Institut de veille sanitaire

About: Institut de veille sanitaire is a healthcare organization based out in Saint-Maurice, France. It is known for research contribution in the topics: Population & Public health. The organization has 1055 authors who have published 1547 publications receiving 56945 citations. The organization is also known as: INVS & InVS.

Multicenter Outbreak of Infections by Saprochaete clavata, an Unrecognized Opportunistic Fungal Pathogen

Abstract: Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, wholegenome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens. IMPORTANCE Several cases of rapidly fatal infections due to the fungus Saprochaete clavata were reported in France within a short period of time in three health care facilities, suggesting a common source of contamination. A nationwide alert collected 30 cases over 1 year, including an outbreak of 18 cases over 8 weeks. Whole-genome sequencing (WGS) was used to analyze recent and historical isolates and to design a clade-specific genotyping method that uncovered a clone associated with the outbreak, thus allowing a case-case study to analyze the risk factors associated with infection by the clone. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen.

The Deleterious Effect of Admission Hyperglycemia on Survival and Functional Outcome in Patients With Intracerebral Hemorrhage

Abstract: Background and Purpose—We aimed to evaluate the association between blood glucose (BG) levels at admission and both functional outcome at discharge and 1-month mortality after intracerebral hemorrhage (ICH). Methods—All cases of first-ever ICH were identified from the population-based Stroke Registry of Dijon, France from 1985 to 2009. Clinical and radiological information was recorded. BG was measured at admission. Multivariate analyses were performed using logistic and Cox regression models. Multiple imputation was used as a sensitivity analysis. Results—We recorded 465 first-ever ICH. BG at admission was obtained in 416 patients (89.5%) with a median value of 6.92 mmol/L. In multivariate analyses, BG in the highest tertile (≥8.6 mmol/L) was an independent predictor of functional handicap (odds ratio, 2.51; 95% CI, 1.43–4.40; P=0.01) and 1-month mortality (hazard ratio, 2.51; 95% CI, 1.23–2.43; P=0.002). The results were consistent with those obtained from multiple imputation analyses. Conclusions—Admis...

Burden of acute gastroenteritis and healthcare-seeking behaviour in France: a population-based study

Abstract: In France surveillance underestimates the true burden of acute gastroenteritis (AG). We conducted a population-based, retrospective cross-sectional telephone survey between May 2009 and April 2010 in order to obtain more accurate estimates of the incidence and the burden of AG and to describe healthcare-seeking behaviour for AG. Of the 10 080 persons included in the survey, 260 respondents reported 263 episodes of AG. The incidence rate of AG was estimated at 0·33 cases/person-year (95% CI 0·28-0·37). It was highest in children aged <5 years and declined with age. Thirty-three percent (95% CI 27-40) of the AG cases consulted a physician and 76% (95% CI 70-82) used medication. Our results indicate that there are more than 21 million episodes of AG each year in France. These results allow a more accurate interpretation of the data derived from existing AG surveillance systems.