Publications by authors named "Frédéric Frippiat"

24 Publications

  • Page 1 of 1

Clinical Use and Adverse Drug Reactions of Linezolid: A Retrospective Study in Four Belgian Hospital Centers.

Antibiotics (Basel) 2021 May 4;10(5). Epub 2021 May 4.

Pharmacologie Cellulaire et Moléculaire, Louvain Drug Research Institute, Université Catholique de Louvain, B1200 Brussels, Belgium.

In Belgium, linezolid is indicated for pneumonia and skin and soft tissue infections, but is more broadly used, due to its oral bioavailability and activity against multiresistant organisms. This could increase the risk of adverse drug reactions (ADR), notably hematological disorders (anemia, thrombocytopenia), neuropathy, or lactic acidosis. We analyzed linezolid clinical use in relationship with occurrence of ADR in Belgian hospitals and highlighted risk factors associated with the development of thrombocytopenia. A retrospective analysis of electronic medical records and laboratory tests of adult patients treated with linezolid in four Belgian hospitals in 2016 allowed the collection of ADR for 248 linezolid treatments. Only 19.7% of indications were in-label. ADR included 43 thrombocytopenia, 17 anemia, 4 neuropathies, and 4 increases in lactatemia. In a multi-variate analysis, risk factors of thrombocytopenia were a treatment duration > 10 days, a glomerular filtration rate < 60 mL/min, and a Charlson index ≥ 4. Off-label use of linezolid is frequent in Belgium, and ADR more frequent than reported in the summary of product characteristics, but not statistically associated with any indication. This high prevalence of ADR could be related to a high proportion of patients presenting risk factors in our population, highlighting the importance of detecting them prospectively.
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http://dx.doi.org/10.3390/antibiotics10050530DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147790PMC
May 2021

Continuous infusion, therapeutic drug monitoring and outpatient parenteral antimicrobial therapy with ceftazidime/avibactam: a retrospective cohort study.

J Glob Antimicrob Resist 2021 May 12;26:15-19. Epub 2021 May 12.

Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium.

Objectives: Based on recent pharmacokinetic/pharmacodynamic (PK/PD) evidence, continuous-infusion (CI) β-lactam administration is increasingly recommended for serious infections. Since 2016, the combination ceftazidime/avibactam (CAZ/AVI) is administered as per the manufacturer's instructions as an intermittent infusion of 2.5 g every 8 h. Thus, CI has not yet been evaluated in clinical trials.

Methods: We aimed to evaluate the use of CI of CAZ/AVI in a retrospective case series from December 2016 to October 2019. All isolates displayed in vitro susceptibility to CAZ/AVI according to EUCAST definitions. Patients were initially given CAZ/AVI as CI of 5 g every 12 h, and dosages were adjusted according to therapeutic drug monitoring of ceftazidime with a therapeutic goal of ≥4-5 × MIC in plasma and/or at the site of infection.

Results: CAZ/AVI was administered by CI in 10 patients with infections mainly caused by multidrug-resistant Pseudomonas aeruginosa (54.5%) and Klebsiella pneumoniae (36.4%). Bacteraemia occurred in 30% of cases. Sepsis or septic shock was present in 20% of cases. CAZ/AVI was used as monotherapy in 60% of cases. Clinical cure and microbiological eradication were achieved in 80% and 90% of cases, respectively. The 30-day mortality after CAZ/AVI treatment onset was 10%. The therapeutic goals of ≥4-5 × MIC in plasma and/or at the site of infection were achieved in 100% and 87.5% of cases, respectively, without adverse events.

Conclusion: Despite a limited number of patients, CI of CAZ/AVI provided promising results after optimisation of PK/PD parameters both in plasma and at the site of infection.
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http://dx.doi.org/10.1016/j.jgar.2021.04.015DOI Listing
May 2021

infective endocarditis: analysis of eight surgical cases from a single centre.

Infect Dis (Lond) 2021 Mar 23;53(3):189-195. Epub 2020 Dec 23.

Department of Cardiovascular Surgery, CHU Liege, Liège, Belgium.

Background: (GBS) infective endocarditis (IE) is a rare clinical entity. It is associated with a high mortality rate compared to other streptococci endocarditis. The aim of this study is to define the clinical characteristics, treatment and outcomes of a series of eight non-pregnant adults with GBS IE managed by a combination of antibiotics and surgery at our institution.

Methods: We retrospectively reviewed the medical records of all adult patients with a definite diagnosis of IE by Duke modified criteria and who underwent surgery at our centre between January 2008 and December 2018.

Results: A total of 190 patients underwent surgery for IE during the study period. Eight cases of GBS IE were identified, including six males and two females. The mean aged was 54 years (range, 32-68). Seven cases suffered native valve endocarditis and one involved an aortic bioprosthesis. Seven patients had underlying comorbidities. Furthermore, four patients had experienced serious complications. Of these, the most common were heart failure, septic shock, and cerebral emboli. Vegetations tended to be large, very mobile, and pedunculated. Most of the patients were treated with penicillin plus an aminoglycoside. Surgery was emergently performed in one patient and urgently performed in seven patients. In- hospital mortality rate was 37.5%.

Conclusion: GBS IE is a virulent disease with an aggressive clinical course. It mostly affects patients with debilitating diseases. Early surgery should be considered to prevent the development of serious complications. However, overall mortality rate remains high despite surgical treatment.
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http://dx.doi.org/10.1080/23744235.2020.1863460DOI Listing
March 2021

Evolution of Drug Interactions With Antiretroviral Medication in People With HIV.

Open Forum Infect Dis 2020 Nov 18;7(11):ofaa416. Epub 2020 Oct 18.

Infectious Diseases Department, Liège University Hospital, Liège, Belgium.

Background: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time.

Methods: This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions.

Results: We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor-based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016.

Conclusions: This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care.
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http://dx.doi.org/10.1093/ofid/ofaa416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651038PMC
November 2020

Surgical management of Staphylococcus capitis prosthetic valve infective endocarditis: Retrospective review of a 10-year single center experience and review of the literature.

J Infect Public Health 2020 Nov 11;13(11):1705-1709. Epub 2020 Oct 11.

Department of Cardiovascular Surgery, CHU Liege, Belgium.

Background: Staphylococcus capitis (S. capitis) is a subtype of coagulase-negative staphylococci and a commensal of the skin of the human scalp and forehead. S. capitis has been occasionally reported in infective endocarditis and rarely in prosthetic valve endocarditis (PVE). The purpose of this report is to present the clinical course and the surgical management of a series of four patients with S. capitis PVE.

Methods: The medical records of 190 adult patients with a definite diagnosis of infective endocarditis by the Duke modified criteria and who underwent surgery at our center between January 2008 and December 2018 were retrospectively reviewed.

Results: There were four cases of S. capitis infective endocarditis among 190 patients. All were male with an average age of 70.25 years (range, 58-80 years). The four cases were PVE: 3 aortic (1 mechanical and 2 biological bioprostheses) and 1 mitral (bioprosthesis). Their mean Euroscore II was 32.43 (range, 9.19-50.8). Three patients had underlying diseases (diabetes mellitus=2, chronic obstructive pulmonary disease=3, chronic kidney disease=1, peripheral arterial disease=2, ischemic heart disease=1, dilated cardiomyopathy=1). Preoperative clinical presentation was characterized by the occurrence of sepsis in three patients and heart failure and sepsis in one patient. Two patients presented with vegetation (mitral bioprosthesis, aortic bioprosthesis). A prosthetic dehiscence was present in all patients, and two presented with a localized annular abscess. All but one patient received triple antibiotic treatment with vancomycin plus rifampicin plus gentamycin. Surgery was performed on an urgent basis in all patients, and the in-hospital mortality rate was 50%.

Conclusions: While limited by the small number of patients, our series highlights the aggressive clinical course of S. capitis PVE with a mortality rate close to that of Staphylococcus aureus PVE. Therefore, early surgical management is recommended to improve the clinical outcome of this serious disease.
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http://dx.doi.org/10.1016/j.jiph.2020.09.010DOI Listing
November 2020

Meropenem: continuous or extended infusion?

Crit Care 2020 05 5;24(1):192. Epub 2020 May 5.

Department of Intensive Care Unit, University Hospital of Liège, Liège, Belgium.

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http://dx.doi.org/10.1186/s13054-020-02883-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201795PMC
May 2020

Detectability of HIV Residual Viremia despite Therapy Is Highly Associated with Treatment with a Protease Inhibitor-Based Combination Antiretroviral Therapy.

Antimicrob Agents Chemother 2020 02 21;64(3). Epub 2020 Feb 21.

Infectious Diseases Department, Liège University Hospital, Liège, Belgium.

HIV persistence despite therapy contributes to chronic immune activation and inflammation, increasing the risk of aging-associated events in HIV-infected individuals. We sought here to better understand the complex link between clinical and treatment features and HIV persistence despite therapy. A total of 11,045 samples from 1,160 individuals under combination antiretroviral therapy (cART) with an unquantifiable viral load (VL; limit of quantification, 20 copies/ml) were categorized as detectable or undetectable depending on the detection of a PCR signal using a commercially available assay. Generalized estimating equation (GEE) regression was used to model viral load detectability and to assess the determinants of residual viremia (RV; VL detected below 20 copies/ml) despite therapy. A high VL zenith was associated with a higher probability to have a detectable viremia under cART. Conversely, the probability to have a detectable viral load below 20 copies/ml decreased with time under therapy. Of therapy regimens, protease inhibitor (PI)-based cART was associated with a significantly higher probability of detectable RV compared to nonnucleoside transcriptase inhibitor- or integrase inhibitor-based cART. We found that a PI-based treatment regimen is highly associated with an increased frequency of RV, supporting previous evidence suggesting that PI-based cART regimens could favor ongoing viral replication in some individuals.
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http://dx.doi.org/10.1128/AAC.01902-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7038286PMC
February 2020

Factors associated with late presentation for HIV care in a single Belgian reference center: 2006-2017.

Sci Rep 2018 06 5;8(1):8594. Epub 2018 Jun 5.

Infectious Diseases department, Liège University Hospital, Liège, Belgium.

Late presentation for HIV care is a major issue and the cause of higher morbidity, mortality and transmission. In this regard, we analyzed the characteristics of patients presenting for care at our center from January 2006 to July 2017 (n = 687). The majority of the studied population was of African origin (54.3%) with heterosexual women representing the main group (n = 292; 42.5%). 44% of the patients were late presenters (LP) (presenting for care with CD4 T cells <350/mm or an AIDS defining event) and 24% were late presenters with advanced disease (LP-AD) (presenting for care with CD4 T cells <200/mm or an AIDS defining event). A very high risk of being LP and LP-AD was associated with Sub-Saharan origin (OR 3.4 and 2.6 respectively). Other factors independently associated with LP or LP-AD were age (OR 1.3), male gender (OR 2.0 and 1.5 respectively) and heterosexual route of transmission (OR 2.4 and 2.3 respectively). A significant increase in HIV screening without forgetting those groups would contribute to earlier HIV diagnosis, a key element to end the HIV epidemic. To achieve this goal, addressing the specific hurdles to HIV testing in the migrant population is critical.
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http://dx.doi.org/10.1038/s41598-018-26852-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988738PMC
June 2018

Antimicrobial stewardship in long-term care facilities in Belgium: a questionnaire-based survey of nursing homes to evaluate initiatives and future developments.

Antimicrob Resist Infect Control 2016 8;5. Epub 2016 Mar 8.

Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de L'Hòpital 1, 4000 Liège, Belgium.

Background: The use of antimicrobials is intense and often inappropriate in long-term care facilities. Antimicrobial resistance has increased in acute and chronic care facilities, including those in Belgium. Evidence is lacking concerning antimicrobial stewardship programmes in chronic care settings. The medical coordinator practicing in Belgian nursing homes is a general practitioner designated to coordinate medical activity. He is likely to be the key position for effective implementation of such programmes. The aim of this study was to evaluate past, present, and future developments of antimicrobial stewardship programmes by surveying medical coordinators working in long-term care facilities in Belgium.

Methods: We conducted an online questionnaire-based survey of 327 Belgian medical coordinators. The questionnaire was composed of 33 questions divided into four sections: characteristics of the respondents, organisational frameworks for implementation of the antimicrobial stewardship programme, tools to promote appropriate antimicrobial use and priorities of action. Questions were multiple choice, rating scale, or free text.

Results: A total of 39 medical coordinators (12 %) completed the questionnaire. Past or present antimicrobial stewardship initiatives were reported by 23 % of respondents. The possibility of future developments was rated 2.7/5. The proposed key role of medical coordinators was rated <3/5 by 36 % of respondents. General practitioners, nursing staff, and hospital specialists are accepted as important roles. The use of antimicrobial guidelines was reported by only 19 % of respondents. Education was considered the cornerstone for any future developments. Specific diagnostic recommendations were considered useful, but chest x-rays were judged difficult to undertake. The top priority identified was to reduce unnecessary treatment of asymptomatic urinary infections.

Conclusions: Our study shows that the implementation of an antimicrobial stewardship programme is reported only in a minority of nursing homes. The possibility of future developments is uncertain. Nevertheless, the self-selected medical coordinators who responded to the survey reported a good knowledge of this complex problem. Despite a lack of optimism, medical coordinators seem to have the appropriate competencies to play a key role in antimicrobial stewardship in the future.
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http://dx.doi.org/10.1186/s13756-016-0106-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784372PMC
March 2016

Decreased Antibiotic Consumption in the Belgian Community: Is It Credible?

Clin Infect Dis 2016 Feb 3;62(3):403-4. Epub 2015 Oct 3.

Department of Intensive Care Unit, University Hospital of Liège, Belgium.

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http://dx.doi.org/10.1093/cid/civ868DOI Listing
February 2016

Prevention of ventilator-associated pneumonia and ventilator-associated conditions: a randomized controlled trial with subglottic secretion suctioning.

Crit Care Med 2015 Jan;43(1):22-30

1Department of General Intensive Care, University Hospital of Liege, Liège, Belgium. 2Department of Medicine, University Hospital of Liege, Liège, Belgium. 3Department of Emergency Medicine, University Hospital of Liege, Liège, Belgium.

Objectives: Ventilator-associated pneumonia diagnosis remains a debatable topic. New definitions of ventilator-associated conditions involving worsening oxygenation have been recently proposed to make surveillance of events possibly linked to ventilator-associated pneumonia as objective as possible. The objective of the study was to confirm the effect of subglottic secretion suctioning on ventilator-associated pneumonia prevalence and to assess its concomitant impact on ventilator-associated conditions and antibiotic use.

Design: Randomized controlled clinical trial conducted in five ICUs of the same hospital.

Patients: Three hundred fifty-two adult patients intubated with a tracheal tube allowing subglottic secretion suctioning were randomly assigned to undergo suctioning (n = 170, group 1) or not (n = 182, group 2).

Main Results: During ventilation, microbiologically confirmed ventilator-associated pneumonia occurred in 15 patients (8.8%) of group 1 and 32 patients (17.6%) of group 2 (p = 0.018). In terms of ventilatory days, ventilator-associated pneumonia rates were 9.6 of 1,000 ventilatory days and 19.8 of 1,000 ventilatory days, respectively (p = 0.0076). Ventilator-associated condition prevalence was 21.8% in group 1 and 22.5% in group 2 (p = 0.84). Among the 47 patients with ventilator-associated pneumonia, 25 (58.2%) experienced a ventilator-associated condition. Neither length of ICU stay nor mortality differed between groups; only ventilator-associated condition was associated with increased mortality. The total number of antibiotic days was 1,696 in group 1, representing 61.6% of the 2,754 ICU days, and 1,965 in group 2, representing 68.5% of the 2,868 ICU days (p < 0.0001).

Conclusions: Subglottic secretion suctioning resulted in a significant reduction of ventilator-associated pneumonia prevalence associated with a significant decrease in antibiotic use. By contrast, ventilator-associated condition occurrence did not differ between groups and appeared more related to other medical features than ventilator-associated pneumonia.
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http://dx.doi.org/10.1097/CCM.0000000000000674DOI Listing
January 2015

Modelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: the PROMESSE study.

J Antimicrob Chemother 2015 Jan 12;70(1):207-16. Epub 2014 Sep 12.

Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium.

Objectives: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia.

Patients And Methods: Among 55 patients in intensive care treated with 1 g of meropenem every 8 h for severe nosocomial pneumonia, 30 were assigned to intermittent infusion (II; over 0.5 h) and 25 to extended infusion (EI; over 3 h) groups. Based on plasma and epithelial lining fluid (ELF) concentrations determined at steady-state, pharmacokinetic modelling and Monte Carlo simulations were undertaken to assess the probability of attaining drug concentrations above the MIC for 40%-100% of the time between doses (%T > 1-fold and 4-fold MIC), for 1 or 2 g administered by either method.

Results: Penetration ratio, measured by the ELF/plasma ratio of AUCs, was statistically higher in the EI group than in the II group (mean ± SEM: 0.29 ± 0.030 versus 0.20 ± 0.033, P = 0.047). Considering a maximum susceptibility breakpoint of 2 mg/L, all dosages and modes of infusions achieved 40%-100% T > 1-fold MIC in plasma, but none did so in ELF, and only the 2 g dose over EI achieved 40%-100% T > 4-fold MIC in plasma.

Conclusions: The optimum regimen to treat severe nosocomial pneumonia was 2 g of meropenem infused over 3 h every 8 h. This regimen achieved the highest pharmacodynamic targets both in plasma and in ELF.
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http://dx.doi.org/10.1093/jac/dku354DOI Listing
January 2015

Fatal alveolar echinococcosis of the lumbar spine.

J Clin Microbiol 2013 Feb 21;51(2):688-91. Epub 2012 Nov 21.

Department of Medical Microbiology, University Hospital of Liège, Liège, Belgium.

For the last 10 years, the southern part of Belgium has been recognized as a low-risk area of endemicity for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a severe liver condition and can sometimes spread to other organs. However, alveolar echinococcosis involving bones has been described only very rarely. Here, a fatal case of spondylodiscitis due to E. multilocularis contracted in southern Belgium is reported.
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http://dx.doi.org/10.1128/JCM.01906-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553908PMC
February 2013

Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.

Crit Care Med 2012 Aug;40(8):2304-9

Department of General Intensive Care, University Hospital of Liege, Domaine universitaire de Liège, Liege, Belgium.

Objectives: To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients.

Design: Single-center, prospective, randomized controlled study.

Setting: Five intensive care units from a tertiary teaching hospital.

Patients: All consecutive adult patients hospitalized for >48 hrs in the intensive care unit during a 9-month period.

Interventions: Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist.

Measurements And Main Results: There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6±34.4% and 57.7±34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p=.11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value>1µg/L and 14.9% of the cases with confirmed infection had procalcitonin levels<0.25 µg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve=0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician.

Conclusions: Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients.
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http://dx.doi.org/10.1097/CCM.0b013e318251517aDOI Listing
August 2012

Gentamicin in infective endocarditis: how to use it?

Clin Infect Dis 2009 Jul;49(2):320-1; author reply 321

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http://dx.doi.org/10.1086/600063DOI Listing
July 2009

Autoimmune angioneurotic edema in a patient with Helicobacter pylori infection.

Helicobacter 2009 Feb;14(1):9-11

Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire, Liege, Belgium.

Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not elucidated. We describe a patient with IgA antibodies against C1-INH without other autoimmune markers. Our patient had gastritis and Helicobacter pylori infection, proven by biopsy. This case suggests that H. pylori infection can act as triggering factor for acquired autoimmune angioneurotic edema.
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http://dx.doi.org/10.1111/j.1523-5378.2009.00651.xDOI Listing
February 2009

Report of a case of Streptococcus agalactiae mycotic aneurysm and review of the literature.

Int J Surg Pathol 2008 Jul;16(3):314-9

Department of Infectious Diseases, Center Hospitalier Universitaire de Ligeg, Ligeg, Belgium.

A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a variety of infections in human beings, aortitis is uncommon. Chronic alcoholism and diabetes mellitus are the 2 major predisposing conditions for group B Streptococci infection and both were present in this case. The abdominal pain and elevated inflammatory markers in the absence of fever were elusive in presentation; however, the diagnosis of mycotic aneurysm was established by abdominal computed tomography scan. The patient was treated successfully by resection of the diseased aorta and aortic allograft replacement. Culture of the excised tissue grew Streptococcus agalactiae sensitive to penicillin G and (other commonly tested antibiotics) fluoroquinolones. A prolonged course of moxifloxacin (for 6 months) was administered due to the persistence of elevated inflammatory markers and was remarkably well tolerated. Sixteen months after stopping the antibiotics, the patient is doing well, and the control imaging studies are satisfactory.
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http://dx.doi.org/10.1177/1066896907310304DOI Listing
July 2008

Downregulation of CD94/NKG2A inhibitory receptors on CD8+ T cells in HIV infection is more pronounced in subjects with detected viral load than in their aviraemic counterparts.

Retrovirology 2007 Oct 10;4:72. Epub 2007 Oct 10.

University of Liège, Laboratory of Immunology and Infectious Diseases, GIGA-R, Liège, Belgium.

The CD94/NKG2A heterodimer is a natural killer receptor (NKR), which inhibits cell-mediated cytotoxicity upon interaction with MHC class I gene products. It is expressed by NK cells and by a small fraction of activated CD8+ T lymphocytes. Abnormal upregulation of the CD94/NKG2A inhibitory NKR on cytotoxic T cells (CTLs) could be responsible for a failure of immunosurveillance in cancer or HIV infection. In this study, CD94/NKG2A receptor expression on CD8+ T lymphocytes and NK cells was assessed in 46 HIV-1-infected patients (24 viraemic, 22 aviraemic) and 10 healthy volunteers. The percentage of CD8+ T lymphocytes expressing the CD94/NKG2A inhibitory heterodimer was very significantly decreased in HIV-1-infected patients in comparison with non-infected controls. Within the HIV infected patients, the proportion of CD8+ T lymphocytes and NK cells expressing CD94/NKG2A was higher in subjects with undetectable viral loads in comparison with their viraemic counterparts. No significant difference was detected in the proportion of CD8+ T lymphocytes expressing the activatory CD94/NKG2C heterodimer between the HIV-1 infected patients and the healthy donors, nor between the vireamic and avireamic HIV-1 infected patients. In conclusion, chronic stimulation with HIV antigens in viraemic patients leads to a decreased rather than increased CD94/NKG2A expression on CD8+ T lymphocytes and NK cells.
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http://dx.doi.org/10.1186/1742-4690-4-72DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2098781PMC
October 2007

A patient with HIV infection, cough, asthenia, and fever.

Clin Infect Dis 2007 Sep;45(5):662-3, 559-600

Infectious Diseases and AIDS, Internal Medicine, Centre Hospitalier Universitaire, Liege, Belgium.

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http://dx.doi.org/10.1086/520656DOI Listing
September 2007

Place of newer quinolones and rifampicin in the treatment of Gram-positive bone and joint infections.

J Antimicrob Chemother 2004 Dec 21;54(6):1158; author reply 1159. Epub 2004 Oct 21.

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http://dx.doi.org/10.1093/jac/dkh451DOI Listing
December 2004