Search PubMed⌕ Search

Biomedical subjects

Y Hansmann

Publications and source records attributed to Y Hansmann.

At least 19 recordsLinked to original sources
PubMed2006

An outbreak of Pneumococcal pneumonia among residents of a retirement home in France during October 2003.

We describe an outbreak of pneumonia due to Streptococcus pneumoniae in a French retirement home. Eleven residents developed pneumonia. Eight patients had positive results of urinary antigen tests. There were no further cases after the implementation of control measures, which involved isolation of and receipt of antibiotic therapy by symptomatic residents. No risk factors for transmission of S. pneumoniae were identified in this population.

Aged↗
PubMed2006

Impact of the use of aminoglycosides in combination antibiotic therapy on septic shock and mortality due to Staphylococcus aureus bacteremia.

BACKGROUND: The purpose of this study was to evaluate the possible impact of antimicrobial combination regimens containing an aminoglycoside (AG) on morbidity and mortality associated with S. aureus bacteremia. METHODS: All inpatients over 18 years of age with S. aureus bacteremia were prospectively enrolled in three tertiary care hospitals in France and Ireland. Patients were included in the group "treated with AG" if they received at least 24 h of aminoglycoside therapy within 7 days after a positive blood culture in combination with an effective antimicrobial against the S. aureus. A Cox's proportional hazard model was used in univariate and multivariate survival analysis, the covariate "treatment with AG" being introduced as a time-dependent covariate. RESULTS: Nine percent of the 90 patients who received AG died because of infection versus 13% in the group that did not receive a combination including an AG (p>0.05). In the multivariate Cox model, stratified by septic shock and controlling for age and Charlson-weighted index of comorbidity, the adjusted odds ratio for death due to S. aureus infection associated with the use of AG was 0.6 [95% CI: (0.2-1.9); p=0.4]. However, AG was found to have a protective effect on septic shock occurrence [OR=0.3; 95% CI: (0.1-0.7), p=0.004], controlling for age, portal of entry not related to catheter infection, and diabetes. CONCLUSION: Although there was no decrease in mortality due to S. aureus infection in patients treated with AG therapy, we found a significant benefit of AG in preventing septic shock. This data argues for the early use of AG in patients with S. aureus bacteremia.

Journal Article↗
PubMed2006

Comparison of microbiological results of needle puncture vs. superficial swab in infected diabetic foot ulcer with osteomyelitis.

AIM: To study prospectively two methods for the bacteriological diagnosis of osteomyelitis related to diabetic foot ulcer: needle puncture performed across normal skin surrounding the foot ulcer and superficial swabbing of the ulcer. PATIENTS AND METHODS: Diabetic patients with a foot ulcer complicated by bone or joint infection, as detected by X-ray imaging, were included in the study. Ulcer swabbing and needle puncture were performed in each patient. To reach the tissue nearest the bone surface, needle puncture was guided by X-ray imaging and the drop of fluid obtained by aspiration was used for both aerobic and anaerobic bacterial culture. RESULTS: Twenty-one diabetic patients were included. The mean number of microorganisms isolated by needle puncture was significantly lower compared with that obtained by superficial swabbing: 1.09 vs. 2.04 (P < 0.02). Three bacterial species were isolated by needle puncture only in one patient while three or more bacterial isolates were obtained by superficial swabbing in six patients. No bacterial isolate was detected in five patients by needle puncture and in two patients by superficial swabbing. Staphylococcus aureus accounted for 70% of cases (seven patients) when a single bacterial species was obtained by needle puncture. After needle puncture, no wound complication or infection was observed. CONCLUSION: Culture of samples obtained by needle puncture revealed one or two bacterial isolates in two-thirds of diabetic patients with osteomyelitis following foot ulcer. Given the lack of complications, this invasive diagnostic technique should be considered for deep direct sampling in diabetic patients with osteomyelitis related to foot ulcer when surgical debridement is contraindicated or delayed.

Adult↗
PubMed2005

[Cogan's syndrome revealed by haemorrhagic glairous diarrhoea].

INTRODUCTION: Cogan's syndrome is defined by the combination of non syphilitic interstitial keratitis and inner ear dysfunction, similar to Meniere's disease. OBSERVATION: Cogan's syndrome was revealed by haemorrhagic glaireous diarrhoea in a 21 year-old woman whose medical history included Hirschsprung's disease. Cerebral MRI revealed viral-like bilateral neuritis of the eighth cranial nerve, never described in the literature before. The auditory and visual disorders regressed after treatment with corticosteroids. CONCLUSION: The early diagnosis of Cogan's syndrome permits the cure of the visual and auditory and notably inner ear symptoms with corticosteroid therapy.

Adult↗
PubMed2004

Positive surveillance blood culture is a predictive factor for secondary metastatic infection in patients with Staphylococcus aureus bacteraemia.

PURPOSE: Staphylococcus aureus bacteraemia (SAB) may be complicated by secondary metastatic infection such as endocarditis, osteomyelitis or septic arthritis. This cohort study aimed to assess the prognostic value of sustained bacteraemia for outcomes related to Staphylococcus aureus bacteraemia. SUBJECTS AND METHODS: The study took place in three tertiary-care, university-affiliated hospitals. Patients were prospectively included if they agreed to participate and if the following data were available: (a). surveillance blood culture taken between 24 and 48 h after commencement of effective antibiotic therapy; (b). appropriate investigations (at least a TTE) performed as suggested by the infectious diseases consult service. Patients with sustained bacteraemia defined as persistent positive blood cultures more than 24 h after commencement of effective antibiotic therapy were compared to patients for whom the surveillance blood culture was negative. RESULTS: One hundred and four patients were enrolled, including 51 patients diagnosed with sustained bacteraemia. Sustained bacteraemia was significantly associated with a higher frequency of secondary metastatic infection (p<0.001) and with a higher frequency of CRP>100 mg/l. Frequency of acute complications due to infection, septic shock and death due to bacteraemia was higher for patients with sustained bacteraemia but this difference was not statistically significant. Using a Cox model, the risk for death associated with sustained SAB, controlling for Index of comorbidity and age (categorised as or=70 years), was 1.2 (95% CI: (0.5, 3); p>0.05). CONCLUSION: In conclusion, surveillance blood cultures, especially performed on effective antibiotic therapy, may be a simple and cost-effective way to select a population at risk for secondary metastatic infection from SAB.

Adolescent↗
PubMed2004

[Risk factors for nosocomial Clostridium difficile diarrhoea in an infectious and tropical diseases department].

FOREWORD: Clostridium difficile associated diarrhea (CDAD) accounts for 25% of all cases of diarrhea occurring in hospital. Infectious diseases departments are considered as presenting with an important risk of CDAD because of the large quantity of antibiotics used. OBJECTIVES AND METHOD: The authors made a prospective study in the first 6 months of 2001, in order to identify the risk factors of CDAD in their department. One hundred and fifty-two patients hospitalized for at least 6 days were included in this study. The studied factors were: age, mean number of days of hospitalization (MDH), antibiotic therapy, WHO scale of reduced mobility of patients, recent hospitalization (less than 3 months before). RESULTS: MDH was 36 (IC95%: 23-48). Beta-lactam antibiotics were found as significant risk factors, as reported in the literature. However, age and a recent hospitalization were not related to the CDAD as described in the literature. A reduced mobility of patients was identified as a significant risk factor for developing a CDAD in our department.

Age Factors↗
PubMed2004

[Anthrax].

Explore the source record for details and available documents.

Anthrax↗
PubMed2003

[Severe acute respiratory syndrome (SARS). The questions raised by the management of a patient in Besançon and Strasbourg].

INTRODUCTION: In mid-June 2003, 8500 probable cases of Severe Acute respiratory Syndrome (SARS) responsible for 800 deaths in 29 countries were reported by the World Health Organization (WHO). In France, 5 probable cases of SARS were diagnosed until May 2003. We report the case of one of the 5 French cases, hospitalized successively in Besançon then in Strasbourg. OBSERVATION: This 54 year-old man was infected during the Air France flight from Hanoi to Paris via Bangkok by the index case, who himself had been contaminated at the French hospital in Hanoi and who was hospitalized in a critical state in the Tourcoing hospital shortly after his arrival in France. The first clinical signs (fever and dry cough) appeared 4 days after contact with the index case. The chest X-ray showed a pulmonary consolidation 6 days after the first clinical symptoms. Blood test revealed deep lymphopenia and elevated LDH. The patient finally recovered with a treatment combining ribavirin and steroids. CONCLUSION: The clinical symptoms of SARS are unspecific and its evolution may be misleading. The epidemiological context (contact with the index case) is a key point for the diagnosis. The management of such a patient requires the careful protection of contacts, the adequation between medical and paramedical staff and excess work and communication to the general public.

Aircraft↗
PubMed2003

Human anaplasmosis presenting as atypical pneumonitis in France.

Human anaplasmosis is a febrile illness caused by Anaplasma phagocytophilum, an intracellular bacterium transmitted by Ixodes ticks in the United States and Europe. Although cough is reported in 30% of the American cases, interstitial pneumonitis has been noted only once. Of the 9 confirmed cases reported in Europe, 3 presented with atypical pneumonitis. A. phagocytophilum should be added to the list of agents responsible for interstitial pneumonitis, especially in areas where human anaplasmosis is endemic.

Anaplasma phagocytophilum↗
PubMed2003

Haematogenous brain abscess complicating a case of Austrian syndrome.

Austrian syndrome includes pneumococcal endocarditis, meningitis and rupture of the aortic valve. This study reports a case with a haematogenous brain abscess. Physicians should be aware of the risk factors and dramatic evolution of this rare disease, to avoid delays in diagnosis, and to prevent embolic complications and rupture of the aortic valve.

Aortic Valve Insufficiency↗
PubMed2002

Prospective assessment of a new polymerase chain reaction target (STEVOR) for imported Plasmodium falciparum malaria.

The diagnostic value of a polymerase chain reaction (PCR)-based method for amplifying a new target of repeated genes (STEVOR) in Plasmodium falciparum was prospectively assessed on samples from 210 febrile patients returning from areas endemic for malaria. This method is capable of detecting 0.01 parasites in one microliter of blood. Plasmodium falciparum STEVOR PCR confirmed the results of the thin- and thick-film direct examination method but identified Plasmodium falciparum in four patients in whom direct examination was inconclusive at the species level. Moreover, PCR was positive in two patients with a negative direct examination. Thus, Plasmodium falciparum STEVOR PCR had 100% sensitivity and specificity and could be used in selected parasitology laboratories when expert advice is required.

Animals↗
PubMed2002

Long-term prognosis of patients treated for erythema migrans in France.

BACKGROUND: The long-term prognosis of patients treated for erythema migrans has only rarely been assessed. OBJECTIVES: To evaluate the clinical characteristics and long-term prognosis of patients treated for erythema migrans in the region of Alsace, France. METHODS: In a prospective study, 56 consecutive patients presenting with erythema migrans at the Strasbourg University Hospital between 1995 and 1999 were examined and a Borrelia burgdorferi enzyme immunoassay was performed. Patients were treated with tetracyclines or amoxycillin. Patients were re-examined 6 weeks later and a telephone interview was performed in summer 2000 to evaluate the long-term outcome. RESULTS: There were 25 women and 31 men of mean age 49 years presenting with single (n = 54) or multiple (n = 2) erythema migrans lesions. At the time of diagnosis, 30% of the patients had systemic signs, myalgias or arthralgias and only 36% of 50 patients were seroreactive against B. burgdorferi. None of the 51 patients evaluated at 6 weeks and none of the 37 patients interviewed after a median delay of 3 years had developed complications attributable to Lyme borreliosis. CONCLUSIONS: The prognosis of patients treated for Lyme borreliosis in this part of France is excellent. Therefore, a complete clinical examination is sufficient as an initial evaluation and long-term follow-up is not necessary.

Adolescent↗
PubMed2002

[Borrelia strains that cause erythema migrans in Alsace, France].

INTRODUCTION: In Europe, Borrelia burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii are known as pathogens among the Borrelia burgdorferi sensu lato group. Since it is not yet known which Borrelia are responsible for Lyme borreliosis in France, the objective of this study was to identify the species of Borrelia responsible for erythema migrans in the region of Alsace, France. PATIENTS AND METHODS: Eighteen patients with erythema migrans (EM) of more than 5 cm of diameter were included in this prospective study. All patients were investigated at the Strasbourg University Hospital. Patients were biopsied on the active border of their lesion. Cutaneous biopsies of the active border of the lesion were cultivated in BSK-H medium (Sigma) and analysed in vitro by PCR after 8 weeks of culture, using flagellin consensus sequences which are present in all species of Borrelia burgdorferi sensu lato group as primers. Species-specific oligotyping was used for species identification. RESULTS: Among the 18 patients biopsied, 7 had evidence of borrelia infection revealed by culture and/or PCR. Borrelia afzelii was detected in 4 patients and Borrelia garinii in three. CONCLUSION: These preliminary results appear to confirm that Borrelia afzelii and Borrelia garinii are the predominant borrelial species in EM lesions in our geographic area, as in other European countries.

Adult↗