and 80 mg/L, which corresponds to approximately 8 times the MIC breakpoint, as defined by the European Committee on Antimicrobial Susceptibility Testing. The aim of this study was to assess the incidence and impact on mortality of an amikacin concentration between 60 and 80 mg/L in patients suffering from severe sepsis or septic shock.

Methods: This was a prospective observational cohort study conducted in two intensive care units (ICU). Patients receiving amikacin at a loading dose of 30 mg/kg for severe sepsis or septic shock were enrolled in the cohort. The target C for amikacin was between 60 and 80 mg/L, as recommended by French guidelines (i.e. C /MIC breakpoint = 8-10).

Results: Over the study period, the amikacin C was <60 mg/L, between 60 and 80 mg/L, and >80 mg/L in 20 (18.2%), 46 (41.8%) and 44 (40%) of the 110 selected patients, respectively. Mortality rate was 40, 28.3 and 56.8% in the groups of patients with C  < 60 mg/L, 60 mg/L < C  < 80 mg/L and C  > 80 mg/L, respectively. Following multivariate analysis, mortality rate was significantly lower in the group of patients with amikacin C between 60 and 80 mg/L than in the group of patients with amikacin C  > 80 mg/L (P = 0.004). The multivariate analysis also revealed that the factors independently associated with a higher in-ICU mortality rate were age (P = 0.02) and norepinephrine dose (P = 0.0001).

Conclusions: With a loading dose of 30 mg/kg of amikacin, concentration was potentially suboptimal (C  < 60 mg/L) in only 18.2% of patients. The pharmacodynamic target (60 mg/L < C  < 80 mg/L) recommended by French guidelines was reached in 41.8% of patients and was associated with reduced in-ICU mortality. But amikacin overexposure (i.e. C  > 80 mg/L) was frequent and potentially associated with increased mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13613-016-0211-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093100PMC
December 2016

Assessment of the National French recommendations regarding the dosing regimen of 8mg/kg of gentamicin in patients hospitalised in intensive care units.

Anaesth Crit Care Pain Med 2016 Oct 28;35(5):331-335. Epub 2016 Apr 28.

Département d'Anesthésie-Réanimation, AP-HP, CHU Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France. Electronic address:

Introduction: To assess the French National Agency for Medicines and Health Products Safety (ANSM) guidelines concerning the peak plasma concentration (Cmax) of gentamicin when using a loading dose of 8mg/kg administered in patients hospitalised in the intensive care unit (ICU).

Patients And Methods: A prospective observational cohort study conducted in one ICU.

Results: During the study period, 34 patients with a median simplified acute physiology score 2 of 54 [44-70] received a median dose of 8 [7.9-8.1] mg/kg of gentamicin. The median Cmax was 17.5 [15.4-20.7] mg/L and no patient had a Cmax>30mg/L. Twenty-four of 34 patients (71%) had a Cmax>16mg/L. Following multivariate analysis, the only factor associated with Cmax<16mg/L was a positive fluid balance 24hours before gentamicin administration (per 1000mL increment) (OR: 0.37, 95% CI: 0.18-0.77, P=0.008).

Conclusions: These results suggest that a Cmax>30mg/L [which corresponds to approximately 8 times the minimal inhibiting concentrations (MIC) breakpoints for Pseudomonas aeruginosa and Enterobacteriaceae with intermediate sensitivity] of gentamicin as recommended by ANSM guidelines seems impossible to obtain with a loading dose of 8mg/kg in the ICU. A loading dose of 8mg/kg should probably not be used in the empiric antibiotic treatment of infection due to non-fermenting Gram-negative bacilli and Enterobacteriaceae with intermediate sensitivity whose MIC breakpoint is 4mg/L. A Cmax>16mg/L was not reached in almost 30% of patients, particularly in the group with a positive fluid balance who require higher doses than currently recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.accpm.2015.12.012DOI Listing
October 2016
-->