Subject(s)
Contact Tracing/methods , Tuberculosis/diagnosis , Tuberculosis/transmission , Age Factors , Aged , Aged, 80 and over , Disease Progression , Humans , Immunologic Techniques/methods , Immunologic Techniques/standards , Interferon-gamma Release Tests/methods , Interferon-gamma Release Tests/standards , Tuberculosis/pathologySubject(s)
Diagnostic Techniques, Respiratory System/standards , Interferon-gamma Release Tests/standards , Latent Tuberculosis/diagnosis , Tuberculosis/diagnosis , Age Factors , Aged , Aged, 80 and over , Coinfection/diagnosis , Contact Tracing , Data Interpretation, Statistical , HIV , HIV Infections/complications , HIV Infections/diagnosis , Humans , Interferon-gamma Release Tests/methods , Latent Tuberculosis/metabolism , Predictive Value of Tests , Tuberculosis/metabolismABSTRACT
The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Communicable Diseases/diagnosis , Communicable Diseases/drug therapy , Infection Control/methods , Patient Care/standards , Adult , Aged , Cross-Sectional Studies , Female , France , Humans , Male , Middle Aged , Tertiary Care Centers , TurkeyABSTRACT
Extensively drug-resistant (XDR) tuberculosis is rare in France. Treatment of XDR tuberculosis is difficult and therapeutic failures are frequent. Surgery is considered as one of the therapeutic options, but is of little use regarding its high morbi-mortality. We report successful treatment of a XDR tuberculosis case with a 21-month antibiotic regimen followed by a surgical collapse therapy because of persistence of a large cavity. No relapse was observed after five years. Surgery in the XDR tuberculosis treatment is discussed.
Subject(s)
Collapse Therapy , Extensively Drug-Resistant Tuberculosis/surgery , Antitubercular Agents/therapeutic use , Combined Modality Therapy , Extensively Drug-Resistant Tuberculosis/drug therapy , France , Humans , Male , Young AdultABSTRACT
We report a case of severe aortic bicuspid valve endocarditis, revealed by global cardiac failure without fever, in a 38-year-old man who had developed cerebral mycotic aneurysms nine months earlier. PCR analysis of the excised aortic valve and serological tests (even 9 months earlier) were positive for Bartonella henselae. A combination of intravenous then oral doxycyclin at 200mg/day and intravenous gentamycin at 90mg/day was given for 6 and 2 weeks respectively. The evolution was favorable on follow-up, 12 months after completion of the therapy. Only 49 cases of B. henselae endocarditis have been reported to date, none with associated mycotic aneurysm but most often located on the bicuspid aortic valve, and usually with severe valvular damage due to late diagnosis.
