Objectives: This study evaluated the microbiological distribution and sensitivity of clinical strains from respiratory samples of inpatients to the antibiotics usually recommended for treatment of lower respiratory tract infection (LRTI).
Methods: Using the French SPARES (Surveillance et Prévention de l'AntibioRésistance en Etablissement de Santé) database, we recorded all respiratory microbiological samples collected in 2022 in 409 hospitals located in all regions of France. The distribution of main bacterial species and their resistance to the most frequently prescribed antibiotics for LRTI were compared by age group (18-64 years, 65-79 years, ≥ 80 years).
Aims: To explore differences between sexes in the prognosis of severe community-acquired pneumonia.
Methods: We analysed consecutive patients admitted to 27 intensive care units (ICU) from nine European countries and included in the EU-VAP/CAP cohort. All were mechanically ventilated for severe CAP.
Next-generation sequencing might improve diagnosis of infective endocarditis. A case in Switzerland was initially attributed to Solobacterium moorei bacteria. Metagenomic analysis of the affected heart valve detected Streptococcus gordonii, but not S.
View Article and Find Full Text PDFExpert Rev Respir Med
April 2025
Introduction: Pneumonia is a common occurrence at the end of life (EOL). However, clear definitions and consensual guidelines for managing this condition are lacking. Diagnosing EOL pneumonia and deciding whether to treat it with antibiotics can be challenging.
View Article and Find Full Text PDFPneumonia is a leading cause of death and functional decline in the older population. Diagnosis of pneumonia conventionally includes the presence of respiratory signs and symptoms, systemic signs of infection and a radiographic demonstration of lung involvement. Pneumonia diagnosis in the very old patient is compromised by atypical and unspecific presentation, resulting in a high proportion of false positive diagnosis.
View Article and Find Full Text PDFIntroduction: We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU).
Methods: We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019-2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality.
Purpose: Elderly patients with suspected pneumonia represent a significant proportion of hospital admissions, which is a prognostic challenge for physicians. Our research aimed to assess the prognosis of patients with pneumonia using soluble urokinase plasminogen activator receptor (suPAR) combined with clinical data.
Methods: In a prospective observational study including 164 patients > 65 years (mean age 84.
Purpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI).
Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021.
The number of elderly people is constantly increasing in Switzerland. This population is often at higher risk of infections and concomitant decompensation of underlying comorbidities, in particular cardiac or respiratory diseases. Vaccines are some of the most effective preventive measures for limiting morbidity and mortality related to some of those infections, such as influenza or shingles.
View Article and Find Full Text PDFBMC Infect Dis
March 2024
Background: The burden of herpes zoster (shingles) virus and associated complications, such as post-herpetic neuralgia, is higher in older adults and has a significant impact on quality of life. The incidence of herpes zoster and post-herpetic neuralgia is increased in people living with HIV (PLWH) compared to an age-matched general population, including PLWH on long-term antiretroviral therapy (ART) with no detectable viremia and normal CD4 counts. PLWH - even on effective ART may- exhibit sustained immune dysfunction, as well as defects in cells involved in the response to vaccines.
View Article and Find Full Text PDFEur Radiol Exp
February 2024
Background: Artificial intelligence (AI) seems promising in diagnosing pneumonia on chest x-rays (CXR), but deep learning (DL) algorithms have primarily been compared with radiologists, whose diagnosis can be not completely accurate. Therefore, we evaluated the accuracy of DL in diagnosing pneumonia on CXR using a more robust reference diagnosis.
Methods: We trained a DL convolutional neural network model to diagnose pneumonia and evaluated its accuracy in two prospective pneumonia cohorts including 430 patients, for whom the reference diagnosis was determined a posteriori by a multidisciplinary expert panel using multimodal data.
Objective: To perform an external validation of the Dat'AIDS score for predicting 5-year overall mortality among people with HIV (PWH) aged 60 years or older.
Methods: This was a multi-centre prospective cohort study at all sites participating in the Swiss HIV Cohort Study (SHCS). We calculated the Dat'AIDS score in PWH aged 60 years or older at their first visit between 1 January 2015 and 1 January 2020.
J Antimicrob Chemother
June 2023
Introduction: The effect of remdesivir on COVID-19 mortality remains conflicting. Elderly individuals are at risk for poor COVID-19 outcomes. We aimed to assess the effect of remdesivir on COVID-19 mortality among elderly individuals, using real-world data.
View Article and Find Full Text PDFSepsis is a frequent disease in older people, characterised by an inappropriate systemic inflammatory response following an infection, leading to life-threatening organ dysfunctions. In the very old, sepsis is often difficult to diagnose, given the frequent atypical presentation. While there is no gold standard for the diagnosis of sepsis, new definitions published in 2016, aided by clinical-biological scores, namely Sequential Organ Failure Assessment (SOFA) and quick SOFA scores, allow earlier recognition of septic states at risk of poor outcome.
View Article and Find Full Text PDFAtypical pathogens are intracellular bacteria causing community-acquired pneumonia (CAP) in a significant minority of patients. spp., and , , and are commonly included in this category.
View Article and Find Full Text PDFDilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction in the absence of abnormal loading conditions and severe coronary artery disease. Once dilated cardiomyopathy is discovered, a careful and detailed history with laboratory tests may reveal a potential toxic cause. In this article, we present the case of a patient with suspected toxic dilated cardiomyopathy, and then discuss the common causes and treatment of toxic dilated cardiomyopathy.
View Article and Find Full Text PDFRev Med Suisse
November 2022
The management of infections in the elderly requires medical and nursing expertise with a standardized global geriatric evaluation. We present here an original and pioneering unit in Switzerland, dedicated to polymorbid and complex elderly patients hospitalized for an acute infection and who will benefit from joint management by an interdisciplinary team including a geriatrician, an infectious diseases specialist and a pharmacogeriatrician. The Hôpital des Trois-Chêne, which has geriatric emergencies, intermediate care beds, SOMADEM (somatic dementia) and UGIMP (medico-psychiatric) programs adapted to this population, seems to be the ideal place to host this unit.
View Article and Find Full Text PDFNot all antibodies against SARS-CoV-2 inhibit viral entry, and hence, infection. Neutralizing antibodies are more likely to reflect real immunity; however, certain tests investigate protein/protein interaction rather than the fusion event. Viral and pseudoviral entry assays detect functionally active antibodies but are limited by biosafety and standardization issues.
View Article and Find Full Text PDFObjective: To identify predictors of 30-day survival in elderly patients with coronavirus disease 2019 (COVID-19).
Methods: Retrospective cohort study including patients with COVID-19 aged ≥65 years hospitalized in six European sites (January 2020 to May 2021). Data on demographics, comorbidities, clinical characteristics, and outcomes were collected.
Background: The SARS-CoV-2 pandemic was particularly devastating for elderly people, and the underlying mechanisms of the disease are still poorly understood. In this study, we investigated fusion inhibitory antibodies (fiAbs) in elderly and younger COVID-19 patients and analyzed predictive factors for their occurrence. Methods: Data and samples were collected in two cohorts of hospitalized patients.
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