Papers by Xavier Bertrand
Microorganisms
Staphylococcus aureus (SA) belonging to the clonal complex 398 (CC398) took a special place withi... more Staphylococcus aureus (SA) belonging to the clonal complex 398 (CC398) took a special place within the species due to its spread throughout the world. SA CC398 is broadly separated in two subpopulations: livestock-associated methicillin-resistant SA (MRSA) and human-associated methicillin-susceptible SA (MSSA). Here, we reviewed the global epidemiology of SA CC398 in human clinical infections and focused on MSSA CC398. The last common ancestor of SA CC398 was probably a human-adapted prophage φSa3-positive MSSA CC398 strain, but the multiple transmissions between human and animal made its evolution complex. MSSA and MRSA CC398 had different geographical evolutions. Although MSSA was present in several countries all over the world, it was mainly reported in China and in France with a prevalence about 20%. MSSA CC398 was frequently implicated in severe infections such as bloodstream infections, endocarditis, and bone joint infections whereas MRSA CC398 was mainly reported in skin and ...
European Journal of Clinical Microbiology & Infectious Diseases
Veterinary microbiology, 2018
We evaluate here the presence of the mcr-1-like and mcr-2 genes in Escherichia coli and Salmonell... more We evaluate here the presence of the mcr-1-like and mcr-2 genes in Escherichia coli and Salmonella spp. isolated from healthy food-producing animals at slaughter between 2002 and 2014 in Europe. Isolates were retrieved from cattle, pig and chicken from 11 European countries of production. The susceptibility to colistin and antibiotics used in human medicine was determined by agar dilution. Colistin-resistant isolates were PCR-screened for mcr genes. mcr-positive isolates were typed by Pulsed-Field Gel Electrophoresis (PFGE) and Multi-Locus Sequence Typing. Among the 10,206 E. coli and 1774 Salmonella spp. isolated from cattle, pigs and chickens, 148 E. coli and 92 Salmonella spp. isolates were resistant to colistin. We found mcr-1-like gene in 68 (0.7%) E. coli and 2 (0.1%) Salmonella isolates whereas none of the isolates tested positive for mcr-2. MCR-1-like-positive E. coli were isolated from 2008 to 2014 in chicken (n=44, 1.2%) and pigs (n=24, 0.7%). The presence of mcr-1-like va...
Antimicrobial resistance and infection control, 2018
The ongoing extended spectrum β-lactamase-producing (ESBL-PE) pandemic has led to an increasing c... more The ongoing extended spectrum β-lactamase-producing (ESBL-PE) pandemic has led to an increasing carbapenem use, requiring release of guidelines for carbapenem usage in France in late 2010. We sought to determine factors associated with changes in carbapenem use in intensive care units (ICUs), medical and surgical wards between 2009 and 2013. This ward-level multicentre retrospective study was based on data from French antibiotic and multidrug-resistant bacteria surveillance networks in healthcare facilities. Antibiotic use was expressed in defined daily doses per 1000 patient-days. Factors associated with the reduction in carbapenem use (yes/no) over the study period were determined from random-effects logistic regression model (493 wards nested within 259 healthcare facilities): ward characteristics (type, size…), ward antibiotic use (initial antibiotic use [i.e., consumption of a given antibiotic in 2009], initial antibiotic prescribing profile [i.e., proportion of a given antibio...
Infection control and hospital epidemiology, 2018
OBJECTIVE To describe an outbreak of multidrug-resistant Pseudomonas aeruginosa in which the hosp... more OBJECTIVE To describe an outbreak of multidrug-resistant Pseudomonas aeruginosa in which the hospital waste-pipe system was the likely source of contamination and to report the bundle of measures that facilitated the long-term control of the outbreak. DESIGN Outbreak investigation. SETTING The hematology unit of a tertiary-care referral center. PATIENTS Patients who were colonized or infected with P. aeruginosa belonging to the clonal outbreak. METHODS Patients admitted to our 15-bed stem-cell transplantation hematology unit were screened for P. aeruginosa carriage. Pseudomonas aeruginosa isolates were also obtained from diagnostic samples. We assessed the microbiological contamination of P-traps, water and toilets for 42 months. Extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) were screened and identified by polymerase chain reaction (PCR) and sequencing. Molecular typing of ESBL- or MBL-producing isolates was carried out using pulsed-field gel electrophoresis...
International journal of antimicrobial agents, Jan 25, 2018
The spread of carbapenemase-producing Enterobacteriaceae (CPE) in the Southwest Indian Ocean isla... more The spread of carbapenemase-producing Enterobacteriaceae (CPE) in the Southwest Indian Ocean islands is poorly known. We describe here an outbreak of colistin-resistant Enterobacter cloacae harboring bla in the French overseas department of Mayotte. Between October 2015 and January 2017, all isolates of imipenem-non-susceptible E. cloacae at the Mayotte Medical Center and University Hospital of Reunion Island were screened for carbapenemase production. Positive isolates were typed by pulsed-field gel electrophoresis and WGS-based MLST and all β-lactamase genes identified by PCR and sequencing. The resistance profiles were determined by agar diffusion and E-tests. Genetic support of the bla gene was determined by WGS. We detected 18 isolates of E.cloacae harboring the bla gene in 17 patients from Mayotte. PFGE analysis showed 16 of the 18 strains to be clonally-related and belonging to sequence type ST820. Based on clinical data, this outbreak most likely had a community origin. The ...
Journal of global antimicrobial resistance, 2018
Fluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum β-lac... more Fluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae that are susceptible to these agents. Owing to increasing non-susceptibility to carbapenems among Enterobacteriaceae, in this study FQ resistance mechanisms were characterised in 36 ertapenem-non-susceptible Klebsiella pneumoniae isolated from North-Eastern France in 2012. The population structure was described by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Among the 36 isolates, 13 (36%) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35-encoding gene might be considered a major resistance determinant that could explain the non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA-48a plasmid. All 36 K. pneumoniae isolates also harboured a FQ resistance determinant. The aac(6')-Ib-cr gene was the major plasmid-mediated quinolone resistan...
International journal of antimicrobial agents, 2018
The vancomycin minimum inhibitory concentration (MIC) has been shown to affect the outcome of met... more The vancomycin minimum inhibitory concentration (MIC) has been shown to affect the outcome of methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. In this study, the outcomes of patients with MSSA bacteraemia with a vancomycin MIC ≥ 1.5 mg/L were assessed. A prospective cohort of patients with MSSA bacteraemia in two tertiary-care hospitals was collected. The vancomycin MIC was determined by Etest. Staphylococcus aureus strains were categorised as low (<1.5 mg/L) or high (≥1.5 mg/L) vancomycin MIC. First- and second-line treatments were recorded and classified as optimal, appropriate and inappropriate. The primary endpoint was 30-day mortality. A total of 250 patients with S. aureus bacteraemia were analysed, of whom 64 (25.6%) had strains with a high vancomycin MIC. History of dialysis (P = 0.001) and ultimately fatal disease (P = 0.005) were associated with strains with a high vancomycin MIC. The 30-day mortality was 24.7% (46/186) in patients with a low vancomycin...
Microbial Genomics
Pseudomonas aeruginosa is a ubiquitous opportunistic pathogen with several clones being frequentl... more Pseudomonas aeruginosa is a ubiquitous opportunistic pathogen with several clones being frequently associated with outbreaks in hospital settings. ST395 is among these so-called 'international' clones. We aimed here to define the biological features that could have helped the implantation and spread of the clone ST395 in hospital settings. The complete genome of a multidrug resistant index isolate (DHS01) of a large hospital outbreak was analysed. We identified DHS01-specific genetic elements, among which were identified those shared with a panel of six independent ST395 isolates responsible for outbreaks in other hospitals. DHS01 has the fifth largest chromosome of the species (7.1 Mbp), with most of its 1555 accessory genes borne by either genomic islands (GIs, n=48) or integrative and conjugative elements (ICEs, n=5). DHS01 is multidrug resistant mostly due to chromosomal mutations. It displayed signatures of adaptation to chronic infection in part due to the loss of a 131 kbp chromosomal fragment. Four GIs were specific to the clone ST395 and contained genes involved in metabolism (GI-4), in virulence (GI-6) and in resistance to copper (GI-7). GI-7 harboured an array of six copper transporters and was shared with nonpathogenic Pseudomonas sp. retrieved from copper-contaminated environments. Copper resistance was confirmed phenotypically in all other ST395 isolates and possibly accounted for the spreading capability of the clone in hospital outbreaks, where water networks have been incriminated. This suggests that genes transferred from copper-polluted environments may have favoured the implantation and spread of the international clone P. aeruginosa ST395 in hospital settings. DATA SUMMARY 1. This whole-genome sequencing project has been deposited at GenBank/EMBL/DDBJ; accession number: CP013993.1 (urlhttps://www.ncbi.nlm.nih.gov/nuccore/CP013993.1). 2. The collections of ST395 and non-ST395 isolates have been deposited at GenBank/EMBL/DDBJ; Bio-Projects: PRJNA379554 (urlhttps://www.ncbi.nlm.nih. gov/bioproject/?term=PRJNA379554) and PRJNA380885 (urlhttps://www.ncbi.nlm.nih.gov/bioproject/?term= PRJNA380885) (Table S2, available in the online Supplementary Material). 3. The 82 Pseudomonas aeruginosa isolates for which complete genomes were available from the National Center for Biotechnology Information at the time of the study (June 2017) were included in the study.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 22, 2017
Despite the non-clonal epidemic population structure of Pseudomonas aeruginosa, several multi-loc... more Despite the non-clonal epidemic population structure of Pseudomonas aeruginosa, several multi-locus sequence types are distributed worldwide and are frequently associated with epidemics where multidrug resistance confounds treatment. ST235 is the most prevalent of these widespread clones. In this study we aimed to understand the origin of ST235 and the molecular basis for its success. The genomes of 79 P. aeruginosa ST235 isolates collected worldwide over a 27-year period were examined. A phylogenetic network was built, using a Bayesian approach to find the Most Recent Common Ancestor, and we identified antibiotic resistance determinants and ST235-specific genes. Our data suggested that the ST235 sublineage emerged in Europe around 1984, coinciding with the introduction of fluoroquinolones as an antipseudomonal treatment. The ST235 sublineage seemingly spread from Europe via two independent clones. ST235 isolates then appeared to acquire resistance determinants to aminoglycosides, β...
Trends in Microbiology, 2017
Bacterial typing is crucial to tackle the spread of bacterial pathogens but current methods are t... more Bacterial typing is crucial to tackle the spread of bacterial pathogens but current methods are time-consuming and costly. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been recently integrated into the microbiology laboratory workflow for a quick and low-cost microbial species identification. Independent research groups have successfully redirected the original function of this technology from their primary purpose to discriminate subgroups within pathogen species. However, identical bacterial subgroups could be identified by unrelated peaks by independent methods, thus limiting their robustness and exportability. We propose several guidelines that could improve the performance of MALDI-TOF MS-based typing methods for use as a first-line epidemiological tool.
International journal of antimicrobial agents, 2016
Sequence type 131 (ST131) is a predominant lineage among extraintestinal pathogenic Escherichia c... more Sequence type 131 (ST131) is a predominant lineage among extraintestinal pathogenic Escherichia coli. It plays a major role in the worldwide dissemination of E. coli producing extended-spectrum β-lactamases (ESBLs). Here we describe the long-term epidemiology of this clonal group in a French university hospital, where the incidence of ESBL-producing E. coli has increased from 0.018 case per 1000 patient-days in the year 2000 to 0.50 case per 1000 patient-days in 2014. The first of the 141 ST131 isolates was recovered in 2006, and the ST131 clonal group accounted for 18.1% of total ESBL-producing E. coli over the whole period (2000-2014). Subclonal typing showed that 75.9% (107/141) of ST131 isolates were H30, of which 81.3% (87/107) were H30-Rx. The large majority (137/141) of ESBLs produced were of the CTX-M group, with 94 CTX-M-15, 19 CTX-M-1, 10 CTX-M-27, 8 CTX-M-14 and four other CTX-M types (n = 6). Pulsed-field gel electrophoresis (PFGE) analysis showed high diversity, which i...
Journal of microbiological methods, Aug 1, 2016
Within the last decade methicillin-resistant Staphylococcus aureus belonging to CC398 has become ... more Within the last decade methicillin-resistant Staphylococcus aureus belonging to CC398 has become a worldwide threat associated with livestock. More recently, methicillin-susceptible S. aureus (MSSA) belonging to CC398 have been increasingly reported as a cause of invasive infections in patients without livestock contact. It appears therefore necessary to implement a convenient tool for the surveillance this emerging pathogen. We evaluated the MALDI-TOF MS as a tool for rapid detection of S. aureus CC398. We used 626 S. aureus isolates characterized by a CC398-specific PCR, to constitute independent training (300 isolates including 60 isolates CC398) and validation sets (326 isolates including 82 isolates CC398). Fifteen peak biomarkers of CC398 were identified from the mass spectra of the training set. Ninety four % (307 of 326) of strains of the validation set were well assigned with an overall sensitivity of 93% and a specificity of 95%. Six CC398 and 13 non-CC398 isolates were mi...
GMS hygiene and infection control, 2016
We aimed to study the impact of new water systems, which were less contaminated with P. aeruginos... more We aimed to study the impact of new water systems, which were less contaminated with P. aeruginosa, on the incidence of healthcare-associated P. aeruginosa cases (colonizations or infections) in care units that moved to a different building between 2005 and 2014. Generalized Estimated Equations were used to compare the incidence of P. aeruginosa healthcare-associated cases according to the building. Twenty-nine units moved during the study period and 2,759 cases occurred in these units. No difference was observed when the new building was compared with older buildings overall. Our results did not support our hypothesis of a positive association between water system contamination and the incidence of healthcare-associated P. aeruginosa cases. These results must be confirmed by linking results of water samples and patients' data.
Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, Jan 18, 2016
We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes ... more We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; ...
Antimicrob Agents Chemother, 2010
A nationwide study aimed to identify the extended-spectrum -lactamases (ESBLs), metallo--lactam... more A nationwide study aimed to identify the extended-spectrum -lactamases (ESBLs), metallo--lactamases (MBLs), and extended-spectrum oxacillinases (ES-OXAs) in a French collection of 140 clinical Pseudomonas aeruginosa isolates highly resistant to ceftazidime. Six ESBLs (PER-1, n ؍ 3; SHV-2a, n ؍ 2; VEB-1a, n ؍ 1), four MBLs (VIM-2, n ؍ 3; IMP-18, n ؍ 1), and five ES-OXAs (OXA-19, n ؍ 4; OXA-28, n ؍ 1) were identified in 13 isolates (9.3% of the collection). The prevalence of these enzymes is still low in French clinical P. aeruginosa isolates but deserves to be closely monitored.
Ma Decine Et Maladies Infectieuses, Apr 1, 2006
ABSTRACT Until 2001, the infection control department of the Besançon university hospital (France... more ABSTRACT Until 2001, the infection control department of the Besançon university hospital (France) recommended isolation precautions for all patients colonized–infected by Acinetobacter baumannii (Ab) whatever the antibiotic susceptibility of the strain. These systematic isolation procedures were given up at the beginning of 2002 since the number of colonized–infected patients remained stable from 1998 to 2001.
Annals of Intensive Care, 2016
PHYSICIANS ABSTRACTSO1 Impact of tracheal cuff shape on microaspiration of gastric contents in in... more PHYSICIANS ABSTRACTSO1 Impact of tracheal cuff shape on microaspiration of gastric contents in intubated critically ill patients: a multicenter randomized controlled study (BEST CUFF)Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stephanie Barrailler, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad NseirO2 Bicarbonate versus saline for contrast-induced acute kidney injury prevention in critically ill patientsXavier Valette, Isabelle Desmeulles, Benoit Savary, Romain Masson, Amélie Seguin, Cédric Daubin, Bertrand Sauneuf, Jennifer Brunet, Pierre Verrier, Véronique Pottier, Marie Orabona, Désiré Samba, Gérald Viquesnel, Mathilde Lermuzeaux, Pascal Hazera, Jean-Luc Hanouz, Jean-Jacques Parienti, Damien Du CheyronO3 Neurally adjusted ventilatory assist in the early phase of weaning from mechanical ventilation: a multicenter randomized studyAlexandre Demoule, Marc Clavel, Camille Rolland-Debord, Sébastien Perbet, Nicolas Terzi, Achille Kouatchet, Florent Wallet, Hadrien Roze, Frédéric Vargas, Claude Guérin, Jean Dellamonica, Samir Jaber, Thomas SimilowskiO4 Very high volume hemofiltration with the Cascade system in septic shock patientsJean-Pierre Quenot, Christine Binquet, Christophe Vinsonneau, Saber-Davide Barbar, Sandrine Vinault,, Valérie Deckert, Stephanie Lemaire, Ali Ait Hssain, Rémi Bruyère, Bertrand Souweine, Laurent Lagrost, Christophe AdrieO5 Effect of rapid response systems on hospital mortality, a prospective interventional study and systematic reviewBoris Jung, Aurelien Daurat, Audrey De Jong, Gérald Chanques, Martin Mahul,, Marion Monnin, Nicolas Molinari, Samir JaberO6 Beta-lactams serum concentrations in critically ill cirrhotic patients: a matched control studyOlivier Lheureux, Eric Trepo, Maya Hites, Frederic Cotton, Fleur Wolff, Rudy Surin, Jacques Créteur, Jean-Louis Vincent, Thierry Gustot, Frederique Jacobs, Fabio Silvio TacconeO7 Systematic overdosing of oxa- and cloxacillin in severe infections treated in ICU: Risk factors and side effectsMathilde Neuville, Jean-François Timsit, Najoua El-Helali, Alban Le Monnier, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Romain Sonneville, Lila Bouadma, Bruno MourvillierO8 Amikacin peak concentrations in patients receiving extracorporeal membrane oxygenation (ECMO) support: a case-control studyElodie Gélisse, Mathilde Neuville, Etienne De Montmollin, Guillaume Voiriot, Jean-François Soubirou, Roland Smonig, Aguila Radjou, Eric Magalhaes, Lila Bouadma, Bruno Mourvillier, Jean-François Timsit, Romain SonnevilleO9 A high aminoglycoside regimen associated with renal replacement therapy for the treatment of multi-drug-resistant pathogensAlexandre Brasseur, Maya Hites, Sandrine Roisin, Frederic Cotton, Jean-Louis Vincent, Daniel De Backer, Frederique Jacobs, Fabio Silvio TacconeO10 Optimization of administration of vancomycin in septic patients: a prospective randomized studyValerie Van Ruychevelt, Eric Carlier, Michael Piagnerelli, Michel Vanhaeverbeek, Christine Danguy, Patrick BistonO11 Impact of elevated intra-abdominal pressure on the ability of dynamic parameters to predict fluid responsivenessSiu-Ming Au, Emmanuelle Begot, François Dalmay, Xavier Repessé, Gwenael Prat, Koceila Bouferrache, Michel Slama, Philippe Vignon, Antoine Vieillard-BaronO12 Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysisXavier Monnet, Paul Marik, Jean-Louis TeboulO13 Predicting volume responsiveness by using combined end-expiratory and end-inspiratory occlusion tests with echocardiographyMathieu Jozwiak, Jean-Louis Teboul, Christian Richard, Xavier MonnetO14 Early dynamic left intraventricular obstruction is associated with hypovolemia and hight mortality in septic shock patientsJean-Louis Chauvet, Shari El-Dash, Olivier Delastre, Bernard Bouffandeau, Dominique Jusserand, Jean-Baptiste Michot, Fabrice Bauer, Julien Maizel, Michel SlamaO15 Predictive factors for poor hemodynamic tolerance to fluid removal in ICU: the DepleRea studyFrançois Brazier, Pablo Mercado, Loay Kontar, Dimitri Titeca, Bertand De Cagny, Gaelle Bacari-Risal, Antoine Riviere, Michel Slama, Julien MaizelO16 High-flow nasal cannula: first-line treatment of noninvasive ventilation for infants with bronchiolitis. Applicability and risk factors for failureCamille Guillot, Claire Le Reun, Marie Lampin, Ahmed Sadik, Astrid Botte, Alain Duhamel, Stéphane LeteurtreO17 Is high-flow nasal cannula better than nasal continuous positive airway pressure for bronchiolitis management in pediatric intensive care unit?Aurélie Collins, Céline Kempeneers, Nathalie CajgfingerO18 Interest and risk of high-flow cannula during acute hypoxemic pneumonia in children: a retrospective studyCamille Ohlmann, Robin Pouyau, Fabien Subtil, Florent Baudin, Bruno…
Journal De Mycologie Medicale Journal of Medical Mycology, 2013
Objective.-To evaluate the level of microbial contamination of general pratice environment. Metho... more Objective.-To evaluate the level of microbial contamination of general pratice environment. Methods.-Ten points, including air, water and surfaces were sampled in general practitioner's consultation room of 30 general practices in Franche-Comté region (eastern France). For each sample, a global microbial count was assessed as well as the presence of potential pathogen microorganisms: Aspergillus fumigatus, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae. Results.-We note that 66.3% of the samples (n = 202) were on the target level (< 51 ufc/25 cm 2 , < 101 ufc/m 3 , < 100 ufc/mL in total bacteria, without pathogenic species and without A. fumigatus respectively on surfaces, air and water, without isolation of coliforme bacteria or P. aeruginosa for 100 mL of water). A. fumigatus, S. aureus, P. aeruginosa and Enterobacteriaceae were recovered in 8.0%, 2.1%, 0.7%, 0% respectively. However, 66.7% of air sampling were positive to A. fumigatus with 2 to 12 cfu/m 3. Conclusion.-This study shows a low level of bacterial contamination of general practitioner's consultation room. A. fumigatus frequency in air samples seems equivalent to that found in housing without air treatment.
Infection Control and Hospital Epidemiology, Sep 1, 2001
Uploads
Papers by Xavier Bertrand