In this sero-epidemiological study, we investigated humoral immunity to three vaccine-preventable diseases—tetanus, diphtheria and pertussis—among 331 adults (aged 18–60 years) attending vaccination centres for travellers and who had been vaccinated according to national recommendations in France. Serological results showed that the percentage of subjects with antibodies to diphtheria and tetanus decreases with age. Results also confirmed surveillance data on vaccination in France, with 7.6% of the study population (13.4% of those aged 18–29 years) having recently acquired a pertussis infection. These results confirm the importance of following French recommendations for regular boosters for tetanus and diphtheria among adults. They also indicate the need for better implementation of the current recommendations for pertussis-vaccine boosters in adults.
An open, non-comparative multicentre study was conducted at 36 sites in six countries to test the efficacy and safety of piperacillin/tazobactam in the therapy of lower respiratory tract infections. Piperacillin 4g and tazobactam 500 mg were administered intravenously every 8 h for a minimum of five days. Two hundred and thirty patients were enrolled: 133 were evaluable for clinical efficacy and 106 for bacteriological efficacy. The clinical response was favourable in 96% of evaluable patients and the bacterial eradication rate was 93%. Nine patients (4%) had severe adverse events related to piperacillin/tazobactam and requiring discontinuation of therapy. In this study piperacillin/tazobactam was an effective and safe drug in the treatment of hospitalized patients with lower respiratory tract infection caused by sensitive organisms.
Coronavirus SARS-CoV-2 : mesures dans les taxis et vehicules de co-voiturage, en phase 3 du deconfinement
Validation : 20/06/2020
Mise en ligne : 28/06/2020 (8 pages)
https://www.hcsp.fr/Explore.cgi/AvisRapportsDomaine?clefr=867
Dans le cadre de l’evolution du niveau de circulation du virus SARS-CoV-2 et de la reprise progressive de l’activite en France, notamment en phase 3 du deconfinement, le Haut Conseil de la sante publique actualise dans le present avis ses recommandations du 24 avril 2020 concernant les mesures barrieres et de distanciation physique a mettre en œuvre dans les taxis et vehicules de co-voiturage.
Les mesures barrieres (distance physique, gestes barrieres, hygiene des mains et port de masque grand public) restent pour le HCSP des mesures indispensables pour le controle de la circulation du virus.
Aussi il est imperatif de respecter les gestes barrieres a l’interieur du vehicule, en particulier de ne pas serrer les mains, d’eternuer dans son coude et d’utiliser des mouchoirs jetables pour se moucher. Une hygiene des mains doit etre realisee par friction hydro-alcoolique des qu’on entre et qu’on sort du vehicule. Il convient de toucher le moins possible de surfaces a l’interieur du vehicule en laissant au chauffeur l’exclusivite de l’ouverture et de la fermeture des portes du vehicule. Les clients chargeront et dechargeront eux-memes leurs bagages dans le coffre du vehicule.
Les passagers et le chauffeur doivent porter pendant le trajet un masque grand public (ou un masque a usage medical pour les personnes a risque de forme grave de Covid-19), ou eventuellement et si possible de mettre en place un ecran de protection separant le conducteur du (des) passager(s) a l’arriere du vehicule.
A l’arriere du vehicule, ne doivent pas etre acceptes plus de deux passagers, par rangee de sieges, n’appartenant pas au meme foyer ou au meme groupe, en laissant libre la place du milieu entre les deux passagers. Il est possible qu’un passager prenne place a cote du chauffeur si le passager porte un masque grand public ou un masque a usage medical pour les personnes a risque de forme grave de Covid-19 et est separe du chauffeur par un siege ou eventuellement par un ecran de protection.
Le HCSP emet egalement des recommandations concernant l’aeration, la ventilation, la climatisation et le nettoyage du vehicule.
Lire aussi :
Coronavirus SARS-CoV-2 : Mesures barrieres et de distanciation physique en population generale du 24 avril 2020
Covid-19 : mesures barrieres et de distanciation physique dans la restauration commerciale et les debits de boissons (hors restauration collective) du 19 mai 2020
Covid-19 : mesures barrieres et de distanciation physique dans les espaces culturels du 27 mai 2020
Ministere des solidarites et de la sante : information aux professionnels de sante
Decret n° 2020-759 du 21 juin 2020 modifiant le decret n° 2020-663 du 31 mai 2020 prescrivant les mesures generales necessaires pour faire face a l’epidemie de covid-19 dans le cadre de l’etat d’urgence sanitaire
The experience of clinicians in charge of the in-hospital management of peritonsillar abscesses supports the association between severe forms and anti-inflammatory drug (AID) consumption. However, this observation is based on a limited number of clinical studies. Our objective was to assess the prevalence and impact of AID consumption in patients with peritonsillar abscesses.All patients referred to the ear, nose and throat surgery department for a peritonsillar abscess were included in a retrospective cohort study (2012-2014).Among the 216 included patients (male, 55 %; median age, 32 years [IQR, 26-40]), 127 had received AID (59 %), including corticosteroids (n = 67, 31 %) and/or non-steroidal AIDs (NSAIDs, n = 76, 35 %). 199 patients (92 %) benefit from a puncture and 5 (2 %) from a surgery under general anesthesia, associated with ceftriaxone/metronidazole (51 %) or amoxicillin/clavulanic acid (46 %). An iterative surgical procedure was required in 93 cases (43 %), including 19 % under general anesthesia. Bacteriological analysis (79 %) mainly disclosed streptococci (66 %) of A (18 %) and/or milleri (33 %) groups. The prevalence of anaerobes was higher in patients using AIDs (46 % versus 29 %, p = 0.034), regardless of prior antibiotic therapy. 65 patients benefited from a CT-scan; AID consumption was associated with larger abscesses (6.8 [IQR, 3.7-12.7] versus 2.9 [IQR, 0.9-7.8] cm(3); p = 0.005). AID consumption was not a risk factor of iterative surgical procedure.In comparison to the prescribing habits in uncomplicated upper respiratory tract infection, the high prevalence of AID consumption in patients with peritonsillar suppuration suggests a role of AIDs in promoting these complications.
A 38‐year‐old woman, known to be HIV‐antibody‐positive for 2 months, presented with a progressive swelling of the right thigh of 1‐month duration. She had no history of trauma or breaking of the skin. She suffered from oral candidiasis, but had no previous AIDSdefining illness. She had no systemic symptoms such as pulmonary symptoms, weight loss, organ enlargement, or fever. Her laboratory tests were unremarkable, except for a CD4 count of 115/mm3. On examinafion, an ulcerated, fluctuating 3‐cm mass with surrounding erythema was noted with only a small volume of purrulent discharge. A punch biopsy, showing a necrotizing inflammation of the hypodermis without granulomas, and a swab and two blood cultures (Isolator 10, DuPont, Wilmington, DE, USA) were performed. The patient was discharged with a diagnosis of a bacterial abscess and treated with pristinamycin, 1 g t.i.d., and local wound care. One month later, the ulceration persisted, but the inflammation and purulent discharge had disappeared. Because direct examination of a Ziehl‐Neelsen stained specimen had revealed acid‐fast bacilli, later identified as Mycobacterium avium complex, the therapy was changed to clarithromycin, 2 g b.l.d., given for 3 months, complete healing was obtained without incision and drainage. She was given rifabutine, 300 mg once daiiy, 7 months later as her CD4 cell count became <100/mm”, No relapse had occurred after a 18‐month follow‐up.
