Evaluation of Temocillin for treatment of nosocomial infections
LAYIOS, Nathalie ; CIUTEA, Mirela ; et al
Poster (2014, September)Detailed reference viewed: 6 (1 ULg)
Modelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: the PROMESSE study.
; ; Seidel, Laurence et al
in The Journal of antimicrobial chemotherapy (2014)
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in ... [more ▼]
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in intensive care treated with 1 g of meropenem every 8 h for severe nosocomial pneumonia, 30 were assigned to intermittent infusion (II; over 0.5 h) and 25 to extended infusion (EI; over 3 h) groups. Based on plasma and epithelial lining fluid (ELF) concentrations determined at steady-state, pharmacokinetic modelling and Monte Carlo simulations were undertaken to assess the probability of attaining drug concentrations above the MIC for 40%-100% of the time between doses (%T > 1-fold and 4-fold MIC), for 1 or 2 g administered by either method. RESULTS: Penetration ratio, measured by the ELF/plasma ratio of AUCs, was statistically higher in the EI group than in the II group (mean +/- SEM: 0.29 +/- 0.030 versus 0.20 +/- 0.033, P = 0.047). Considering a maximum susceptibility breakpoint of 2 mg/L, all dosages and modes of infusions achieved 40%-100% T > 1-fold MIC in plasma, but none did so in ELF, and only the 2 g dose over EI achieved 40%-100% T > 4-fold MIC in plasma. CONCLUSIONS: The optimum regimen to treat severe nosocomial pneumonia was 2 g of meropenem infused over 3 h every 8 h. This regimen achieved the highest pharmacodynamic targets both in plasma and in ELF. [less ▲]Detailed reference viewed: 4 (0 ULg)
First report of Mortierella wolfii causing human disease
LAYIOS, Nathalie ; HAYETTE, Marie-Pierre ; HUWART, Aline et al
Conference (2013, September)Detailed reference viewed: 8 (6 ULg)
Procalcitonin for antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ;
in Current infectious disease reports (2013), 15(5), 394-9
Procalcitonin (PCT), a 116-aminoacids prohormone, has been substantially studied over the last 2 decades in the field of sepsis. Disappointingly low sensitivity values led to the abandonment of the ... [more ▼]
Procalcitonin (PCT), a 116-aminoacids prohormone, has been substantially studied over the last 2 decades in the field of sepsis. Disappointingly low sensitivity values led to the abandonment of the concept of it as a diagnostic tool and then to its being considered more as a prognostic marker with a good correlation with severe infection. Later on, growing concerns about multidrug-resistant bacteria in the ICU environment and about the cost and side effects of antibiotics suggested that PCT might prove to be a valuable asset in stewardship programs. Numerous but hardly comparable randomized controlled trials assessing either initiation or deescalation in ICU patients have been published. Stewardship encompassing PCT should focus on the latter, because of the high negative predictive value of this biomarker. However, there still would be safety concerns if a systematic implementation of PCT were to be considered in daily stewardship programs in the ICU, especially in extra-thoracic sepsis. [less ▲]Detailed reference viewed: 4 (0 ULg)
Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ; LAMBERMONT, Bernard ; CANIVET, Jean-Luc et al
in Critical Care Medicine (2012), 40(8), 2304-9
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]Detailed reference viewed: 51 (6 ULg)
Les prélèvements microbiologiques ont-ils encore une place dans le diagnostic de pneumopathie acquise sous ventilation mécanique ?
LAYIOS, Nathalie ; DAMAS, Pierre
in Réanimation (2012), 21
Diagnosis of ventilator-associated pneumonia (VAP) is based on non-specific clinical signs. Several indicators have been tested in order to improve the accuracy of VAP diagnosis. The quantification of ... [more ▼]
Diagnosis of ventilator-associated pneumonia (VAP) is based on non-specific clinical signs. Several indicators have been tested in order to improve the accuracy of VAP diagnosis. The quantification of clinical parameters by using the clinical pulmonary infection score (CPIS), however, failed to improve the specificity of the diagnosis. This was the same for all the biomarkers tested either in the serum (procalcitonin, C-reactive protein) or in the bronchoalveolar lavage (BAL) fluid [soluble triggering receptor expressed on myeloid cells 1 (sTREM 1), elastin fibers, endotoxin, pro-inflammatory cytokines, Clara cell protein 10]. The microscopic examination of endotracheal samples alone, especially of the BAL fluid, may provide useful information for the detection of infected cells. Thus, microbiology is still needed. [less ▲]Detailed reference viewed: 25 (9 ULg)
Severity of ICU-acquired pneumonia according to infectious microorganisms
DAMAS, Pierre ; LAYIOS, Nathalie ; SEIDEL, Laurence et al
in Intensive Care Medicine (2011), 37(7), 1128-35Detailed reference viewed: 30 (6 ULg)
La décontamination digestive sélective: vieux démons ou .... jeune fiancée?
in Réanimation (2009), 18Detailed reference viewed: 9 (1 ULg)
Pseudomonas aeruginosa and severity of ventilator associated pneumonia
; LAYIOS, Nathalie ; LEDOUX, Didier et al
Conference (2008)Detailed reference viewed: 4 (0 ULg)
Pseudomonas aeruginosa and severity of ventilator associated pneumonia
LAYIOS, Nathalie ; LEDOUX, Didier ; NYS, Monique et al
in Intensive Care Medicine (2008), 34(Suppl 1), 38Detailed reference viewed: 4 (0 ULg)
Toxoplasma encephalitis after autologous stem cell transplantation.
; ; LAYIOS, Nathalie et al
in Leukemia & Lymphoma (2007), 48(1), 201-3Detailed reference viewed: 9 (0 ULg)
Relapsing T-cell lymphoma mimicking adult respiratory distress syndrome and sepsis.
; LAYIOS, Nathalie ; et al
in Leukemia & Lymphoma (2006), 47(9), 1989-90Detailed reference viewed: 6 (0 ULg)